Saturday, March 13, 2010

Co-sleeping


Why Do Some People Choose to Cosleep?

Cosleeping supporters believe — and some studies support their beliefs — that cosleeping:

* encourages breastfeeding by making nighttime breastfeeding more convenient
* makes it easier for a nursing mother to get her sleep cycle in sync with her baby's
* helps babies fall asleep more easily, especially during their first few months and when they wake up in the middle of the night
* helps babies get more nighttime sleep (because they awaken more frequently with shorter duration of feeds, which can add up to a greater amount of sleep throughout the night)
* helps parents who are separated from their babies during the day regain the closeness with their infant that they feel they missed

But do the risks of cosleeping outweigh the benefits?
Is Cosleeping Safe?

Despite the possible pros, the U.S. Consumer Product Safety Commission (CPSC) warns parents not to place their infants to sleep in adult beds, stating that the practice puts babies at risk of suffocation and strangulation. And the American Academy of Pediatrics (AAP) agrees.

Cosleeping is a widespread practice in many non-Western cultures. However, differences in mattresses, bedding, and other cultural practices may account for the lower risk in these countries as compared with the United States.

According to the CPSC, at least 515 deaths were linked to infants and toddlers under 2 years of age sleeping in adult beds from January 1990 to December 1997:

* 121 of the deaths were attributed to a parent, caregiver, or sibling rolling on top of or against a baby while sleeping
* more than 75% of the deaths involved infants younger than 3 months old

Cosleeping advocates say it isn't inherently dangerous and that the CPSC went too far in recommending that parents never sleep with children under 2 years of age. According to supporters of cosleeping, parents won't roll over onto a baby because they're conscious of the baby's presence — even during sleep.

Those who should not cosleep with an infant, however, include:

* other children — particularly toddlers — because they might not be aware of the baby's presence
* parents who are under the influence of alcohol or any drug because that could diminish their awareness of the baby
* parents who smoke because the risk of sudden infant death syndrome (SIDS) is greater

But can cosleeping cause SIDS? The connection between cosleeping and SIDS is unclear and research is ongoing. Some cosleeping researchers have suggested that it can reduce the risk of SIDS because cosleeping parents and babies tend to wake up more often throughout the night. However, the AAP reports that some studies suggest that, under certain conditions, cosleeping may increase the risk of SIDS, especially cosleeping environments involving mothers who smoke.

CPSC also reported more than 100 infant deaths between January 1999 and December 2001 attributable to hidden hazards for babies on adult beds, including:

* suffocation when an infant gets trapped or wedged between a mattress and headboard, wall, or other object
* suffocation resulting from a baby being face-down on a waterbed, a regular mattress, or on soft bedding such as pillows, blankets, or quilts
* strangulation in a bed frame that allows part of an infant's body to pass through an area while trapping the baby's head

In addition to the potential safety risks, sharing a bed with a baby can sometimes prevent parents from getting a good night's sleep. And infants who cosleep can learn to associate sleep with being close to a parent in the parent's bed, which may become a problem at naptime or when the infant needs to go to sleep before the parent is ready.

Making Cosleeping as Safe as Possible

If you do choose to share your bed with your baby, make sure to follow these precautions:

* Always place your baby on his or her back to sleep to reduce the risk of SIDS.

* Always leave your child's head uncovered while sleeping.

* Make sure your bed's headboard and footboard don't have openings or cutouts that could trap your baby's head.

* Make sure your mattress fits snugly in the bed frame so that your baby won't become trapped in between the frame and the mattress.

* Don't place a baby to sleep in an adult bed alone.

* Don't use pillows, comforters, quilts, and other soft or plush items on the bed.

* Don't drink alcohol or use medications or drugs that may keep you from waking and may cause you to roll over onto, and therefore suffocate, your baby.

* Don't place your bed near draperies or blinds where your child could be strangled by cords.

Transitioning Out of the Parent's Bed

Most medical experts say the safest place to put an infant to sleep is in a crib that meets current standards and has no soft bedding. But if you've been cosleeping with your little one and would like to stop, talk to your doctor about making a plan for when your baby will sleep in a crib.

Transitioning to the crib by 6 months is usually easier — for both parents and baby — before the cosleeping habit is ingrained and other developmental issues (such as separation anxiety) come into play. Eventually, though, the cosleeping routine will likely be broken at some point, either naturally because the child wants to or by the parents' choice.

But there are ways that you can still keep your little one close by, just not in your bed. You could:

* Put a bassinet, play yard, or crib next to your bed. This can help you maintain that desired closeness, which can be especially important if you're breastfeeding. The AAP says that having an infant sleep in a separate crib, bassinet, or play yard in the same room as the mother reduces the risk of SIDS.
* Buy a device that looks like a bassinet or play yard minus one side, which attaches to your bed to allow you to be next to each other while eliminating the possibility of rolling over onto your infant.

Of course, where your child sleeps — whether it's in your bed or a crib — is a personal decision. As you're weighing the pros and cons, talk to your child's doctor about the risks, possible personal benefits, and your family's own sleeping arrangements.

Retrieved March 13, 2010 from http://kidshealth.org/parent/pregnancy_newborn/sleep/cosleeping.html#

By Yap Peck Shing, T2

Got Milk? How?



We put it in cereal. We drink it with cookies. And we eat tons of foods that are made from it, including yogurt, cheese and even some crackers, breads and granola bars. For most of us, milk is a staple that would be hard to live without.

Thousands of years ago, though, only babies drank milk — and that milk came from their mothers. Now, scientists are investigating the beginnings of mankind’s long-lasting love for daily products. They are looking back thousands of years, to the days when people first squeezed milk out of cows and other animals for use as food and drink.

Tracking down the first milk drinkers could give insight into some bigger questions. For example, why do so many people today still get sick from drinking milk? In some countries, almost nobody can digest dairy products.

The work could also help explain major events in human history. Before refrigerators and grocery stores kept a steady supply of fresh food around, dairying probably transformed societies.

“If you can have an animal supply nutrition without killing it, that’s a real step in agriculture,” says Richard Evershed, a chemist at the University of Bristol in the United Kingdom. “That’s spectacular in terms of human nutrition.”

As easy as milk is to find these days, though, its history is challenging to piece together. Like detectives, researchers are tackling the milk mystery in more ways than one.

