Category Archives: Feeding

Diaper Surprise! 12 Freaky Things to See in Baby’s Diaper during the first year

Breastfeeding, Feeding, Infant Health & Safety, New Moms, solids

Changing your baby’s diaper may feel a bit like unwrapping a surprise gift or delicately defusing a small package bomb. You’re never quite sure what’s inside until its too late, and the contents may shock you, amuse you, or make you run for Dr.Google.

Don’t underestimate the fascination you may have with your baby’s diaper contents. Embrace this stereotypical new parent obsession, though do try to limit detailed diaper discussions to other new parents, and those who feign polite interest without turning white or audibly gagging.

Surprise! Here are 12 freaky things you might find in your baby’s diaper during the first year:

Day 3: Brick dust (uric acid crystals) – a rust or pinkish colored residue staining the front of the diaper. This resolves as baby’s urine becomes more dilute.

Week 2: Gel crystals. These look like oversized grains of sugar stuck to your baby’s genitals. Don’t panic – they’re not coming from your baby! Instead, they’re from the absorbent lining escaping from tiny tears in a disposable diaper.

Week 6: Green spinachy-looking poop. Like the occasional random projectile vomit, these bizarre baby things sometimes happen, possibly on days when baby is nursing more than usual. Unless it’s frequent, frothy, with mucus and blood, don’t worry about occasional green poop in the diaper.

Month 3: Nothing. No poop. Nada. Perhaps several days or even a week may go by with nary a stool. Perfectly normal for breastfed babies, as long as baby is content and pee is plentiful. No need to intervene. What goes in will eventually come out (and usually at the least opportune time and in abundance), so be fully prepared for a poop explosion.

Month 4: Containment Failure or Blow Out. When baby is in a seated position (car seat, bouncer, baby carrier) there’s really only one place for poop to go, and that’s UP. Tell-tale sign of the Blow Out is a yellowish wet spot located at the small of the baby’s back. Usually involves a complete change of clothes, bath optional. For both of you.

Month 5: Mom’s hair (because it’s falling out everywhere). Tip: Time to get a short, sassy hair cut. Hint: Beware the Hair Tourniquet.

Month 6: Slimy mucus in poop when baby has a cold. Swallowed mucus isn’t absorbed by the GI tract and will pass through unchanged into the diaper with poop.

Month 8: Little black threads which look exactly like tiny worms. These are from baby eating fresh bananas (not jarred). They’re just like the little black strings you see in homemade banana bread. Mmm. Banana bread.

Month 9: Gas-mask worthy smells. The strongest odors yet are typically from introducing more protein foods. Whew. Just. Wow.

Month 10: Bits of paper are likely from the tag she was chewing in the store or cardboard from gnawing on the corner of a board book. Paper is one of the four basic food groups of mobile babies. Bonus points if you can still read a letter or word.

Month 11: Easily identifiable bits and pieces of food. Oh, there’s a blueberry! Hey, look, a lima bean! Tip: If you want to know how long it takes for food to make it through your baby’s digestive tract, feed baby some corn. My estimation is you’ll see it again in about 18 hours.

Month 12: Poop that looks (and smells) just like big-people poop. If it’s not too squashed, you can shake it into the toilet instead of sealing it up in the diaper. The more solid food your baby eats, the more their poop will start to look more “familiar”.

Bonus – 18 months: Brightly colored flakes – from that crayon you needed to pry out of your toddler’s mouth. Makes for some pretty poop, though!

Pumping at Work: Uneven Production

bottles, Breastfeeding, Feeding, New Moms, ,

I’m back at work and my baby is 14 weeks old. I have been pumping twice during my workday (9 AM and 1 PM) and I can pump about 10 to 12 ounces a day with these sessions.

My left breast is producing a lot more milk than my right, and might look a little larger. 

After 2 min of stimulation, milk starts to flow from my left breast. I don’t see any milk from right breast until about 5-8 min into pumping, and maybe collect two ounces by the time the session ends between 15 and 20 min. Suggestions? ( I’m using size 27 cups with Medela freestyle).

Congratulations on making the (hard, so hard!) transition back to work, and wow, expressing 10 – 12 ounces in two sessions is great. Good job, you!

Since you mention pumping at 9 AM and 1 PM, you might consider adding a “before leaving work” pumping session after you’re done for the day but before leaving. This might mean that you arrive home with 15 ounces instead of the 10 – 12, if that is important to you. You can pump at work and still breastfeed on arrival home or to childcare.

