Saturday, December 16, 2017

在美国生孩子你必须要知道的十五件事

之前写了一系列美国生产育儿的文章,介绍从找医生,找医院,产检到费用一连串在美国生孩子的流程,受到不少粉丝的欢迎。既然有这么多人关心在美国生孩子的那些事儿,我今天就跟大家分享几条我自己印象最深刻的经验。本篇只是把印象最深的15条经验记录下来,给后来人一些提示,要看完整的美国生娃攻略,还请大家参考我之前写的一系列美国生产育儿的文章。

1. 最好找说中文的医生

这一条真的只是我的个人偏好,我这样建议的理由主要有两条:第一,即使你的日常英文沟通没有问题,但涉及到一些医学术语,其实还是会有语言障碍。尤其如果怀孕过程中发生特殊情况,能否顺畅地与医生沟通就更加重要。以我个人的经验为例,我曾经在大学里做过同声传译,应该说英文水平还是可以的,但是遇到跟医学相关的专业术语,还是经常一脸迷茫。第二,很多美国的医疗机构会提供翻译服务,但是在我看来,这样其实就让就医的灵活性打了很大的折扣。而且,直接沟通的效率永远比通过一个第三方来转述要准确效率高。


2. 生产住院的时间

大家都知道美国的医疗很贵,如果涉及到住院手术费用就更是天文数字。因此,了解生孩子可以在医院住多长时间就很重要了,如果超出这个时间,保险就不管了,那每多住一天都可能会耗费巨大的成本。
一般情况下,如果是顺产可以住48小时,如果是剖腹产可以住96个小时。

3. 一定要问清楚麻醉师是不是包括在你的医疗保险里面!

大部分人应该会在生孩子之前确保自己的产检医生和医院生产部分是包括在保险里面的。但是,事实上并不是确认了主诊医生和生产医院就完事大吉了。我身边发生过好几个案例,明明事先确认过医生和医院都没有问题,但生完之后收到巨额账单,说是因为麻醉师是保险不含的。所以,切记一定要提前确认生产时候的麻醉师是否在保险范围之内!友情提示:麻醉师的英文是 anesthetist。


顺产相关


4. 什么时候去医院?

在美国,如果是选择顺产,去医院的时间也是很有讲究的,一般在三种情况下才可以去医院。 第一,宫缩的情况达到了 5-1-1, 所谓的 5-1-1,就是每隔5分钟来一次宫缩,每次宫缩的感觉持续超过一分钟。 第二,有流血现象,如果在怀孕后期有流血现象,要立刻联系医生;如果流血现象发生在预产期 Due Day 附近几天,就可以直接去医院了。第三,如果羊水破了,要立刻去医院。

5. 并不是去了医院就万事大吉,医院有可能会把产妇赶回家

我是到了美国才知道去了医院还会被赶回家!上述说的第二和第三种情况都是可以毫不犹豫去医院,不会被赶回家的。但是用宫缩来判断的时候,每个人的感受不同,尤其是很多怀第一胎的妈妈会因为紧张而觉得自己马上要生了,比如说我!到了医院的时候,会有医生和护士把产妇带到一个房间去做简单的检查,如果开指情况很不理想,宫缩也没有达到入院的要求,就会被赶回家。

6. 如果开指情况不理想,护士会要求产妇在医院来回走

即使医院没有赶产妇回家,也有可能为了加快开指的进程要求产妇在医院里面来回走动。想要顺产的妈妈,千万不要抗拒这个要求,虽然在宫缩的同时还要走动有点痛苦,但产前的运动说不定可以加快孩子出生的这个漫长过程喔!尤其是第一胎!


7. 不要过早要麻药

现在无痛分娩已经很普遍了,在美国用的比较多的是 Epidural。个人非常推荐使用,因为确实会让整个过程的痛苦减轻至少80%。 但是,要麻药的时间点很重要。我有朋友因为已经开到8指,9指而被医生告知来不及上麻药了,就只能硬上。我自己的情况是,开到2指就痛得不行,要求上麻药,上了是舒服了,但是后面开指的进程非常慢。虽然没有百分百医学上的依据支持开指慢和麻药有关系,但个人认为还是个可能原因。也有妈妈反映说,用了 Epidural 之后,背后注射麻药的那片区域一直会痛。

