Vitamin D for a healthy baby and mom

Vitamin D supplements are recommended in Finland and the US for babies who are exclusively breastfed. It is the one vitamin not produced in high enough quantities by mom. Vitamin D is important for healthy bone development as it facilitates the absorption of calcium and a lack of it can lead to growth disorders and illness.

In Finland, however, the use begins at an earlier age. Our health center recommended that Peanut begin at age two weeks. We started with one drop a day and built up to the full 5 drops over 5 days. For infants under one year, the dose is 10 micrograms/day year round until the age of one - three when the dose is 5 - 6 micrograms/day. After that, from age 3 - 15, it is recommended that children continue the 5 - 6 micrograms/day during the dark time of year (Nov - March).

There were two major brands of Vitamin D drops - Devitol and Jekovit. The nurse suggested that Devitol tasted better. Though I tasted it - not much flavor as its sesame seed oil based - but to see Peanut screw up her face when she takes the drops tells me these is obviously some taste. The other difference was that Devitol has to be stored in the refridgerator, but you only have to give 5 drops a day. Jekovit can be kept at room temperature, however, you have to administer like 12 drops. That was the deciding factor for me! 5 drops is challenging enough. I only hope that it can be absorbed through the skin, particularly on the chin since that's where it often seems most of the drops end up.

MiniSun for mama
Since the sun is a major source of Vitamin D for humans, in Finland, pregnant and nursing mothers should take a Vitamin D supplement during the dark months - beginning of November to the end of March. Other sources for Vitamin D are milk products with Vitamin D additives, eggs and fish oil.

I chose a happily named product - MiniSun. It came in regular tablets and pear-flavored with added calcium (my choice). I had a suspicion that it seemed like a good idea for anyone living in Finland and convinced Peanut's dad to join me in taking a daily supplement. Whether it was psychosomatic or not, I think we both felt more cheerful as well :-)

Registering Baby -- makes her a consumer, too!

All Finnish babies receive a social security number at birth. We didn't even have to do anything - we found out Peanut's social even before we left the hospital.

The maternity hospitals are required to report all births to the National Population Registry (Väestörekisteri) within 24 hours of their birth. The Registry then generates the number and registers the baby with the appropriate Magistrate (Maistraati) and if the mother is a member of the Luthern or Orthodox church, then also with their local church. The first part is the same for all babies - it consists of the birth day, month and year. This is followed by a letter and then a three digit number and letter which are unique for every individual. This number is extremely important in Finland as its your national identification which is used to identify you for virtually everything throughout your life in Finland.

Within a week, a form is sent to your home with the details. This is also the form you use to register the child's name, mother tongue and to register her with the church once christened. The mother tongue selection plays a role later when baby starts school as every child is entitled to a certain amount of education in her mother tongue.

Companies also take advantage of discovering new little consumers in the National Population Registery where they can evidently buy mailing lists of newborns' mothers. In the past few weeks we've recieved several offers in the mail for subscriptions to baby book clubs, the Libero diaper club (which we joined -- bring on the diaper discounts!!!) and Super K-Market baby club (which we also joined -- again, awaiting discount coupons). I suspect there will be more offers dropping through our mailslot in the coming weeks.

I personally don't mind the chance to join these baby clubs. As a first time mom, I read almost everything and anything about newborns often picking up hints and tidbits of information. Especially being away from home, I find alot of information in printed materials in Finland. And, as mentioned above, discounts and free samples always welcome. Sometimes I have found the consumer marketing environment in Finland under developed as compared to the US and am pleased to see this sector works. When marketing is appropriately targeted and useful, its doing its intended work - informing and often leading to trial and purchase.

Some other free baby clubs - several offering free webpages for you to post your own baby pics, etc:
www.piltti.fi (baby food company)
www.ainu.fi (can order baby care pamphlets)
www.pampers.fi (diapers)
www.pirkka.fi for the Napero Club -a benefit for Plussa card holders

Boy or Girl? We can't tell you...

Like many parents, we wanted to know if our Peanut was a boy or a girl before her birth.

Since I didn't have the amniocentesis test, the method open to us was to have an ultrasound.

In Helsinki (perhaps all of Finland), a woman has two ultrasound exams during her pregnancy to monitor the development of the fetus. The first one is around week 12 and the second around week 22. The ultrasounds are usually done at the maternity hospital where the baby will be born. In our case this was the Kätilöopisto.

The first ultrasound is to check the development and identify any potential issues, such as swelling or fluid at the base of the neck (a possible sign of Down's Syndrome). It also is used to determine the estimated due date by taking a measure of the femur to estimate the baby's age. We also saw the beginnings of the stomach and brain formation. In this exam, the used both an internal and external ultrasound device.

