The "What to Expect" Series Revihttp://www.blogger.cohttp://www.blogger.com/img/blank.gifm/img/blank.gifew

The "What to Expect" Series by Arlene Eisenberg, et al
	comments by Kelly Bonyata

The "What to Expect" Series includes the books What to Expect When You're Expecting, What to Expect the First Year and What to Expect the Toddler Years (plus some related books like What to Eat When You're Expecting, and so on).

Update: I've just looked through some of the breastfeeding information in the Third Edition (2002) of What to Expect the First Year. All in all, the general breastfeeding information is significantly better than in the first edition, but quite a number of inaccuracies and misinformation remain scattered throughout. The authors seem to have pushed their comfort level for breastfeeding up to around a year, but they continue to perpetuate myths such as breastfeeding being "exhausting" for mom, particularly when it comes to breastfeeding past a year. In addition, the moms whom I have worked with continue to mention that they go to the book with a question and come away feeling worried, inadequate and guilty.

The book What to Expect the Toddler Years (which has not been updated since the first edition) is very negative when it comes to breastfeeding a toddler, with many comments similar to the ones quoted below from the First Edition of What to Expect the First Year.

The first editions of the books (I've read through the pregnancy, first year and toddler books), give lip service to breastfeeding in the early months (though much of the info is quite outdated), but gets less and less supportive of breastfeeding as babies pass 6 months. Weaning is suggested well before 12 months. The authors also advocate letting baby cry (to do otherwise is "cowardly") and are very much against co-sleeping. Here is a quote from What to Expect the First Year (first edition):

By the end of the first year, however, scientists tell us that breast milk ceases to be adequate--not only is its protein content is insufficient for the older baby, but it suffers from a decline in several vital nutrients including zinc, copper, and potassium. In the second year, infants require the nutrients in cow's milk, and the mother who is still breastfeeding should recognize that although both she and her baby may still be enjoying the experience, breast milk can't be considered a major source of nutrition for her baby. Nor do babies past a year appear to need the sucking breast feeding provides. In spite of much speculation, there's no solid evidence that nursing past the first year--or even well into the second or third or beyond--hinders a child's emotional development. But it does seem that prolonged breastfeeding, like prolonged bottlefeeding, can lead to dental decay.

These statements are so full of misinformation, it's hard to know where to start! See Extended Breastfeeding Fact Sheet for referenced infomation on the nutritional and many other benefits of breastfeeding during the second year and beyond... Cow's milk is certainly not needed for anyone but baby cows... Some babies have breastmilk as their main source of nutrition well into the second year... There are many studies that show that the sucking need (as exhibited through continued pacifier, finger or thumb sucking) persists for several years in many children, with most stopping by age 4-5... There is good evidence that nursing into the second and third year (and beyond) has psychological benefits... There is no evidence that there is a link between extended nursing and dental decay...

http://www.kellymom.com/store/reviews/review_whattoexpect.html

Breast Babies and Schedules

BREASTFED BABIES AND SCHEDULES

Breastfed babies typically need to nurse more often than their formula-fed peers. You may have a friend whose baby is on formula remark that her baby only feeds every 3-4 hours during the day and sleeps through the night. You may wonder why your breastfed baby's eating and sleeping patterns are quite different than this. Perhaps you have tried to put your baby on a schedule only to find that he cried before you thought he should or you found that you were constantly looking for other ways to pacify him until feeding time.

Breastmilk is digested with much more ease than formula. In fact, your first milk, known as colostrum, has a natural laxative effect on the baby, enabling him to pass the meconium (the stool he has been storing since before birth) more quickly. The earlier this stool is expelled the less likely your baby will develop jaundice. Due to breastmilk's ease of digestibility, breastfed babies are rarely constipated while only receiving mother's milk.

Formula consumption, on the other hand, puts a strain on baby's digestive system causing it to work "overtime". Thus the formula-fed baby sleeps for longer stretches of time and demands to feed less often. However, in this case, sleeping longer is not necessarily a good thing! The formula-fed baby is more likely to suffer with constipation than the solely breastfed baby.

Putting your breastfed baby on a rigid schedule may interfere with the successful intitiation of breastfeeding and put your baby at risk for slow weight gain and other developmental problems such as failure-to-thrive. Breastmilk is produced on a supply and demand basis. The more your baby nurses the more milk your body will make. The less your baby nurses the less milk your body will make. Insisting on an artificial schedule may result in not enough stimulation to your breasts and therefore a scanty milk supply. As a result you may not be able to fully meet your baby's nutritional requirements thus resulting in the need to supplement with artificial milk.

In the first few weeks of nursing when lactation is just becoming established, frequent, unrestricted feedings are crucial to establishing a healthy milk supply. Nursing at least every 2-3 hours during the day and at least once during the night even if your baby must be awakened for the first few weeks will ensure that your milk supply is established and remains adequate as your baby grows.

