How to go from breast to bottle.

I look back with fondness on those days of breastfeeding. But the part where I had to transition from breast to bottle doesn’t conjure warm memories. I had to wean my first baby cold-turkey due to a medical condition. That wasn’t easy at all! Second time around with the next child, weaning was much easier — less painful too — because I had a transition plan. Read more for expert tips on how to go from breast to bottle without agonizing yourself or your child.

Topmost question is, when do you wean? The American Academy of Pediatrics (AAP) recommends pure breastfeeding until your baby is 6 months old. After that you can start introducing solids into her diet which should still include your milk or probably milk-formula.

When to wean from breastmilk to formula is a very personal decision. It depends on what’s best for your family’s situation. Maybe your maternity leave is over in 4 months so you decide to wean your baby at this time so you can get back to work. In the US, the AAP reports that most mothers choose to wean their babyies off the breast between 4 and 7 months.

Your baby can also give you signs she’s ready to wean. Telltale signs your baby can take solid food? She holds her head in an upright position, sits with support, or takes interest in what you’re eating. The active tongue-thrust reflex may have also disappeared — or is in the process of disappearing. Some babies even act like they don’t care for the breast anymore.

Plan out a practical schedule and set a specific time when you want to wean. The month before that, ease into a weaning routine. Drop one feed a day and let Daddy or the sitter give your baby a bottle instead. Maybe you can start with the most inconvenient breastfeeding session for you or maybe when your baby is least interested. The next week drop two feedings, until you get to solely using the sippy cup or the bottle.

If you can ask someone’s help, don’t give the bottle yourself. I noticed both my kids would only take the bottle if I was out of the room — or even the house — and had someone else giving it to them. It’s as if they were asking, why are you giving me that bottle when you’re boob is right there?

Avoid weaning during stressful times. Planning a move? Starting a new job? Did your little one just start teething? You may want to hold off for a month or so, because stressful situations don’t work well with weaning. Weaning alone can be stressful, so don’t compound the stress with even more stress.

Prevent engorgement by weaning slow. Cold-turkey weaning can cause milk to fill up your breasts leading to painful engorgement. Your body needs time to adjust to producing less milk until it stops completely. If there’s pain, it can be soothed with ice packs, cold cabbage leaves (worked for me) and acetominaphen. Use the pump to extract a bit at a time. But don’t extract too much or else you won’t stop producing milk.

Take heart — weaning can also take its toll on mom. I felt a bit melancholy each time I had weaned. It marks a time when your baby is growing more independent and it’s normal for moms to feel like tugging back. But then again they can’t be babies forever. We can only wish.

Start looking even before baby comes.

Soon as the pregnancy test is positive, get ready to start looking for a doctor who will help you care for your baby. By your eighth month, you should have already made your choice. Ideally, it’s your baby’s own pediatrician who checks on him after birth and discharges him from the hospital.

You will be seeing a lot of the pediatrician throughout your baby’s first years. Note that doc isn’t just there for sick babies. There will be regular check-ups and vaccinations along with growth and development assessments. You will be visiting your pediatrician at least eight times in the first year – not counting baby’s sick days. So choose well!

Start by asking for referrals from other parents. Your trusted primary care physician or obstetrician can also give you some leads. The American Academy of Pediatrics (aap.org) and the American Academy of Family Physicians (aafp.org) have online databases to help you locate providers in your area. Once you’ve got a list of candidates, check your health insurance plan, if you must choose a provider from a list. Consider these other factors before narrowing down your choice of doctors:

Competence. Know the doctor’s credentials. First, any doctor should be board certified. You might want to see if the doctor has additional fellowships or special training that may be relevant to your child. Does he or she have a reputation for being a good doctor? What do other people you trust say about the candidate doctor?