The second is more extensive and covers the development of the internal organs and the brain. In particular they check the position of the placenta; measure the head and femer; development of brain and its chambers; heart and its chambers; kidneys and urinary tract; stomach; backbone; umbilical cord and the amount of embroyotic fluid. Its at this age that the gender of the baby could also been seen.

However, public hospitals are told specifically that they cannot tell parents the gender of the baby - even if the technician is able to see it. One reason is that these are publically funded hospitals and they don't want to waste money or time on a item that is not critical to the health of the baby. Time is certainly an issue - I was 'triple-booked' for my ultrasound slot, meaning my turn would come once the person who had the actual time slot and the person double-booked for it had their exams! Another reason is that ultrasounds are not a 100% accurate way to determine gender. They don't want the responsibility of giving parents the wrong information.

Each one cost me 22 EUR and we were given several "photo" print outs to take home. These we quickly scanned and emailed off to the anxiously awaiting grandparents and family for their first glimpses of Peanut.

How to Find Out
Well, we still wanted to know. So we had to go to a private clinic for another ultrasound.

We chose to go to Femeda, a clinic in Helsinki on the recommendation of a friend and also because they have 3D ultrasounds! I think Peanut's Dad was especially fascinated by the technology :-)

It was admittedly very cool to see a 3D image of Peanut. This was printed out and could be recorded onto a VCR tape or DVD. Both of which we forgot at home, but we re able to purchase at the clinic. During the exam we also saw more detailed images of the organs and could see that her facial features were forming normally (ie, no cleft lip). Every one of these visits is reassuring to expectant parents. Though the 3D peek was almost seemed to be a bit more than we should be seeing - somehow almost invading her privacy.

This visit was more expensive - around 150 EUR with a portion refundable by KELA.

Where to buy

Here's a list of stores selling maternity and baby clothing, equipment, etc.

Our favorites:
Lastentarvike - a chain with stores across Finland. Their mega-store, I believe the largest in Finland, is in Petikko outside of Helsinki
Lindex - a low price store with limited maternity wear and underwear as well as good selection of baby clothes similar to a Target in the US
H&M - has the affordable MaMa line for expectant mothers and also makes mini-sized fashion outfits for baby
Kappahl - expansive baby wear department
IKEA - offers baby furniture, linens, toys and more
Stockmann - of course!
KKKK Supermarkets - diapers, baby clothes, bath tubs, baby wipes, toys, stollers, etc
Etola - toys, toys, toys as well as all sorts of equipment made of plastic (bathtubs, potties, plates, etc)


Some boutiques I've visited (with prices to match!)
Belua in Helsinki (also sells the HugaBub baby wrap)
bebes in Helsinki baby and maternity clothing, books, lotions etc, gifts
Nelliina in Tapiola gifts, photo frames, nursery decor
BamBami in Kämp Galleria a Dutch chain - strollers, car seats, clothing, furniture, gifts


Others:
Seimi designer baby furniture
Embia in Lahti clothing, cloth diapers
Pikku Eero sleepsacks, baby wraps, clothing
Pikku Kenguru with several locations furniture, nursery decor, clothing, gifts
Missy Mom
Lasten Verkkopuoti
Pikku Prinssi
Pikku Selma
Pehmo Peput nursing wear, baby wraps, cloth diapers
Jutta natural clothing, baby swim gear, cloth diapers
Lastenturva mega store in Varisto (Vantaa) - baby carriages, etc
Vaavisänky rental baby beds
Vauvatalo Johanna baby stollers, beds, car seats and more
Pienet Ihmiset
Kulta Pieni sleep sacks, baby wraps, cloth diapers, clothing, toys
Liinameri baby wraps, cloth diapers, nursing pillows
Vauva Buumi baby wraps, backpack carriers, cloth diapers
Me & Mama cloth diapers, baby wraps, natural fabrics, maternity wear, toys, baby care products
Vauvatar online shop with baby carriages, stollers, jogger strollers, car seats, feeding chairs, beds, etc
Suomen Lastenvaunutukku wholesaler of baby carriages/stollers featuring some brands out of the ordinary - Koelstra (Dutch), Quinny (Dutch), Princess (German), ABC Design (German), Haberkorn (Austrian), NeoNato (Italian)

Highly satisfied with the Finnish Maternity Clinics (Neuvolat)

In the June 15th Helsingin Sanomat newspaper there was an article reporting that according to a survey done by Vauva ("Baby") magazine, Finnish parents are satisfied with the local maternity clinics (neuvola).