When pumping,  see if the 24mm flange might do better on the right breast, even if the 27mm does better on the left. If that is the case, it may stimulate more milk let down and removal over time. Try a dab of olive oil for lubrication and use my suggested pumping techniques (hands-on, massage and compression, repositioning angle of nipple several times, varying vacuum strength and cycling speed accordingly)

It’s normal to find a discrepancy between the two breasts – we are not mirror-image or symmetric people (we have one liver, one spleen, one heart) and each breast functions independently from the other. Between the two breasts, you should be able to make all the milk baby needs and then some, but you may not make an even amount from each.

Some women become aware that one breast makes a lot more milk than the other only once they begin doing a lot of pumping. Other moms can see physical differences in breast size (up to 1 – 2 bra cups sizes) and some moms or babies have a clear preference due to production (with oversupply or very heavy let down, baby may prefer the slower-producing other breast!).

How can you “even things out”?

When nursing your baby, you could try to start her on the right breast – babies are typically most vigorous at the beginning of the feeding session and this “enthusiasm” might help encourage the milk to flow and assist with production. Use lots of breast compression and massage to help things along.

Another perspective: if she is cranky when starting on the “slower” side because she’s used to a fast flow from the bottles and frustrated at having to work hard and wait for the milk when starting on the right side, then instead, you could try starting her on the left breast, and then switch her over to the right to nurse and linger longer. There’s no definitive answer, just try out some of these ideas and see if one helps more than the other.

Keep up the awesome hard work, Mama!

 

 

Help! Baby Won’t Take Bottle! and IBBM Method

bottles, Breastfeeding, Feeding, Infant Health & Safety, New Moms, ,

Hello,
Since you’re here, you’re probably pretty stressed. Sorry about that. I’m here to help with resources and support. I have a pretty good track record on this – which is why you’re here 😉
Hang in there.

Please READ:
Won’t Take a Bottle
Selecting Bottle Nipple
Bottle Feeding the Breastfeed Baby

Please WATCH:
Help, Won’t Take Bottle.

Please TRY IBBM 2x/day for 5 days.

Personalized Support – Home and Phone Consults

Introducing Solids: Traditional Methods and Alternatives

Infant Health & Safety, solids

Introducing Solid Foods, Part 2gerber

The “traditional” method of introducing solid foods has been around for decades: spoon feeding single-ingredient, pureed “baby foods” and gradually increasing variety and texture as baby becomes older.
As we discussed in part one, the “Traditional” method of introducing foods to infants in the US is actually unsupported and increasingly contradicted by research, and may be gradually falling out of favor. Even so, most pediatricians and baby books still recommend a slow and careful introduction of spoon-feeding specific pureed foods and avoiding others.

The “Feed Baby Almost Anything” Method
Several alternatives to the “traditional” method exist. One option is to continue to offer pureed or modified table foods but introduce a much wider variety of food types and flavors (including egg, fish, wheat and combination foods) sooner. Earlier exposure to these foods, rather than avoiding them, may actually help reduce the risk of allergy and celiac disease. Dairy foods and protein foods (pureed meat) are also offered much earlier than in the traditional method. Check with your pediatrician for specific advice.

Baby-Led Weaning (or, Baby Self-Feeding)
Another option rising in popularity is called “Baby-Led Weaning”. I’d prefer to call it “Baby Self-Feeding” because here in the US, “weaning” commonly refers to the reduction or stopping of breastfeeding. In Europe, where Baby-Led Weaning first became popular, “weaning” refers to the introduction of solid foods. This method is all about allowing a baby to explore food on her own terms and gradually learn to chew and swallow. Spoon-feeding purees are not used, and the saying “Food Before One is Just for Fun” narrates the attitude that the amount of food the baby eats may be minimal, and that’s ok. We’ll talk more about “finger foods” vs Baby-Led Weaning/Baby-Self Feeding in Part 3.

Traditional Method of Introducing Purees:
If using this method, it is common to first introduce a cereal, then an orange vegetable, a green vegetable, and then a fruit. Then, simply alternate remaining single-ingredient fruits and vegetables one by one, adding one new food every few days until all of the following have been introduced. This should take several weeks or a month. Remember, there’s no rush or reason to push. These foods aren’t particularly nutritious, are less caloric than your baby’s milk, and won’t help your baby sleep longer: in fact, feeding too close to bedtime can cause gas and digestive upset.

Cereals, Iron-Fortified: Oatmeal, barley cereal, brown rice cereal, mixed with breastmilk, formula (if already introduced) or water.
Vegetables: Carrots, sweet potatoes, winter squash, peas, green beans, beets.
Fruits: Applesauce, peaches, pears, apricots, plums/prunes, bananas, avocado.