Location. It’s important that you choose a doctor nearby. Proximity is key – considering how often you’ll have to take your child for well-baby visits. And you do not want to have to drive far in case of an emergency! A doctor within your community will also know what services your town offers, including child care, preschool, speech or physical therapy, help for learning problems, and special education – when these are needed.

Bonuses. Some pediatric clinics offer parenting workshops, information web sites or old-fashioned house calls. Some practices have in-house facilities that can handle trauma or asthma crises or other procedures that can save you a trip to the ER. Look into such perks your candidate doctors may offer.

It’s important to choose a doctor you can establish good rapport with. When you go for an initial interview, ask your candidate questions to see how his or her approach matches your own – Do you encourage breast feeding? What if you decide to bottle feed? What is the doctor’s advice on when to start solids? What’s her approach on antibiotics? It’s a lot to ask before your child is born, but you would want a pediatrician who is generous with answers – and answers to such questions can tell you if you will both be in sync.

Pay attention to small details that can say a lot. The doctor’s clinic should be clean but inviting to children – with toys and books to keep them occupied. Do the people in the waiting room go in on time? Are the nurses and staff gracious and kid-friendly?

Your relationship with your child’s pediatrician is going to be very crucial. Make sure you take time and effort to choose the right one. It won’t be easy hopping from one doctor to the next once baby has arrived.

The answers to your nursing S.O.S .

We often see pictures of moms breast feeding in complete joy and ease. But even in the best nursing relationships, moms can experience problems. We’ve taken the most common nursing dilemmas… and their simplest, most effective solutions.

1. Too Little Milk

First, how sure are you that you aren’t making enough milk? According to the American Academy of Pediatrics (AAP), the fear of low milk supply is largely unfounded.

Practically all mothers can produce enough milk for their babies. It is all a matter of supply and demand. The more your baby suckles at the breasts, the more milk your body will produce. In the early days of breast feeding, it is important to make your newborn nurse every two hours for your body to start building ample milk supply. The AAP advices about 10 feedings per day for the first few weeks, then about eight feedings per day for the next three months.

if your baby needs extra time in the incubator or cannot feed directly at your breast for other medical reasons, use a good breast pump. I swear by double breast pumps – particularly the Medala Pump in Style.

Make sure you are drinking plenty of water and other healthy liquids. Note that lactating mothers need to eat an additional 300 to 500 calories a day to stay healthy.

2. Poor Latching

This is a problem encountered when breast feeding has just started. A poor latch means the baby has not properly positioned his mouth’s hold onto the nipple, resulting in poor milk suction. Typically, this is caused by a newborn that is still trying to figure out how to suck on the breast efficiently. Some women also have inverted or flat nipples that make it harder for baby to latch on properly.

These can both be solved with some guidance and by sticking to a regular nursing schedule.

Help your baby latch on properly by helping him get most of your nipple into his mouth. Try gripping your baby by the back of his head and guiding as much of the nipple into his mouth. If your baby is latched on improperly, remove him from the breast by sticking a finger into his mouth to break air pressure – then release and re-latch.

As for the inverted nipples, nursing regularly will eventually make it protrude enough for easier feedings. For some women, using breast shells that fit over the nipple can help as it applies gentle pressure to help it protrude. Breast pumps can also help pull the nipple out.

3. Cracked, Painful Nipples

This is also typical in the early days of breast feeding and especially for first time nursing moms. Poor latch can also contribute to cracked, painful, sometimes bloody nipples.

A nursing must-have for me was Lansinoh lanolin breast cream. It is a nipple cream endorsed by La Leche League – completely safe, no need for you to remove before your baby nurses. Babies can eat this with no worries. It soothes and even heals nipple wounds. Apply on your nipples regularly – everyday, before and after feedings.

If the wounds are bleeding and need time to heal, use the breast pump until your baby can latch on directly again.

4. Clogged Milk Ducts

Milk ducts, like plumbing pipes, can also get clogged. This is also called plugged ducts, which happens when milk gets stuck on the pipelines from the breasts to the nipples. We have quite a few ducts, so sometimes they don’t get completely emptied. These localized milk blockages can feel like painful knots.

