My experiments with water paints : These are the few landscapes that I have painted!

Three years ago, I had the privilege of holding the most precious and fragile gift I ever held, my newborn daughter whom we now dearly call ‘Anu’. Being the engineers we are, Bharath and I had made a custom hammock for her.  The first 2 days were straight from a happy movie. Everything seemed just perfect. Within the next couple of days though, Anu started to become weak. By the 7th day, she looked very sluggish and very very yellow. It was not something that we had no idea of; My family is full of doctors and  we knew that neo-natal jaundice is a very common occurrence. What we did not know was the slope of the precipice. Between the 6th and 7th day, Anu deteriorated to the point of not waking up for feeds. Neo-natal jaundice can at times set up a vicious cycle of low feeding and hence further worsening of the jaundice. The result was a 3 day hospitalization that was the lowest point in our lives. From the comforts of the custom-hammock that we had built with so much love, Anu was now shifted to a bed made of a glass bottom and a single layer of bubble wrap. Her blue-light treatment had begun.

I am not going to talk much about neo-natal jaundice itself. There are a zillion articles on the web already. I am going to talk about preventing it and my personal experience of fighting it with my second child.

The first mistake is to listen to the grandmas. Don’t get me wrong here. Grandmas are great! They are right 99% percent of the time. But, times have changed. For whatever reason, neo-natal jaundice is a bigger problem now than it was. Neo-natal jaundice is supposed to naturally disappear through the passing of stools. More milk means more stools and hence better recovery. But not everything is straight forward; The gut bacteria ecosystem (gut biome) that helps in this process of cleanup may not form efficiently. No one knows what exactly causes this issue, but our modern lifestyle may have something do with it. When our grandmas say that mother’s milk should be the only milk given to the baby, they may be wrong. They are remembering their experiences from a time when things were probably better. Breast milk consumption is not easily measured. The baby may not feeding well. Even if it is feeding well, the rate of removal of bile may not be sufficient. Top feeding for the first 10-15 days significantly improves the removal rate of bile. But top-feeding has it’s own risks. One careless feed, and your baby is going to have  a terrible tummy. One cannot be paranoid enough about maintaining hygiene.

Neo-natal jaundice is measured using the bilirubin count. The total count is a sum of two counts – Direct and Indirect. Neo-natal jaundice is a physiological jaundice and this results into a higher indirect bilirubin count. The direct count usually remains within safe limits. If the direct count is higher, the issue may be a different one and the details of other types of neo-natal jaundice are not covered here. If the indirect count goes beyond 15, it is a sign of concern. A value beyond 20 usually means hospitalization with blue-light treatment. The serendipitous discovery of this treatment is its quite remarkable.

There are several logistical issues with blue-light treatment. The first one is that it involves hospitalization. Specially, in a CSec, a re-hospitalization when the mother is barely recovering is extremely painful. Moreover, making sure that the baby’s eyes are not exposed is a big task that requires someone to watch-over 24×7. Many hospitals do not allow any help other than the mother and the father to accompany the baby. The already over-stressed parents are further pushed.

Fortunately, their are some options for home treatment available these days (Not common in India though). The Biliblanket is one such comfortable option –

Given the dreaded experience with our first child’s treatment, I was not going to take any chances with the second (there is a family history of all neonates suffering from jaundice). Due to the non-availability of easy home treatment options in India, I decided to make one in advance. Turns out that making one is quite simple, but making sure of the safety requires a reasonable knowledge of electronics, optics and a lot of common-sense.

The first step was to study the irradiance limits. I found some online publications and also read specs of existing medical products. This one gives a good comparative study. I got some Phillips blue LEDs from the Phillips Lighting Store, but it was important to make sure that they do not emit UV. The LEDs claimed they did not emit UV, but we did not want to take chances. We have many kids toys that are phosphorescent when exposed to UV, so the verification was pretty straightforward.

As per the specs and irradiance calculations, 5 LED modules were needed to get to about half the dosage of a standard medical device used in the hospitals. The 5 modules were connected in series to make sure the same current flows through all of them. The next step was to get a suitable power source. I bought an adjustible boost converter from here and wired it to a regular USB power bank. For making sure the power is monitored and within limits, I used a USB power meter that is readily available here. The boost converter’s voltage was adjusted till the USB power meter read 2A@5V.

Since we had made a cradle for our baby (which also happens to be our start-up), rigging up everything to the cradle was easy.

Blue light is particularly harmful to neonates’ eyes and genitals. Adequate safety precautions were an absolute must. Diapers are sufficient for protecting genitals. We got an eye protection band meant for the purpose from a local medical store.

We still lacked one critical thing! We did not have a way of measuring bilirubin. We got the permission of a doctor to monitor bilirubin levels on a daily basis using a non-invasive transcutaneous bilirubinometer that was available at the hospital we used to consult with.

The ends results were great! With about 5 days of moderate treatment as per our conveniences, Samyak was out of Jaundice while sleeping cozily in a hammock with music and swinging to sooth him. About 10 hrs of advanced preparation saved us 72 hrs of agony we would otherwise have had to go through.