Continue to offer cereal at each meal, along with the fruit and/or vegetable. Cereal is the bulk and the main calorie source of the “meal”. The vegetables and fruits are fairly low in calorie and high in water. Peas, bananas, avocado, sweet potato are about twice as caloric than green beans, carrots, winter squash, applesauce, peaches, pears.

Remember that your baby’s milk source is still their primary source of nutrition and is a complete food, and in fact is more caloric and nutritious than these “solid foods” you’re offering. 4 ounces of breastmilk contains about 100 calories and the perfect mix of fats, proteins, vitamins and minerals for your baby to grow. 4 ounces of applesauce or pureed carrots contains less than half the calories of breastmilk or formula, and only trace nutrients.

Try to avoid any tension or struggling over feedings and do not push to finish the portion or play the “just one more bite” game. You have far too many years of feeding your child ahead of you to create struggles over food!

Dairy foods are traditionally offered starting around 7 months (unless there are special concerns about cow’s milk protein sensitivity – check with your pediatrician). Start with whole-milk (full fat) plain yogurts. You may feed it plain or stir in some pureed fruit.

Protein foods are usually introduced next, around 7 to 8 months- pureed chicken, turkey, beef, tofu, egg, small amounts of low-mercury fish like scrod and salmon. Check with your pediatrician for recommendations about giving whole egg vs. egg yolks, and if fish or shellfish should be given or avoided.

Purred meats are thick and pasty. Try adding a tablespoon of pureed chicken to applesauce and feed it alongside a vegetable or cereal.

Again, these suggestions follow the “traditional method” of introducing solid foods, and many experts feel they are outdated and unnecessary. However, they are still the most common recommendations given by pediatricians and baby care books, and many parents feel most comfortable using this traditional method as a guide.

 

Next up: Making or Buying Baby Foods, Is Organic Important, Finger Foods and Baby Led Weaning

 

Biting and Breastfeeding

Breastfeeding, Feeding, Infant Health & Safety

Is your growing baby starting to bite at the breast?

Do your best to (a) be proactive and divert the bite from occurring, (b) If a bite occurs, remove baby from the breast safely using the smoosh-in/release method rather than instinctively pulling your baby away from the breast (which can cause damage, especially once there are has teeth). ( c) No biting/teething/gnawing on other people’s flesh. (fingers, nose, etc)

Biting is most common just before cutting a tooth, and so may come and go as a phase. Babies tend to be most likely to bite toward the end of a feeding so if you know your baby is in a nippy phase, you can be proactive and end the feed yourself when baby slows down, is on and off or mostly “playing around” toward the end.

When nursing, keep your hand close behind baby’s head/neck/shoulders (such as cross cradle position) so that if baby does bite down, you can use your hand to quickly “Smoosh” his face directly right into the breast – because this covers his nose and he can’t breath, he’ll immediately open his mouth, then you can take him off the breast safely without more pain or damage, and calmly but firmly say “No biting”. Do not yell or act angry (or playful). Sometimes it’s hard not to yelp (once child has top and bottom teeth) but you can frighten an older baby into a nursing strike. For a young baby, you can try re-latching or switching sides. For an older baby or toddler, after another bite at the same session, you may consider saying “no bite!” and ending the feeding. (Can try again in a little while).

Starting around 5-6 months (or just before teeth erupt),  don’t let him “chew” on your fingers (or chin or nose) any more. No biting anyone else’s flesh (he doesn’t understand why it’s ok to teethe on your fingers but not your nipple), or, why it’s ok for him to chew on your fingers before he has teeth, but not after…

Biting is an unpleasant phase but like most stages, this too shall pass.

Wean Me Gently poem

Breastfeeding, Feeding, New Moms

Wean Me Gently

I know I look so big to you,
Maybe I seem too big for the needs I have.
But no matter how big we get,
We still have needs that are important to us.
I know that our relationship is growing and changing,
But I still need you. I need your warmth and closeness,
Especially at the end of the day
When we snuggle up in bed.
Please don’t get too busy for us to nurse.
I know you think I can be patient,
Or find something to take the place of a nursing;
A book, a glass of something,
But nothing can take your place when I need you.
Sometimes just cuddling with you,
Having you near me is enough.
I guess I am growing and becoming independent,
But please be there.
This bond we have is so strong and so important to me,
Please don’t break it abruptly.
Wean me gently,
Because I am your mother,
And my heart is tender.
Credited to Cathy Cardall
Always makes me weepy. How about you?