They are analyzing ancient milk scum on extremely old pots. They’re tracking down the genes that allowed people to digest milk, which is surprisingly hard for many people to stomach. They’re even looking for clues in the buried bones of cows, sheep, horses and other milk-making animals.

“Milk was probably the world’s first superfood,” says Mark Thomas, a scientist at University College London who studies how genes have changed throughout history. The advantages of being able to drink it, he adds, “are just out of this world.”

Thanks, moms

To most people, milk comes in a carton. But milk originally comes from the bodies of mammals. Human as well as other mammal mothers, including dogs, cats, pigs and mice, produce milk to feed their babies.

Mammal babies, including goats, get milk from their mothers. Human mothers also provide milk to their very young children, but most people get milk from the store.

Mammal babies, including goats, get milk from their mothers. Human mothers also provide milk to their very young children, but most people get milk from the store.

isaact/iStockphoto

Most of the milk in U.S. grocery stores comes from cows. In other countries, it is common to drink the milk of sheep, goats, camels, even horses. Each type of milk has a different flavor. Some types are easier to stomach than others.

Evershed recently sampled milk from horses in Kazakhstan. “It was the most disgusting drink I’ve ever tasted,” he says. “I just didn’t like it.”

Unlike meat, milk does not require that an animal be slaughtered. But the first dairy farmers had to figure out for themselves how to turn wild animals into ones that could be raised in captivity. Then, they needed to herd the animals, care for them and continue to milk them even after the animals’ babies grew up.

Another complication: Milk drinking doesn’t come naturally to older kids and adults. Milk contains a type of sugar called lactose. In order to turn lactose into energy, our bodies need an enzyme called lactase. Enzymes are proteins that help the body do its work.

Like other newborn mammals, baby humans have plenty of lactase, which allows them to gulp down their mothers’ milk. After age 2 or so, though, lactase levels drop.

Without lactase, people can get very sick from dairy products. Symptoms include gas, stomach cramps and severe diarrhea. The condition is called lactose intolerance.

None of our early ancestors could digest milk as adults because their bodies never had to — milk drinking simply wasn’t an option. As people began to extract milk from animals, though, some people developed the ability to keep drinking it throughout their lives.

That biological switch proved to be a huge boost toward survival. Milk is full of calories, fat, protein, calcium and other nutrients. For ancient man, it would have been a valuable and steady source of food.

Scientists now know of a milk-related mutation in our genes — the chemical instructions for life that we carry in almost every cell in our bodies. People who have a mutated form of one particular gene can drink milk just fine. People without the mutation tend to get sick from milk.

“The ability to digest milk, Thomas says, “has been incredibly important for people’s survival for the last 8,000 to 10,000 years. We still just don’t know why.”

The first milk drinkers

To figure out where, and possibly why, milk drinking started, some scientists have been looking at who has the milk-digesting mutation today. Patterns are striking.

Most adults in Northern and Central Europe are able to digest milk — and they do. Cheese, butter and other dairy products are popular in countries such as Sweden, Denmark, Germany and England. Because European settlers dominated North America, most people here can handle milk just fine, as well. That may explain why ice cream is such a popular dessert in the United States.

In much of Africa, Asia and South America, on the other hand, people tend to avoid dairy products because they lead to diarrhea and other stomach problems. (That’s why you won’t typically find cheese on the menu at a Chinese, Japanese or Ethiopian restaurant.) Native Americans are also unable to digest lactose.

Based on these genetic patterns, scientists have long thought that milk drinking started in Northern Europe, where dairy is an institution and the milk-digesting mutation is everywhere.

The different circles of color on this map of Europe show where lactose tolerance—the ability for older children and adults to drink milk without it causing illness or discomfort—developed in a particular area. The red area in the center shows where lactose tolerance most likely developed (each dot shows a place where computer simulations produced results very much like real-world conditions).



The different circles of color on this map of Europe show where lactose tolerance—the ability for older children and adults to drink milk without it causing illness or discomfort—developed in a particular area. The red area in the center shows where lactose tolerance most likely developed (each dot shows a place where computer simulations produced results very much like real-world conditions).

Yuval Itan, Adam Powell, Mark G. Thomas



A recent study painted a different picture. With a computer model, Thomas and colleagues looked at the spread of the milk-drinking mutation, farming and other related factors. Working backward, the scientists concluded that the first milk-drinkers lived in Central Europe around what’s now Hungary about 7,500 years ago. The practice didn’t start farther north, as scientists had thought before.

Around that time, a farming culture called the Linearbandkeramik also sprouted in the area that’s now Hungary. The culture spread quickly over the next few hundred years into most of northwestern Europe.

Milk drinking, Thomas says, was probably responsible for the success of the Linearbandkeramik. And milk-drinking Linearbandkeramik may have transformed Europe.

“They probably shaped the language and cultural map of Northern Europe over the last several thousand years,” Thomas says. “We now think the ability to digest milk was crucial to [their] spread.”

Dairy before milk

The story doesn’t start or end there. It’s now clear that people ate dairy foods before they actually drank milk.

Over the last decade, Evershed has analyzed pottery remains from many hundreds of ancient vessels at dozens of sites in Europe.

His group has also identified dried-up milk fat on the oldest pottery shards ever found, dating back 9,000 years from an area outside Europe, in the Middle East, called the Fertile Crescent. The region now includes Iraq, Syria and Israel. It’s probably where people first domesticated animals.

In fact, milking may have started even earlier than that. Although archaeologists haven’t found older pottery remains, scientists do have evidence that early sheep herds were mostly female. That might mean that the herd was used for milk, rather than meat. It’s the females, after all, that produce milk.

Despite those clues, Thomas — who has pulled genetic material out of the bones of early European farmers — has found no sign that people had the gene mutation for digesting lactose before 7,500 years ago.

So, why were people milking animals if they couldn’t digest the milk?

It turns out that fermenting and processing milk into yogurt, cheese and other products removes much of the lactose. Even people who are lactose-intolerant can often eat these foods without getting sick.

Dairy foods last longer than milk without spoiling. And fermenting, for instance, is not hard to do: In a hot country, people would have just needed to leave milk in a pot outside for most of the day to turn the milk into a nutritious, digestible yogurt.

“We are now pretty convinced,” Thomas says, “that the ability to digest milk came after the skills necessary to produce it.”

From when and where, to why?

Now that scientists know more about when and where milking started, they are struggling to explain why people started drinking milk in the first place.