In particular, parents are satisfied with the location of the clinics, the frequency of visits and the ability to get appointments. Areas receiving the most criticism were the lack of breastfeeding guidance (moms are too easily moved to bottle feeding) and the difficulty in discussing tough topics such as substance abuse and depression after delivery. It was also noted that in 60% of cases, mothers are the ones taking children to the health clinic. Fathers' participation in the visits diminishes after the birth of the child.

The knowledge and skill of the health workers was the most important factor in determining satisfaction.

My pre-natal care experience
I was also for the most part satisfied with the pre-natal care and neuvola visits I had at the Kallio clinic. Fortunately, my pregnancy with very easy so I never had any major concerns or needed any special medical assistance or advice.

> in general, I met (and my husband) met with our midwife once a month in the beginning of the pregnancy and then every other week around the 7th/8th month and then weekly during the last month. The visits usually lasted about 1/2 hr.
> at every visit my blood pressure, weight, sugar levels and size of the uterus were monitored. About every third visit, my hemoglobin levels were also tested. Since I am Rh negative, I had three separate blood tests to make sure that I wasn't producing antibodies which could be harmful to the baby. After the fourth month, the baby's heartbeat was monitored with a Doppler device.
> while the midwife usually answered any questions I had, she did not often offer any unsolicited advice. I felt her knowledge and experience were sufficient.
> I met with the doctor twice. She performed the internal exams. Kallio's clinic was unique in that it had its own ultrasound machine so I also had ultrasounds taken when we saw the doctor. She used the ultrasounds to check the baby's heart, growth and development of the organs. Towards the end of the pregnancy, this information also gave us a better estimate of the birth weight.
> Like the midwife, the doctor answered questions we had, but did not offer any additional advice or information.
> All the information was recorded on my Neuvola Card -- this was the method it would transferred to the maternity hospital!
> There was no cost for any of the midwife or doctor's visits or for any lab work.

The areas I would like to see improved are:
> more information, especially for first-time mothers since I felt I did not always know all the questions I should be asking
> better phone access to the midwife. Currently, they have an hour a day when they answer the phone.
> better birth preparation classes - there weren't any in English. We found one at a local evening school, but I found very weak.
> electronic links between the health clinics and the maternity hospital so we don't have to depend on deciphering handwritten notes on a card.


Move to a new Neuvola
Following the birth of Peanut, we moved to the suburb of Espoo and are now part of the Otaniemi health center. This clinic is very small compared to the one in Kallio. There are only 2 midwives and the doctor visits twice a week.

We've been to the clinic on two occasions. Once for Peanut's 1 month visit and for my post-partum check-up.

The childcare professional who examined Peanut obviously adores babies and children, which is also important, but I wasn't as confident about the depth of her knowledge and experience. She had trouble answering our questions about what could be causing occasional droplets of blood in Peanut's diaper or even about finding a gentle baby wash. Peanut now also has her own Health card with handwritten observations about her reflexes, disposition and nutrition as well as her weight and height.

The doctor I met with was also charmed by Peanut, but seemed a bit flighty to me. When I asked about taking allergy medications while breastfeeding she had to turn to her medical reference book. I also had to remind her about discussing birth control options with me and then in the end, after again checking her reference book, she wrote out a prescription for birth control pills - but in Peanut's name! In the end, she recommended I make an appt with my new ob/gyn for a check-up in a month.

This makes me a bit concerned. What if we have a more serious medical issue? Will I feel confident that the local clinic can handle it?

See upcoming post on the case for private health insurance for baby!

Thumb vs Pacifier!

Like most issues in raising a baby, this one has strong advocates for both sides of the debate.

Our little Peanut has recently discovered her own thumb and is surprisingly adept at getting it into her mouth. While a relief to her parents that she can now soothe herself wherever and whenever without our assistance, I admit images of her as a 6 year old sucking her thumb are disturbing. But, what to do? Should we let her suck her thumb ? Do we just pop it out? Do we replace it with a pacifier?

Most childcare resources agree that babies simply have a strong need to suck beyond what they have to do for feeding. Its soothing for them. How that need is satisfied is the question. It could be at mom's breast (though the idea of having her hang on to me for hours seems not only painful, but rather inconvenient), with a pacifier or with her own hand/fingers/thumb.

When I asked at the Neuvola what they thought was best I was told that pacifier rather than thumb. I feel as if I see more pacifiers in use here than in the US. Admittedly, we've used a pacifier since the early weeks to help her fall asleep or if we're in the car. The challenge at night has been when the pacifier falls out - mom or dad have to drag themselves out of bed to re-insert. But, there are also those that think that using a pacifier is 'lazy parenting' meaning parents should seek to soothe their babies in some other way.

But, now, Peanut clearly prefers her own thumb to the pacifier. I've also found several advocates of the thumb who claim its a habit that disappears well before school age. So, for the time being we're happy to let her suck her thumb since it only happens when she's tired and readying herself for sleep or when she's very hungry and that's a problem mom can easily solve!


www.babycenter.com under Ask the Experts has some advice as well.