If I feel a plugged duct, I would use hot compress on the area and massage it to loosen up the milk. When my baby couldn’t finish all the milk, I would also pump if the pressure was too much to bear until the next feed. While feeding, you can also massage clogged areas to help it flow through and make sure baby gets to relieve you from the plugged duct himself.

Experts advice: to avoid ducts, you should wear comfortable fitting bras – nothing tight, no underwire bras allowed. And nurse regularly to get the milk out! If you have to be away from your baby, use a breast pump.

5. Engorgement

If you go too long without feeding, your breasts can fill up to the point of engorgement. How does it feel? Your breast become big, rock hard and painful. To relieve yourself, you just have to let the milk out by getting back to your baby and nurse, nurse, nurse. The problem is, the breasts can be so engorged, it is difficult for your baby to latch on. In this case, you will have to hand express some milk or use the breast pump, before directly feeding your baby.

If nursing or pumping doesn’t fully relieve the pain right away, experts advice using cold compress or good old cabbage leaves. I have been saved by the cabbage leaf trick myself and it does work. Whenever I’m nursing, I make sure we always have cabbage leaves in the refrigerator. It is the perfect breast shaped cold pack that fits right inside your bra.

Hello happy baby!

I gave birth to a healthy baby girl. Apgar score 9-10. She took to nursing like a pro in no time. She was our little 6-pound angel. We take her home from the hospital and after a few days, the nights become short of, uhm… nightmarish.

The baby that was so peaceful and content for most of the day turned into a non-stop crying machine at night. The crying jags would last for one or two hours. We had even reached 3 hours non-stop. Witching hour would begin almost like clockwork sometime before 8 in the evening. After a few nights of this, I ended up crying along with her.

Her pediatrician said it was colic that was agitating her at night. If this story of the non-stop crying newborn sounds familiar, don’t worry there is light at the end of the tunnel.

A lifesaver for us then was a book called The Happiest Baby on the Block by Dr. Harvey Karp. Read more to find out what advice he gave celebrity moms Madonna and Michelle Pfeiffer to keep their babies happy – and colic-free.

Dr. Karp, pediatrician to the stars, has a theory. He believes humans are actually born a bit too early – that babies still need to go through a “4th trimester”. But since humans are only inside their mothers for 3 trimesters, we’ll need to simulate the womb environment to make the transition from womb-to-world much easier.

Those babies that are considered colicky are the ones extra sensitive to this transition. Hence, all the crying and fussing. In a way, you can say that they’re the ones taking the transition the hardest.

Dr. Karp has done extensive research on baby behavior. Among his notable observations were tribeswomen who carry their babies on their bodies for most of the day. They also sleep with them at night and would breast feed on demand. These mothers don’t know about colic. They have never experienced it.

Putting  observations like this together with sound theories, Dr. Karp has come up with the 5 S’s that could spell Sssssleep for a colicky baby. Let’s face it, most of us modern mothers can’t replicate tribe life. But he believes all parents of newborns should be doing these:

• Swaddling– Tight swaddling mimics the continuous touching and support the fetus experiences within the womb.
• Side/stomach position– The infant is placed on her left side to assist in digestion, or on his stomach to give support. This is also feels very reassuring to a baby. But do note this warning form Dr. Karp: “Never use the stomach position for putting your baby to sleep.” Sudden Infant Death Syndrome (SIDS) is linked to stomach-down sleep positions. When a baby is in a stomach-down position do not leave them — even for a moment.
• Shushing sounds— Going shhh, shhh, shhh imitates the continual whooshing sound made by the blood flowing through arteries near the womb. This kind of white noise is soothing to immature babies.
• Swinging– Newborns are used to the swinging motions within their mother’s womb. Coming into the world of gravity after life in-utero is like a sailor adapting to land after nine months at sea. “It’s disorienting and unnatural,” says Karp. Rocking, car rides, and other swinging movements all can help. Rocking chairs and gliders are very useful.
• Sucking– “Sucking has its effects deep within the nervous system,” notes Karp, “and triggers the calming reflex and releases natural chemicals within the brain.” Nursing your child at the breast – on demand, like the tribeswomen – is ideal for fussy babies.