Among a variety of theories about milk, Thomas likes the idea that animals provide a steady supply of it. Crops boom and then bust. Meat comes with finality: the end of an animal’s life. But on the other hand, as long as you keep feeding and milking a cow, her milk keeps coming.

There would have been other advantages, too. Milk is cheap. It’s nutritious. And it harbors fewer dangerous bacteria compared with liquids like river water, which could have made people terribly sick.

Investigating milk, scientists say, is a great way to help people connect with their food and where it comes from. In a recent presentation for schoolkids, Evershed included a poster of someone squeezing milk from the udders of a cow into a pot.

“It was a lovely picture,” Evershed says, and the image was symbolic, too. “It brought home man’s intimate relationship with animals and the way we live with them and rely on them. The supermarket makes you forget that.”


Retrieved March 13, 2010 from http://www.sciencenewsforkids.org/articles/20100120/Feature1.asp

By Yap Peck Shing, T2

Alternative for breast feeding



Breastfeeding has been a part of our culture since human existence, so why does it seem so difficult? Most soon-to-be-moms fantasize about the sweet, quiet moments that they will share with their precious bundle as they suckle at her breast, but moments after birth they find that the breastfeeding experience does not come as natural as was thought, but is a learning experience. Due to excruciating, long labors; post-partum depression; decisions to return back to work and many other problems that mothers are facing, some are turning to other feeding options.

breast-pumping-the-alternative-feeding-option.jpgIs this such a bad decision? Perhaps 30 or 40 years ago, when the fad of breastfeeding was not in, the only option was to use formula. However, we are very fortunate to have many feeding options to keep our beautiful newborns healthy, plump and happy: breastfeeding, formula, exclusive pumping, supplementing breast milk, supplementing formula, and many other combinations. But, why is it that we are instantly, right after the birth of our newborn, only given two options (breastfeeding and formula)? It is very rare for someone in our society, especially the medical community, to give you the option to pump, let alone give you a good explanation of how it works, the advantages and disadvantages, or recommend a good pump to use.

Today, our society pressures mothers to breastfeed because of the many benefits that have been proven. This pressure entails bringing baby to breast exclusively, and though this is an incredible way to create bonding with your baby while providing the best milk for your little one, this pressure can be detrimental to some mothers. Guilt, depression, inadequacy, anger, and many other emotions are felt by many mothers who feel this pressure, but are unable to successfully complete the beautiful fantasy of rocking quietly in a serene environment as baby suckles at a contented mother’s breast. Yet, instead of admitting that bringing baby to breast exclusively is not for every mother, and helping those discover the many other options, we impatiently thrust a can of formula in the confused mother’s arms.

Most of these mothers do not selfishly decide that their newly born child just does not deserve their time and sacrifice of bringing the baby to breast, it is usually quite the contrary. There are numerous reasons why a mother is unable to successfully bring baby to breast exclusively:

* baby is not nursing well (sleepy, low blood sugar, jaundice);
* baby is not able to nurse at all (premature, illness of mom or baby);
* mom or baby has surgery;
* postpartum depression.

And these are only a few of the many reasons that a mother is not capable of bringing baby to breast exclusively.

How many of these mothers are informed that they can still give their sweet babies their own perfect milk right from mom? Pumping has actually been around since the late 1700’s, with a glass bowl and brass syringe. Yet, the pumps of eras past are put to shame by the incredible breast pumps of today. You can choose from many different brands, styles, and usage requirements. Though it is not one of the first thoughts that come into one’s head when thinking of feeding options, there are many moms who breast pump exclusively, and are very proud of it.

There are many opponents of breast pumping who may inform others of the disadvantages, such as finding hours a day to do the pumping, risk of decreasing milk, or inconvenience of making and warming bottles. Yet, many mothers who find that the only way to provide their own milk to their infants is by breast pumping would argue that, although these are problems that need to sometimes be overcome, there are still many more benefits.

One benefit may include the emotional stability that some mothers experience when others are able to feed the baby while they get some extra sleep, the confidence of actually seeing how much milk the baby is consuming, or not becoming frustrated from latch-on problems, sore nipples, and biting. Another benefit is the financial cost, which is pretty minimal compared to the excessive prices of baby formula. Some babies may benefit from the length of time mothers will continue to pump as opposed to bringing baby to breast exclusively. Though 70% of mothers begin to breastfeed their baby in the hospital, only 36% continue to breastfeed their baby by 6 months, according to a study conducted by the U.S. Centers for Disease Control. This decrease can be contributed to mothers returning to work, the desire to begin to sleep longer periods of time, and many other reasons. However, because of the many benefits pumping moms encounter, these are also some of the reasons that they are able to continue to give their babies breast milk longer. One of the most important reasons to breast pump is the ability to help others in need. Many mothers who become experienced at pumping find that they are able to pump far more milk than their baby is consuming. For these fortunate mothers, they are able to share their milk with the milk banks across the U.S., which pasteurize and distribute the milk to sick and premature babies. This is one of the most satisfying and heart-felt advantages of breast pumping.

So, again, with the great advantages of breast pumping, why are we not promoting it as a major feeding option? We need to take it upon ourselves to educate others of the incredible benefits of breast pumping. Some very simple things that mothers can do to assist with breast pumping becoming a feeding option can be talking with other mothers, informing pregnant women about breast pumping as a feeding option, or asking your OB/GYN or baby’s pediatrician about their views of breast pumping. Those dedicated to making breast pumping a feeding option may contact government officials or charities to assist new mothers with funding for breast pumps, learn more and educate others about the wonderful services of breast milk banks, or get involved with educating the medical community about breast pumping and the benefits to both baby and mother.

One day, hopefully in the near future, mothers will be asked how they feed their baby, and instead of receiving strange looks when they profess that they exclusively pump, they will be greeted with a welcoming, “So do I! What type of pump do you use?”

Retrieved March 13, 2010 from

http://www.babiesonline.com/articles/baby/breastfeeding/breastpumping.asp



By Fong Khai Yan, T2

Breastfeeding





When can I start pumping my breast milk?

Some experts feel that if you start pumping and giving bottles too early — before your baby is used to breastfeeding — your little one might have "nipple confusion" and may decide that the bottle is the quicker, better option than the breast. While some babies experience this confusion, others have no problem transitioning between a bottle and the breast.

Some lactation consultants recommend pumping right from the start as a way to stimulate and increase your milk production. This pumped milk can be given to the baby with a bottle, or through a nursing system in which the pumped milk goes through a small tube that attaches to the mother's nipple.