Also at www.askdrsears.com

How to raise on baby on 15,20 EUR/day

In the 5/2005 issue of Vauva magazine ("Baby") there is a profile story about how far the daily minimum maternity allowance will get you. Mothers in Finland are entitled to a maternity allowance from the Social Insurance Institution (KELA) based on their income level. For mothers who worked outside the home, were studying, unemployed or the annual income was less than 4,905 EUR the minimum daily allowance is 15.20 EUR (about 18 US dollars).

According to the article, there are some 20,000 families who receive this minimum benefit which was increased from 11,45 EUR/day to 15,20 EUR/day at the beginning of this year.

In 2004, the minimum daily allowance was paid out to 18,151 mothers and 797 fathers.

In addition to the minumum daily allowance, families receive a monthly benefit for each child from its birth to age 17. Its 100 EUR/month for the first child, 110.50 EUR/month for the second, 131 EUR/month for the third, 151.50 EUR/month for the fourth and 172 EUR/month for each subsequent. Single parents get an additional EUR 36.60/month on top of that amount.

For families with low annual incomes, there is the possibility to get further financial assistance in the form of a housing subsidy (for rent or mortgage).

But is this fair...
One example in this article about how to manage your fiances to survive on the minimum allowance was about a 29 year old single mom living in Helsinki. She has been living abroad for the past 7 years, most recently in Ireland. She returned to Finland when she found out that she was pregnant because of the strong social safety net here.

From the social services office, she was able to borrow a stroller and baby bed.

As for monetary benefits, per month she gets:
Maternity/Parental benefit - 403.38 EUR
Child welfare assistance - 118.15 EUR
Child allowance + single parent benefit - 136.60 EUR
Housing subsidy - 452.93 EUR
General living subsidy (toimeentulotuki) - 75 EUR

TOTAL = 1,186.06 EUR/month

Now, I compare that with what's left of the average monthly paycheck (about 2,500 EUR) after taxes and they're not that far off from each other.

But, that's what the social safety net in Finland is about - supporting those who can not support themselves. However, I have two concerns about this particular case.
> Can't a 29 year old in Helsinki with work experience abroad find work to support herself? (I assume she worked since the article talks about her spending 30 - 50 EURs on meals in Ireland without real worries).
> Do we really need to subsidize her entire lifestyle?

She lists the following as her monthly expenses:
Rent - 613.27 EUR (for 56 sq meters WITH sauna and balcony!!)
Phone - 35 EUR
Internet - 25 EUR
Food - 200 EUR
magazines - 25 EUR
diapers - 70 EUR
yoga - 24 EUR
pharmacy - 15 EUR
personal hygiene - 100 EUR
trip to Turku to visit parents - 100 EUR
gifts - 60 EUR

TOTAL - 1,267.27 EUR/month

Sure, we're all entitled to our small luxuries, but come on! My husband and I who both worked full-time lived in a smaller apartment in Helsinki because rent is expensive here! And we didn't dream of having our own sauna or balcony for that amount. 613 EUR/month for rent for someone without an income is a lot. Why not housing in a less expensive area? Why not live at home?

And she talks about how she could save on groceries by substituting 'flavorless Edam cheese for the goat's cheese she now buys, but she just doesn't like it'. Perhaps she could also forgo the shampoo and conditioner she has to buy from the hairdresser. She also prefers to buy new clothes for her baby rather than buy them from the fleamarket. Fine - I agree with her. I'd also rather do all those things, but if I didn't have any money, I'd have to make some compromises.

This is where I begin to wonder if the social support has gone a bit too far. Its my taxes supporting her. I know it would be impossible to monitor how everyone spends the benefit money they receive, but this seems a bit out of hand to me.

Midwife visited us at home following the delivery

After the delivery of our baby, the first visit with the midwife took place in our own home. A few days after we came home, I called my midwife at the Neuvola and set up a time/date about two weeks after Peanut's birth. It was very nice that we didn't have to go anywhere because at the point, its still a large production to get everyone out the door and mom is still in her early recovery period. Though it created some anxiety as we tidied up a bit and wanted to make sure we had all the baby equipment in order.

On that day, she came to our home with a small bag of supplies to give both me and Peanut a check-up. My medical information is basically all in the 'Maternity Card' I've carried with me since my first visit. I also had a printed out report from the maternity hospital describing the birth, my recovery and Peanut's first doctor's visit at the hospital. The information is not shared electronically among the health centers and hospitals even though they are both public services.