These frequent feedings also ensure that your baby is getting the milk that he needs. Most young babies need to nurse at least 8-12 times or every 2-3 hours during a 24 hour period. Studies show that newborns who are allowed to nurse frequently and on demand regain their birthweight more quickly and are at less risk for developing low blood sugar and jaundice. Conversely, babies who are fed strictly by the clock regain birthweight more slowly and need medical intervention for treatment of low blood sugar and jaundice largely due to the fact that their mothers' milk is slow to become more plentiful due to less frequent feedings.

Crying is actually a late hunger cue. Babies will all demonstrate early hunger cues such as turning the head side to side, rooting, bringing the hands to the mouth, and even sucking the hands before they cry.

As baby grows he will experience periods of heightened growth that generally last for several days. Commonly referred to as growth spurts, these periods require more feeding flexibility. Baby demands to feed more often and your body responds to this increased demand by increasing your milk supply. Adhering to a set schedule during these times may result in a baby who's increased caloric needs are not met. Furthermore, your breasts will not receive the added stimulation they require to boost up your supply to meet your baby's growing needs.

Many babies also "cluster feed", "stack feed" or "bunch feed". These are all different terms to describe a feeding pattern in which the baby nurses almost constantly for several hours. This is a normal pattern for a breastfed baby. Many will feed in this way prior to bedtime as they "tank up" for a longer period of sleep. Also milk supply is normally lower in the late afternoon and evening hours. Many babies compensate for this slight daily drop in mother's milk supply by feeding more often.

Finally, babies need to suck and find great consolation at the breast when they feel lonely, insecure, tired, overstimulated, and overwhelmed with the changing world. It is this non-nutritive need for mother's breast that ensures that this emotional as well as physical need is met. Thus, breastfeeding - unlike bottlefeeding - is more than feeding. It is communication between mother and baby. It is a form of nurturing; it is an act of love.

---

Written by Becky Flora, BSed, IBCLC

http://breastfeeding.hypermart.net/schedules.html

Mom is sick... is it okay to nurse baby?

"If you become sick with a "bug" while nursing, don't fret about spreading the sickness to your child. Amazingly enough, white blood cells appear in the breast milk on the fourth day after the mother is exposed to the illness - cells her body has created specifically to eat that bacterium or virus! Thus your milk will give your child a specific antidote for the illness you are worried about. (This sickness-healing sequence obviously works better if the mother gets sick first. Fortunately, most times, mothers are "considerate enough" to do so.)"

-http://www.naturalchild.org/guest/george_wootan.html

When Baby is Sick...

My baby is sick - should I continue to breastfeed?

(all the links work except camphor hepatoxicity which links to a published journal article requiring access)

By Kelly Bonyata, IBCLC

Absolutely! Anytime a sick baby is able to take anything by mouth, it should be his mother's milk. Mom's milk provides antibodies specifically tailored to fight baby's illness, and is quickly and easily digested.

Temporary weaning, besides depriving baby of antibodies to fight the illness and the most easily digestible food source available, can make life miserable for both mother and baby. Nursing is extremely comforting to an ill baby and a major part of the healing process. Mom would have to pump to maintain milk supply and then there would still be some risk that supply would drop somewhat. Not pumping would put mom at risk for breast infection and extreme discomfort.

• Colds and congestion
• Baby refuses to nurse when sick
• Vomiting and Diarrhea
• Breastmilk vs. Pedialyte
• Additional Information and References

Colds and congestion

If baby has a cold and is congested, it can make breastfeeding difficult. However, it is almost always easier for a sick baby to nurse than to take a bottle. If your baby has a stuffy nose and is having a hard time breathing and nursing at the same time, try the following:

