Breastmilk Storage Guidelines for Pinay Moms

A handful of working moms asked me on milk storage guidelines. Different sources would have different guidelines, and I thought somebody should put down a localized guideline for a temperate country like ours.

Months ago, I tagged along one of my mentors in a breastfeeding lay forum and she shared the one laid out by Philippine National Committee on Human Milk Banking. Credits to Dr. Jessa Sareno for this table.

Here it is:

Recently, I underwent the UNICEF/WHO module on Breastfeeding Management for health-workers in Dr. Jose Fabella Memorial Hospital. The guidelines are pretty much simplified. Here is the set of guidelines for a healthy term baby at home:


Milk should NOT be stored above 37 degrees.
4 hours at 25-37 degrees Celsius
8 hours at 15-25 degrees Celsius
8 days refrigerated (2-4 degrees Celsius)
However, many refrigerators do not keep a constant temperature. Thus, it's safer to use refrigerated milk within 3-5 days of storage and freeze* milk that will not be used within 5 days  right away.
Source:  Unicef/WHO Baby Friendly Hospital Initiative Section 3: Breastfeeding Promotion and Support in a Baby-Friendly Hospital, Jan 2006

* Do not fill up a container completely, only up to 3/4 full because milk expands when frozen.

* You may refrigerate milk collected over 24 hours and then batch freeze.
 Author's note: If you are pumping milk in the office, or elsewhere you still need to transport milk you plan to store, it is best to store temporarily in a REFRIGERATOR and then just batch freeze when you get home. Why? If your milk partially or completely froze, and   you transport home, then there is a chance of it thawing to some degree. This can affect the quality of your milk.

*If you must, COOL freshly obrained milk before adding to the frozen batch.
Author's note: Again remember the principle of thawing. If you add freshly express milk (usually warm from our breast), it may thaw the frozen milk it gets into contact with. The viability of this combined milk will then take on the oldest milk collected.

*If you are using the cooler transport your pumped milk home, make sure that the milk is in contact with the ice/frozen gel packs. Frozen gel packs are better than ice cubes to keep milk cold or frozen.

*Domestic refrigerators are the ones that we usually have at home or the office. One-door types have more fluctuating temperatures so the two-door types keep milk longer. It's important to keep milk where the temperature is most constant (at the back, NOT on the door especially if you are using your office refrigerator to temporarily store).

*Preparing a Container of Expressed Breastmilk at Home
1. Wash the container with warm soapy water and thoroughly rinse.
2. Drip dry on a clean towel.
3. Pour hot water into the container.
4. When ready to express milk, pour the water out of the container.

*Preparing to Express Milk with a Breast Pump
1. Read the instruction sheet in the pump prior to first use.
2. Wash the parts of the pump that touch the breast or milk with clean warm soapy water. Thoroughly rinse and air dry.

(*Source: Strengthening Human Milk Banking Practices: A training manual for human milk bank personnel on the best practices of handling human milk and educating breast milk donors). Created by the UNICEF Technical Working Group on Human Milk Banking, reviewed by the Philippine National Committee on Human Milk Banking)
 

Here are some more practical tips:

1. As a rule, wash your hands properly before you collect milk. 
2. If you plan to store your milk, store it in the coldest storage RIGHT away. If you are placing milk on a temporary cold storage, you may keep it cold and then freeze it within 24 hours. 
3. Once frozen milk is thawed, NEVER freeze it again. If kept in the refrigerator, it should be consumed within 24 hours. 
4. Left over thawed milk should be consumed on the next immediate feeding. When in doubt, it's better to just discard it than give spoiled milk to your child. Thus it's very practical to freeze and thaw in small portions to prevent wastage or overfeeding (1-2oz blocks).  
5. Do NOT shake or overheat human milk, as this will destroy the nutrients - particularly the proteins that are supposed to protect your baby. Did you know that antibodies are actually tiny intricately folded proteins? Shaking and microwaving/overheating will actually cause them to unravel so they loose their protective powers. It's normal for milk to separate into layers, and you may swirl gently before offering it to your child. NEVER shake vigorously.
6. It's actually ok to give cold milk to babies :) To date, there is  no evidence that cold milk causes harm or colic. But for those who wouldn't want to give cold milk, be careful not to overheat (as this may cause scalding) and stay away from the microwave as much as possible. 
7. It's best to store milk in small cloudy-colored BPA-free plastics. Leukocytes may stick to the sides of some bottles. For short-term storage, there are special commercially available milk bags. In a milk bank I know, they use recycled BPA-free containers of a commercially available sterilized water brand.