The midwife asked us some questions about general well being, nursing, sleeping and my mental health (occasionally weepy!,but to be expected, she said). She then undressed Peanut and checked her skin condition, eyes, mouth and reflexes. The midwife then produced fish weighing scales from her bag and wrapped Peanut in a diaper cloth before lifting her up by the scales to weigh her. She then took a look at my breasts to see how the nipples were and if the breasts were still engorged. Then, I undressed the lower half and she did a quick visual exam to see how everything was healing.

I had a long list of questions to review with her before she left. Our next appointment will be a childcare nurse at the Neuvola.

You're pregnant in Helsinki - now what?

Finland offers a very comprehensive pre-natal care system for its citizens and residents. Choosing to start a family in Helsinki is very comforting!

When we decided we would like to start our family, I first visited a private clinic for a pre-pregnancy check-up and discussion. I chose a local Diacor office just because it was close by and I was able to combine it with the annual ob/gyn visit my employer paid for. So this required first getting a reference from my office health clinic. During the visit I ran through a list of questions with the doctor who also performed an internal exam and did an ultrasound to check with condition of the cervix and uterus. She did not recommend any pre-natal vitamins or even folic acid because "all of this should be available in the healthy diet Finns eat." I, however, have taken multivitamins all my adult life decided to continue with the LadyVita tablets for expectant mothers (they contain no Vitamin A) and with 400mg folic acid supplement which is highly recommended to ensure healthy spinal and cranial development.

When I thought I was pregnant, it was off to the local pharmacy for a home pregnancy test which to our delight was positive! :-)

I then checked the Helsinki city home pages to find my maternity health center. When I gave them a call, the first question was if this was a desired pregnancy or not. From there I was put in touch with the midwife who covered our area (determined by street address) to make an appointment.

The first appointment was mostly spent getting the basic information down. But, I was surprised they did not perform their own pregnancy test; it was enough that I had a home pregnancy test. She also asked me to chose which hospital I'd like to give birth in - Kätilöopisto or Naistenklinikka. I didn't know much about either, but chose Kätilöopisbecauseuase it offered family rooms where dad could also stay overnight.

What happened from then on is outlined in another posting - Highly Satisfied with Finnish maternity clinics

There is such a thing as a free lunch - if you're a child

On Friday, I witnessed one of the summer rituals in the Helsinki suburb of Espoo - free lunch in the park for children!

The free lunches had just kicked off that week on Monday - early June. The park I visited - Asukas Puisto in Tapiola - was overflowing with children ranging from toddlers to young school aged kids who had come with their parents to participate. All they need to bring is their own plate/bowl and eating utensil.

At 11.30, the hot lunch distribution begins. Everyone just lines up and takes their turn. On the menu was a simple potato and chicken casserole. Food is distributed until 12.30 or until supplies run out. Around noon, one of the park "aunts" made an announcement over a bull-horn that no seconds for anyone until everyone has gotten their first plate because 'until supplies run out' means everyone gets some.

A nice tradition that brings parents and children in the neighborhoods together during the summer; it also gives mom/dad a break from preparing one meal. But, its not without its controversy.

I read in the local paper that nearly 700,000 EUR of tax payer money is spent annually on the lunches in the parks. Unfortunately, a lot of food often goes to waste because not enough people show up to eat. This is particularly an issue if its a cooler, rainier summer. But, since food has to be ordered a week in advance, its hard to plan for the weather. One of the mothers in the park on Friday said its a shame that the left-over food cannot be given to the parents. They won't even sell it to the parents. Rather, it goes straight into the trash can.

I also wonder if this kind of benefit is really needed in every neighborhood. On the surface at least very few of the children/parents I saw on Friday looked to be in dire need of a free meal. But, perhaps the purpose is more in developing a sense of community and making sure that every child gets at least one 'healthy', warm meal a day.

Ahh maternity leave ... paid, loooong and guilt free!

Maternity leave is truly a wonderful thing in Finland. I've been on leave since a month before the due date in April and am not expected back in the office until Jan 2006 when I'm guaranteed a return to my previous position (or equivalent). In the meantime, I earned three months full pay and for the rest of the time, I'm paid a generous monthly sum by KELA (the national social welfare system). And best of all -- its GUILT FREE!!!

Paid leave
All mothers who have been covered by the national health insurance from KELA for at least 180 days immediately before the due date are eligible for the maternity (and later parental allowance) allowance. To make the claim, your midwife at your local Neuvola (health clinic) will provide you with a form that verifies you have been pregnant for at least 154 days. You then drop this form in the mail and KELA will send you a confirmation of the benefit once they process it.

The maternity allowance is paid for the first 105 days (not including Sundays or holidays -- Saturday is considered to be a working day for many benefits), so about the first three months. So, this amount is paid to the mother as she is expected to remain at home to care for the baby during this time. The amount of the allowance is based on your last tax year's income. KELA provides a nifty calculator to help you figure out the daily amount.