• Keep baby as upright as possible while nursing (this link includes pictures). At night, try propping up on lots of pillows and nursing/sleeping semi-upright. Also try the Australian position (mom is "down under") - in this position, mom is lying on her back and baby is on top (facing down), tummy to tummy with mom.
• The best thing you can do to help baby's illness end quickly is to nurse often - that way she gets lots of the antibodies that your body is making to help her fight off the illness. Frequent nursing also helps to ensure that baby is getting plenty of milk (congested babies often nurse for shorter times since it's hard to breathe and nurse at the same time).
• Use saline drops (or breastmilk) & a rubber suction bulb to clear baby's nose before nursing (if baby won't tolerate the bulb syringe, then the saline drops/breastmilk alone should still help).
  • Put baby on your knees, face up and tilt your knees a little downhill (so baby's head is angled away from you, toward the floor).
  • Put 2-3 drops of saline in each nostril and let it sit for a minute or so.
  • To suction the mucus out, squeeze the bulb part of the syringe first, gently stick the rubber tip into one nostril, then slowly release the bulb.
  • If baby is really congested, you may have to do this several times a day. Do it BEFORE baby nurses; if you do it afterwards your baby may spit up everything she's eaten because syringing can stimulate the gag reflex.
  • To prepare saline drops at home, dissolve one teaspoon of salt in two cups of warm water.
• Run a vaporizer or humidifier, preferably in a small closed room.
• Boil a pot of water (some moms use small crock pots/potpourri pots), remove from the stove and add a few drops of essential oil (for example, eucalyptus, sage or balsam), and let the scent permeate the air. This may help relieve some head congestion.
• Do NOT apply products containing peppermint oil, camphor or menthol on the face (especially in the nose) or chest of a baby or young child. There have been cases where the direct application of menthol or camphor products (for example, Vicks VapoRub™) to baby's skin resulted in severe breathing difficulties or liver problems (see Camphor Hepatoxicity, Camphor Monograph and Menthol Toxicology).
• Nurse in a steamy bathroom. To pump up the steam, run a really hot shower and set a chair outside the shower for nursing.
• The US Food & Drug Administration (FDA) and the American Academy of Pediatrics strongly recommend that children under the age of six not be given over-the-counter cough or cold medicines due to the risk of serious and life-threatening side effects. There is also no evidence that over-the-counter cold meds actually benefit children younger than six years old. There are several well controlled studies where there has been no difference shown between children given medication and those who have not.

Sometimes moms are advised to limit or discontinue breastfeeding because milk increases mucus production. This is not good advice for two reasons:

1. You are not a cow and your milk is not a dairy product. So even if dairy is a problem, your milk would not be.
2. In addition, there is no scientific evidence that cow's milk results in the production of more mucus unless you are allergic to dairy products. See this page for more info.

Baby refuses to nurse when sick

Some babies may refuse to nurse when sick (particularly if something like a sore throat or pressure from an ear infection makes nursing painful for baby). If this happens, try different nursing positions - particularly those where baby is upright - and keep offering to nurse at least every hour or so. See also: What to do about a nursing strike. Rest assured that your baby will return to nursing when he feels better. Here are some things to try if baby is too uncomfortable to nurse:

• feed baby expressed milk from a cup, dropper, spoon or syringe
• try momsicles, or freeze your milk until it's slushy and let baby eat it with a spoon
• for older babies (over six months) who are eating solids: if baby will take solids but not nurse, add lots of breastmilk to the solids. You might also try making yogurt from breastmilk.

Vomiting and Diarrhea

Another time when moms can be unsure about whether to continue nursing is when baby has diarrhea or is vomiting. Frequent and loose stools in a breastfed baby is not necessarily diarrhea. Here is more information on normal stooling patterns for breastfed babies: What Are Baby's Stools Supposed to Look Like? Diarrhea in a breastfed baby is diagnosed when a baby has 12-16 stools per day (or more often than the baby's regular stool frequency), watery stools, and an offensive odor to the stools. Just one of these symptoms does not in itself mean the baby has diarrhea.

The current recommendations when vomiting or diarrhea is present in the breastfed child are as follows:

• Breastfeeding should be the FIRST choice if your child can take anything by mouth. Because of the ease and rapidity with which breastmilk is digested, even if your child vomits or stools shortly after nursing, he will still have retained some of the nutrients. Other foods that are often suggested (such as Pedialyte, sports drinks, gelatins and sodas) offer little nutritional value and none of the antibodies that human milk contains.
  
  
• When your breastfed child is ill you'll want to offer more frequent feedings -- this can limit the volume taken in at one time and helps to comfort and soothe a sick child. If your child is vomiting often and not keeping the milk down for long, it may be helpful to breastfeed frequently but limit the length of each nursing session (so your child takes in less milk at once). Another option is for Mom to express some milk before breastfeeding so that the milk flow is slower. RARELY does the baby who is allowed to breastfeed at will during a vomiting or diarrhea illness become dehydrated.

The use of an oral rehydration therapy such as Pedialyte is a sound recommendation for a formula-fed infant who is vomiting or who has diarrhea, but using this in place of breastmilk offers no benefit to the breastfed baby. Human milk is a natural fluid, unlike formula and other milk products, that again is easily and rapidly digested.

Forego the Pedialyte as long as baby continues to nurse well and as long as there are no signs of dehydration. If baby is showing signs of dehydration, talk to your doctor. Following are signs of dehydration:

• fewer than 2 wet diapers in a 24-hour period
• baby not behaving normally (more irritable, less active, sleeping more)
• lethargy
• listlessness
• weak cry
• no tears (in an infant older than 3 months)
• dry mouth
• skin that stays wrinkly-looking when pinched (pull up the skin on the front of the hand; it should pop easily back into place - not stay pinched or wrinkly-looking)
• eyes that look sunken
• cool, clammy extremities, especially the fingers and toes
• fast breathing, or a heart that is beating faster than usual
• fever
  

Babies who are allowed to continue breastfeeding through an illness such as this are less likely to become dehydrated than those who are taken off the breast. Continued nursing also provides your child with precious antibodies that will prevent the illness from worsening and speed healing. Nursing is also very comforting to your child, which is healing in itself.