There, that's it for now. Will try to come up with more practical guidelines and sources soon :)

Have a great weekend!

Dr. Lei

When I say I am a breastfeeding advocate...

1. I believe that every mom is created fearfully and wonderfully - fully capable of nurturing each offspring.

A lot of moms are made to feel inadequate. That they can't produce enough milk. Too many times, the natural process of supply and demand is not well understood and this leads to frustration..

Did you know that an average newborn's stomach is just about the size of a calamansi or jackstone ball? This little tummy expands as the mom's milk builds up. Little by little until the milk "comes out". (Even this is not accurate, because mommy has milk even though she can't see it dripping yet!) And what increases mom's milk? It's the cues that the nursing baby sends mommy's brain, releasing substances that prompt her body to produce more milk. 

But how can her baby ask for more milk if it's tiny capacity is brimming with water or formula? And as this crucial demand for her milk decreases, so does her milk production. 

Moreover, some make moms feel that certain products or services are necessary to sustain lactation. And it doesn't help that these commodities are usually not that accessible, not that affordable, and not even evidence-based. Though enterprises that arise from breastfeeding should be encouraged to make the lives of moms easier, integrity and accountability should still be foremost.

2. I understand its benefits for my own child, and I hope you would consider it for your own too...

I am not shoving it down your throat. Most moms obsess about keeping everything clean and giving their kids shots on time to protect them. We all love talking about antibodies because they fight infection. 

ABPro

Did you know that mommy's body remembers most nasty microbes and produces antibodies against them? And when her body meets those bugs again, she won't get sick anymore because the antibodies stay for life and protect her system. 

A whole bunch of these antibodies, developed throughout her lifetime of fighting nasty bugs, gets passed on to the baby through breastmilk!

Talk aboout "sana ako na lang ang nagkasakit". This, to some extent is literally possible - simply, and only through breastfeeding. 

And this is is why solid medical evidence confirm that formula-fed babies are more sickly. Of course milk companies won't say that in their gimmicks, and that is where the Milk Code comes in to protect mothers' and babies' best interest.

I bet NO formula milk will be able to mimic antibodies in breastmilk even if they attempt for the next 50 years. And having a molecular biology background, I am definite that they won't even attempt because the effort is not going to be worth it. Lugi sila.

Of course, this is just one of the countless benefits. The IQ, the EQ, the cancer protection for the mom and everything else - just google it up.

3. I believe it is every Filipino mother's right to breastfeed.

Photo taken from  http://breastfeedingpinay.wordpress.com

Breastfeeding is not just for moms who get around with a driver, a yaya and a personal assistant. It is the right of the boss, and the right of the janitress who just gave birth. It is the right of the urban mom, and the right of a mother in an isolated island.

Furthermore, it is not just the right of the mother. Isn't it the right of the baby to eat and survive? And everything must be done to protect this right.

As breastfeeding becomes trendy these days, something's fishy when commercial areas set up breastfeeding rooms that can be accessed only by their VIPs.

Or when establishments throw out breastfeeding moms, just because they are breastfeeding.

And something seems fishy when legislators start to weaken the very laws that protect this right. (Read more about this below)

4. I am not against formula-feeding mothers. 

For those who work and choose to breastfeed, it takes a lot of determination to sustain the commitment. But a lot of working moms intentionally choose not to breastfeed and they can't be blamed.

Getty Images

It's just natural for any parent to decide on what is perceived to be the best choice. With all the marketing gimmicks and the apparent convenience it offers, it's easier to choose formula. Each of us make decisions based on our unique circumstance and on the kind of information that we have (especially if this comes from sources that we trust, like our doctors or favorite celebrities?).

To breastfeed or not is mostly decided prior to the baby's arrival. Some moms decide not to breastfeed altogether because they worry about getting back to work. It has been known that the length of maternity leave impacts breastfeeding success. (Did you know that in other countries, the maternity leave is 1 year and paid? And that there is a four-year-old house bill that aims to increase ours from 60 to 120 days?).

These days, there are so many reasons for moms not to breastfeed. But when they are provided with accurate information and good social support, they tend to breastfeed.

5. I am not claiming to be a better mom. 

But I want you to know that I care, I understand, and you can find company in me. I am a doctor, but was not spared of the problems other breastfeeding moms typically encounter - the pressure to give formula, the bleeding nipples, the sore engorged breasts. I have been in your shoes. I am not saying that I am a better mom than you, but I am telling you that if I was able to do it, you definitely can too.