The minimum daily amount is 15.20 EUR paid to those working outside the home, studying or unemployed the previous tax year.

In my case, my employer paid my regular salary the first three months of my maternity leave. During this time, the KELA benefit was paid to my employer. Now, I receive a smaller sum from KELA which is about a third of my regular monthly income after tax. Still, by any comparison to the US - extraordinarily generous!

Actually the allowance I'm receiving now is not just a maternity allowance - its the paternal allowance designed for either the mother or father, whoever is staying at home. In practice, its nearly always the mother who continues the leave. This benefit is paid for 158 weekdays, or about 5 months. The amount is calculated in the same manner as the maternity benefit. Both are taxable income.

Details from KELA


Looonnngggg and Guilt Free

I suspect one of the main drivers for many mothers returning to work is simply the need for income. With the money questions ameliorated with the maternity and parental allowances in Finland, the drive to return to work subsides quickly. Not that I'm not a career oriented woman - I am. I have an MBA on top of a college degree and a position at work that carries responsibility, is challenging and on my career path. Its just that I know when I've complete my leave, I'll be able to return to that position without any repercussions on my career, thus dealing a blow to the other reason many women are anxious to return to the workplace.

In fact, as I was getting ready to begin my leave (one month before the due date!), many colleagues wondered if I was planning to take the usual year or was I going to extend my leave for another 2 years. It was assumed I would be gone at least for the year and possibly chose the option of staying home until the child is three. After the extended leave, I would still be guaranteed my job when I returned. No one - and I mean absolutely no one, begrudged me for the leave, hinted that I'd be slipping off the career ladder, etc. What a relief to be able to enjoy this wonderful and unique time with our little one without a single ounce of guilt!!! That's already worth more than any amount of money.

My employer in the meantime would hire a 'maternity leave replacement' worker to cover my tasks temporarily. This topic deserves its own posting, but briefly there is an influx of mostly women who easily end up in a series of these temporary positions. Though temporary workers have access to many of the same benefits as full-time employees, they are still in a precarious situation and at a disadvantage when it comes to trying to obtain loans,etc. They are also not eligible for maternity leave - ie, sometimes having to put off their own families.

Its estimated that each woman out on maternity leave costs the employer about 8,000 - 10,000 EURs in wages, recruitment, training and related expenses.

Naturally, I know many women crave the workplace because they get such a great deal of satisfaction from their jobs and find themselves miserable at home. Fine. These women should return to work as soon as possible for the benefit of themselves, their children and families.

Free public transport for babies in Helsinki

A friend just clued me in on another wonderful benefit for parents with children under the age of 6 traveling in prams or strollers - free public transportation in Helsinki! What a child-friendly attitude! This includes travel on the metro, trams and buses. I'm not sure if it covers the regional buses or trains, however. But, would imagine that it extends to any transportation that falls within the city zone on the fare charts.

Details at the Helsinki Area Transportation Authority website.

Metro
So far, Peanut and I had tried out the metro. Access is always by elevators that are conveniently placed alongside the escalators. The only downsides are the slowness of the elevators and the fact that some are used as 'public restrooms' making the time enclosed in them rather unpleasant.

Buses
Next up for us is the bus. Many buses in the region are low-riders so they should be easy to board and get off without needing additional assistance. If not, usually a friendly passenger boarding the bus will lend a hand. Or, I've also heard mothers shout into the bus if someone could give her a hand. When disembarking, be sure to press the button with the pram icon, it notifies the doors and driver you need a little extra time to get off.

Strollers should enter by the middle doors where there is a large space intended precisely for prams/strollers. Bus etiquette states that only two prams/strollers per space, so if its full, pls wait for the next bus. There is often a fold out seat for mom/dad to sit next to the stroller.

On the bus schedules, look for the small letter 'e' to denote more old-fashioned buses which are not low-riders and require climbing steps to get in. Also on the brilliant online Journey Planner service from YTV you can see which buses are low riders (matalalattiabusseilla) - just click on the bus number once you have your route selected and scroll down to the bottom of its schedule page. For example, the 103

Trams
Trams are more daunting since most have steps to navigate and the space on board is smaller. There are several tram lines (like the 3T/3B, 4, 6) which have some newer caterpillar trams that are level with the platforms, again making it easy to roll on/roll off.

Our little baby is already making 100 EURs/month

Well, technically its really us, her parents, who are earning an additional 100 EURs/month since the birth of our baby, "Peanut".

The amount is from the Finnish social system and is paid to all parents with a child until the child reaches the age of 17. This family allowance (lapsilisä) is a social benefit to help parents purchase those basic child care items.

