The KELA Box - one year later

Peanut's birthday is approaching! Our little one is nearly a year old -- and so is her mama's blog :-)

Looking back, we are both much wiser, calmer and confident in our parenting. Peanut is just amazing - a year has brought so many changes and so much growth.

And, our KELA box (the baby starter kit given by the State government to all new mother's in Finland - though it means so much more) has been with us through it all, starting out as Peanut's first bed. Where is it now you wonder? Stacked up on other boxes in Peanut's closet, filling up with clothes that too small and toys that are no longer interesting. Unfortunately, we lost the lid in the move (though the rough&tough packers in Helsinki did take an extra moment to ask me if I wanted to bring it - mind you, they did not ask about ANYTHING else in the whole apartment!!)

What about the contents? Let's take a quick look.

Still in use today:

• cloth diapers - as sunshade on Peanut's stroller and washclothes
• bath towel with hood - best towel we have, still fits Peanut, soft!
  
• bib - lightweight yet water resistent (not quite proof) , good for meals on the go
• 'changing cloth' - not sure what the material is, but its water proof on one side, we use it for diaper changes on our bed
• hair brush
• nail clippers
  
• book
• rattle - good for teething and shaking
• the Box - for storage

Very useful:

• the diapers
• bedding - mattress, sheet and blanket fit the box perfectly
• thermometer for bath - unfortunately we lost it during the summer
• Baby guides - I used the breastfeeding guide the most
• some of the clothes though I almost took the size 60 out too late. I was a bit surprised at the poor quality of the buttons (came off in the wash) and how much they shrank in dryer (OK, they were cotton so probably not that big of a surprise). Peanut used the bodysuits with legs and one-piece crawler outfit the most.
• woolen socks
• And we also used up the sanitary napkins, breast pads and condoms (this year they've also added a lubricant - luckily new moms)
  

Hmmmm:

• What I thought was the sleeping bag or travel playblanket, but really was a stroller bag to keep baby warm -- we had two of these. I used them as playblankets on the floor until Peanut got too big.
• Baby lotion
  

We didn't use:

• the winter outerwear outfit + hat, gloves, etc - since we were moving to Texas, I donated this to children in the Baltics
• lighter outerwear outfit - ditto
• hats - ditto, plus Peanut hated hats as an infant
• wrap-around body suit - too difficult with all the little strings
  

And for those out shopping, here's a list of what to buy.

State provides home assistance to families with children

An article in today's Helsingin Sanomat newspaper highlighted yet another source of assistance for families with children: kotipalvelu or home-based services. It wasn't clear to me what all it covered, but it seems to be various kinds of assistance and services to help families cope with newborns, sick children, sick parents, situations where family counseling is needed or when parents are just plain exhausted.

The article was based on a survey of how well local districts are in providing this legislated support. The legislation is evidently vague enough that districts don't have to provide any specific amount or types of support, but simply have something that qualifies as home-based services which are funded each year.

The current situation varies dramatically among big cities and was described as dire in some areas, such as Oulu. It was best in Tampere and Lahti. In Tampere, the city has made a concerted effort to focus on preventative measures to keep families from falling into crisis situations by supporting families when a new baby arrives, during divorce, and dealing with stress caused by long-term illness or disability in the children or parents. Helsinki was better than average. In Turku and Espoo, the services focus on 'lastensuojeluperheille' (child welfare families)

Help in Oulu
A very nice example of how valuable this assistance can be was of a family in Oulu. The third child had just been born, the birth had been traumatic, the family moved house and dad had to travel on business for several weeks and the new baby hardly slept. As a result, mom was totally burned out, but didn't realize it until she was asked at the neuvola how she was doing. In answer, she burst into tears.

A family worker was requested. She came once a week for 3 - 4 hours to play with the children. It was just what the mom needed - a few hours to sleep, take a bath, go to the store or to talk a walk. This relief gave her new found strength to cope with the situation. The family worker came for four months.

Private Baby Health Insurance

Most of the posts here highlight how efficient and high-quality the Finnish state-run health care system is, but there is also a brisk market for private health care and private health care insurance for babies.

Why private care?
With the neuvolat and state hospitals there is always the possibility of having to wait to get an appointment or to see a doctor. In the case of your own baby, most parents simply want the best care as fast as possible. Or, in case of a serious illness or disease, you want access to specialists and treatments which may be costly and therefore more difficult to get through the state system or on your own

One baby health care insurance provider, Pohjola, offers insurance that can be applied for before the baby is born or then you must wait until the baby is 2 months old and provide a health backgrounder (which could limit the coverage you can then get).

To apply for it in advance of the birth and have coverage which is in effect from that day forward, you must do so before the beginning of the seventh month (ie, three months before the due date). For this insurance, the mother's health and age will impact the available coverage. This insurance is not available to mothers who are 40 or older. It is somewhat more expensive than if you apply for the coverage once the baby turns 2 months, but then he/she is without insurance for the first two months.

Other insurance providers:
If

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.

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.

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.

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.

And your total hospital bill will be --- 130 EURS

Only?! When will we be billed for the rest? I was pretty surprised when the hospital bill for Peanut's delivery arrived - and it was only 130 EURS!