I hope you'd drop your biases and give it a shot. There are so many moms out there who understand and are willing to help. 

And as I watch my own son peacefully drift off to sleep while nursing, I felt all the more 

compelled to share this post with you.

“But we proved to be gentle among you, as a nursing mother tenderly cares for her own children.”

1 Thessalonians 2:7

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Read about the House bill against breastfeeding. I am appalled that 3 women (one's even a doctor*) co-authored it. Sign a petition against this bill and help protect Filipino babies!
*in defense of Dr. Bondoc, I quote Atty. Jenny Ong of Chronicles of a Nursing Mom below:  "the original bill sponsored by one of the doctors, Dr. Bondoc is a good bill - HB 3396 which aims to extend the marketing restrictions to 3 years. but it has been corrupted when it was consolidated to other bills. the author is on leave due to a delicate pregnancy.. that's when rufus rodriguez and anthony golez stepped in". 

Read about a Filipina doctor, Dr. Natividad Clavano - well-respected all over the world for her studies at the Baguio General Hospital. Her startling findings caused a global movement to promote breastfeeding.

"What you need to know about breastfeeding." - a brochure by the respected Joint Commission.

Learn about Unang Yakap (Essential Intrapartum and Newborn Care) - the best standard of care for mothers and newborns as dictated by medical evidence, a process jointly endorsed by the WHO and DOH in order to decrease illnesses and deaths among newborns and mothers. Among it's core steps are non-separation of mother and baby and early initiation of breastfeeding.

How to Shop Online through Multiply

When I got an email from MULTIPLY asking me to represent them at the Expo Mom @ Rockwell Tent, I got so excited! First, they trusted me (hey are you sure you're making me do it?). Second, I am just new to the scene. And third, there are thousands of great shops out there in Multiply (naks, why me?)! I am just thankful for this opportunity.   

Sharing an excerpt of my presentation. Specifically, some background on my store and a simple online shopping guide for your reference :)

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  Now here comes the SHOPPING GUIDE!!! 

Welcome to my store front...

 

The best way to navigate is to click on the "VIEW ALL PRODUCTS", so that all the goodies will come up!

 For example, you might want to buy Charlie's Soap (one of our bestsellers!) so you click on the encircled item...tada! Related items will show up:

 

For this particular example, you see right away that the Trial Pack is SOLD OUT. No need to ask which items are available. As long as you can click on it, as long as the item is not hidden, it's with me and ready to ship. I keep my inventory updated 98% of the time to keep you happy. Save the 2% for me and Caleb :) After all, I am still a full-time mommy!

  

Moving forward, you want the whole jar so you click on the item..

  

There is a drop down menu for the quantity of items you might like, also for items with applicable options (e.g. diaper color). I also try my best to describe the items that I carry, sometimes even providing external links. It would really make me happy if you could read them up!

Clicking the BUY NOW button, your order goes into your shopping cart. Here is what happens: 

If you don't have a Multiply account or haven't signed in yet, this is the point where you will be prompted to create one or sign in. It's easy don't worry :)

Now, you've decided to buy some more so you shopped until you are done...

Note that I took an extra mile to be a Trusted Seller, yipee! This is good for you :)

Upon check out, everything is so neat! 

 

Multiply automatically computes shippping rates based on the details you have entered. Right now until the end of June, it's FREE SHIPPING up to P100 worth for minimum orders of P400.

Upon choosing your payment mode, Multiply gives you clear directions on how to go about with the payment. If you encounter any problems, you can always contact them .

Items are shipped the same day if payment was posted before the courier picks up (usually at 12 noon. They arrive the next day if within Manila, and in 2-3 days if Provincial. I usually update completed transactions with tracking numbers.

I must admit that it has been quite a challenge to keep up with all the queries lately. But with this system, you can always check on the availability of stock and buy even while I am asleep or out of town. Multiply always notifies the buyer and the seller of any payments made, so don't worry about it. All payment modes post real time anyway, except for BDO which usually reflects the next day.

Oh, my sister Mae is already doing her on-the-job training with me. So don't be surprised if she is the one who responds to your orders. She is nicer than me, actually :)

  

Hope this shopping guide showed you how convenient it is to shop via my Multiply platform. See you there!