8. 催产要谨慎

很多顺产的妈妈可能都经历过催产。有的时候催产是很必要的,例如羊水提前破了,产妇有孕期高血压或其他疾病,可能主治医生都会用催产来保护产妇和孩子。但也有时候催产并没有很强大的医学理由作为支撑,这个时候就要谨慎对待这件事了。非必要的催产可能会增加顺产剖的机率,这可不是道听途说,很多医学文章和医生都这么说。还有几种情况是特别危险的:第一,如果怀孕未满39周,催产可能会危害胎儿;第二,如果第一胎是剖腹产,第二胎尝试顺产,医生通常不会允许催产,因为怕剖腹产的伤口裂开。

剖腹产相关

9. 在美国也可以 Schedule-C Section (预约剖腹产)

我在美国生孩子之前,一直听说美国医生都主张自然产,要选择剖腹产一定要有医学上的理由,例如胎位不正,胎儿过大。但事实并不是这样子的,如果你就是想剖腹产,可以跟你的医生商量(医生当然都会有自己的偏好,但有不少医生都是可以商量的),选择一个黄道吉日来迎接一个小生命。一般 Schedule-C 都会在预产期前两周之内。


10. 止痛片真的很有用

以我个人经验,止痛片对于剖腹产之后的一周真的很有用!在这个时候千万不要介意太多止痛药的副作用之类的,在剖腹产后24小时麻药退了之后,那种疼痛是很难忍受的,除非你对疼痛的忍耐力特别强。

11. 生产后的24小时需要家人陪伴在医院

有剖腹产经验的妈妈们都知道,手术完成后24小时产妇完全不能动,连上厕所都要借助尿管。很多美国的医院(我是在南加州的一个医院生产的),新生儿除了常规检查之外都会和产妇待在一起的,包括喂食和晚上睡觉。所以一定要有家人陪伴,并照顾新生儿。但也有听说有医院不是母婴同室的,这样的好处在于产妇可以得到更好的休息,但也有新妈妈会想要跟自己的宝宝待在一起,可以在产前参观医院的时候问一下。

生产后

12. 如果有条件,可以自己准备一些适合产妇的热汤热水

美国人生完孩子在饮食方面是没什么讲究的,我记得我剖腹产生完我女儿,医院给我的第一顿饭里面就有冰的苹果汁和冰淇淋。所以,如果家里有条件的话,最好在家里做一些热粥热饭,清淡的热汤给刚生完的产妇食用。本身身体不是特别强的产妇,切记不要饮用医院提供的冰果汁和冰淇淋之类的食品。现在在华人比较集中的区域,医院也越来越人性化,听说很多医院会提供华人比较习惯的产后膳食。

13. 在护士询问新生儿的喂养方式时,切记告诉护士是混合喂养

一般医院都会询问妈妈新生儿的喂养方式,特别要提醒大家的是,千万不要说是单一的母乳喂养。美国这边有些医院会坚信用母乳喂养有天大的好处,所以如果妈妈说是要母乳喂养,即使在孩子出生的头两天,妈妈无法自产足够的母乳时,医院也会拒绝提供液体奶。我有朋友的孩子就是因为这个原因,在医院的前两天饿得一直哇哇大哭。


14. 产后能不能洗澡?

产后到底能不能洗澡?对于这个问题,现在大家的答案众说纷纭,有坚持产后多少天不能洗澡的,也有人说不能洗澡纯粹是民间科学。美国人没有坐月子的说法,所以刚生完就鼓励产妇去洗澡,医院里一般都设有淋浴间。个人经验是,医院冷气开得都很强,如果身体虚的产妇不妨回家再洗,至少可以避免受凉。当然,如果你坚信我们华人坐月子那套,那就遵守期间的一些禁忌。不管怎么说,产妇心里爽最重要!

15. 要提前准备好出院那天要用的汽车安全座椅,产妇和新生儿的衣物

在美国的医院,住院的那几天产妇有病号服,孩子也有医院提供的包巾和帽子。但是出院那天产妇和孩子需要穿的衣服要自己准备,千万不要觉得孩子包在包巾里面抱着走就可以了,如果要坐车回家的话,孩子必须坐婴儿座椅(Car Seat),用包巾是很不方便的。