When baby is extra fussy, using all the 5 S’s together can do wonders. It did help with our night-time diva. After just a few days of applying the 5 S’s the extended non-stop crying got better. She would still get antsy near bed time, but the nursing with the simultaneous shushing and swinging got the fussiness under control.

Before she hit her third month, she was a happy baby – day and night. See, light at the end of the tunnel? She’s a happy preschooler now.

If by chance you’re expecting – get yourself Dr. Karp’s bestselling book. Get better acquainted with the 5 S’s even before baby arrives. These days, they even have the video version. Lucky you!

Is your child getting enough Vitamin D?

Seven out of ten American children have low levels of vitamin D, putting them at risk for bone and heart disease when they become adults. These findings are significant as vitamin D deficiency is linked to high blood pressure and other risk factors for heart disease. Low vitamin D also causes poor bone growth and development.

This finding was published by Pediatrics, the official publication of the American Academy of Pediatrics (AAP). The study was conducted by researchers at Albert Einstein College of Medicine of Yeshiva University.

It has already been established that low levels of vitamin D contribute to having higher parathyroid hormone levels, which is not good for bone health and growth. Low vitamin D also leads to low calcium – that’s bad for bones. Not having enough of this essential vitamin also lowers good cholesterol – that’s bad for the heart.

Previous smaller studies had already identified high rates of vitamin D deficiencies among children. The study cited by Pediatrics is the first one to examine nationwide data.

Researchers discovered that 9 percent of the study sample, which totals 7.6 million children nationwide, was vitamin D deficient. Another 61 percent, or 50.8 million, was vitamin D insufficient. Vitamin D deficiency is defined as having less that 15ng/mL of blood. Insufficiency is having 15 to 29ng/mL of blood.

That’s millions of kids across America low in Vitamin D. The study’s lead author Dr. Juhi Kumar says, “we expected the prevalence of vitamin D deficiency would be high, but the magnitude of the problem nationwide was shocking.”

Kids typically low in Vitamin D were older, female, African American, Mexican-American, obese, drank little milk, or spent more than four hours a day in front of the TV or computer. Breast fed babies may also need supplementation as human milk is not fortified with the D vitamin.

Doctors say vitamin D levels have gone down the past 20 years as children have become more sedentary and don’t spend as much time outdoors. The more common use of sunscreens has also contributed to this trend. Our bodies use UV-B sunlight to convert a form of skin cholesterol into vitamin D. So some sunlight is healthy – even necessary for our health!

Doctors also recommend that children should eat more fish and drink more milk which are rich in vitamin D. But they do add that it is hard to rely on food sources alone to get enough. Both food and healthy levels of sun exposure must work together to keep vitamin D levels sufficient.

Supplements can help cure deficiencies as well. The AAP has updated its vitamin D guidelines. They now recommend that babies, children and teens must take 400 IU per day in supplement form.

You might want to ask your own pediatrician to screen your child for vitamin D deficiency. Get your kids to drink more milk, eat more fish and play outdoors more often. Remember, you can even skip the sunscreen once in a while.

Dr. Michael L. Melamed of the Albert Einstein College of Medicine advices parents, “It would be good for them to turn off the TV and send their kids outside. Just 15 to 20 minutes a day should be enough. And unless they burn easily, don’t put sunscreen on them until they’ve been out in the sun for 10 minutes, so they get the good stuff but not sun damage.”

Is my baby ready for solids?