Introducing Solid Foods

Feeding, Infant Health & Safety, solids
"Give Peas a Chance"!
All we are saying, is “Give Peas a Chance”!

Rice cereal at four months or at six months?
Or, don’t start with cereal at all – instead, offer avocado or sweet potato to begin.
Don’t give egg whites, wheat or fish during first year, and only introduce one new food at a time. Offer pretty much anything, including traditional allergens, any time after 5 months.
Spoon feed purees. Don’t spoon feed purees, instead, let baby learn to feed herself. Don’t let baby feed herself, she’ll choke. 

When it comes to the topic of introducing solid foods, there are so many conflicting recommendations and opinions, even among the experts and research.

For the past 50 years, the common advice has been along the lines of “sometime between 4 to 6 months, introduce rice cereal (oatmeal if baby becomes constipated), then orange and green vegetables and pureed fruits, one at a time.” It’s possible that all of that is wrong, but on the other hand, going that route may not hurt, either. Yes, it’s clear as mud…

The American Academy of Pediatrics’ recommendation is for exclusive breastfeeding for the first six months of life, (iron-fortified infant formula if breastmilk is not available), with iron-fortified solid foods introduced gradually thereafter to complement the milk intake. This message has been the same for the past 15 years, and reaffirmed in a 2012 policy statement, yet, you will find many conflicting recommendations about when to begin solid foods, how to feed your baby, and what to foods to start with or avoid. Your pediatrician may give you suggestions that are very different from what your friend was told by her pediatrics practice. Some recent research questions the typical recommendations to introduce foods in specific orders and avoid common allergenic foods like egg whites and wheat. It’s possible that delaying the introduction of these foods could actually be causing more allergies, rather than fewer.

What introducing solid foods is all about: Socializing baby to the feeding experience, introducing new flavors, textures and oral motor skills.

What introducing solid foods isn’t really about: Packing in foods in hopes that he’ll sleep better.

Signs of readiness: Typically around 5-6 months, you’ll notice your baby watching, grabbing, and otherwise showing interest in your own meals and snacks, and she should be able to sit up with support. The best sign of readiness, however, is that once you do begin offering food, your baby gets the hang of it within a few “meals” or over the course of a week: quickly learning to open mouth for the spoon, seeming interested or eager, reaching for it, wanting more. If your baby seems to find it unpleasant and fusses, squirms away, gags or extrudes most of the food back out repeatedly, continue to offer, but don’t push or force your baby to put food in his mouth. If after three or four “meal” attempts, it is not going well and your baby is not enjoying the experience, shelve the food and try again several days or a week later. It’s okay to have a false start and then wait another week before “re-starting”.

Often a baby is happy just to have a bowl and spoon to play with, and to join you at the table in a highchair. Sometimes they want the “tools of the trade” but not necessarily the food just yet. There’s no rush: once your baby starts eating, he’ll be eating for the next 90 years. A few more weeks won’t make any difference.

How much should my baby eat? Some babies sample only a teaspoon or tablespoon of oatmeal or avocado at a meal, while others will eat an entire bowl of cereal and fruit and holler for more when it’s done. Follow their cues; don’t push them to eat more than they ask for. When she leans forward and continues to opens her mouth for the spoon, continue feeding. When her mouth is closed and she is turning away, she’s done. Try to avoid any tension or struggling over feedings and do not push to finish the portion or play the “just one more bite” game. You have way too many years of feeding your child ahead of you to create struggles over food already!

Give baby her own spoon to hold so she won’t grab at yours (she still will!). Let her suck the food off her hands or plastic spoon or teether. Learning to eat is a tactile, sensory (almost) play experience. Babies first learn to swallow by sucking, so it’s common for babies to put their fingers or a toy in their mouth along with the food, to help organize their swallowing and tongue movements as they employ the more familiar suck-swallow-breathe pattern.

Good first food options:

Whole grain cereals: Oatmeal, barley cereal, brown rice cereal, mixed with breastmilk, formula (if already introduced) or water. Avoid mixed grain cereals as a first food.

Vegetables: Carrots, sweet potatoes, orange squash, peas, green beans, beets.

Fruits: Applesauce, peaches, pears, apricots, plums/prunes, bananas, avocado.

Meats: Chicken, turkey, lamb, beef.

Iron rich foods can be served with Vitamin C (most yellow/orange fruits and vegetables) to enhance absorption. Meats, egg yolks, prunes, sweet potatoes, beans, peas, lentils, and iron-fortified rice, barley or oatmeal cereals are good sources of iron.