We were in the hospital for several days before and after the delivery. I made liberal use of the pain killers available - including having an epidural and two additional injections. There was loads of monitoring equipment used during the delivery -- not to mention many other medications. Peanut's dad also stayed overnight in the hospital with us in a private room. We saw a pediatrician for Peanut and I had a post partum check-up with a midwife. We ate lots of hospital food.

Yet, it really all cost only 130 EURS - it was the food that got us in the end.

The bill really only was for the meals we ate - about 22 EURs a day for each of us. In addition to breakfast, lunch and dinner, we had afternoon coffee and a snacktime in the evenings. The fare was bland and seemed surprisingly low on veggies. But, I guess for breastfeeding moms you want to keep it simple, but filling. The afternoon coffee break seemed ususal since I thought we shouldn't have too much caffine, but in a country of ardent coffee lovers, it would be hard to imagine a day without a coffee break!

We had selected on of the public hospitals - the Kätilöopisito - and did not use any private health insurance. I can only imagine what all this would have cost in the US for someone without insurance! Here it was a case of a good return on the oodles of taxes we pay. I suspect we'll continue to see more benefits of the system as we venture with Peanut. So far, all of our pre-natal visits were entirely free and our post-natal vists will also be - as long as we make use of the public clinics and doctors.

Peanut's First Bed -- a cardboard box

Finland offers a very unique service for mothers-to-be in the form of a 'baby package' from the national social services (known as KELA). There is an option for all expecting mothers to chose a monetary grant of 140 EUR from the State intended to help them buy the basic baby neccessities OR you can select the 'baby package'. Most first time mothers opt for the baby package and its arrival is an eagerly anticipated part of pregnancy.

Packed with goodies galore....
In order to qualify for the baby package or the monetary benefit, mothers must have had a prenatal exam at their local health center, their pregnancy must have reached 154 days and they must submit the required forms to KELA. Once sent in, the wait begins.

When the notice finally arrives that your baby package is ready to be picked up at the post office there is still a few final moments of speculation - did I get last year's package or am I part of the group to get the 2005 package?! It makes all the difference when other new mothers spot you on the street.

When I picked my package up -- it was a 2004 model -- I was surprised at how large the carton actually was. Measuring about 70 cm x 45 cm it contained a mountain of baby starter gear. The contents of the box are carefully reviewed and selected by a panel of childcare professionals each year to provide baby with the bare neccessities for the early days. Since Peanut was our first baby, I was looking for guidance on what kind of clothing she would really need and was confident the baby package would enlighten us.

What we found in the box was a number of little baby outfits from pjs to a warm outerwear suit designed for Nordic winters; sample packs of diapers; baby's first nail scissors & hairbrush; blankets, sheets & a comforter; and even a few toys such as a rattle and a book of nursery songs. But, what was more unexpected were a few gifts for mom and dad: some sanitary pads and a package of condoms :-) There were also a number of booklets on breastfeeding, making your own baby food and general childcare. All in all a real treasure trove worth much more than the monetary benefit.

There has been some debate in the local paper about how unstylish the clothing is. I have to agree, it ain't very pretty stuff. Its all designed to be unisex and practical. The 2004 package had evidently chosen lime green as one of its theme colors. Some would argue - lime green - that's one of the hot spring colors this year. Yet, in the clothing it comes off as more discount store knock-off than top designer wear. The other side of the debate argues that today's generations are becoming too style conscious and should appreciate this package for its sturdy, practical items ensuring that every Finnish baby has the basics. And, fashion has nothing to do with that.

Once you make the decision to have your baby wear any of the clothing from the box - you are outwardly indicating your 'class year'. As I walk down the street and catch a glimpse of another lightblue/lime green outdoor suit on a baby, I know they are part of the 2004 alma mater.

I haven't yet decided if Peanut will wear the KELA outfits in public or its something we keep on inside the house.

... and its a bed!
And, the box itself converts into baby's first bed! At first the idea seemed really outrageous -- what, put my baby to sleep in a cardboard box??!! But, yes, it makes sense. When our little bundle came home from the hospital she was so small compared to the baby crib we had bought her - she was completely floating in the middle of giant mattress with nothing around her. We decided to put the KELA box inside her crib. Since the box comes with its own custom sized mattress, it was easy to make the sheets and blankets fit inside. Peanut has been sleeping comfortable in her box and I believe has felt more secure in the smaller space.

She's now nearly 4 weeks old and we often hear her little fists tap against the sides of the box as she changes positions and shifts from one side of the box to the other. One of her favorite sleeping positions has been to squirm her way up so that her head is solidly pushed against the top of the box. Economically, we saved money on not buying a Moses' crib or other baby-sized cot which we'd be looking at putting it away.

in a few weeks, she'll outgrow her "first bed", but until then, I'll appreciate the easy mobility of it and she'll continue to enjoy the comfy cozy space. And, they we'll use it start storing all those newborn outfits she has also outgrown.

For the 2005 package contents, see KELA's website at http://www.kela.fi/in/internet/suomi.nsf/NET/100502155308EH?openDocument