-- Lei

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Thanks Maurice, Erben and Rianna for giving me a reason to do this. Been putting this off for a looong time! Haha! :)

What First-Time Bazaaristas Should Know!

It's almost Expo Mom!!! Nope we are not joining this time. But I am sharing this post because I owe one mompreneur.

At the very last minute, we joined Mommy Mundo's Expo Kid event last March in Rockwell. The first thing I did after confirming our slot was google up " bazaar 101, bazaar for dummies, bazaar tips, etc." but nothing substantial showed up.

Sharing with you some practical notes I gained during the activity:

1. Get a booth early. Simple. So you can choose your spot well.

2. BARYA. Pambalot. Calling cards. Flyers. Thanks for this tip, Love and William!

Prepare lots of change and make sure you have packaging materials. Be eco-friendly. Get paper bags or reusable bags if possible. And always ask buyers if they need one. Many would decline anyway. You can never have enough flyers and calling cards! Bazaars, beyond the sales, are a good venue to connect with fellow entrepreneurs and new markets :)

3. Know in advance what to expect of your booth. I was shocked to find out that it was a bare space we were renting!! Good thing, we were adjacent to Stork Studio's nice sturdy wall, and the wooden toy stalls somehow "framed" everything well. Take this into consideration, so that your display would be nice :)

4. Plan your store layout properly. I had tons of stuff barely able to fit in the little space. Twenty minutes before opening, my booth was still a complete chaos! I have to credit my suppliers for helping me out before I froze in panic.

I was hoping buyers would come in to see more stuff inside my booth. But most didn't!! So display all your stuff well and don't expect people to really come in. They have a very short attention span too. So display your best in front!

5.  Make sure that your brand is visible so that people can easily identify you. But because I didn't know #5, I wasn't even able to make use of my standee.

6. BE ORGANIZED.  In our case, it's just 2 people allowed to man the booth because the space was limited. It was me, my husband and my sister rotating and taking turns with Caleb. There were times when foot traffic was overwhelming and it got a little bit confusing.

Suggestions: Keep an area or a box for essential items (like ORs, packaging materials, pens, inventory lists) so you won't need to scurry for their whereabouts.  Prepare an easy system to track down your sales. My supplier suggested to list down all the items in stock and tick beside it for every item sold. This worked for us. The person who received the money did the ticking so that there's no duplication.

7. I suggest you keep the cash close to you by all means. It may not be the most fashion-forward thing to do, but a belt bag or something like it is convenient.

8. If you are a breastfeeding mom, it may be convenient to pump ahead (I didn't! Didn't expect to be busy the whole day!). Isotonic drinks, granola bars and wipes for freshening up would also be great. The Expo Kid bazaar was such a hit that I was only able to step out of the booth to breastfeed and change my baby's cloth diapers. We also just took turns eating our lunch. I didn't even pee the whole day!! (oops, too much disclosure)

9. Document. If we had good photos, this article could have been more interesting. Haha! Don't forget to take pictures, and grab photo ops that would boost your credibility.

10. Have FUN!!  Don't be shy to talk talk talk! And don't feel bad if the sales doesn't turn out as well as you have expected. My suppliers cautioned me on dull moments - that the ROI will come in later, especially if the bazaar organizer is really good in promoting the event! (THIS IS SO TRUE!) Don't be overly concerned about the sales, but try to sincerely connect and share, and the sales will follow. Thanks Mommy Mundo!!

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Ok no pictures and no linkies  because this was written in haste. Apologies for that. If I have not put you to sleep and have come this far , you probably need this for your first bazaar. Go and have fun!!

OR you're a professional mompreneur!!  Any tips to add for the rookies ? :)

Stay-at-home no more?!

Caleb is turning 16 months soon and my stint as a stay-at-home mom is getting a new twist. The 16 months were fast-paced and insightful. Becoming a mother changed me.

First, I became more conservative in two major aspects. I have always been the adventure-seeking type and never had any second thoughts about small plane rides or routine open-sea boat trips. 

That changed.

I also had the tendency to splurge when I am sad. That also changed.

Scariest ever. Didn't know I was 2 weeks pregnant.

Flight out via a chartered plane in Pamalican. ~16  weeks pregnant

Official summer travel costume during boat rides. Don't laugh.  Did I tell you I can't swim?

Transferring to smaller boats called "bote-bote" during low tides.

Second, I found new passions.

