Travel Tips

Work travel and my first nights apart from baby

July 3, 2019 by PI author Leave a Comment

One mom’s experience with work travel and the first nights being apart from baby since she was born… Quick summary – it wasn’t as difficult as expected!

I had to go work temporarily for one month in the US. Hubby decided to take time off from his work as vacation days in order that the baby could come with me for the month, and so he could take care of the baby while I would be in the office.

In a “two birds, one stone” effort, he also planned to visit his family while he was in the US with the goal of his family being able to spend time with the baby, but also secretly (or not so secretly) to get support in taking care of the baby during the long days I’d be at the office. And 10 hours is a long day for someone who is usually in the office himself and not used to taking care of the baby all day! He booked flights to visit his family for 8 days and my immediate reaction was “how will I ever make it through 8 days of not seeing the baby!”. So I then went and bought tickets to fly there over the weekend, so it would only be approximately 5.5897 days that we would be apart (just kidding – but only a little bit).

Planning distractions

I also scheduled a very long hair coloring and cutting appointment one evening, and a dinner with friends another evening in order to fill up the time that I would have to myself and be wondering what the baby was doing and how she was doing, and missing her deeply and just wanting to hug and squeeze her little body and chubby cheeks!

As it goes, very surprisingly, I became so engrossed in the me that I was before I had a baby, I was actually OK. I mean, I genuinely wasn’t thinking about her all the time and wondering how she was, and wishing that I was with her. I was so wrapped up in all the conversations, meetings, decisions that I had to make at work that I managed the days just fine.

Physiological changes

I was reminded how stressed I used to get at work. I realized physiologically I was changing – I had a tense knot in my stomach and my shoulders were up tight around my neck. I was walking very quickly and scarfing down whatever food was left in the cafeteria for lunch when I went down there at 3pm. I was strategizing and making tactical decisions, agenda-setting in meetings and conversations and having to think logically and maintain a flow from start to finish in my thoughts and communications. This had been a challenge in previous months – “baby brain” had felt like a very real thing for me. So these work-life skills were all things I had largely, for better and for worse, forgotten about and gotten out of practice with during the previous 11 months while I had been out of the office. But it was reassuring to learn that they returned fairly quickly.

The other physiological difference was that after 2 days my milk supply had gone down a lot. At this stage I had only been breastfeeding about 3 times per day, once when we woke up, once in the afternoon and once before bed. I decided not to pump since the baby is now almost 11.5 months old and I feel that, for me, this is a good length of time to have been the provider of so many nutrient goodness for the baby. She has many other sources of nutrients now from the wide variety of foods that she eats – and she is a good eater – eats a lot and not picky!

I have no guilt about finishing up breastfeeding, as some moms do when they finish breastfeeding. I do, however, have some sadness that “my baby isn’t a baby anymore”. I mean, yes, she is still a baby, but it’s not that same tight, inseparable bond that we had when she was dependent upon me for the milk (not completely dependent obviously since of course there is formula and, after 6 months, other foods). There is a process of letting go there. And this is also good practice for the future when there will be many more “let them go and grow” situations.

Reconnecting with the pre-baby ‘me’

It was liberating and empowering to be using my work skills again. It was refreshing to connect with the self that I was before the baby. It was enjoyable not rushing home to take the baby from the carer, and being able to take an extravagant 15 minutes to pick some cheeses and a wine that I would have for dinner as I used to do in my single days – no fuss, no cooking (also not healthy, I agree, but very enjoyable!).

Definitely easier than expected

So for any mothers out there dreading and worrying about their first time spending more than some hours during the day apart from their baby, please feel reassured that this mother, at least, found the experience to be a positive one.

I find this to be the case not least of all because – the same with most things in life – once I have been able to do it once, it becomes much less scary the next time. This creates space and opportunity for many more things than I would have said yes to in previous months. And I openly invite and look forward to these new opportunities!

6 tips for breastfeeding when you have food poisoning

June 20, 2019 by PI author Leave a Comment

We traveled to Phuket, Thailand, when baby was 7 months old and unfortunately on that trip I managed to pick up food poisoning from a meal or water we ate or drank somewhere. I narrowed it down to two places that I ate at but, as is often the case, it was hard to tell for sure where exactly the poisoning came from. Having food poisoning while taking care of a 7 month old baby presented three main challenges in terms of breastfeeding: two of which passed quickly and the other having seemingly slightly longer term implications.

