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Health & Wellness

Health & Wellness
Health & Wellness



2016: The year we became four :)

This blog post will be the obligatory last-day-of-the-year post.

Q: What's my most notable achievement in 2016?
A: Pregnant for 38 weeks + 2 days and the arrival of our second baby boy. Just like 2013.

Well, that pretty much sums up my entire 2016. Lol.

Here are recent blog posts about my birth story and dealing with neonatal jaundice.

If you haven't yet, you can follow my Facebook page ( and Instagram (@joycescapade and @myfluffjournal) for my latest adventures with two kiddos.

Here are the #2016bestnine collages from my two Instagram accounts.

See you next year!


Dealing with Neonatal Jaundice

Have you read my recent birth story? Now, I'd like to share about dealing with neonatal jaundice with the focus on prolonged jaundice which happened to both my sons.

What is neonatal jaundice?

Neonatal jaundice is a common condition in newborns. The newborn's skin and whites of the eyes become yellow due to too much bilirubin in the blood. Bilirubin is a yellow substance that the body creates when it replaces old red blood cells. The liver then helps break down this substance so it can be removed from the body in the stool (poop).

In newborns, bilirubin builds up at a rate faster (due to high turnover of red blood cells) than his liver can break it down, so jaundice happens. Also, a newborn's liver is under-developed and unable to remove enough bilirubin from the blood.

Types of jaundice

Physiological (normal) jaundice:
  • happens to most full-term newborns because their liver is still maturing
  • often appears at 2 to 4 days old and disappears by 1 to 2 weeks of age

Jaundice of prematurity:
  • happens to premature babies (born before 37 weeks of gestation) because their bodies are less ready to excrete bilirubin effectively

Breastfeeding jaundice:
  • happens when breastfeeding babies don't get enough breast milk due to difficulty with breastfeeding or because the mother's milk isn't in yet

Breast milk jaundice:
  • happens in 1% to 2% of breastfed babies, caused by substances in breast milk that can make the bilirubin level rise and prevent the excretion of bilirubin through the intestines
  • starts after the first 3 to 5 days and slowly improves over 3 to 12 weeks

Blood group (ABO) incompatibility:
  • happens in babies whose mothers are blood type O, and who have a baby with type A, B, or AB
  • ordinarily, the antibodies against the foreign blood types A and B that circulate in mother's bloodstream remain there, because they are of a type that is too large to pass easily across the placenta into the fetal circulation. Some fetal red cells always leak into mother's circulation across the placental barrier (mother and fetal blood theoretically do not mix, but in actuality, they do to a small degree)
  • these fetal red cells stimulate the formation of a smaller type of anti-A or anti-B antibody which can pass into the baby's circulation and there cause the destruction of fetal red cells. The increased rate of destruction of red cells causes a subsequent increase in waste product production (bilirubin)

Treatment options

Based on bilirubin reading and newborn's age (in hours), see graph below.

My baby's jaundice story

My baby's serum bilirubin (SB) reading was 314 at day 7 (9am). He was admitted to NICU at Hospital Pantai Bangsar by noon and triple phototherapy (one biliblanket under baby plus two sets of photolights above baby) was conducted. However, the SB reading shot up to 340 (2:30pm). Our pediatrician asked us to get ready for exchange transfusion if the reading kept going up and past 360. O_O

We began to inform our family members, relatives, and some friends to pray for us and baby. Baby was put on drip to keep him hydrated and more settled under the lights. At 8pm, the number went down to 311, thus exchange transfusion was halted. Thank You Lord!

Hubby and I stayed at the prenatal ward as lodger. Good thing about Pantai Bangsar is that the prenatal ward and NICU are on the same floor and less than a minute walking distance. Throughout the day, I breastfed him every 2.5-3 hours. In between, I expressed my milk and passed the storage bottles to the NICU nurses. Same thing throughout midnight. I woke myself up to express milk and sent over to the nurses. It was not stressful as I have milk and I wasn't worried too much about this whole situation (well, except for the exchange transfusion scare).

The next morning, the reading went further down to 215. Woohoo! Baby was discharged (day 8) with the diagnosis NNJ (Neonatal Jaundice) ABO Incompatibility. Our pediatrician advised us to continue with home phototherapy.