Breastfed babies sometimes need oral rehydration therapy (Pedialyte, etc), though far less often than artificially fed infants. The World Health Organization recommends continuing to breastfeed during and after oral rehydration therapy. Research shows that babies lose more weight and actually have more stools during diarrhea when they are deprived of breastmilk.

Sometimes moms are recommended to withhold breastmilk "because it is a dairy product." Breastmilk is NOT considered a dairy or milk product (mom is not a cow!).

Anytime there is diarrhea (in adults as well as babies) it can take a while for the bowel to heal and the stools to get back to normal. So even if you identify the problem and take corrective action, you may not see favorable results for a few weeks. This is because if the bowel gets irritated it is harder for the bowel to digest lactose - the undigested lactose then actually creates more irritation and runny stools... it can be tough to turn around at times. There is usually an inflammatory response with diarrhea - that is the part that takes time to heal. When the cause of the problem is removed (when baby recovers from the illness), the gut will heal even if the baby is still fed breastmilk. More here on secondary lactose intolerance.

Breastmilk vs. Pedialyte

When baby is sick, moms are sometimes told to discontinue or restrict breastfeeding and substitute an oral rehydration therapy such as Pedialyte. This outdated practice has been shown to offer no benefits to the breastfed baby, and can even delay healing.

Your milk has four things that your baby needs even more than usual when he's sick:

1. Antibodies to fight this illness - you want baby to get as much of these as possible. Encourage *more* nursing rather than less. Pedialyte has no antibodies.
2. Liquids to keep baby hydrated. Your baby may not be eating as much because he doesn't feel well. Sick babies are more likely to nurse than to take anything else by mouth, so nursing is important to keep baby hydrated. Keeping baby well hydrated also helps keep the mucus secretions thinned out if baby has a cold or other congestion. So again, you want to nurse *more*. Pedialyte will keep baby hydrated, but so will breastmilk.
3. Concentrated nutrients. Breastmilk is easily and quickly digested, so baby gets more nutrients and absorbs them faster. Pedialyte will keep baby hydrated but has little nutritional value. Again, it's best to nurse *more* since baby may not be eating as much if he feels bad.
4. Comfort. Sick babies need more comforting - what better way to do this than at the breast?
   

See the section above for more information on the use of Pedialyte in breastfed babies - Breastfed babies sometimes do need oral rehydration therapy (Pedialyte, etc), though far less often than artificially fed infants. The World Health Organization recommends continuing to breastfeed during and after oral rehydration therapy.

Here is the link: http://kellymom.com/health/illness/baby-illness.html

Page last modified: 11/09/2010
Written: 02/23/2002

Past One Year

Many people wonder if there is any benefit to breastfeeding a baby beyond one year. Here are some references that might give some helpful info to answer that question. I believe there are many, many, many benefits and they go far beyond just nutrition (though, nutritionally, you can't beat breast milk ;)

These references were collected by Kathy Dettwyler while compiling research for her own studies and published material. Kathy has a Ph.D. in Anthropology and studies breastfeeding and other infant behavior from an anthropological standpoint. I find it very interesting.

http://www.kathydettwyler.org/detrefs.html

Breastfeeding a Toddler: One Mom's Perspective

A friend of mine passed along this link about a Mom who is breastfeeding her toddler (3 yrs) and she expresses some of her feelings about the experiences she has had doing so. I enjoyed it so I'm passing it on, too.

http://www.kveller.com/blog/parenting/it-may-be-time-to-wean-my-three-year-old/

What's in it....?

Ever wondered what's in breastmilk? Or how it compares with formula?

Check this out: It will amaze you.

http://www.bcbabyfriendly.ca/whatsinbreastmilkposter.pdf

A Letter From Baby...

A friend of mine shared this with me and she said it made her cry. Well... it made me cry, too!

Its a short narrative from the perspective of a newborn baby, explaining how they cherish their mother and the gift of breastfeeding. I thought it was so beautiful and so sweet, I had to share.

A Letter From Baby

Book Review

The Baby Whisperer, by Tracy Hogg, is a book that claims to help parents who are unsure how to care for their babies and read their cues. I was reading the book, looking for insights on normal infant sleep patterns. What I found was information on how to get your baby to sleep, eat and play on an adult's schedule. I was kinda disappointed, because I thought this would be a book that was more geared towards Attachment Parenting and would explain the needs of infants... I guess I was mistaken. While she does offer advice on all imaginable topics, and claims her solutions will work for every baby (I'm not a huge fan of the "one-size-fits-all" method) I just didn't feel she was qualified to be so aggressive in her opinions.