This is how the baby would see the lights from the cradle (if he were allowed to).

If you are in your 9th month of pregnancy then you should read this blog. It is the right time to get everything ready to welcome a new member  to your family. I was recently blessed with a baby girl and I am writing this blog to help would-be mothers to prepare well. Buying and packing all baby and mommy things is an important activity. This reduces the burden later on and helps you take care of the baby well. Most of the items which I mention in the blog are available on online baby care e-commerce website(for e.g. First Cry). I did 90% of the shopping online. It is better to do so than go around shopping in your 9th month.

For Baby :

Grooming :

• Baby scissors for cutting nails : Baby nail cutter is dangerous to use in 1st month. Scissors are good for cutting nails during the 1st month. Later you can use baby nail cutter.
• Nail cutter :  Use nail cutter only after 1 month.
• Comb : This is useful only after 2 weeks to comb the hair. Mee Mee brand soft hair brush is available on First Cry.
• Powder box with good puff for face and body. Use this only for face and body and do not use this puff to apply powder on buttocks while changing diaper.
• Ear buds for cleaning nose and ears : Chicco brand ear buds are available on First Cry.
• Some cotton balls can be kept ready in a box.

Cosmetics :

• Powder : ‘SebaMed’ or ‘Mee Mee’ brand powder is good. Apply powder with a soft puff to the entire body after bath.
• Oil : Use coconut oil for head massage.For body massage you can use any of the following oils and give a good massage before bath.
  • Use ‘Til oil’ or ‘Sesame oil’ as base and mix almond oil, castor oil and apricot oil in a bottle. Use this mixture to massage the body.
  • You can also buy ‘Shishu Thailam’ from  ‘Omved’ brand.
  • ‘Sudhabala Tailam’ oil is also good and is available in any ayurvedic shop. (This oil was prescribed to me by a very good ayurvedic doctor)
• Kajal : Buy some good ayurvedic kajal. Do not buy the kajal sticks from brands like Lakhme etc. Balaji Tambe’s ayurvedic brand ‘Santulan’ kajal is good.
• Baby soap : ‘OmVed’ ayurvedic honey and almond soap is good.
• Baby Shampoo : ‘Seba Med’ brand shampoo is good.
• Baby detergent and fabric softener :  Buy some good baby detergent for washing clothes. Mee Mee and Tollyjoy brand detergents are good.

• Neosporin powder : When the umbilical cord stub falls down, apply coconut oil so that the navel area becomes a little soft. The next day apply neosporin powder so that the wound dries up.

Diapering :

Items that are required for changing diaper are :

• Dry sheet
• Wet wipes
• Disposable diapers
• Powder box with puff
• Diaper rash cream
• 10ml syringe filled with water
• One cloth diaper

Keep all the above items in a plastic box shown in the picture below. This helps the mother to be organized. It is easy to lift one box with all items in it than searching and assembling individual items once the baby poops. Especially in the night when energy is quite low and baby diaper needs to be changed. It is possible that the dustbin is not near the bed where the mother and baby are sleeping. It is painful to get up and dispose the soiled wet wipes and diaper. Keep a smaller dustbin as shown in the image ready with the diaper box. The soiled diaper can be immediately put in this small dustbin. When you get up to wash your hands after the diaper changing activity is over you can empty the small dustbin into the big one.

• Diapers : Disposable diaper is the best invention for mother and baby ! They are hygenic and the amount of work for mother is greatly reduced. While feeding, if the baby pees or poops, imagine the mess that will happen if baby is not wearing a diaper !! It is necessary to use good quality diapers to avoid rash on the skin. Also it is good to change the diaper frequently which will help in maintaining that area dry. Diapers from ‘Pampers’ are the best.
• Dry sheet : Buy atleast two dry sheets. This sheet is useful while changing the diapers. First place the dry sheet and then place baby on the dry sheet and change the diaper.
• Wet wipes : To clean the baby, use wet wipes which are non-alcoholic and fragrance free. Wet wipes from Mee Mee and Pampers are the best. If the wet wipes are not soft, then the buttocks becomes red because of repeated cleaning. Try to dap the buttocks rather than wiping it.
• Powder Box : Keep a separate powder box with puff for applying powder while changing diaper. Do not use this powder box for applying powder elsewhere to the body. After cleaning the baby, apply powder generously on buttocks before tying the new diaper.
• Diaper rash cream : Keep a diaper rash cream ready with you. Baby cream from ‘Seba Med’ is the best. You can also use coconut oil near the buttocks. Do not apply coconut oil entirely on the buttocks. Keep that area as dry as possible by applying powder while changing the diaper.
• 10ml disposable syringe : Sometimes while the baby is fast asleep and has pooped, the poop dries and sticks to the skin. While cleaning using wet wipes you will have to apply force to remove the dried poop which is stuck to the skin. Doing this repeatedly will make the soft skin of the baby red. Instead use a 10cc syringe filled with water ready. Sprinkle water on the anal area and then wipe it so that the poop easily comes out.
• Cloth diapers : Continuously using disposable diapers is also not good for the skin of the baby. It is good to give the baby some diaper free time. Keep a cloth diaper in the box so that you can tie cloth diaper for 30 mins which will the skin to breathe some air.
• Small dustbin : Keep a small dustbin near the diaper box. While changing diaper, it is cumbersome to dispose the soiled items into the big dustbin if it is not close to the bed. Throw all the items in the small dustbin and when diaper changing activity is over, empty it into the big dustbin.

