Moving Abroad and Living in Costa Rica With a New Baby

The fun really begins once you have had a baby abroad.

Suddenly, you may not only be a first time parent, but far away from home and family with a newborn to look after. Here are some of the issues unique to parents of expat babies which will crop up.

How to Find a Good Pediatrician

This will usually have been done before the baby is born in consultation with your obstetrician and other expatriates. If possible, do try to arrange to meet your new pediatrician before the baby arrives so that he/she can be the one called in when the baby is born to administer the initial tests. The medical standards of your pediatrician will naturally depend on where you are posted.

If you are hoping to breast feed (a subject covered in a moment) do find out in advance if your pediatrician will be supportive. That is very important. I personally chose not to breast feed either of my children, but reports from women who did confirm that support is critical from your medical advisors. Attitudes towards breast feeding will vary depending on the culture, so be sure to find out how it is viewed in the one you’re living in.

In many developing countries, pediatrics is not considered primary care which means that pediatricians are likely part of the hospital staff. Your subsequent visits will be at the hospital rather than a private surgery or office such as you may have done at home. Many pediatricians are women, Western-trained, and extremely efficient.

They may also not easily suffer Western women who tend to over-react or come by with the baby on too many visits, many of which really don’t require the services of a doctor. My daughter Lilly suffered from diarrhea so much in her first year in Bangkok, despite our best safeguards, that I felt like a soiled diaper service delivery person to the hospital. It was not pleasant. If my doctor didn’t like to see me so much, I’m afraid it was her tough luck.

Don’t Worry About Worrying

New mothers should expect to be over-cautious because you are, after all, a new mother. But your natural neuroses may be heightened when living abroad because in some countries, you simply don’t know what might develop. Better to err on the side of the overzealous and let your husband make fun of you. Of course once you have had a second or third child you realize how foolish you might have been with your first, but everyone must live and learn.

More serious situations are when babies run especially high fevers out of nowhere or start exhibiting signs that may not be normal for their development. Some of these developmental signs include: failure to thrive, allergic reactions to formulas and lactose intolerance, failure to meet developmental milestones such as being able to lift the head, turn over, sit up etc. But while you worry about such things, always remember that there will be wide variations in development: some babies will walk at eight months, some at 18 months. A baby is going to do stuff when he/she is good and ready and not a moment sooner.

Registering Your Baby

The hospital and your own Embassy or consulate can assist you in the paperwork associated with your newborn. You may wish to begin the process of securing a passport for your baby soon after the birth. Always give your child his/her own passport. Avoid future bureaucratic hassles at airport departure gates by not listing your children on the mother’s passport. Be sure they have their own. Also, do not assume that your baby automatically assumes the citizenship of the country of birth.

Early Nutrition To Breast Feed or Not?

This will be the first and most important nutritional question. This is an individual decision, but if you are living in a developing country you will likely be encouraged to consider the breast feeding option if only because it provides the baby with immunities not provided by bottles.

Having said that, however, I can’t stress enough that this is once again an individual decision and mothers who can’t breast feed because their milk supply isn’t high enough, or any other number of personal reasons should not feel like their child is somehow missing out. An entire generation of adults were raised on bottles and most of us turned out all right.

If you do decide to breast feed, though, there will be many advantages, not the least of which is the hygiene factor: there will be no worries about sterilization of bottles. Also, if you plan to be flying a lot with the new baby, a breast offered on take-off is a sure-fire way to keep the baby quiet.

Introduction of early solid foods may be problematic for those living in countries where strained baby foods and cereals may not be available. You may have to import some of the foods. On the other hand, when I had my daughter Lilly in Bangkok, it was amazing what could be made in a blender from the vast array of fresh fruits and vegetables.

In regard to adding foods to your baby’s diet (which are typically introduced any time after three months): remember to be sure to introduce one food at a time to determine if there are going to be any allergic reactions.

Immunizations and Vaccines

It is best to maintain the immunization schedule from your own country or the one to which you will return. An immunization book should be started immediately to keep records. Have a look on the internet at your own government’s health department to find out what is required.

For the most part, your local doctor will typically stick to the standard vaccinations such as the DPT plus Polio given at 2,4 and 6 months with a booster given again at 18 months. MMR (Measles, mumps and rubella) is commonly given between 12 and 15 months. In countries where the population suffers from TB, babies will be given a BCG at birth. This is quite acceptable in countries where the risk of TB is high but can cause problems later when the child is tested for TB at home (in which case the test may turn positive).

In countries where there is a risk of hepatitis B, a vaccine can be given at birth followed by two booster dosages. Please ensure that the Hepatitis B vaccine is of the new genetic formulation (and not made from serum). Generally speaking in the matter of vaccines, where possible, do try to secure the vaccines from your home country or use those produced by reputable international pharmaceutical companies.