For instance, she down plays the benefits of breastfeeding, while suggesting that breastfeeding on demand is not only unnecessary, but creates a demanding, fussy child. I have found the opposite to be true, but regardless, she isn't an Internationally Board Certified Lactation Consultant (IBCLC), so I'd question her knowledge and understanding of successful breastfeeding and wouldn't follow her advice. Her suggestions had breastfeeding failure, written all over them. She also thought it was a good idea to wean babies at around 8 months, which isn't supported by WHO or the AAP... just not good advice.

I also didn't like how she demonized co-sleeping and co-bedding. She blamed these for SIDS and said cribs are where babies should be. What bothers me about that statement is that babies have been in bed with their parents for centuries before this book was written. Even today, nearly all other cultures practice bed-sharing with babies and don't have SIDS rates as high as we do here in the "modern world", in some "less civilized" cultures that practice bed-sharing, SIDS is almost unheard of... And nevermind the fact that SIDS was only recently changed from "Crib Death"....

Another inconsistency was that she recommends parents follow the AAP on their recommendation for when to start solids (6 months) but suggests that "bigger babies" and babies that suffer from GERD should be introduced at 4 months. Again, she really has no authority to be giving such recommendations and this goes against the AAP and other research I have read, so it bothers me that she gives such erroneous advice so willy-nilly.

I try to find the "good" in each thing I read, because I believe one can usually glean something beneficial. Something that I did find that I could agree with her on was her philosophy of not using the Cry-It-Out method (CIO).

I thought she made some good points:

"I don't believe in allowing infants to cry alone, not even for five minutes. Your baby doesn't know where you have gone or why he's suddenly abandoned. To use another analogy, its' as if you have a boyfriend, you set a date, and he doesn't show up for two nights in a row. You wouldn't trust his word. trust is the foundation on which any relationship is built. My hair stands on end when parents tell me they've allowed a baby to cry for an hour, two hours. Some infants get so upset and cry long and hard enough that they vomit. Others simply expend energy, become even more overstimulated, and eventually get hungry as well, leaving both of you confused and exhausted. Many babies who've been left to cry it out become chronically bad sleepers from that point on, putting up a battle whenever it's time for sleep, even becoming fearful of their own beds."

We don't see eye-to-eye on how to teach your baby to go to sleep... She suggests that allowing your baby to co-bed with you will result in a needy, clingy child and I just don't agree. The research doesn't show this to be true, in fact, many studies show the opposite, so we just don't see eye-to-eye on that point.

Another criticism I have with this book is that the Author's tone of voice is very antagonistic and arrogant. She speaks as though she is the best and only expert on babies and it just rubs me the wrong way. My philosophy on the topic of "who knows best?" is that parents usually know best, when they are sincerely seeking to do the best thing for their child. When their heart is in the right place, and they acknowledge and follow their baby's cues, I think the parents are the "experts" for all intents and purposes. And I believe each baby is unique and will march to the beat of a different drum, so I find it silly to be so rigid as to think that each baby should conform to one pattern of behavior.... I think consistency is important but flexibility is, too. She says she believes that but, I'm not convinced.

Well, that's my 2 cents. Hope it helps.

Sleeping Through the Night....

Did you know that the AAP (American Academy of Pediatrics) defines "sleeping through the night" as a stretch of 5 hours? Not 10 to 12 hours, like some people suggest as "normal" and "expected" for babies. It is normal for babies to wake during the night.

Here is an informative article by an Anthropologist - Katherine Dettwyler Ph.D., who discusses the topic of infants and when they should sleep through the night. I thought it was interesting.

http://www.kathydettwyler.org/detsleepthrough.html

Excellent Blog on Healthy Sleep Solutions

I found this blog while searching for info on infant sleep and I am just so happy. This blog contains so much great information! I had to share... Enjoy. :)

http://www.drmomma.org/2009/12/sleep-training-review-of-research.html

"Crying-it-out does not lead to 'sleeping through the night' - it results in learned helplessness."

~ Danelle Frisbie

The Big Pink Bus - Latch On America Event

Mark your calendars, to support breastfeeding awareness this month!

The Big Pink Bus - Latch On America Event will be visiting the THR Euless/Bedford area Hospital (Texas Health HEB) to recognize the work THR has done in supporting breastfeeding in the North Texas area. Come out and support breastfeeding with us!

It will be August 19th, 2011 at the above mentioned hospital. Go to Milkforthought.com for more info on the event. This link has the cities that will be on the tour - http://www.milkforthought.com/tour/cities

This is posted on the Milk For Thought website:

Uniting the breastfeeding community.