Home phototherapy

We rented the Firefly home phototherapy machine (3D2N package) from

We set the machine on the bed so that I could monitor baby's condition and it's also more convenient to breastfeed him.

On day 10, the SB reading was a nice 180.

What's next?

What can be done now - despite rebound jaundice - is to continue breastfeeding him and make sure he poops and pees well, and monitor his poop color. It must be seedy, mustard yellow breastmilk poop, NOT pale/chalky colored.

Learning from the past

Looking back three years ago, my elder son would have the ABO incompatibility issue as well (I'm O and both my sons are A). His condition was worsened by breastfeeding jaundice (because he had tongue-tie and I had mastitis, thus my milk supply was severely compromised, he couldn't feed well and had very low weight gain). Since his jaundice was prolonged till almost 8 weeks, it was diagnosed as breastmilk jaundice. You can read his story on my blog post about the first 4 weeks postpartum in 2013.

Now, my milk supply is adequate, so this second boy doesn't experience breastfeeding jaundice. He's still mildly jaundiced at 20 days young but I don't know his SB reading. If it's breastmilk jaundice, I know it will resolve on its own. The best course of action now is don't fret and just breastfeed him round the clock to make him poop and pee out the bilirubin faster.


My Birth Story 2016

Every birth deserves a story. My first birth story was written in 2013. Now in 2016, here's my second (and most probably the last) birth story.

A miracle, a gift from God

This baby is truly a miracle baby, a gift from God. He was conceived in the third month after a miscarriage. Even then, before the pregnancy test kit showed positive, I never thought I'd be pregnant in that cycle because there was so much spotting past the implantation window. But God had decided otherwise.

Starting 19/20 weeks pregnant, I experienced on and off brown spotting every 4-5 weeks. By 31/32 weeks, when spotting happened twice in a week, I admitted myself to the hospital, anticipating an early delivery but at the same time, trusting what my body was capable of doing. After taken the dexamethasone jabs, I was discharged with the diagnosis minor antepartum hemorrhage. By God's grace, baby decided to stay on till week 34/35 when spotting happened again. I was prepping myself mentally in case I gave birth to a preemie at that time. But baby stayed till 38w+2d before he decided that he should arrive on the day of my scheduled appointment on 6 Dec 2016.

Burst of energy

[5 Dec 2016]

Working from home
Splitting headache
Sudden urge to drink white coffee
Cranky, easily irritated
Publishing blog posts, I just had this weird feeling to tie up loose ends

The birth

[6 Dec 2016]

Woke up every 1.5-2 hours since 1:30am till 6:30am due to mild surges, I dismissed them as stronger Braxton-Hicks.

Birth (bloody) show.

My toddler, who hasn't been waking up so early for the longest time ever, woke up and we talked and he nursed for a while.

Boarded a Uber car to Pantai Bangsar for my 38th week obgyn appointment.

Reached Dr Paul Ng's clinic, told nurse Premah about the show and surges and she directed me to the labor ward to get CTG done.

At the labor ward, surges became more rhythmic but still manageable because I practiced breathing with every surge and kept on chanting to myself that every surge brings baby nearer to me. I also kept reminding myself to relax my jaws (not clenching in pain) because a relaxed jaw = relaxed pelvic area.

I WhatsApped hubby to tell him to put the bag of food I've set aside earlier on into his car before he came over after dropping our elder boy at the babysitter. Luckily about two days before, we've put all hospital bags and car seat into his car.

Dr Paul came to the labor room, looked at the CTG chart on the machine and said, "So today's the day yeah?" I remembered during the 37th week appointment, I mentioned perhaps next time we met, it would be at the labor room. Hah. Prophecy fulfilled.

Dr. Paul did a VE (with my consent), I was 3cm dilated. I was surprised because for my first birth, it took way longer and way more unbearable surges to even reach 3cm. Dr Paul asked the attending labor ward nurse (Shin Nee) to get me started with the admission process.

Hubby reached the labor room after sending our elder boy to the babysitter. He bought Starbucks chicken-cranberries sandwiches for me because I was hungry.