Clothing :

Wash all the baby clothes with baby detergent and keep them

• Mittens and socks
• 3 Cotton shirts with sleeve and 3 sleeveless
• 2 tying head caps
• 2 pull on kind head caps
• 2 Towels
• Swaddle cloth : Keep 3 to 4 cotton swaddle clothes are required. It is good to make big squares of old cotton saris.  The used cotton saris are soft and best for baby skin.

• Cotton handkerchiefs : These handkerchiefs are very useful to wipe the milk on mouth of the baby after feeding. It is necessary to wipe the lips of milk or else they will turn black. Soft cotton handkerchiefs from Mee Mee are available on First Cry.

• Baby pillow : Buy  a good pillow which has cotton material cover as shown in the image above. Avoid using fur pillows as the synthetic fur leaves strands and they might go into the mouth of the baby. Also for summers synthetic material will cause heat. Wash the pillow every 3-4 days. Hence you need to buy 2 sets.
• Blankets : Buy 2 sets of good quality cotton blankets. Mee Mee brand blankets are good.
• Cloth diapers : Buy 12 cloth diapers. For first 1 week use cloth diapers instead of disposable diapers as the baby skin is too sensitive.

Generic :

• Laundry bag : Keep a laundry bag close to the bed so that soiled clothes can be dumped into it. Make a compartment inside the laundry bag. Potty clothes must be kept separately in one compartment and put baby clothes in the other to avoid any infections to the baby.
• Cane mat :  This is required for sitting down and massaging the baby.
• Cradle : Buy a cradle of your choice. Preferably buy ‘Indian Jholi’ kind of cradle than buying ‘PaLna’. The jholi gives a good shape to the body of the baby.

• Small baby bed : While you are in the hospital with the baby, this bed is useful to place the baby as the hospital bedsheets might not be clean. This bed is useful later too.

• Basket for keeping baby clothes : There are a lot of small clothes like mittens, socks, shirts, napkins etc. that is required for the baby. Using basket as shown in the image above helps to organize the clothes properly and easy to find when clothes are required urgently.

• Cloth drying hanger : Small baby clothes can be dried on the hanger shown above.

Nursing :

• Feeding pillow : This is very useful while breast feeding for first time moms. Using a normal pillow is troublesome because the baby curves into the soft pillow. This leads to the baby unlocking while feeding. This not only irritates the baby but also it is strenuous and painful for the mother to see the baby not receiving milk properly. Feeding pillow gives a stable platform to place the baby and also it contains a back support for the mother. It is a true companion for the mother and baby! The feeding pillow in the image is bought online from ‘Mom and me’ website.

• Nipple cream : For first time moms, it is quite common to get soar nipples because of frequent feeding sessions. Nipcare ointment is very good. Apply it on the nipples after every feeding session and wipe it with a cloth before start of feeding.
• Things required for giving powder milk to the baby :  For first 2-3 days mother has only colostrum  and milk flow has not yet started. During this time, doctors advise to give milk made out of milk powder. Also it is necessary to feed this milk than keep the baby crying. It is extremely important to boil the bottle or cup and spoon before feeding the baby to avoid infections and loose motions.  Keep following things ready for giving powder milk

• Induction hot plate
• Steel bowl
• Steel spoon
• Small steel dish
• Nestle Nan Pro 1 (Milk powder).
• Bibs

For Mother :

• Nursing gowns:  ‘Mother 2 B’ nursing gowns are very good. Buy atleast 3 such gowns.
• Sanitary napkins
• Turkish napkins
• Slippers
• Thermos flask
• Detergent for cleaning clothes
• Brush to wash clothes
• Pregnancy belt
• Oil
• Nursing bras
• Breast pads : Better to use disposable breast pads for first one month. Later you can use small handkerchiefs.

General Tips :

Last few days are filled with anxiety while you wait for the D-day.  There are few things that you can do to prepare to have a comfortable delivery :

• Watch some videos on how to change diapers.
• Watch videos on how to swaddle the baby.
• Massage your nipples with oil or else there is a possibility of cracked nipples.(Do this only in your 9th month. Do not do it earlier as it may induce labor.)
• Watch some videos on how to breast feed the baby.
• Pack your hospital bags by 36th week.
• Carry adult diapers which can be used before and after the delivery. The hospital sanitary napkins are not comfortable.
• Start taking ‘Shatavari Kalpa’ in milk ( 2 spoons twice a day). Shatavari helps in milk production.