Connecting advocates, experts and parents. Providing the very best and most trustworthy breastfeeding information. Offering the support new moms need.

Milk for Thought is bringing together the energy from different parts of the breastfeeding community to share, support, educate and create. Whether you’re passionate, dedicated or simply curious about breastfeeding, you can join forces, find answers and meet likeminded people here at Milk for Thought.

I believe this is a GREAT cause and I am so excited to see people coming together to support eachother - so join with us, why don't you?! :)

Motherhood is full of challenges... finding a place to breastfeed your baby shouldn't be one of them.

Did you know that you have legal rights when it comes to breastfeeding your baby in public places? You do! In most states, it is considered legal anywhere a Mother is "authorized to be".

Check out your state laws, HERE.

I included the website link on the left side bar, too.

Recently a mother was harassed and asked to leave a Whole Foods Marketplace in Salt Lake City, UT because she was breastfeeding her child. You can read about it HERE.

Its a shame that a place like that would be so discriminating when they tout "healthy living" and "healthy food" in their marketing... What is healthier than BFing a baby?

I hope this doesn't happen often and I think it is sad that Mothers are made to feel like they aren't welcome to care for the needs of their children in public. Our culture has some pretty unhealthy views, in my humble opinion.

HERE is some info on a "NURSE-IN" that is being organized on August 20th, in protest of Whole Foods discrimination of breastfeeding mothers.

Growth Charts

Have you ever wondered about your baby's growth and where they fall on the Pediatrician's chart for height and weight averages? I have and I wondered why my Pediatrician seemed concerned when Colin looks and acts very healthy. He is growing and learning. He is happy and he is FAT. So why the concerns at his well baby check?

The Pediatrician said that most babies will fluctuate up and down on the bell curve of weight gain... Okay. Then in the same breath, he said that Colin had gone down on the bell curve and he was concerned. "Why?", I thought, when he had just told me that it was normal for them to go up and down... weird.

So I started researching. Did you know that the graphs and charts that are commonly used in Pediatrician's offices to measure a Baby's growth (height and weight) are primarily based off of formula fed babies? It makes sense when most babies are fed, at least in part, some amount of formula before 6 months of age.

Kellymom.com has this to say on the topic:

"Healthy breastfed infants tend to grow more rapidly than formula-fed infants in the first 2-3 months of life and less rapidly from 3 to 12 months. All growth charts available at this time include data from infants who were not exclusively breastfed for the first 6 months (includes formula-fed infants and those starting solids before the recommended 6 months). Because many doctors are not aware of this, they see the baby dropping in percentiles on the growth chart and often come to the faulty conclusion that the baby is not growing adequately. At this point they often recommend that the mother (unnecessarily) supplement with formula or solids, and sometimes recommend that they stop breastfeeding altogether. Even if mom realizes that her baby is perfectly healthy and doesn't follow these unnecessary recommendations, she ends up worrying for no reason (and moms don't need anything extra to worry about!). "

You can read more HERE.

The pattern of growth that kellymom described was exactly what I have seen with Colin's growth... exactly.

Colin is exclusively breastfed so I wondered if there was a chart that more accurately depicted the normal growth pattern for a breastfed baby. And ya know what? There is! The World Health Organization published a chart for just such babies. The CDC (the US Center for Disease Control) is starting to use it and encourage Pediatricians to use it for breastfed babies, as well.

Great!

Here it is for Boys:

http://www.cdc.gov/growthcharts/data/who/GrChrt_Boys_24LW_9210.pdf

And this one is for Girls:

http://www.cdc.gov/growthcharts/data/set1clinical/cj41c018.pdf

And wouldn't you know, Colin's growth has been consistently right below the 50th percentile, all along....

When you use the correct tools for measuring things, you get a more accurate picture. Imagine that. :) Now I just have to print this puppy off and take it with me to Colin's next well child visit to show the Pediatrician. He is a healthy happy baby.

Marketing Formula

Have you ever stopped to think about why the trend is so high in the developed world (and the developing world is sadly following suit) for babies to be formula fed instead of breastfed? No other mammal feeds its young another mammal's milk. Its kinda odd.

Don't get me wrong. I think formula has its place and I am grateful that it is available for those who truly need it. But why are only 14.2% of US babies exclusively breastfed to 6 months? There are many variables to this equation, but one very big one is marketing. Formula makes money.

I found this article on Pub Med, which focusing on the pervasiveness of formula marketing and I thought it was interesting. It was published through Princeton University.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2443254/

Delaying Solids - an interesting article

I just found this article interesting. It makes some good points about why it can be beneficial to delay giving baby solids. Hope you like it. :)

http://www.naturalnews.com/027418_iron_food_foods.html

Naps: are they hard for you and your little one?