Friday, December 15, 2017

孕妇如何应用抗生素


小云:“小博士,孕妇应该如何应用抗生素呢?”
小博士:“妊娠期用药有可能影响胎儿的正常发育,这~点目前已引起人们的高度重视,但也不可谈药色变,得了病硬扛着不治,尤其是感染性疾病,这样对孕妇及胎儿都不利。其实妊娠期只要正确选用抗生素,是能做到既能治疗孕妇疾病又不影响胎儿健康的。具体选用原则为:⑴具有明确致畸作用、对胎儿危害大的应禁用。⑵用后有一定的危险、它药又无法替代的应慎用。⑶对母胎安全的抗生素应放心使用。”
小雷:“具体说说吧!”
小博士:“目前已有足够的证据证明,青霉素类(如青霉素、氨苄西林、阿莫西林、氧哌嗪青霉素、美洛西林等)及头孢菌素类(如头孢氨苄、头孢唑啉、头孢拉定等)抗生素对胎儿是安全的。以上两类药物都能抑制细菌细胞壁合成而起到杀菌作用,人的细胞没有细胞壁,故药物的毒性低,可安全用于妊娠各期感染患者。”
小云:“第二类呢?”
小博士:“大环内酯类(如红霉素、林可霉素、严迪、罗红霉素等)毒性也小,也可用于孕妇。红霉毒可代替青霉作为首选药物治疗妊娠期淋病、梅毒、妊娠期尿路感染。林可霉素对多种革兰阳性球菌有特效,对脆弱杆菌及其它厌氧菌亦有效。但由于20%的用药者可发生腹泻,因此,孕妇使用时应慎重,最好用于临产时的厌氧菌感染。”
小博士:“还有一类。氨基甙类抗生素(如庆大霉素、卡那霉素、丁胺卡那霉素、妥布霉素等)对胎儿听力及肾脏有损害。四环素类抗生素(如四环素、土霉素、强力霉素、甲烯土霉素等)容易经胎盘进入胎儿体内,孕早期可致胎儿畸形,四肢发育不良及小肢畸形,孕中期可致牙蕾发育不良,从而使乳牙呈棕黄色及牙釉质发育不良,恒牙发育也受影响,易造成龋齿,孕后期可引起肝、肾损害。喹诺酮类(如吡哌酸、氟哌酸、氟啶酸、氟嗪酸等)在动物实验中可引起幼崽儿关节发育受损,虽然在人尚无这方面的证据,应用时也应谨慎。磺胺类(磺胺甲基异恶唑等),容易通过胎盘进入胎儿体内,与血浆蛋白结合,而将胆红素替换出来导致新生儿黄疸。甲硝唑类药物容易通过胎盘进入胎儿体内,动物实验有致畸作用,尤其是妊娠头3个月,组织器官形成时期更是危险,故不宜应用。”
小云:“好复杂啊!“
小博士:“没关系。总之,妊娠期患了感染性疾病要及时到医院在医生指导下合理选用药物进行治疗。”
小雷:“知道了。”
摘自《儿童健康红宝书-胎儿篇》,人民军医出版社,2008年,王新良主编

Tuesday, December 5, 2017

Top 100 baby names of 2017

RANK
GIRLS
BOYS
1SophiaJackson
2OliviaLiam
3EmmaNoah
4AvaAiden
5IsabellaLucas
6MiaCaden
7AriaGrayson
8RileyMason
9ZoeElijah
10AmeliaLogan
11LaylaOliver
12CharlotteEthan
13AubreyJayden
14LilyMuhammad
15ChloeCarter
16HarperMichael
17EvelynSebastian
18AdalynAlexander
19EmilyJacob
20AbigailBenjamin
21MadisonJames
22AaliyahRyan
23AveryMatthew
24EllaDaniel
25ScarlettJayce
26MayaMateo
27MilaCaleb
28NoraLuke
29CamillaJulian
30AriannaJack
31ElianaWilliam
32HannahWyatt
33LeahGabriel
34EllieConnor
35KayleeHenry
36KinsleyIsaiah
37HaileyIsaac
38MadelynOwen
39PaisleyLevi
40ElizabethCameron
41AddisonNicholas
42IsabelleJosiah
43AnnaLincoln
44SarahDylan
45BrooklynSamuel
46MackenzieJohn
47VictoriaNathan
48LunaLeo
49PenelopeDavid
50GraceAdam
51ElenaEli
52PeytonLandon
53LillianJoseph
54SkylerChristian
55NatalieIan
56CharlieAnthony
57StellaBrayden
58SavannahAaron
59KennedyHunter
60LilaAdrian
61LilianaJoshua
62BellaAndrew
63CallieCarson
64AudreyDominic
65LucyAsher
66AuroraColton
67HazelChristopher
68MakaylaJordan
69VioletBryson
70ReaganEzra
71EmeryEaston
72EmiliaXavier
73GabriellaJeremiah
74MariaZane
75SophieLuca
76ClaireCharlie
77EverlyNolan
78AllisonHudson
79EvaDamian
80EleanorThomas
81MelanieMax
82KylieEvan
83NevaehJonathan
84AliceMiles
85AdelineElliot
86AlainaElias
87GiannaAustin
88LondonKai
89NaomiEzekiel
90BaileyXander
91SerenityMaverick
92JocelynChase
93JulianaTristan
94JuliaJason
95IslaCooper
96SadieJameson
97ArielGavin
98CarolineAlex
99JasmineEric
100ClaraBentley