Challenge #1:

The first challenge was finding out whether I could pass on the infection to the baby through the breast-milk. Some people in the know may think this sounds crazy but, for me, I knew that so many other viruses and substances that the mother ingests (medicines, alcohol etc.) can be passed through breast-milk, and so I wanted to be sure that I wouldn’t pass any harmful infection on to the baby. In terms of food poisoning, the one thing worse than having horrible symptoms of your own, would be having to watch your baby suffer through those horrible symptoms. It turns out that breastfeeding after food poisoning is fine in most cases. I found this article on kellymom about breastfeeding when sick to be helpful. Additional useful information from the CDC on breastfeeding with food-borne and waterborne illnesses like travelers diarrhea.

What the experts say:

A nursing mother with diarrhea believed to have been caused by food or water sources should be encouraged to increase the frequency of breastfeeding while significantly increasing her own fluid intake… The organisms that cause travelers’ diarrhea do not pass through breast milk. Use of oral rehydration salts by breastfeeding mothers and their children is fully compatible with breastfeeding. Breastfeeding mothers should carefully check the labels of over-the-counter antidiarrheal medications to avoid using bismuth subsalicylate compounds, which can lead to the transfer of salicylate to the child via breast milk… Most experts consider the use of short-term azithromycin [antibiotic] compatible with breastfeeding.
Centers for Disease Control and Prevention

As long as the symptoms are confined to the gastrointestinal tract (vomiting, diarrhea, stomach cramps), breastfeeding should continue without interruption as there is no risk to the baby.
Kellymom.com

Challenge #2:

The second challenge was getting through the 2 – 3 days where I was feeling very sick – the first 24 hours being the worst. Without getting into too much undesirable information here, I could barely make it to the bathroom, did not leave the hotel room for at least 36 hours, was not able to drink very much and was able to eat only dry, plain crackers.

Needless to say, taking care of a crying, pooping, hungry baby was not easy. I had barely any energy to lift a glass of water, never mind lift the baby to breastfeed her, and it was so hard to be patient when she was crying. It is no fun trying to care for the baby when you can barely even take care of yourself, but we did because there is no alternative! I do think she sensed that something was wrong though, and was calmer for us.

Challenge #3:

3. The third challenge was the implications on our breastfeeding quantity, which I was not aware of until after it had happened. Normally, her most filling breastfeed was first thing in the morning when we would wake up, and then each feed later in the day was a little smaller than. On the first morning after being awake all night with the food poisoning symptoms, I could tell my breasts were not as full as they normally would be at that time in the morning, after not having fed her for about 9 hours or so.

I could barely lift the baby and I decided not to breastfeed her that morning so I asked my partner to feed her the solid food breakfast earlier than usual. I knew I had lost a lot of liquids through diarrhea and sweating, and not being able to keep up my usual water intake. And I knew that dehydration could have a detrimental effect on breastfeeding.

I figured that by the next day I would be better hydrated and the milk supply would be back to normal. Although I had been drinking some oral rehydration salts in my water, I unfortunately had not been able to consume as much liquids that first daytime as I had hoped and I was still very dehydrated.

On the second day after the food poisoning, I woke up again with my breasts not as full as they usually would be first thing in the morning. This time, I was strong enough to hold the baby and I fed her, but I knew it would not be enough to fill her and so straight after that I gave her some solids (whereas normally we would wait an hour or two until ‘solid food breakfast’).

The same thing happened on the third morning. And by the fourth morning, I began to wonder if we had entered a ‘new normal’ in that my body was producing less in the morning now as standard, rather than because I was sick.

After recovery…

Unfortunately, my ‘normal’ milk supply and full-feeling in my breasts never returned after that bout of food poisoning, even two months later as I write this.

Now, if the baby was still under 6 months old and exclusively breastfeeding this whole scenario would have been much more challenging and stressful, but we were fortunate in the timing since she was already used to eating solid food and had been doing so for just over a month. It was therefore easy to supplement more of the solids to compensate for the reduced amount of breast-milk. Had we not been able to add more of the solids, we would have struggled more as she would have been hungry and crying more. In that scenario, it would have been good to be able to use some previously expressed milk stored in a fridge or freezer, however, when you’re traveling you may not have access to a pump or to a fridge or freezer or facilities to sterilize all the necessary equipment for expressing milk.

Medical advice in this scenario is to increase the frequency of the breastfeeding sessions and increase intake of liquids. However, having been in the position of being very sick and unable to even lift or barely hold my baby, I’m not sure this will work in every situation. If your baby is not on solids yet and/or is not used to drinking milk or formula from a bottle, food poisoning could potentially be a concern for you on your travels to consider how you would ensure baby gets enough to feed on.