If you're returning to work after maternity leave, it's a good idea to start trying to pump a couple of weeks beforehand. If you wait until the day you go back to work, you may be frustrated to learn that it's not always easy to get your body to respond to the pump, which isn't nearly as cute and cuddly as your baby. In fact, it may take some practice and patience before you're able to produce enough milk without your baby's help. It also may take time for your baby to get used to taking a bottle.

Depending on how heavy their milk flow is, some women can fill a bottle in one pumping session, whereas others may need to pump two or three times (and sometimes more) to get a full bottle.

As frustrating as pumping may seem for some women at first, giving your baby a bottle of breast milk can allow you to get some much-needed rest and can let your partner, or other family members, participate in the bonding experience of feeding your baby. It also can allow you to continue to provide breast milk for your child when you return to work.
Continue
What type of pump is best?

Which kind of breast pump you opt to use is really up to you. Some women find manual (or hand-operated) pumps to be more portable, more discreet, and easier to use. And they're definitely cheaper than electric pumps (manuals are usually under $50, whereas electric models can cost hundreds of dollars). But other nursing mothers may find that the effort required for manual pumps is too much.

Despite their expense, electric (or automatic) pumps can be easier to use than manual ones because they don't require you to exert much physical effort. And many models allow you to pump both breasts at once.

Options include double electric pumps, which pump each breast simultaneously, or the kind that alternate pumping action back and forth from one breast to the other.

Some women find that electric pumps are sometimes faster and, therefore, more efficient than manual, especially if you pump both breasts at the same time. But some find the noise of the electric pumps to be a little much (especially if you're pumping at work or away from home). And though they often come in easy-to-carry bags (such as backpacks or arm bags), the weight and bulk of many can be somewhat cumbersome.

You'll also want to keep in mind where you might be using the pump. Some electric pumps can be plugged in or battery-operated; others can't. So, unless you want to have to find a comfortable spot and an electrical outlet every time, you might consider finding one that offers both options. It's also important to consider a back-up method, such as a battery-operated or manual pump, in case of a power outage.

Whichever type of pump you use is up to you. You can look into which type of pump, if any, as well as how much of the cost, your insurance will cover.

If you don't have the money to buy a pump or don't receive one as a gift, contact the governmental organization Women, Infants, and Children (WIC) to find out about their pump program and to see if you qualify.
Are used pumps OK?

Most doctors and pump manufacturers will tell you that it's not a good idea to borrow or buy someone else's used pump. Why? Because bacteria and viruses from the previous owner can get trapped inside the pump. These germs can be difficult to get rid of and can be potentially hazardous to your baby's health, even with thorough and repeated sterilization and cleaning. There are some hospital-grade pumps which are meant for multiple users, each with their own accessory kit.
BackContinue
How can I make pumping easier?

As with nursing, it's important to be comfortable when pumping (which doesn't always seem possible while you're attached to a machine). It can be hard, especially at first, for your body (and your mind!) to become accustomed to producing milk without your baby's help.

Often, women's milk will "let-down" (or start to be released) when they see or hear their babies cry. So, when faced with an object instead of the welcoming face of your little one, you may find it hard to pump.

If you're having trouble with let-down, you may find it helpful to hold something that reminds you of your baby — a picture, a blanket, a favorite toy. Your let-down also can be affected if you're frustrated, embarrassed, or rushed. Try relaxing in a comfortable chair or couch and don't stress out too much about producing enough milk.

If your breast just doesn't seem to fit the pump correctly, the pump may come with different sized breast shields or you can buy a smaller or larger breast shield to place over your breast.

If you're pumping at work, try to find a discreet and comfortable place to do it. Many companies offer their employees pumping and nursing areas. If yours doesn't, ask fellow employees or the human resources department about an office or other private area that might be unused. If you have to pump in a bathroom, find a large one with a comfortable chair and some type of privacy barrier.

If your employer doesn't provide an adequate nursing or pumping area, ask that they do, reminding them of the benefits of breastfeeding.

Also, just like when you're nursing, it's important to place the breast shield of the pump correctly over your breast, covering your nipple and areola (not just the tip of your nipple), and getting a good seal. If you place the pump incorrectly, may be uncomfortable and you'll be much less likely to get the milk you need. And if you're using an electric breast pump, make sure to adjust the speed and suction to the level that's comfortable for you so as not to cause unnecessary discomfort.

What type of pump is best?

Which kind of breast pump you opt to use is really up to you. Some women find manual (or hand-operated) pumps to be more portable, more discreet, and easier to use. And they're definitely cheaper than electric pumps (manuals are usually under $50, whereas electric models can cost hundreds of dollars). But other nursing mothers may find that the effort required for manual pumps is too much.

Despite their expense, electric (or automatic) pumps can be easier to use than manual ones because they don't require you to exert much physical effort. And many models allow you to pump both breasts at once.

Options include double electric pumps, which pump each breast simultaneously, or the kind that alternate pumping action back and forth from one breast to the other.

Some women find that electric pumps are sometimes faster and, therefore, more efficient than manual, especially if you pump both breasts at the same time. But some find the noise of the electric pumps to be a little much (especially if you're pumping at work or away from home). And though they often come in easy-to-carry bags (such as backpacks or arm bags), the weight and bulk of many can be somewhat cumbersome.

You'll also want to keep in mind where you might be using the pump. Some electric pumps can be plugged in or battery-operated; others can't. So, unless you want to have to find a comfortable spot and an electrical outlet every time, you might consider finding one that offers both options. It's also important to consider a back-up method, such as a battery-operated or manual pump, in case of a power outage.

Whichever type of pump you use is up to you. You can look into which type of pump, if any, as well as how much of the cost, your insurance will cover.

If you don't have the money to buy a pump or don't receive one as a gift, contact the governmental organization Women, Infants, and Children (WIC) to find out about their pump program and to see if you qualify.
Are used pumps OK?

Most doctors and pump manufacturers will tell you that it's not a good idea to borrow or buy someone else's used pump. Why? Because bacteria and viruses from the previous owner can get trapped inside the pump. These germs can be difficult to get rid of and can be potentially hazardous to your baby's health, even with thorough and repeated sterilization and cleaning. There are some hospital-grade pumps which are meant for multiple users, each with their own accessory kit.

How can I make pumping easier?

As with nursing, it's important to be comfortable when pumping (which doesn't always seem possible while you're attached to a machine). It can be hard, especially at first, for your body (and your mind!) to become accustomed to producing milk without your baby's help.