Friday, December 1, 2017

A Dad's Guide to Life After Childbirth

After All That, Everyone Needs a Little Nurturing

You're overjoyed to be a father, and that's putting it mildly. So why are you also feeling emotionally spent? After all that buildup, all the planning and spending and drama, your child has been born…and you feel not only run-down (that's the sleep deprivation) but also a tiny bit letdown. Welcome to the Postpartum Dads Club, when you suddenly realize why the word postpartum is so often followed by depression. Not everyone experiences the so-called baby blues (about 10 percent of new dads do), but expect a profusion of emotions that can last from a few weeks to a year — in both of you (fortunately usually only one of you at a time). Be ready. And be strong. You'll need the patience of a saint, the endurance of a triathlete, a temper with a mile-long fuse, and a sense of humor (big time), to work through this period of adjustment.

What to Do This Month

  • Create a new "normal." On some level, you may have been waiting for the pregnancy to end and life to get back to normal. Forget it — those days are history, and it's time to work out what your new routines are. Who does the shopping now? You should. Who does the laundry? Ditto. (How can such a small human being generate so much laundry, anyway?) When do you both shower? (Do you both shower?) What time do you eat? For the first time, it hits you what it really means for your life to have changed. Don't fight it — go with the flow, and fall into a rhythm that works (don't expect to hit your dad stride right out of the gate, though — it'll take plenty of time and practice).
  • Get used to sleepus interruptus. It's only fair, so take turns visiting the crib in the middle of the night (this will be a way shorter trip if baby's sleeping in a bassinet in your room or right next to your bed in a bedside co-sleeper). Even if she's breastfeeding and doesn't "need" you at 3 a.m., be there (she'll need you for the diaper change). Besides, those middle-of-the-night cuddles are prime bonding times for all of you. Don't miss them. And even if you're tired during the day — let her nap while you take over baby-duty. Sure, you both need to catch up on your z's, but remember that she's also recovering physically from childbirth (and if she's nursing, expending plenty of energy making milk), so she definitely wins the exhaustion competition hands down (and eyes closed)
  • Keep an eye on her mood. Baby blues are one thing (they're normal and self-limiting), but true postpartum depression is another (it's a serious medical condition that requires treatment). If the new mom still seems truly overwhelmed several weeks after the baby comes home, or experiences bouts of crying, irritability, or sleep disruptions (other than those caused by the baby), encourage her to talk to her practitioner about it. Don't leave it up to her if she says no — she may not recognize the signs of depression. Go with her on her next office visit and make her 'fess up about what's going on. Then make sure she gets the treatment she needs to feel better.
  • Be good to yourself. Your own hormones are in flux (remember your old pal couvade?), and it's natural for the combination of the new baby, the stress of the past nine months and the new sense of responsibility to take their toll. In fact, one in four dads experience paternal postnatal depression (PPND), a dad's version of postpartum depression. You may feel left out, or you may feel overwhelmed by everything that's expected of you. Keep your energy level up by eating well and resting when you can. And if you suspect you have PPND, talk to your partner or a trusted friend or family member about it, and don't hesitate to seek professional treatment — for the health and wellness of both you and your baby.
  • Celebrate with her. Maybe you're still so excited you can barely stand it! If the thrill of being a father puts you in a celebratory mood, do your celebrating at home. If you call in your buddies (to show off the baby you made), make sure they don't overstay their welcome and that you're the one offering up beverages and snacks and cleaning up in their wake.
  • Be good to her. Take over the bulk of the household chores for now (if you can score some paid or volunteer domestic help that lets you both focus your energy and attention on the new baby and each other, go for it). Bring her a snack and a drink while she breastfeeds, rub down her shoulders afterward. And hug her often — and for no reason at all.
  • Be a 50-50 father. Parenting, when there are two parents around, is a two-person job — sign up for it in earnest. Share baby care (from bathing and diaper changing to rocking and singing) equally. Don't worry that you're not qualified for the job — no one's born knowing how to swaddle or burp (a baby!). Moms and dads both learn on the job — one sleepless night, one dirty diaper at a time. Still unsure of yourself? Read up on baby care (What to Expect the First Year is a good place to start). And don't worry that you do things differently than your spouse — every parent does things differently, and it's a difference that your baby will love.
  • Be confident that they both need you, forever. And just be plain confident — you'll pick up this dad thing in no time.
  • Be patient when it comes to sex. It may be the last thing on your mind right now — or the last thing you have energy for. You may even be waging some inner conflict (between the father in you and the lover in you), which will definitely work itself out as the weeks pass. But if you find yourself with that loving feeling, there are a few things you need to keep in mind before you act on it. You will live to love (on a regular basis) again — it might just take a while. First, you'll need the practitioner's green light, but that may come weeks before hers, which may still be yellow…or red. Remember, she's been through the wringer physically — and so has her vagina, especially if she delivered via that route. Second, once she agrees to give it a try — you'll need to proceed very slowly and extremely gently. Ask her what feels good, what hurts, what you can do to help. Focus on foreplay (for her), and don't even consider going in for the main event until she's been well warmed (she'll need lots of massage, and lubrication will help get her juices going, since hormonal changes left her extra dry). And don't be surprised if you get an accidental eyeful of milk. Laugh about it.