I managed to finish eating when surges that took my breath away started in waves of every five minutes. At first I was sitting on the bed, with hubby applying counter pressure massage on my lower back. Then for the next two hours or so, I spent the bulk of the time riding the surging waves on the porcelain throne. I didn't know about this at that time but at the time of writing this birth story, I've read that our pelvic area is conditioned to relax whenever we are seated at the toilet bowl. So that explains my urge to stay on the toilet bowl to labor.

It looked like I've reached the hallmark stage. I couldn't talk anymore. Midwife (Yun Fong) did a VE with my consent. 8cm. Woohoo! I was so relieved to hear that. Good job cervix! At one point I was making pitiful crying sounds when Sister Seow the head nurse reminded me to breathe and don't cry like that. Oops.

With the help of Yun Fong and Sister Seow, I propped myself against the bed's headrest and knelt on my knees - my favorite birthing position. I heard someone mentioned station minus one, call Dr Paul.

Water bag broke soon after I knelt down. Bearing down sensations started. Dr Paul arrived.

I quite welcomed the bearing down sensations because they were far less intense than surges. I could take a rest while waiting for the next wave, which was pretty much feeling like I was about to pass a very huge motion. After the third wave of bearing down sensations, I finally felt the famous ring of fire, i.e. the baby's head is crowning! From this point onwards till baby's whole body was out, I remembered I was vocalizing very loudly, like the sound of a war cry. I remembered making arrrggghhh.... sound until the whole baby came out.

And..... Baby was born!
Skin to skin right away after Dr Paul coaxed a stunned me to turn around and take the baby.
Delayed cord clamping.
Baby was covered with some vernix and he wasn't wiped down.
Placenta was out on its own.
Superficial tear so Dr Paul stitched it up.
Breast crawl a little bit.

I was ravenous and lunch was so good! See photo.


Stayed in labor room till almost 5pm.

Transferred to two-bedded postnatal ward because there were 18 babies born and all single rooms were taken.

Roomed in with baby 24 hours and breastfeeding on demand.

The next day

[7 Dec 2016]

Baby passed his first meconium and I proudly cleaned him up without calling the nurses.

 Baby pooped meconium again.

More meconium!

My first selfie on the first night with my newborn. :)

Nurse came in to bring baby to nursery for shower, jabs, and blood work.

Dr Paul checked me and proceeded to discharge me.

Trainee nurses came over and taught me how to clean my stitches with antiseptic solution. I was pretty impressed.

Paediatrician Dr Yong came over and had a chat with us.

Hello baby!

Confinement menu chit for lunch.

I chose Braised Turmeric Chicken. Look at that amount of greens!

Discharged after baby's results were out. All normal.

Baby home!

Note: 8 days later, we went to NICU for his phototherapy treatment. Diagnosis: Neonatal Jaundice ABO Incompatibility. All's well as we continued with home phototherapy as suggested by Dr Yong. I will blog about this soon.


Gearing up before baby arrives!

Don't worry, it's just the camera angle. I know it looks like I'm gonna explode soon. Hahaha!

Just wanna blog about things done and to be done before baby decides to say "Hi!" to us. We're at 38 weeks now so it could be anytime soon.....

  • Banking stuff (update credit card PIN, change debit card)
  • Do up baby's wardrobe
  • Indulge in Häagen-Dazs dessert
  • Eat ayam masak lemak cili padi
  • Get baby car seat ready with newborn body support
  • Get hospital bags ready
  • Get ob-gyn to approve my birth plan
  • Stock up snacks in the pantry for the boy (here and here)
  • Paid road tax and car insurance
  • Get part-time cleaners to clean the house
  • Get new mattress ready with mattress protector
  • How and where to place the boy when I'm in the hospital (a few plans to choose from)
  • Put hospital bag and baby car seat into the car booth

  • Boy's preschool arrangement
  • Watch all movies I want to watch online (streaming rocks!)
  • After-birth arrangements (the plan is sort of firmed up)

  • Finish reading a book
  • Watch Fantastic Beast

Just one more photo! :P


My Birth Wishes (Plan)

Individual quotes from the Internet

"The power of a birth plan isn't the actual plan, it's the process of becoming educated about all your options!"