Unlike many of the monetary benefits paid by the social system, this is not subject to taxation and neither is to pro rated according to a families other income. While I certainly appreciate the additional income, however small it may be, I wonder if this is really a logical distribution of benefits. Honestly, in our case we don't really "need" the 100 EURs/month, whereas I can imagine there are families where it makes the difference of being able to live within their budget or not. Wouldn't it be more logical to allocate, say 200 EURs/month to these families and have some of us do without the benefit?

We've decided to put the monthly benefit for Peanut in a savings account which we are starting for her where all other gifts, etc will go. It'll be hers to do with as she pleases when she gets old enough. At this rate, she'll earn 1200 EUR/year and by the time she is 17, she'll have 20,400 EUR or even more assuming that the money is held in an interest-bearing account or invested prudently in bonds or similar. With that amount, Peanut will be able to begin a good education, start her own business or travel around the world -- all valuable life experiences.

When a family has more than one child, the family benefit amount increases per child.

The specifics are available on the KELA website.

My name is Baby X

Babies without names
When our Peanut was born everyone at the hospital simply assumed that she would be known as 'Mom's surname Girl' because in Finland most babies are not given their name until their christening ceremony around the age of 3 months.

So when you meet new parents they will usually be tight lipped about the baby's possible names and tell you the working name they are using. Sometimes this is a cute nickname, like Princess, Mr. Helsinki, Raisin, Bundle, Mini, and so on. Other parents will give their baby a real name - but, it just won't be what the baby will be called.

My theory is that the tradition is a holdover from the days when infant mortality was very high and many babies simply did not live to see their 2 - 3 month birthdays. Another reason friends of ours tell us is that they want to first get to know their baby and his/her personality before they can give it a name that reflects who they are.

The rules for naming your baby
Yes, in Finland there are even rules for what you can name your baby! These are set out by the Vaestorekisterikeskus (Population registration centers) and provided to new moms in a brochure at the hospital. I've heard tales of ministers refusing to christen children because the parents had not followed the guidelines.

FIRST NAMES
> at the most, a baby may be given three first names
> the first name cannot be inappropriate or cause the child problems
> a name is usually not approved if it is spelled in a different way than the usual spelling in Finland
> a boy cannot be given a girl's name and vice versa
> a last name is not suitable as a first name
> siblings and half-siblings can have the same name only when both have another first name in addition to the one they share

EXCEPTIONS!
> in case of religious beliefs
> nationality
> or other 'good reasons'

WEHN IN DOUBT
discuss your name ideas with the local maistraatti (courthouse) or Evangelical Luthern or Orthodox church, if you are a member.

The result is that there are many people with very similar names and in several cases the exact same name, except for the surname of course. :-) Also in Finland, American style birth announcements are not common. The Sunday pages of the Helsingin Sanomat newspaper however are filled with announcements of when a baby was christened and what their name is. Also mentioned are the names of the godparents.



Ella, Emma, Anni...Niko, Eetu, Juho topped the charts in 2003
For a list of most popular names and the number of times any given name has been used, visit the Vaestorekisterikeskus website at
https://192.49.222.187/Nimipalvelu/default.asp?L=3

ouch! Vaccinations start at age two DAYS

First Injection
Even before we left the hospital, at two days old our Peanut got her first injection; the tuberculosis vaccination (BCG).

Its not mandatory, but highly recommended to protect babies born in Finland against possible cases of TB carried across the border from Russia or from across the gulf from Estonia and the other Baltics. There are many workers from the areas working in Finland as well as brisk travel for pleasure and business by Finns to the countries.

Peanut got the shot in her left thigh as part of her 'exit check-up' with the doctor. The shot often leaves a tell-tale round mark that remains for the rest of a baby's life. She did not have any adverse side effects from the shot ; only a short cry in the doctors office and now, 7 weeks later, a slightly raised scab and reddish circle at the injection site.

The American Academy of Pediatrics in their Recommended Childhood and Adolescent Immunization Schedule for the US (Jan - June 2004) did not recommend the TB vaccine.