It seems like with each new "stage" in Colin's life, we find that nap time changes, a little. In the early days (first 3 months) Colin would sleep whenever he needed to. I didn't have a schedule for him to nap and I just followed his cues. He usually took between 3-5 naps per day, ranging from 30 minutes to 2 hours. Then around 3 months, naps became more challenging. He seemed to be easily distracted by what was going on around him and couldn't "let go" to sleep. I had to make some changes.

I started watching his cues more carefully. I tried to be home for nap time, because this seemed to help him sleep better and longer. I also made an effort to help him drift off to dream land. Sometimes that meant patting his back/bottom to help him fall asleep. Many times I would nurse him to sleep, which worked very well. (I'm a big fan)

Now that he is 6 months old, it seems like he doesn't need to take as many naps but also has a harder time falling and staying asleep. I do not subscribe to the "cry-it-out" philosophy, which seems to be the typical advice I am given....

I don't like "cry-it-out" methods for two reasons:

1) I think that letting a child cry alone is a very sad thing and sends a very sad/depressing message to the child. I worked in orphanages in Romania and saw first hand, the effects of neglecting a child's needs in this way. Babies and Children do not cry there. At all. It was very strange and very sad. They have learned that crying will not illicit a response from a care giver so crying is not beneficial. They have learned to be silent because they will not be helped. This is an extreme example, I know, but it has the same result. Babies who are left in their cribs to "cry it out" learn a form of behavior modification, which leads them to the conclusion that when they are in their crib, they will not be helped. They won't cry because they know no one will come to them. I cannot, and will not, ever do that to my child or any other child.

Information on "cry-it-out" methods and reasons it is not beneficial:

http://www.pantley.com/elizabeth/books/0071381392.php?nid=386&isbn=0071381392

http://www.kellymom.com/parenting/sleep/4mo-sleep.html

http://www.kellymom.com/parenting/sleep/comfortnursing.html#cry

http://www.storknet.com/cubbies/parenting/cryitout.htm

Also, check out AskDrSears.com for more on Attachment Parenting.

2) I believe that parenting wasn't meant to be "easy" or "simple". I believe parenting is about putting your whole heart into it, getting "knee deep in mud" so to speak and making a lot of personal sacrifice. To me, letting your baby "cry-it-out" is taking the easy way out. I think attachment parenting takes more effort and I believe that anything worth having in life is worth the effort and sacrifice it takes to have it. Children included.


So, wanting to find some info on helping Colin take better naps, I stumbled across this website:

http://www.pantley.com/elizabeth/advice/0071381392.php?nid=424

It has a lot of helpful information, in my humble opinion, and helped me come to some realistic expectations. Maybe it will help you, too.

This table of sleeping hours, is included in the link above. I just found it very helpful and I love charts/tables/graphs. ;)

Average hours of daytime and nighttime sleep

Age	Number of naps	Total length of naptime hours	Nighttime sleep hours**	Total of nighttime and naptime sleep
Newborn*
3 months	3	5 – 6	10 – 11	15
6 months	2	3 – 4	10 - 11	14 – 15
9 months	2	2 ½ - 4	11 - 12	14
12 months	1–2	2 – 3	11 ½ –12	13 ½ –14
18 months	1–2	2 – 3	11 ¼ -12	13 – 14
2 years	1	1–2 ½	11–12	13 – 13 ½
2 ½ years	1	1 ½ -2	11–11 ½	13 – 13 ½
3 years	1	1–1 ½	11 –11 ½	12 – 13
4 years	0 -1	0 -1	11–11 ½	11 – 12 ½
5-6 years	0 -1	0 -1	11	11 – 12

Here is some info on Kellymom.com about nursing your baby to sleep and other comfort measures:

http://www.kellymom.com/parenting/sleep/comfortnursing.html

Good luck! I hope naps are a little easier for us all. :)

Tandem Nursing - Is it for you?

My little one is now 6 months (tomorrow!) and boy have things been busy around here! There isn't as much time to be on the computer as I once had (when he was a sleepy newborn...) but its really fun having an active and interactive baby to play with all the time, too! I'll try to post more often, as I get my time more organized. ;)

I've been thinking a lot about having a second (I know, crazy... my little one is ONLY 6 months!) and I've been trying to decide what I would do as far as breastfeeding. To tandem nurse, or not to tandem nurse... that is my question.

I have been reading some great stuff on Kellymom.com and I thought I'd share in case you were thinking about the same things. Hope it helps you, too!