Mommies ask what kind of doctor I am (a tiny one?! haha!). Back ten years ago, all I knew was that I wanted to become a doctor but didn't know that there were many different kinds of doctors. And that to be this or that kind, 3 to 5 years of study, on top of 5 years of medical school, on top of a college degree is a must. Had somebody warned me, I wouldn't have pursued medicine anymore - nah! 

When I was training, I enjoyed almost all fields thoroughly except Psychiatry. (Untoward patient experience. Interns should have salaries or should be insured.). When people asked me what I wanted to be, I tend to answer the specialty where I was rotating in (meaning my answer changed almost every month). I have always dreamed of going to a far-flung place so I felt eager-beaver with all the procedures I can get my hands into. For possible future application, I thought. Served well, great foresight, I had a screaming and kicking psych patient under my care during a tedious 16-hour boat ride. I will never forget that for the rest of my life.

Got this from a kid's nose. The tamarind seed, not the coin. Mother was so happy she brought me a chicken the next day.

Upper GI Bleed.  December 24. Thank heavens, it resolved.

Stab wounds (the involved parties, all  3 of them at the same time, this was the least graphic). Christmas day.

After my barrio stint, I was left with 2 loves to choose from -- obstetrics and ophthalmology. While pregnant, I have seen how my obstetrician cared for me (love her so much!). Knowing my tendency to be OC with patients, I felt I might not be able to adapt to a similar future lifestyle. What a vocation. They have my utmost respect.

When Caleb arrived, I came to terms with my motivation for wanting to become an obstetrician. It was not the prenatal trips. It was not the rush that a bloody surgical field gives. It wasn't even the "baby out" frenzy. 

It is the magical moment when the mother sees her baby for the first time. And equally magical, almost sacred, is when the baby starts to latch on at her mother's breast. 

(Nope, I am not going to say Pediatrics yet. It's still Ophtha for the past 20 months.) 

At the time I delivered,  the WHO and DOH were putting into place a set of  simple guidelines (with emphasis) proven  to result in less infection and less harmful events for both mother and child (ergo less deaths, less hospital stay, less hospital bills, happier experience). The guidelines were relatively new but my attending physicians were proponents of it, so I was confidently delighted. 

To my dismay, the hospital failed to apply it to me and my boy despite the standing orders.

I lovingly prepared a bonnet for my baby as the guidelines called for. The first ever garment that will touch him, I thought. It was lost forever.

Caleb stayed all night in the nursery,  alone in an unfamiliar environment instead of hearing my soothing voice that sang to him every night while he was in my tummy.

He lay in a bassinet, with all the hospital bacterial flora he gets into contact with instead of getting the protective bacteria that my skin can afford.

He was bathed the soonest he could be washed - babies can't cope in the cold like us adults, and early bathing is proven to be a cruel thing to do to a newborn! (Can you imagine dipping a newborn puppy in water? Yep, this is what is being done in most hospitals to newborns. I will tell you more soon why this doesn't make much sense).

I was told that I had to be rolled all the way into the nursery, in all my post-Ceasarean glory, IF and IF I wanted to breastfeed my baby.  (There was no medical indication for Caleb to stay in the nursery by the way).

My bouncing baby boy was wheeled away from Mama :C

I spent my first night as a mother sobbing to have my child taken to my side. And I, a doctor, can't do anything about it. It was terrible. When my attending neonatologist came, I broke down into inconsolable tears and garble. Was my frustration justified or was it the hormones? I think both.

In fairness, Caleb was latched on to me after he was dried and while I was being stitched up. For less than 5 minutes, if my Nubain-tainted memory serves me right. I am not blaming the well-meaning hospital staff or the hospital. In fact, what they did was the norm in most hospitals. And this is what we are trying to change.

Going back to my new life twist.. 

My teacher, a well-respected neonatologist,  was commissioned by the WHO and DOH to form UNANG YAKAP. It's a group of gentle doctors - general practitioners, pediatricians, obstetricians, anesthesiologists, neonatologists and public health specialists - who advocate simple and life-saving birthing and newborn care practices. So far, they have trained health staff from different provinces - from the ARMM to the different military hospitals, from small birthing clinics to big wig (yup, I am talking about big and famous) private hospitals. I got excited when she invited me hang out with them so that I can expand my horizons.

The Unang Yakap team also recently held a workshop in the hospital where I delivered. Hopefully, they will choose to abide.

The idea is all Filipino mothers and newborns, rich or poor, deserve the best care. Our desire is to make it so viral, that all health-care providers will adapt the practices OR all pregnant mothers would ask for it, whichever comes in first.