Often, women's milk will "let-down" (or start to be released) when they see or hear their babies cry. So, when faced with an object instead of the welcoming face of your little one, you may find it hard to pump.

If you're having trouble with let-down, you may find it helpful to hold something that reminds you of your baby — a picture, a blanket, a favorite toy. Your let-down also can be affected if you're frustrated, embarrassed, or rushed. Try relaxing in a comfortable chair or couch and don't stress out too much about producing enough milk.

If your breast just doesn't seem to fit the pump correctly, the pump may come with different sized breast shields or you can buy a smaller or larger breast shield to place over your breast.

If you're pumping at work, try to find a discreet and comfortable place to do it. Many companies offer their employees pumping and nursing areas. If yours doesn't, ask fellow employees or the human resources department about an office or other private area that might be unused. If you have to pump in a bathroom, find a large one with a comfortable chair and some type of privacy barrier.

If your employer doesn't provide an adequate nursing or pumping area, ask that they do, reminding them of the benefits of breastfeeding.

Also, just like when you're nursing, it's important to place the breast shield of the pump correctly over your breast, covering your nipple and areola (not just the tip of your nipple), and getting a good seal. If you place the pump incorrectly, may be uncomfortable and you'll be much less likely to get the milk you need. And if you're using an electric breast pump, make sure to adjust the speed and suction to the level that's comfortable for you so as not to cause unnecessary discomfort.

Retrieved March 13, 2010 from http://kidshealth.org/parent/growth/feeding/breastfeed_pump.html#

By Fong Khai Yan, T2

Kids now getting 'adult' disease




After they’re diagnosed and for the rest of their lives, type 1 diabetics need to regularly test their blood sugar levels with a pinching tool that draws a little blood. They also have to give themselves shots of insulin several times a day to control blood sugar levels.

EvgenyB/iStockphoto

When she was 9 years old, Ann Albright went to the doctor with odd flulike symptoms. She was exhausted. She had to go to the bathroom frequently in the middle of the night. She was always thirsty. Even her vision was blurry.

After a few tests, the doctor pulled Albright’s mother aside.

“I still remember it very vividly,” says Ann Albright, now more than 40 years later. “My mom left the room with the doctor and came back in with tears running down her cheeks.”

The verdict: diabetes, a disease that affects the way people process food.

At the time, the 1960s, the diagnosis meant that young Ann would never have the carefree childhood her mother wanted for her. For the rest of her life, she would have to give herself shots several times a day. She would need to be very careful about what she ate. And she might not realize all of her dreams in life.

“In the era I was diagnosed, most people were told they’d have a shorter life span,” Albright says. “As a little girl with diabetes moving into adulthood, I wondered would I be able to have kids? Would I be able to have a life?”

Science has come a long way since then, says Albright, partly as a result of her own efforts: She’s now a doctor and diabetes researcher at the Centers for Disease Control and Prevention in Atlanta. Since her diagnosis, researchers have developed better technologies, more effective medicines and a sharper understanding of how diabetes works.

Despite the advances, though, scientists still can’t answer a lot of basic questions about what causes diabetes. There still is no cure. And living with the disease remains difficult.

“Everything changes” after a diabetes diagnosis, says Ali Reed, a pediatric endocrine fellow at the University of California, San Francisco. “Life becomes more complicated.”

What’s more, diabetes is on the rise — in both adults and kids. One version of the disease, called type 2 diabetes, is increasing at an especially alarming rate.

Scientists have linked type 2 diabetes with obesity. So now, more than ever, doctors are urging young people to start developing healthy habits as early as possible.

Breakdown

Diabetes refers to a group of diseases, but there are two main kinds: type 1 and type 2. In both types, the trouble begins with the body’s ability to deal with sugar.

Sugar is the body’s main fuel source. When you eat, your digestive system breaks down your food into basic parts, including proteins, fats and a simple sugar called glucose. Glucose gets absorbed through the intestines. From there, it enters the bloodstream. Circulating blood delivers glucose to all the cells, which convert it into energy.

At least, that’s what’s supposed to happen. In people with diabetes, however, sugar can’t get from the bloodstream into the cells. A hormone, or messenger molecule, called insulin is normally responsible for that transfer. But in diabetics, insulin doesn’t do its job.

As a result, sugar builds up in the bloodstream. When levels of sugar in the blood stay high, the condition is called chronic. And for reasons scientists don’t yet understand, chronically high blood sugar can lead to blindness, kidney damage, limb amputations, heart attacks and more.

“It’s not a death sentence, but it’s a very serious disease,” Albright says.

Two types

Exactly how diabetes affects a patient’s life depends in part on which type of diabetes a person has. There are important differences between the two main types.

Type 1 diabetes is the kind Albright has. In this version of the disease, the body stops producing insulin. Symptoms usually begin in kids or teenagers.

After they’re diagnosed and for the rest of their lives, type 1 diabetics need to regularly test their blood sugar levels with a pinching tool that draws a little blood. They also have to give themselves shots of insulin several times a day to control blood sugar levels. So far, scientists don’t know how to prevent type 1 diabetes.

Type 2 diabetics make insulin, but their bodies don’t use the hormone properly. Type 2 diabetes is far more common than type 1, and most people who have type 2 are adults. These days, though, more and more kids are coming to their doctors with symptoms of type 2 diabetes.


Doctors already know that adults who develop type 2 diabetes tend to be overweight or obese. And as kids have become increasingly overweight, the disease has started appearing at younger and younger ages.

Shorrocks/iStockphoto

As recently as a decade ago, type 2 diabetes was called “adult-onset” because kids just didn’t get it.

“When this disease we used to only see in adults started happening in adolescents, it was just shocking to people,” Albright says. “Pediatricians just didn’t know what to do.”

Healthy living

Doctors already knew that adults who develop type 2 diabetes tend to be overweight or obese. (Scientists can’t yet explain why.) And as kids have become increasingly overweight, the disease has started appearing at younger and younger ages.

In the United States, two out of three adults are now overweight, according to the CDC. Nineteen percent of kids between the ages of 6 and 11 are overweight, compared with 7 percent just 20 years ago. Over the same period, the proportion of overweight teens rose from 5 percent to 17 percent.

(You can find out whether you are overweight by plugging numbers into a calculator at an online site. Also, see the sidebar "Understanding Body Mass Index" at the bottom of this article.)