Note: Diaper rashes are commonly a reaction to change in pH balance of stool after introducing fruits and vegetables and don’t have to indicate an allergy. Treat with a generous layer of a thick zinc diaper cream, and switch to warm water and washcloths rather than diaper wipes if the skin is very sore or irritated. Facial rashes are commonly due to acidic fruits smeared on the face and frequent washing after meals – use a soft cloth to wash after meals, dry well with a soft cloth and apply a moisture barrier to treat red skin on cheeks and chin.

Interested in this topic? Watch my webinar on introducing and advancing solid foods.

Continue to Part Two of this “Feeding Your Baby” Series:
How and What to Feed Your Baby – Traditional methods and alternatives (jars, homemade purees, baby-led-weaning aka baby-self-feeding).

 

Tips for New Eaters: Finger Foods

Feeding, Infant Health & Safety, solids, Uncategorized, ,
"Bag Cheese" is a real winner here!
“Bag Cheese” is a real winner here!

Are you moving from spoon-feeding purees to starting to offer bits and pieces of food? Here are some tips that address common questions new parents may have during this transition.

1. Not so big. Bits of food for self-feeding should be about the size of your baby’s thumbnail, or smaller than a dime. Bits of toast, waffles, pancakes, French toast, grilled cheese sandwiches and muffin bits are usually well-received by babies and are easy foods for them to manage.

2. Nothing hard, sticky or chewy. Hard foods like raw carrots or apples can be sliced then steamed before offering. Raisins may be soaked in hot water to soften.

3. Avoid round foods and coin-shaped slices. Foods like grapes, steamed carrots, string cheese sticks, hot dogs  (a whole other can of worms) should be chopped small to reduce the risk of choking.

4. Teeth aren’t needed to chew. As long as the foods you offer are soft enough for you to to squish between your thumb and forefinger, your child should be able to chew them just fine with his gums even without molars.

5. Offer a preloaded fork or spoon if your child is eager to feed himself. Reduce frustration by using foods that stick to the spoon (like yogurt) rather than foods that drip off  (like soup). Soft cooked elbow macaroni makes a good introduction to fork feeding.

6. If your baby stuffs too much in his mouth at once (or throws it all on the floor), just offer a few bits on the tray at a time and add more pieces after the first few are eaten.

7. Skip the kids’ menu at restaurants. Offer bits of chicken, baked fish, meatball, potato, rice, pasta, steamed vegetables, baked beans, roll. Make steak “shavings” by scraping at the surface of the steak with a knife.

8. Say “cheese”. Shredded mozzarella or Monterey Jack cheese in the zip-seal pouches (called “bag cheese” in my house) sprinkled on the highchair tray is a speedy snack that can keep a snacking baby busy for awhile.

9. It’s okay to help. Your baby does need to learn how to feed herself, but it’s okay to pop in a bite here and there or spoon feed purees or mashed food in addition to foods your baby picks up.

10. Sensory-Sensitive. Some babies are especially sensitive to the sensation of textures or dislike having their hands dirty. Use dry foods like toast bits, rice cakes or cereal rather than mushy food like banana slices to practice finger-feeding and hand-eye coordination.

Bonus: Respect your baby’s cues and don’t try to push in more food than your baby wants. “One more bite” really won’t make any difference in terms of your child’s nutrition

Oral Motor Muscle Stimulation Exercises… For Babies

bottles, Breastfeeding, Feeding, Infant Health & Safety, solids, Uncategorized,
This may be cute (sort-of), but it’s certainly not the technique I outline below

Sometimes babies need some help “waking up” all their sucking muscles prior to nursing or taking a bottle. Other babies simply seem to latch or eat solids (purees or textures) better several days after starting these exercises.

Oral Motor Muscle Stimulation massage techniques as follows:

Remember to do each movement several times, with gentle pressure, slowly and deliberately. The entire “routine” should take less than 30 seconds.

  1. Cheek circles (gently move cheeks in circular motion, and inward to make “fishy lips”. Repeat x5
  2. Over the ears and under the jaw. (With both hands, stroke from each cheek to the temples, then around the ears and under the jaw. Repeat x5 )
  3. Trace top lips and bottom lips with finger (“applying chapstick”) x5.
  4. Trace down from nose to lip to chin. Use finger or knuckle to (slowly) gently stroke from bridge of nose down to top lip, bottom lip and chin, gently rolling bottom lip out (only if baby allows) and gently press chin down as if opening mouth (only if baby allows).

Notes:
1. If you are working on tongue extension, remember to stick your tongue way out several times while massaging and praise baby for mimicking the motion.