6 practical tips on breastfeeding when you have food poisoning…

try to avoid or minimize consumption of foods that are known to increase the chances of contracting food poisoning (for example, shell fish, raw foods like salads, unpasteurized dairy, ice cubes, meat not thoroughly cooked) and to eat at places that look busy and/or are well reviewed by many others;
carry a supply of oral re-hydration salts with you when you travel to help re-hydrate more quickly;
carry a supply of loperamide (Imodium) anti-diarrheals, which are considered compatible and safe with breastfeeding;
wash your hands often – after going to the bathroom and before touching baby – to minimize risk of passing any germs;
try to consume as much water as possible, even if you don’t feel like it and it’s difficult to swallow down: you need the liquids for re-hydrating your own body so that you can keep producing milk for baby;
if you feel that your milk supply has decreased, as mine did, increase the frequency of the feedings so that your body gets the message to keep producing more for baby (according to the body’s supply and demand mechanisms of breast-milk production).

Wishing you safe and healthy travels with no food-borne or waterborne illnesses!

8 life-saving lessons I learned from my motorbike accident experiences in Bangkok

June 19, 2019 by PI author Leave a Comment

3-wheeler tuk-tuk, Bangkok. Photo by Max Bender

As a final birthday gift to myself I had scheduled a three hour massage appointment at a local spa – absolute bliss and a major highlight of living in Bangkok! Baby was in good hands and I was so looking forward to it. I headed off down the street with a spring in my step in anticipation of the delights that awaited. Just before I reach the spa door, I get a shock seeing and hearing a motorbike skidding horizontally across the ground and its biker falling off onto the road.

A woman is knocked to the ground in the middle of the road. The traffic stops passing by. I step out onto the road to try and help the woman up off the ground. She was a pedestrian crossing the road when she was knocked over by the biker. By some miracle she manages to stand up herself and limps across to the other side of the road. Other than a bit of limp she seems to have emerged from this accident incredibly well – she could have been killed. The biker on the other hand is still lying on the ground clutching his knee. Thankfully he is wearing a helmet (many bikers do not).

I stand in the middle of the road in front of his bike to try, along with another biker and taxi driver, to protect them from continuing traffic flow and divert it around the scene of the accident. There is almost no patience in Bangkok for road accidents taking up space on the road and blocking continuing traffic flow. Two men manage to lift the biker to the edge of the road – despite the fact that in this situation a person should not be moved until and ambulance has arrived in case there may have been damage to their spine. Cars start to flow again in the side lane past me, and past the fallen motorbike. Once the biker is off the road, I step back onto the pavement on the other side.

Thailand ranks second in the world for highest number of road traffic deaths at 36.2 deaths per 100,000 of the population. Source: World Economic Forum

I watch as other local bikers and taxi drivers stay with the fallen biker. I know they will be able to provide much better help than I at this stage. I don’t know who to call, I don’t speak the language, I don’t know how the healthcare system works here. It is in these moments that you realise you are a true outsider. When it really matters, you don’t know what to do, say, or how things work. I hope what I had already done had helped a little. And I believe that since these accidents are unfortunately so frequent on the roads of Bangkok, that there is a protocol (social rather than legal probably) that Bangkokians know to follow in this situation.

Flashbacks of when I was knocked over by a motorbike in Bangkok

As I start to walk away I realise my chest is heaving and my eyes are filled with tears. I am reminded of the time that I was the pedestrian hit by the motorbike 9 years ago, and I was the one knocked unconscious and carted off to the side of the road by some well-meaning bystanders – or possibly the biker who hit me, who knows, I was unconscious. I gained consciousness at the side of the road with someone waving the strong smelling salts they use very commonly here under my nose. I waited there for a few moments as I came around and finally, I started to make the five minute walk back to my apartment to lie down in bed and lick my wounds. I called a Thai colleague to let her know I wouldn’t be in work that day and she advised me to go to one of the major private hospitals in the city.