Like their type 1 peers, type 2 diabetics have to monitor blood sugar levels. But they often rely on drugs instead of insulin shots. Frequently, they can get the disease under control by simply exercising more and eating reasonable portions of healthy foods.

“We now know that we can prevent or postpone type 2 diabetes by having [adults] at very high risk lose 5 to 7 percent of their body weight,” Albright says.

Scientists don’t yet know whether the same is true for overweight kids. The trend is so new that CDC researchers are still working to gather basic information about how the disease works in young people.

But it can’t hurt to play soccer instead of video games, and to choose fruits and vegetables over junk food.

“There’s no harm in having healthier lifestyle habits,” Albright says. “Get to know what’s going into your body. Make it fun.”

Seeking answers

Weighing more than you should doesn’t mean you’re doomed to develop diabetes. The disease is far more complex than that. And while research has come a long way, plenty of questions remain.

Doctors don’t know, for example, why certain ethnic groups have particularly high rates of diabetes, including American Indians, Hispanics and African Americans. Nor can doctors say for sure why the chances of getting diabetes go up if your parents or siblings have it.

Both relationships suggest that genes play a role in setting people up for diabetes. But something in the environment has to push those genes into action, and scientists aren’t sure what those triggers are. It’s also not clear which genes are involved.

“People spend their whole careers trying to understand this stuff,” Albright says.

If you learn you have diabetes, don’t despair. There’s plenty you can do to live a long and healthy life. Also, know you’re not alone.

Reed encourages all newly diagnosed kids to go to one of the nation’s many diabetes camps. It can be hugely reassuring, she says, to be surrounded by other kids who feel like you do.

“It’s really amazing,” Reed says. “It’s a very supportive and tolerating environment for kids who are often the only ones at their school with diabetes. At diabetes camp, everyone is going through it together.”

Retrieved March 13, 2010 from http://www.sciencenewsforkids.org/articles/20090422/Feature1.asp

By Fong KhaiYan T2

Our generation is better language wise?

This statement that Mr. Tan made during class that our generation has better language than the generations before made me think, is that really true?

Somehow when I compare my language with my aunts and my dad, I have better English compared to my aunt and uncles that were Chinese educated (Phor Tay and Chung Ling) but compared to my aunts that were went to school in those with British education systems last time (St. Georges Girls School in Penang), I don't think mine is better. Even if I compare my mandarin with the previous generation, it is still worse.

The way I see it, a number of factors influenced our use of language. One of it is because our generation uses smses and Internet messaging, which causes our language to deteriorate as we cut the words into short forms (you to u, together to 2gether, etc) and use simple words. When we get used to doing so, we also tend to do it while doing tests, and maybe in our assignments, where we might absentmindedly write u instead of you.

Another factor is because our generation spend much less time actually reading books, be it textbooks, story books or even the newspaper. It's sad really, nobody reads books much now, they all want to watch the movie instead or watch drama shows on the TV, or stay glued to the computer. I believe that children should be encouraged to read from an early age, or even before they can read themselves the parents should read them stories, which will get them interested in books. Then the pathways between the neurons at the left hemisphere that has to do with language will be more developed.

Another contributing factor is in my opinion, the environment, or more specifically the type of language that the people around you, such as your family, peers etc, speak. When your family speaks mandarin always to you, obviously your mandarin will be better. Personally I speak English and Hokkien at home since young, which is why I am pretty fluent in both. Mandarin on the other hand, I avoid like the plague, but using it is sometimes unavoidable, especially in UTAR. Also, there's also Manglish that we Malaysians use so much.

Practice makes perfect, or in the words of Mr. Tan, "Use it or lose it." Language can always be improved by constant use and reading. It may be slow, but for sure it will improve bit by bit.

So I shall end this with a question directed to all those reading : Do you agree that your language is better than the older generation? Just compare yourself to the people in your family and so on. Maybe you can explain your perspective on this. So that we can make this blog more lively :D

Tuesday, March 9, 2010

Why Kids Get Bullied and Rejected

Kids who get bullied and snubbed by peers may be more likely to have problems in other parts of their lives, past studies have shown. And now researchers have found at least three factors in a child's behavior that can lead to social rejection.

The factors involve a child's inability to pick up on and respond to nonverbal cues from their pals.

In the United States, 10 to 13 percent of school-age kids experience some form of rejection by their peers. In addition to causing mental health problems, bullying and social isolation can increase the likelihood a child will get poor grades, drop out of school, or develop substance abuse problems, the researchers say.

"It really is an under-addressed public health issue," said lead researcher Clark McKown of the Rush Neurobehavioral Center in Chicago. And the social skills children gain on the playground or elsewhere could show up later in life, according to Richard Lavoie, an expert in child social behavior who was not involved with the study. Unstructured playtime - that is, when children interact without the guidance of an authority figure - is when children experiment with the relationship styles they will have as adults, he said.

Underlying all of this: "The number one need of any human is to be liked by other humans," Lavoie told LiveScience. "But our kids are like strangers in their own land." They don't understand the basic rules of operating in society and their mistakes are usually unintentional, he said.

Social rejection
In two studies, McKown and colleagues had a total of 284 children, ages 4 to 16 years old, watch movie clips and look at photos before judging the emotions of the actors based on their facial expressions, tones of voice and body postures. Various social situations were also described and the children were questioned about appropriate responses.

The results were then compared to parent/teacher accounts of the participants' friendships and social behavior. Kids who had social problems also had problems in at least one of three different areas of nonverbal communication: reading nonverbal cues; understanding their social meaning; and coming up with options for resolving a social conflict.

A child, for example, simply may not notice a person's scowl of impatience or understand what a tapped foot means. Or she may have trouble reconciling the desires of a friend with her own. "It is important to try to pinpoint the area or areas in a child's deficits and then build those up," McKown explained.

Ways to help
When children have prolonged struggles with socializing, "a vicious cycle begins," Lavoie said. Shunned children have few opportunities to practice social skills, while popular kids are busy perfecting theirs. However, having just one or two friends can be enough to give a child the social practice he or she needs, he said.

Parents, teachers and other adults in a child's life can help, too. Instead of reacting with anger or embarrassment to a child who, say, asks Aunt Mindy if her new hairdo was a mistake, parents should teach social skills with the same tone they use for teaching long division or proper hygiene. If presented as a learning opportunity, rather than a punishment, children usually appreciate the lesson.