WHO-DOH Unang Yakap Essential Intrapartum and Newborn Care Team Workshop in V. Luna Hospital. Me in plaid.

If you are pregnant, or if you have a loved one who is pregnant, tell them about UNANG YAKAP.  If you are a doctor, a hospital or a local policy maker who wants to bring UNANG YAKAP to your community, you can also get in touch with us. 

I am still a stay-at-home mom out on occasional advocacy stints with the team. And I am still breastfeeding my toddler. Residency training is in 7 months!

Excited to live in between :)


Lei
"..by the grace of God I am what I am, and his grace to me is not without effect” (1 Corinthians 15:10)

GUEST POST: Pedia Mom's Cloth Diaper Experience

A morning show feature and a blog giveaway got a handful of moms asking me about cloth diapers. Wow,a LOT of questions.

I love it when moms make informed choices. An informed choice means knowing the advantages and disadvantages before making the decision. After all, the new cloth diapers are quite an investment and we don't want hard-earned money go into waste. I remember back when I wanted to start with the pocket cloth diapers, it seemed I had no one to ask but the online reviews - a lot of them! But I was looking for someone real who tried the diapers, somebody I know and someone I could trust. 

After sharing my own, I asked another like-minded friend to tell you guys about her cloth diaper experience with her newborn. 

Dr. Faith Buenaventura-Alcazaren is also a brand new mom. She is a senior pediatric resident in a notable institution. Our roots trace way back in high school, and she is one of the nicest persons I know. Faith is well-respected in our circles. She is a breastfeeding advocate and adheres to evidence-based medical practices. She also happens to be one of my favorite cheerleaders :) 

* Dr. Faith happily and generously shared her experience without receiving compensation from anyone. The products reviewed are ones she actually owns or purchased as a result of her independent choice.

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A Comparative Review of Cloth Diaper Systems :)
By Faith Buenaventura-Alcazaren, MD


Nine months of infanticipation was a joyous adventure – not the smoothest ride, but it was all worth it.  I had to take an early leave due to pre-term labor. I needed to rest and stay away from hospital work if I wanted my baby to live.  Aside from the few times thinking I was losing IQ each day I spent doing nothing, I couldn't say it was entirely unfortunate.

The resting time allowed thoughts to brew and brought out the mother in me. I wanted to take care of Yanna the best way I can, and I need information just to do that. The internet (thank God for the internet!) sustained this need. My eyes twinkled as I discovered an industry I have never been properly acquainted with – a deluge of information on anything related to the word “BABY.”  I discovered ideas on attachment parenting, skills I wanted to learn (e.g. putting a fussy baby to sleep, swaddling, babywearing), and even totally useless expensive baby gadgets – a lot they don’t teach in Pediatrics.

One of my precious discoveries was the modern lampin or the cloth diaper.

My mother has been bugging me about using lampin. “Nakalampin ka noon kaya hindi ka nagkaka-rashes!”  I always said, “Ok mom, titignan ko muna” (OMG lola na talaga nanay ko!).”  She had a lot of wisdom in her. After reading on cloth diapers, and the many reasons why it’s the better choice over disposables, I got convinced that I will be using cloth on my baby. So here I am, posting my two cents on the subject matter.


Issues


Like any other first time user, I decided NOT to invest on a complete stash of the same brand at once, since I wouldn’t want to waste my money on something that might not work on my baby.

I had so many questions. Will the diaper have a comfy fit? Don’t they use fleece in the winter?  Will it not leak? How do I wash them? Can I sustain using them in the long run until potty training? Am I willing to invest on it?  Unfortunately, these issues will only be answered objectively with constant usage of the product.  

After reading and watching countless reviews, I decided to try out different cloth diapering systems, so I would know which one will be most practical, sustainable, and friendly to use.

I don’t have a washing machine or a tumble dryer, so I would have to choose a diaper that will dry fast with line drying.

I chose brands which received overall great reviews from users and strictly adhered to washing and prepping instructions from each manufacturer.

Diaper Cover with Prefolds

The only cover I bought was the one with the best review among diaper covers – the Thirsties Duo Cover with Aplix¹. I paired this with the traditional lampin, but had to use Chinese DSQ²  prefolds (P1,100/dozen at online stores)  since these have better absorption compared to birds eye lampin and are easier to use. I added a stay dry layer of fleece by Bummis so the baby will not feel too wet when she pees.