Topic of Conversation

Have self-doubts when it comes to your parenting prowess? Every new parent does (that's right, mothers too). Open up to your spouse about your determination to excel at the job of baby care — and your nagging fears (make that terror) that you'll flunk. Chances are she's feeling everything you're feeling — and will be happy to unload her anxieties on you too. (Plus, it'll help her to know your heart's in the right place, even when the diaper's on backward.) Now's a good time, too, to divvy up diaper duties (and other duties). Talk about the best way to do this: 50-50, straight down the line is one way to go, alternating (every other diaper, every other bath) is another, but you can also discuss specializing (signing up for the duties you each end up doing best — she does diapers, you do soothing with your patented rocking moves).

This Month's Survival Tactic

The one thing you can do for the rest of your life: Love the mother.
From the What to Expect editorial team and Heidi Murkoff, author of What to Expect When You’re Expecting. Health information on this site is based on peer-reviewed medical journals and highly respected health organizations and institutions including ACOG (American College of Obstetricians and Gynecologists), CDC (Centers for Disease Control and Prevention) and AAP (American Academy of Pediatrics), as well as the What to Expect books by Heidi Murkoff.

Thursday, November 30, 2017

How to change a diaper

Diapering your baby is as much a part of parenting as feeding, even though it can sometimes be challenging at first. With a good knowledge of the diapering basics, you'll be able to keep your baby dry, comfortable, and ready to learn, sleep, or play.

1. Remove the used diaper and clean between the folds of baby’s skin with gentle diaper wipes, such as Pampers Sensitive Wipes. Remember to always wipe front to back.
2. Raise baby carefully by the ankles and slide a clean diaper underneath. The colorful markings should be on the front, facing you.
3. Close the diaper and adjust the stretchy tabs so it isn’t too tight or too loose, you should be able to fit two fingers snuggly between the diaper and her stomach.

Top Tips:
  • Your baby’s first poop will be a thick, greenish, almost tar-like substance called meconium. It can be tough to clean, but gentle baby wipes will help do the trick.
  • Remember it’s important to check your baby’s diaper frequently, change after every poop, and after every nap or feed.
  • Cover your baby boy’s penis with a diaper or burp cloth while changing him to prevent getting a surprise shower yourself.
  • If you start to experience frequent leaks, it might be time to move up to the next diaper size.

Tuesday, November 21, 2017

标  题: Re: 问个britax  carseat问题

发信人: bonod (DIDA), 信区: Parenting
标  题: Re: 问个britax  carseat问题
发信站: BBS 未名空间站 (Tue Sep  9 23:36:48 2014, 美东)

一个是convertible,一个是booster
理论上讲,convertible是给刚超过infant carseat重量,但是还必须
face back的baby开始用,此时是face back滴,等他们足够大,一般一岁多
不需要face back,convertible就可以转成face front,接着用,到一定lb

等娃再大一些,忘了具体多少lb,就可以只坐booster seat,简单,便宜,
不能face back,我们的是4岁开始坐一个booster。

好奇的问一下,你娃小时候没坐carseat?

【 在 evenny (evenny) 的大作中提到: 】
: 请大家帮忙看看,Britax Pioneer 70 Convertible Car Seat 和 Britax Frontier
90
:  Booster Car Seat 比较。
: 价格差不少,安全性和舒适上,有什么大区别吗?要是有用过的妈妈,请分享经验。
: 孩子4岁了,第二辆车上用,每天早上爸爸送上学用。
: 谢谢