"My body will progress at its own pace; my body knows what to do."

"Each surge brings my baby closer to me."

"My baby is coming."

We have chosen the HypnoBirthing method of quiet, relaxed, and natural birth. Below is our Birth Plan. We understand that these choices presume a normal pregnancy and birth. Should there be a medical emergency, we will give our full cooperation after we have had an opportunity for an explanation of the medical need. We wish to have clear and adequate explanations of all procedures, of the progress of labor as it is accessed, and of any possible complications if they occur.

  • Quiet room, dimmed lights, drawn drapes/closed door at all times
  • Mother wears own gown
  • Allow usage of aromatherapy diffuser
  • Husband (and doula) to be present in labor room

  • Change positions for comfort and progress in labor
  • Freedom to walk and move around
  • Allow labor under hot shower (not for extended period of time)
  • Allow fluids and light food if labor is prolonged

  • No continuous EFM unless medically necessary

  • No suggestion of anesthetic/analgesics unless requested

  • Natural oxytocin stimulation – to be accorded the uninterrupted privacy to do so
  • No Pitocin
  • No artificial rupture of membranes
  • To be fully apprised and consulted before introduction of any medical procedure

  • Minimal – with permission – to avoid premature release of membranes

  • Gentle encouragement during final pushing stage without loud "pushing" prompts

  • Local anesthesia for repair of tears

  • No bulb suction unless medically necessary
  • Mother/father will receive baby if at all possible
  • Wait until cord stops pulsating before cutting (delayed cord clamping)
  • Immediate skin-to-skin contact, with baby on mother's stomach, no wrapping of baby
  • Allow vernix to be absorbed into baby's skin; no cleaning/rubbing
  • Bright lights temporarily removed during birth and until baby is moved to mother's chest
  • Air conditioner temporarily turn down/switch off
  • Baby to remain with mother and father for the 1st hour after birth
  • Breastfeeding only, no bottle, formula, pacifier

  • Spontaneous or encouraged with breast stimulation and nursing baby
  • No cord traction, Pitocin or manual removal of placenta unless there is evidence of excessive postpartum bleeding
  • To bring home placenta

We thank you in advance for your support and kind attention to our choices. We know you join us in looking forward to a beautiful birth.

Note: Dr Paul Ng (Pantai Hospital Bangsar) has approved this birth plan.


Packing my hospital bags

There are way too many what-to-pack-in-your-hospital-bag lists online so I don't want to go through them and fall into the trap of over-packing or under-packing. I use the straightforward method: my common sense. Haha.

Anyway, just for fun, here's my list:

Mommy-and-baby bag (blue-n-white Cath Kidston bag)

  • Birthing gown (I bring a front button-down cotton nightgown)
  • Maternity pads (just in case)
  • Disposable panties (very important!)
  • Pyjamas (2 sets)
  • Bottom healing spray (Earth Mama Angel Baby)
  • Toiletries (Mustela dermo-cleasing, Hydra Bebe & vitamin barrier cream)
  • Going-home clothes (nursing dresses)
  • Nursing bras
  • Breast pads (just in case)
  • Nipple butter (Earth Mama Angel Baby)
  • Ring sling
  • Newborn sleep-suits, hats, mittens, booties
  • Newborn disposable diapers
  • Newborn cloth diapers
  • Swaddles/blankets

My handbag (red Longchamp bag)

  • Birth plan (approved by my ob-gyn)
  • Hospital appointment card
  • Wallet (identification card, money, credit card)
  • Mobile phone
  • Mobile phone charger

Hubby's bag (black backpack)

  • T-shirts
  • Pants
  • Underwear
  • Towel
  • Socks
  • Toiletries
  • Mobile phone charger
  • Power bank
  • Essential oil dewdrop diffuser
  • Lavender essential oil
  • PanAway essential oil

Food bag (brown eco bag)

  • Plain water
  • Dried dates
  • Honey
  • Cookies
  • Instant oatmeal drinks
  • Oatmeal bars

  • Baby's car seat is ready with newborn body support

And now, we wait.