Lei’s notes:

1. Aplix is a closure system similar to the velcro  

2. DSQ = Diaper Service Quality , aha… 

This particular combination is the cheapest – but definitely not the simplest. The downside of this system is clearly the learning curve.  I had to view YouTube videos over and over so I would have a fair amount of know-how once it’s time to put on a real baby. I was going for the Angel Wing fold and was able to execute it loosely (with much grunting from my unhappy customer).  But after several more tries, one will get the perfect fit. It paired well with the Thirsties cover.

The Chinese DSQ prefold is a relatively cheap and versatile cloth diaper. Prepping was fairly difficult as I had to boil them around 6 times to achieve its maximum absorbency prior to actual usage. I find the Angel Wing fold great for newborn poop as it gives extra containment and leak protection around the thighs, it also lessens skin contact with the PUL³ layer of the diaper cover. If folding with a Snappi⁴ is too complicated, then fold it in thirds and it works like an insert. It absorbs a lot, but baby feels wet the soonest with this material, even with the stay dry liner. It washes well and dries fast, which is a plus.

Lei’s note 

3. PUL = Polyurethane Laminate. This type of cloth was originally developed for medical purposes. The durability and water-proof quality makes it applicable for cloth diapers.

4. Snappi is a T-shaped diaper fastener that replaces the diaper pin

The cover stayed leak-free. The first time I used it, though, I found its white piping a little stiff and worried that it might bite on baby’s skin. Compared with disposables, it left less marks, so I was still happy. It was still cloth, but the PUL layer can be felt (and heard). It had a plastic feel to it, but my baby seemed comfortable. The fit was great, the elastic at the back provided a better fit. Aplix vs snaps? For me it would have to be the Aplix, more adjustable and easier to put on. The cover is very economical, I don’t have to change everytime unless it gets soiled, which is not very often. With only 3-4 covers per day is needed and a whole lot of prefolds. Did it fit well? In the first few weeks, the cover may look quite bulky, especially if the baby is really skinny, but when she starts filling out, the cover looks absolutely cute :)

Diaper Cover with Inserts

This system is an upgraded version of the prefold. I tried the Thirsties Stay Dry Duo inserts - it’s actually three kinds of absorbent material packed into 2 neat layers and then joined together by snaps. The top layer is a stay dry material, underneath is a microfiber terry material that wicks wetness away from the top layer, transferring it to the second layer made of hemp, which is 60% more absorbent than regular cotton, hence holding in more pee. I tried this and thought it was so much easier to use than prefolds. Just place the insert on top of the cover then put on baby. The stay dry layer really does its job in keeping wetness at bay. I couldn’t even tell if she’s wet if I only touch the top layer (ask her yaya, she also got amazed). 

The downside is, well, I don’t feel comfortable that some of baby’s skin gets in contact with the PUL layer - it can get warm if the PUL touches the skin. Also, the hemp takes a while to dry, which means there has to be plenty in rotation if you’re line drying everything. When it comes to prepping the inserts, the hemp needs to be washed in hot (not boiling, as it can ruin the snaps) water several times as well as the microfiber terry, which can be washed in cold water, to achieve maximum absorbency prior to use. The prepping of the hemp was a little more tedious since hot water was needed to remove excess oils from the cloth. 

The other cover+insert system I tried was the Smart Nappy System by Mothercare. My mother bought this for me on impulse THEN I read the reviews, which was pretty disappointing. The starter pack contained 4 covers and 8 newborn inserts. To be fair, I never had a leak with this. It’s very trim and did not give baby a huge bum, has an umbilical cut-out as well. Its design includes a waterproof cradle inside which will hold the insert. I had a problem with the garterized piping, though, which bit my baby’s skin. The diaper itself is easily outgrown since its sooo tiny! The insert is folded into two, the top layer being a stay dry layer, bottom layer a microfiber terry material, similar to the Thirsties Stay Dry Duo Insert. Absorbency is great for newborn pee, but I haven’t tried in on poop. All in all, I wouldn’t recommend the Smart Nappy in newborn size– it gets outgrown fast and it doesn’t look very comfortable on baby.

Pocket Diaper System

I tried two kinds of pocket diapers, the one-size⁵ pockets and the mini sized⁶ for my newborn. I researched a lot of brands and decided to try the Charlie Banana, which is a fairly new brand than the more famous US brands and came out cheaper since it had starter packs in boxes of six. It had promising reviews and very nice color options. 