Schedule of Immunizations in Finland
According to the information sheet I recieved from my local health center (Neuvola), the following is the schedule of immunizations given in Finland:

AGE: less than one week
IMMUNIZATION: Tuberculosis (BCG)
AMERICAN ACADEMY OF PEDIACTRICS (AAP): no recommendation

AGE: 3 months
IMM: DTaP (diphtheria, tetanus, pertussis - whooping cough), IPV (Polio vaccine - inactive), Hib (Haemophilus influenza TypeB)
AAP: recommends first DTaP at 2 months - then 4 mos, 6 mos, 6 - 12 mos, 18 mos and 4 - 6 yrs
AAP: recommends first IPV at 2 months -then 4 mos, 6 to 18 mos and 4 - 6 yrs
AAP: recommends Hib beginning at 2 months of age

AGE: 5 months
IMM: DTaP, IPV, Hib
AAP: see above

AGE: 12 months
IMM: DTaP, IPV, Hib

AGE: 14 - 18 months
IMM: MPR (Measles - morbilli, mumps - parotitis, rubella)
AAP: MMR (measles, mumps, rubella) at 12 - 15 mos and before 12 yrs

AGE: 4 yrs
IMM: DTaP, IPV

AGE: 6 yrs
IMM: MPR

AGE: 14 - 15 yrs
IMM: DTaP

Additionally, the American Academy of Pediatrics recommends the following vaccinations not rountinely given in Finland. More specifics are available at their website www.aap.org.

Hepatitis B (HepB) - soon after birth and before hospital discharge

Varicella (chicken pox) - at any drs visit or after age 12 months for susceptible children (those without reliable history of chicken pox)

Pneumococcal (PVC) - age 2 to 23 months

Hepatitis A - recommended for children in selected states and regions and for certain high-risk groups. Those in above regions can get first shot at any visit and booster in following 6 mos.

Influenza - annually for children above 6 mos of age with certain risk factors. Healthy children age 6 - 23 mos are encouraged to get the vaccine.

Delivery from a dad's point of view

Sure, it is kinda late for me to post this now, Peanut is 7 weeks old. No, it did not take me 7 weeks to mentally recover from the delivery, we have recently moved and getting the new place up and running has taken quite some time. Anyway, this article is specifically for the non-physically-pregnant part of the couple. In most cases you will probably be "dad" like me - but this applies to anyone entering the maternity clinic to support a delivery.

So, in modern times in Finland, the dad is expected to play an active role in the delivery room. In all honesty, the thought of being there scared me. I don't handle blood well and the prospect of seeing my lovely wife in pain just made me feel like I did not want to be there. Which is silly really, because she probably needed my presence more than at any time before in her life [except for conceiving the baby :-)].

Despite your active role, do not expect the maternity hospital or the delivery room to specifically cater to the husband. You will have to bring your own food and drinks. Make sure you get some filling foods that will slowly release energy. A delivery can take quite some time (36 Hours in our case). Some caffinated drinks such as coke/pepsi might be good. Don't eat only sugar based energy boosters. They will give you a sugar rush, leaving you more tired than you were before you took it. We had our baby in Kätilöopisto and they have a small relaxation room for dads with a microwave, coffee maker and some other basics. Check it out on one of their tours.

In case of a long delivery, you are also going to make sure you get a break and some rest. When Peanut's mom got an epidural during the delivery process, she fell asleep. I took that time to quickly go home, freshen up and call my mom to get some support. You need to be in shape to support your wife when she gets back to feeling pain and in the final stages of delivery, so you need to manage your own energy levels to make sure you can do that. If the hospital is very full, like when we were having Peanut, you wont be able to sleep in the hospital during your breaks in the birthing process or after the birth. If the hospital is far from home (>20 mins) make sure you can crash at a friend's place close to the hospital or book a nearby hotel. If you are going to Kätilöopisto in Helsinki, there is a Holiday-Inn hotel next to "Messukeskus", close to Hartwall Areena, about 10-15 minutes from the hospital by car.

In the delivery room there really is not that much you can do. The midwife will take care of all the essentials. Ask her to explain what she's doing so you know what is going on. Most midwives speak decent English. Note that a midwife in Finland is really an educated health worker. She's authorized to give injections, install drips etc.

Way before delivery, discuss with the soon to be mother how she would like to give birth. Go through the birth plan if she has one. If she doesn't have one, make one with her. See a previous article on this blog for details. This way you can help in directing the delivery in the way that the mother to be would like. Once the contractions start coming thick and fast, she wont be able to talk or concentrate much, but decisions will need to be made. Other than that, you can help with pain relief, for instance by helping her take the laughing gass in time, applying a hotpack to the lower back and wiping her forehead with a cold cloth.

Once in the pushing stage, your need to support her will depend on the birthing position. If she's on her back, there probably isn't much you can do. If she's ona birthing stool, you'll have to physically support her, which makes for an intense and involved experience. But let that not dictate what position to use, the most important thing is that the baby makes it out quick and safe, the 2nd most important that mom-to-be is as healthy and comfortable as possible.

Finally, giving birth is not a clean, clinical process. There is pain, blood, liquids, needles etc. But you will not be bothered by any of this. You will hardly remember it afterwards. I am probably the least suitable person to enter the delivery room when it comes to these things, but I survived and that means you can do it too. And it is a great experience!