It should go without saying to make sure that disposal syringes and needles are used and that you personally see them come out of a sealed package. Even as I write, new vaccines are being developed which will be added to the list of recommended immunization schedules over time. Use the internet to stay current.

Neo-Natal Care

Most newborns will be seen by a family doctor or pediatrician two weeks to one month after the birth. Follow up appointments will be made for 2,4 and 6 months. As mentioned earlier, be sure to follow an approved immunization schedule. Obviously, during those early days, emergencies will come up, like fever, diarrhea and ear and throat infections.

My own daughter seemed to live on antibiotics during her first year of life, which only in retrospect I can see was probably not terribly helpful but at the time, seemed the proper course of action to take. Low grade fevers can be treated with tepid baths and tylenol; diarrhea, if it persists, should be checked out by a doctor, especially if you are breastfeeding as diarrhea is not as common from mother’s milk.

Circumcision

This is not a very common procedure in many developing countries. If it is required for religious reasons or desired by the family, be sure it is done by a urologist or pediatrician accustomed to carrying out this procedure.

Issues for the New Mother

The new mother often gets lost in the excitement of the new baby. Remember that you can only look after your new baby when you yourself are feeling well. Be sure to give yourself ample time for recovery, either in hospital or at home. However, having said that, there will be the typical post-partum issues which once again, could become magnified in an overseas setting.

Post-Partum Depression

Many women experience some form of post-partum blues. Some feel it while still in hospital, others when they return home with the baby. While a woman’s hormones readjust, mood swings will be a natural occurrence. Overseas, without a mother, friends or family around to comfort you, the depression and feelings of isolation may be worse.

Both fathers and mother should be on the lookout for signs of depression and when it seems to be getting too far out of hand, consult your doctor. Counseling of some form may be required.

Finding Support

In the absence of a community of trained psychologists, the next best thing is a support group. I know from my experience in Bangkok, that without the support of a mother’s group formed there I would have wanted to bury myself away somewhere.

International women got together and formed an organization called the Bangkok Association of Mothers and Babies International (BAMBI) which is still going strong. If such an organization doesn’t exist where you are living, I suggest you try starting one.

The BAMBI model is a good one: monthly meetings brought the entire membership together with their babies to exchange news and lessen feelings of isolation; a newsletter was printed monthly; playgroups were formed for each age group; a breast feeding “hot line” was set up to support breast-feeding mothers; there was even the occasional night time event where fathers could meet each other.

I cannot say enough good things about an organization like BAMBI and will only add that most women who joined claimed never to have belonged to a woman’s group in their life….until baby arrived.

Caregivers

When I was involved with producing the newsletter for BAMBI in Bangkok, one of the articles I wrote which got a tremendous response at the time was a self-help article entitled: “How Not To Let Your Maid Control You and Your Baby”. Laugh if you will, but I had women coming up to me at subsequent meetings telling me their own experiences.

Not everyone will be fortunate enough to have full time caregivers as part of their expatriate experience, but those who do will know exactly what I am talking about. In their enthusiasm over a new born baby (especially a boy in some cultures) you may find yourself with a caregiver giving too much care, to the exclusion of the mother and her feelings about how she wants her child looked after. Remember that you are the mother!

More important, any caregiver should be given a clean bill of health. Anybody handling the new baby for that matter should be medically cleared and trained to your own levels of domestic hygiene.

One Last Word About Babies Abroad

Allow to me add one final footnote about the experience of having babies abroad: remember that a baby never saved a bad marriage. If anything, it can add greater stress to a marriage which may be about to burst due to the stress of the overseas assignment.

Taking into account everything I have written about this subject (despite any cheekiness on my part), I will only say again that having a baby is a serious matter anywhere in the world. Just because the scenery is different from what you are used to, the experience of being a parent (and especially if you intend to stay overseas long-term) is not a decision to be taken lightly.

Robin Pascoe is the author of four books on global living and publishes the popular web site www.expatexpert.com

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Andrew Makarik

to@welovecostarica.com

Andrew Makarik is the main editor of WeLoveCostaRica, a fan of this sunny country. He is also a loving husband and a has a lovely daughter. By being a devoted family man and the biggest Costa Rica fan, he wants to make more people feel at home there. WeLoveCostaRica unites people and helps them find new home or a new travel destination. This website is a friendly community where everyone can find not only information, but also new friends and travel pals. Andrew is also passionate about IT and programming, so he himself maintains a friendly atmosphere in this cozy environment of WeLoveCostaRica.com.