Thoughts from Kellymom.com:
http://kellymom.com/nursingtwo/articles/tandempregnancytips.html

An excerpt from a book called "Adventures in Tandem Nursing": http://kellymom.com/nursingtwo/excerpts/TN_ch.011.pdf

Tandem nursing may not be for every mom, but some moms may really enjoy it. Plus, if you are faced with the idea of having to wean because of pregnancy or a new baby when your current little one is not yet 2 yrs, this might be a viable option to continue nursing. The American Academy of Family Physicians asserts that breastfeeding during a healthy pregnancy is a personal decision for the mother--indeed, that weaning before two years of age can increase a child's risk of illness. (Another option, if breastfeeding while pregnant, or tandem feeding doesn't work for you, is to have some pumped milk frozen that you can give your little one till they are two. Even 3-4 oz a day would give their immune system a boost as they head into the toddler years, not to mention a nutritional boost - the perfect natural supplement!)

When will baby "SLEEP THROUGH THE NIGHT"?

Good question.

There are a lot of different theories on this topic and it is pretty widely debated. Bottom line, do what feels right.

And know that baby will sleep through the night when he/she is good and ready...

For those of you at the point where baby DOES sleep through the night but then a month later (or so) he/she starts waking again, wanting to nurse,please know that this is normal. Your 4 month old is not manipulating you. They do not have the developmental capacity to do so. He/She is simply meeting the needs of his/her body. Your baby is likely having a growth spurt OR is simply at the age where they are easily distracted during the day and probably not getting all the calories they need. Starting around 4 months, babies tend to have a hard time focusing on breastfeeding and tuning out all the fun and interesting things going on around them. Night time is when they make up for lost calories they missed during the day. Think about it: night time is quiet, dark and there are basically no distractions!

You can try to help limit this by feeding baby in a quiet, dark room during the day and feeding as often as possible, even if they are short feeds. This will minimize night time feedings to some extent if not all together. (This advice comes from a Certified Lactation Consultant)

For those of you with babies who still insist on getting up during the night to eat, be patient. This too shall pass. :o) I'm right there with ya!

HERE is a great article on this subject.

There is also tons of good info on Kellymom.com, too!

*** Side Note: It might also help you to get more sleep if you bring baby into your room, either in bed or in a crib, so you don't have to trek to another room to get baby in the night for a feeding. The less baby wakes from crying to get fed, the more easily he/she will likely go back to sleep during the night.

The sidelying position can also help you rest/sleep during the night when baby wants to nurse. If you do not feel comfortable in this position, talk to a lactation consultant or someone who has used this position successfully. They may be able to help you figure out how to make it work and it really makes a huge difference, especially during night time feedings. I use it during the day when I need a little rest, too! Its really quite nice.

Vitamin D

We just went to Colin's 4 month check-up on Tuesday and our Pediatrician mentioned starting solids. I was surprised and mentioned the AAP guidelines, as well as recommendations by WHO not to start solids until 6 months - exclusively breastfeeding until then was best. He back-tracked and agreed.

This opened the door for conversation about starting solids later. I approached the topic cautiously, knowing full well that exclusively breastfeeding beyond 6 months is not widely accepted, though there is limited research to show that it is actually harmful for babies in developed countries whose mothers are well nourished. What little research there is points to third world countries and malnourished mothers who are breastfeeding. Naturally if they are deficient, then so will their babies be at some point....

Anywho, I mentioned breastfeeding exclusively till 7-8 months as I sensed some tension. The Pediatrician launched into an argument that Vitamin D would not be produced in breastmilk sufficient for baby's needs. Agreed. However, the only natural way to get Vitamin D is through sun exposure (not the baking or burning kind, but limited healthy amounts which are good) and Colin does get small amounts of healthy sun exposure through out the week. The Pediatrician argued that he should have sun screen on. And I agree that when out in the sun for extended periods during peak sun exposure, it is good to use sun screen but if you always use it, you won't be able to absorbed the natural rays for the sun which aid the body in synthesizing Vitamin D. When we take supplements, our bodies can't regulate them as well.

So, for those of you wondering about Vitamin D deficiency in your baby, HERE is a great link with tons of great info on how much sunlight is needed for adequate vitamin D, how much is contained in mom's breastmilk, as well as quotes & recommendations from AAP & WHO.

At the bottom of the link on KellyMom.com there is a link to JOURNAL ARTICLES which has a list of research that has been done on the topic of Vitamin D.

I still plan on exclusively breastfeeding beyond 6 months. Colin was born nearly a month pre-mature and if keeping his adjusted age in mind (you always want to adjust baby's age, if he/she was premature for every mile stone, especially for the first year) then he wouldn't be ready for solids until 7 months. I feel that there is some compelling evidence that starting solids at 6 months is not the most beneficial time for all babies, or even most babies. It seems unreasonable and unwise to have a "hard & fast" rule for when all babies should do anything. They all do things a little different and grow at their own pace. And we should let them.

For those of you interested in this also, I will post some info and links to help you decide if this is right for your baby.

Happy Breastfeeding!