"Most kids are so desperate to have friends, they just jump on board," Lavoie said.
To teach social skills, Lavoie advises a five-step approach in his book "It's So Much Work to Be Your Friend: Helping the Child with Learning Disabilities Find Social Success" (Touchstone, 2006). The process works for children with or without learning disabilities and is best conducted immediately after a transgression has been made.

1) Ask the child what happened and listen without judgment.
2) Ask the child to identify their mistake. (Often children only know that someone got upset, but don't understand their own role in the outcome.)
3) Help the child identify the cue they missed or mistake they made, by asking something like: "How would you feel if Emma was hogging the tire swing?" Instead of lecturing with the word "should," offer options the child "could" have taken in the moment, such as: "You could have asked Emma to join you or told her you would give her the swing after your turn."
4) Create an imaginary but similar scenario where the child can make the right choice. For example, you could say, "If you were playing with a shovel in the sand box and Aiden wanted to use it, what would you do?"
5) Lastly, give the child "social homework" by asking him to practice this new skill, saying: "Now that you know the importance of sharing, I want to hear about something you share tomorrow."

The studies are detailed in the current issue of the Journal of Clinical Child and Adolescent Psychology. They were funded by the Dean and Rosemarie Buntrock Foundation and the William T. Grant Foundation.

http://news.yahoo.com/s/livescience/20100202/sc_livescience/studiesrevealwhykidsgetbulliedandrejected

Dads Blessings

A young man was getting ready to graduate from college. For many months he had admired a beautiful sports car in a dealer's showroom, and knowing his father could well afford it, he told him that was all he wanted.

As Graduation Day approached, the young man awaited signs that his father had purchased the car. Finally, on the morning of his graduation, his father called him into his private study. His father told him how proud he was to have such a fine son, and told him how much he loved him. He handed his son a beautifully wrapped gift box. Curious, but somewhat disappointed, the young man opened the box and found a lovely, leather-bound Bible, with the young man's name embossed in gold. Angry, he raised his voice to his father and said "With all your money, you give me a Bible?" and stormed out of the house, leaving the Bible.

Many years passed and the young man was very successful in business. He had a beautiful home and wonderful family, but realized his father was very old, and thought perhaps he should go to him. He had not seen him since that graduation day. Before he could make arrangements, he received a telegram telling him his father had passed away, and willed all of his possessions to his son. He needed to come home immediately and take care of things.

When he arrived at his father's house, sudden sadness and regret filled his heart. He began to search through his father's important papers and saw the still new Bible, just as he had left it years ago. With tears, he opened the Bible and began to turn the pages. And as he did, a car key dropped from the back of the Bible. It had a tag with the dealer's name, the same dealer who had the sports car he had desired. On the tag was the date of his graduation, and the words PAID IN FULL.

How many times do we miss Spirit's blessings and answers to our prayers because they do not arrive exactly as we have expected?

TODAY'S's affirmation: "Today I look beyond the obvious and allow miracles to be created in my life."

Sunday, March 7, 2010

Fetal Development
From conception to birth


Illustration by R.K. O'Bannon
Day 1: fertilization: all human chromosomes are present; unique human life begins.
Click photo to enlarge.

Day 6: embryo begins implantation in the uterus.

Day 22: heart begins to beat with the child's own blood, often a different type than the mothers'.

Week 3: By the end of third week the child's backbone spinal column and nervous system are forming. The liver, kidneys and intestines begin to take shape.

Week 4: By the end of week four the child is ten thousand times larger than the fertilized egg.

Week 5: Eyes, legs, and hands begin to develop.

Week 6: Brain waves are detectable; mouth and lips are present; fingernails are forming.

Week 7: Eyelids, and toes form, nose distinct. The baby is kicking and swimming.

Week 8: Every organ is in place, bones begin to replace cartilage, and fingerprints begin to form. By the 8th week the baby can begin to hear.


Click photo to enlarge

Weeks 9 and 10: Teeth begin to form, fingernails develop. The baby can turn his head, and frown. The baby can hiccup.

Weeks 10 and 11: The baby can "breathe" amniotic fluid and urinate. Week 11 the baby can grasp objects placed in its hand; all organ systems are functioning. The baby has a skeletal structure, nerves, and circulation.




Week 12: The baby has all of the parts necessary to experience pain, including nerves, spinal cord, and thalamus. Vocal cords are complete. The baby can suck its thumb.

Week 14: At this age, the heart pumps several quarts of blood through the body every day.

Week 15: The baby has an adult's taste buds.

Month 4: Bone Marrow is now beginning to form. The heart is pumping 25 quarts of blood a day. By the end of month 4 the baby will be 8-10 inches in length and will weigh up to half a pound.

Week 17: The baby can have dream (REM) sleep.

Week 19: Babies can routinely be saved at 21 to 22 weeks after fertilization, and sometimes they can be saved even younger.



Click photo to enlarge

Week 20: The earliest stage at which Partial birth abortions are performed. At 20 weeks the baby recognizes its' mothers voice.


Click photo to enlarge

Months 5 and 6: The baby practices breathing by inhaling amniotic fluid into its developing lungs. The baby will grasp at the umbilical cord when it feels it. Most mothers feel an increase in movement, kicking, and hiccups from the baby. Oil and sweat glands are now functioning. The baby is now twelve inches long or more, and weighs up to one and a half pounds.

Months 7 through 9: Eyeteeth are present. The baby opens and closes his eyes. The baby is using four of the five senses (vision, hearing, taste, and touch.) He knows the difference between waking and sleeping, and can relate to the moods of the mother. The baby's skin begins to thicken, and a layer of fat is produced and stored beneath the skin. Antibodies are built up, and the baby's heart begins to pump 300 gallons of blood per day. Approximately one week before the birth the baby stops growing, and "drops" usually head down into the pelvic cavity.


Intelligence: More Nature Than Nurture?

ScienceDaily (Oct. 17, 2007) — While showing an impressive growth prenatally, the human brain is not completed at birth. There is considerable brain growth during childhood with dynamic changes taking place in the human brain throughout life, probably for adaptation to our environments.


Evidence is accumulating that brain structure is under considerable genetic influence [Peper et al., 2007]. Puberty, the transitional phase from childhood into adulthood, involves changes in brain morphology that may be essential to optimal adult functioning. Around the onset of puberty gray matter volume starts to decrease, while white matter volume is still increasing [Giedd et al., 1999].