Lei’s note 

5. One-size. as in one-size-fits-most babies. The diaper can be adjusted as your baby grows.
6. Sized, as in Small, Medium and Large. XS or mini for newborns or premies.

What can I say about pocket diapers? They’re the easiest to use and the most comfortable for baby. The diaper shell is made of a waterproof PUL outer and a microfleece inner layer. PUL is completely covered in this type of diaper. Only the softest material is in contact with baby’s skin. The microfiber terry insert is place inside the pocket, beneath the fleece. 

Of course this kind of luxury doesn’t come without a price tag… this type of diaper is also more expensive but STILL cheaper than using disposables. I only got 6 charlie’s and 2 Happy Heiny’s and I’m very happy with them. It works simply like a disposable. Just prep the inserts into the shells ahead of time then grab one and put on baby as the need arises. 

The one-size pocket did not fit well on my newborn, though, as they were to bulky and the snaps could not be adjusted to fit my baby’s waist perfectly. I guess my baby was in between sizes then, but as she grew bigger in a couple of weeks, she eased into the small setting perfectly. 

The Happy Heiny’s small size was the perfect fit in the early weeks. It was very trim and had a wide Velcro, almost like a belt, which adjusted well around the waist. This is perfect for newborns, but will not be used for long since babies grow up so fast! They also wash well, but take a little more time to dry than pockets. Again, the major downside for me here is the price, which means one has to invest a lot at the onset to have plenty in rotation since once it gets soiled, the shell needs to be washed with the insert.

All-in-One (AIO) Diaper System

I got a Grovia Newborn, which is an all-in-one type of diaper, which means everything is sewn into the diaper – no inserts, no fuss. I was looking for diapers to fit a newborn and found out that Grovia released a newborn version. So I gladly ordered two pieces just to try them out. They looked very expensive, well-made and totally cute. Inside the shell is organic cotton which is sewn on one end so that drying time is quicker when washed. I almost loved this diaper but ended up being my least favorite since it leaked terribly. It also dried the longest. The fit around the legs was too loose and did not contain wetness that well. Tried several times and everytime, it leaked! Now she has almost outgrown this diaper and we were only able to use it a few times.

SUMMARY

To answer the question, what worked best for me and my baby? 

I would have to say the pockets. I can see this getting used more frequently as she grows bigger as it has sturdy snaps that the baby cannot undo. 

I still love my covers, though, as it still does its job and is very versatile - it can accommodate any lampin or insert. This system work best for tiny newborns.

I use an organic diaper rash cream (which is also cloth diaper friendly) with every diaper change to protect her skin. I have been cloth diapering for only a few weeks, but so far, I’m not regretting it! No rashes, no leaks!

Welcome to my blog!

I am Lei, and I just started blogging. Let me tell you about myself.

I (am) used to be a geek. A cool one. I took up Molecular Biology and Biotechnology because it sounded nice. And I wanted to wear a biohazard suit to work. They don't wear biohazard suits pala. Wrong motive. After my bloody thesis on the mitochondrial DNA of an obscure fish, I realized it's not for me. I decided to become a physician instead.

Four years into medical school and one year short of graduating,  I took a break and found myself working with a community development NGO in Palawan run by a Christian doctor. That experience made a huge impact in my life, and I knew I would be back to serve. True enough, I got a scholarship during my internship that allowed me to be a barrio doctor. Guess where I was assigned? Smack right in the middle of the sea :) Palawan!

It was every adventurous doctor's dream. The place is breathtaking but the boat rides were notoriously cruel. Because I was the only doctor, I had to treat everyone in my best capacity. Most patients didn't have the money to go to the hospital in the next island, 3-4 hours away. There was even a time when I had to read a surgery textbook before doing a procedure. Good heavens, I would have referred that kid to a hand orthopedic surgeon back in PGH. What I lacked in my skills, the Lord supplied with grace.

Fast forward. I am now a plain housewife to Arvin and a full time mommy to my precious Caleb. Hwhhatt?  A stay-at-home mom? You heard it right. Some say that my decision is anti-climactic. I think otherwise. The thing is, I only pursue things that I am completely passionate about.

And while I am on hiatus with my medical career, don't you want to know what goes inside the mind of a crazy doctor mom? Many doctor moms are too busy to blog anyway.

But hey, full-time moms like me are super busy people too. And I only write when I am inspired, when Caleb is asleep, and when the chores are done. Inspire me more! Let me know what you want to hear :)

Thanks for dropping by!

Lei