An hour or so later, with the shock having passed a little, I got a cab ushered directly to my apartment building by the guard (normally I would have flagged one down from the street by myself but I was still feeling shaken) and headed to the hospital. I arrived at the Emergency section and explain what happened, including mentioning pain in my back and elbow where I must have landed. The receptionist asked what kind of doctor I would like to see: a “back doctor”, a “bone doctor”? Well, I don’t know… I am no medical expert – I would defer to those who are trained in medically treating those involved in road accidents. I choose the bone doctor. Only several days later do I realise there should be some standard procedure for checking people who have been in a vehicle accident to check, for example, do they have concussion? Needless to say, I was underwhelmed at their ability to respond to something that is sadly an everyday occurrence in this city.

While being a bystander to a road accident can cause shock and trauma in itself, I did not realise I may have suffered trauma at a deeper level from my own accident until I saw it happening to someone else.

Source: WHO Global Status Report on Road Safety 2018. The vast majority (74%) of those in vehicles that are killed on Thailand’s roads are 2- and 3-wheeler riders: motorcyclists and tuk tuk drivers.

For more information and data, please refer to The World Health Organization’s (WHO) Global Status Report on Road Safety 2018

Processing it all…

While I get an adrenaline rush perhaps more than other people now when I cross the road, probably due to my accident, I had just tried to forget it. But this event brought it all back. I’m also aware that I take extra precautions that others may not take, for example, minimizing travel by road vehicle during the “Seven Dangerous Days of New Year” where road accidents take a spike due to massive numbers of people travelling for the holidays, and drink driving becoming more common at this time of year. Sadly last new year season there were 463 deaths in 3,791 traffic accidents between December 27 and January 2. I also never taking a motorbike anywhere in the city and never taking baby on one; I also never ride my bicycle on the road here – and I try to convince my husband of the same but he is pretty determined in his bicycle-riding.

It’s saddening to me how it appears that these things don’t improve – how these accidents happen everyday throughout the city, and how 9 years later, people are still scraping the injured off the road and leaving them on the side so that traffic can continue to pass. I am not OK with the ‘hit and run’ aspect where the offender disappears without letting the injured person know who they are, and I don’t understand why the bystanders let them disappear and why the police are not called. But I have to accept this and move on. I choose to be gentle with myself and accept the culture of the place where I choose to live – the good, the bad and the ugly.

Source: WHO Global Status Report on Road Safety 2018. It appears that the number of road traffic deaths are not decreasing in Thailand in recent years.

Oh, the irony!

The irony of this whole story is that one of the main reasons I go every few weeks for a massage is to help deal with the remaining pain I suffer in my shoulder and back from the injuries of the accident 9 years ago.

8 life-saving tips to help get your family around Bangkok more safely:

What I’ve learned, unfortunately the hard way, and what I advise family and friends in Bangkok, are a few simple steps that can make a difference in increasing safety of yourself and your family as you navigate traffic:

Allow yourself more time to walk across the road than other pedestrians: if you are pushing your baby or child in a stroller its wheels can get stuck in holes in the ground and kerbs can be up to 12″/30cm high, making it harder and taking longer to get off the road than for other pedestrians. If you are carrying your baby or child you are unlikely to be able to run or maneuver as fast as others;
Look in both directions to check for traffic flow, even on a seemingly one-way street, before stepping out to cross a road because motorbikes sometimes travel up one-way streets in the wrong direction. This is how I was knocked over;
Don’t assume that motorbikes always stay on the road. I have also seen them ride on sidewalks. Be careful when they do this and move to give them right of way, even though you might expect it to be the other way around;
Avoid checking your phone while you’re walking and particularly while crossing the road, as often stop signs are not observed by vehicles. It’s important to stay fully cognisant of your surroundings and goings-on about you;
Minimize travel by motorbike (taxi or personal) when travelling with baby – whenever possible take alternative modes of transport. While I see Bangkokians travel with their babies in a baby carrier as they ride a motorbike (usually as the back passenger), don’t assume this is safe just because the locals do it;
Minimize travel by tuk-tuk when traveling with your baby, as fun as they may look. As someone once said to me “you go left, you go right, you go over”! They are not the safest vehicles and are grouped in the ‘two and three wheel vehicles’ categorized by the WHO data of road users deaths as the highest number of deaths;
Minimize road travel over the New Year period – end December and early January when people are drinking and driving more frequently and traffic is at a peak;
If you rent a motorbike in a tourist destination, remember that other tourists from many countries in the world are also renting motorbikes there, and they are likely to follow the rules of the road they have learned in their home country, which are not necessarily the same rules as apply in Thailand, or the same rules and standards as you expect and follow in your own country. It can be confusing and accidents are more common. Again, drink driving can be fairly prevalent in tourist destinations as people have a few drinks but still want to get around to see the island.