Recent findings have shown, that variation in total gray and white matter volume of the adult human brain is primarily (70--90%) genetically determined [Baare et al, 2001] and in a recent magnetic resonance imaging (MRI) brain study with 45 monozygotic and 61 dizygotic 9-year-old twin-pairs, and their 87 full siblings also high heritabilities have been found [Peper et al, in preparation]. Thus, while environmental influences may play a role in later stages during puberty, around the onset of puberty brain volumes are already highly heritable.

Hilleke Hulshoff Pol presents persuasive evidence how genetic factors influence the brain structure opening new insights into the reciprocal gene-environment developmental pathways.

Genetic influences

Twin studies have also shown that genetic effects vary regionally within the brain, with high heritabilities of frontal lobe volumes (90--95%), moderate estimates in the hippocampus (40--69%), and environmental factors influencing several medial brain areas.

However, the mechanisms by which interaction between genes and environment occur throughout life as well as dynamics of brain structure and its association with brain functioning still remain unknown. Twin and family studies and newly evolving genetic approaches start to give us a glimpse as to which genes and (interacting) environmental influences are shaping our brains.

Brain structure -- measured macroscopically using MRI -- and the dynamic changes therein, have a functional relevance.

Studies revealed that total brain volume is positively correlated with general intelligence. In healthy subjects, the level of intellectual functioning has been positively associated with whole brain, gray, and white matter volumes [Thompson et al, 2001; Posthuma et al, 2002]. More focally, several brain areas were found to be correlated with intelligence. Interestingly, it was also shown that the trajectory changes in cortical thickness throughout adolescence are associated with the level of intelligence.

Furthermore, a common set of genes may also cause the association between brain structure and cognitive functions. However, in elderly twins, the associations between frontotemporal brain volumes and executive function were found to be because of common environmental influences shared by twins from the same family [Carmelli et al., 2002].

These results point to the possibility that overlapping sets of genes or common environmental influences cause variation in two distinct phenotypes. It might be, for example, that a higher level of cognitive functioning leads a person to select an environment that also increases brain size. The genetic influence on brain size then simply reflects the genetic influences on cognition. Thus, the specific mechanism, pathways, and genes that are involved in human brain morphology and its association with cognitive functions remain elusive.

Although genetic effects on morphology of specific gray matter areas in the brain have been studied, the heritability of focal white matter was unknown until recently. Similarly, it was unresolved whether there is a common genetic origin of focal gray matter and white matter structures with intelligence. In our study involving 54 monozygotic and 58 dizygotic twin pairs and their 34 singleton siblings, verbal, and performal intelligence were found to share a common genetic origin with an anatomical neural network involving the frontal, occipital, and parahippocampal gray matter and connecting white matter of the superior occipitofrontal fascicle, and the corpus callosum [Hulshoff Pol et al., 2006].

For the genetic analyses, structural equation modeling and voxel-based morphometry were used. To explore the common genetic origin of focal gray matter and white matter areas with intelligence, cross-trait/cross-twin correlations were obtained in which the focal gray matter and white matter densities of each twin are correlated with the psychometric intelligence quotient of his/her cotwin.

The results of this study indicate that genes significantly influence white matter density of the superior occipitofrontal fascicle, corpus callosum, optic radiation, and corticospinal tract, as well as gray matter density of the medial frontal, superior frontal, superior temporal, occipital, postcentral, posterior cingulate, and parahippocampal cortices. Moreover, the results show that intelligence shares a common genetic origin with superior occipitofrontal, callosal, and left optical radiation white matter and frontal, occipital, and parahippocampal gray matter (phenotypic correlations up to 0.35).

These findings point to a neural network that shares a common genetic origin with human intelligence. Thus, it seems that the individual variation in morphology of areas involved in attention, language, visual, and emotional processing, as well as in sensorimotor processing are strongly genetically influenced.

In addition, unique environmental factors influenced vast gray matter and white matter areas surrounding the lateral ventricles (up to 0.50). This finding coincides with the significant environmental influences on lateral ventricle volume [common (0.58) and unique (0.42) with no significant contributions of genes] that was reported previously in this twin sample [Baaré et al., 2001].

Clinical implications

Considering the high heritabilities for global brain volumes and particular focal brain densities and thicknesses, the search for genes that are involved in brain growth, aging, and brain structure maintenance is important. Such knowledge can help us understand normal developmental and age-associated changes in individual variation in brain functioning.

Moreover, it enhances our knowledge of individual variation in brain functioning and facilitates the interpretation of the morphological changes found in psychiatric disorders such as schizophrenia [van Haren et al., 2007]. Also, it allows future efforts to find particular genes responsible for brain structures to be concentrated in areas that are under considerable genetic influence [Hulshoff Pol et al., 2006].

A genetic approach to find genes involved in brain structure that has been applied in several studies is that of diseases with a clear genetic etiology such as Huntington's disease, Down syndrome, Williams syndrome, and Velocardiofacial syndrome. A review reveals for these diseases besides disease specific brain changes, decreases in total brain, white matter, and hippocampus volumes, irrespective of the genes and/or chromosomes involved. This suggests that many genes are probably involved in the individual variation of these measures [Peper et al., in press].

It is important to investigate which environmental factors have an influence on the expression of genes (as found in DNA-methylation). Additionally, the study of interaction between genes and environmental factors is warranted. Furthermore, the simultaneous effects of multiple genes and possibly the interaction among genes, also needs investigation as the high heritability of a complex quantitative phenotype such as brain volume cannot be explained by a single-gene polymorphism.

Conclusion

MRI studies in twins indicate that, given the basic additive genetic model, overall brain volume in adulthood is highly heritable.

To test for influences of genetic, common, and unique environmental factors or interactions between genetic and environmental influences. twin studies carried out in large and more homogenous samples, analyzed with advanced quantitative genetic methods are needed.

To investigate the stability of genetic and environmental influences onto functional neural networks in human brain longitudinal twin studies in childhood as well as in adulthood are needed since brain volume changes dynamically throughout life.

New brain-imaging methods, such as DTI-fiber tracking and resting state functional MRI, allow to study the heritability of neural networks underlying brain functioning.

These new methods, in coherence with new genetic approaches, will enable us to further disentangle which genes and environmental factors and interactions therein influence human brain structure throughout life.

Expression of baby having sour food



By Margaret Lim, T2

Quadruplet infecting each other with laughing virus



By Margaret Lim, T2