Somewhere around 6 to 8 months of age, babies can start getting a taste of solid foods. There are cases when babies are started as early as 4 months, but research shows starting them on food later gives better protection from allergies.

If you are breast feeding, giving solids after 6 months is ideal. It’s best to give your baby as much of your breast milk as possible, as it is the perfect food for him at this stage. Again, this has been shown to greatly decrease chances of developing allergies. Take heed, especially if you have a family history of allergies and asthma. Some pediatricians even advice that babies delay food up to one year if they have this family history. This would be something to discuss with your own trusted pediatrician.

There really is no exact calendar time for when to get solids into your child’s diet. As each baby is different, you will have to consider your own child’s readiness.

Here are some signs your child is ready:

• Your baby can sit up on his own.
• Baby no longer pushes solids out of his mouth with his tongue.
• Baby has developed his pincer grasp and picks up food using his thumb and forefinger.
• Baby tends to open his mouth when watching you eat, and may even try to grab your food.

Now a note about the last sign: If your baby starts wanting to take part in meal time with mom and dad before 6 months, it may just be a sign of growing curiosity  and not necessarily a biological need to eat solid fare.

In this case, give him a cup of his milk during family meal times. You can even have it in solid form by making some milk popsicles. Call it a momsicle if it’s your breast milk! Do make sure it is a baby safe size, not too small that he can choke on it.

There are other ways he won’t feel left out at the dinner table. Offering baby bowls, cups and utensils will also keep the little one busy while everyone is eating. It may also be an opportunity for baby to start learning how to use a straw or sippy cup.

When you feel the time has come for your baby to eat solids, pediatricians often recommend starting with iron-fortified cereal. Choose single-grain options so that you can easily determine an allergic reaction. Rice cereal is a good first food.

To help get solid-eating started, here are some guidelines:

• Experiment on when your baby is most open to taking in his first spoons of food. You can try before or after feeding him milk. Take baby’s lead on this (no force feeding!) to make eating a positive experience.
• Begin with just a baby spoon. When starting solids, don’t expect your baby to finish a full serving of food on a bowl. Slowly increase food servings by the spoon as your baby gets the hang of eating.
• To make sure you pick up on possible food allergies, only give one new single ingredient at a time. Wait 3 to 4 days before introducing another food ingredient.

After first trying rice cereal, your baby can move on to oatmeal then barley. After the cereals, you can move on to vegetables then fruits and lastly meats. It is a good idea to make the iron-fortified cereals a regular part of their daily diet, on top of the vegetable, fruit or meat of the day.

In an upcoming post, we’ll give you advice on easy ways  to make your own baby food.

Why Breast is Best

We just did a post about a new study that indicates how breast feeding makes for smarter babies. But that is just one among the many benefits of feeding your baby your own milk. Read on to find out exactly why human milk is the perfect food.

The US Department of Health and Human Services notes that breast milk has just the right proportions of nutrients for growing babies. Breast milk changes in composition from the start to the end of each feeding. The milk will contain more essential fats when needed, more protein and antibodies at the right time for your baby.

It also comes in a variety of tastes that depends on what a mother eats. This is why breast fed babies tend to be open to different tastes once they start eating solids. Yes, they do tend to be less picky eaters.

A mother produces milk that contains ingredients no formula has yet to copy – even the best and most expensive kinds. Among breast milk’s precious nutrients:

Colostrum goes out to baby during his first feedings as a newborn. Nutritionists also call it liquid gold (it is yellowish and thick) that contains antibodies that will protect your child from many diseases. This is why breast fed kids tend to get sick less often even all the way to daycare and preschool.

Lactoferrin helps baby absorb iron and protects the stomach from harmful bacteria.

Lipases assist in the digestion of fats.

DHA and ARA occur naturally in breast milk and belong to a class of nutrients called lipids. These lipids are essential fats that are important for developing a babies vital organs, particularly the brain and eyes.

Breast feeding is natural, but it takes practice.

While breast feeding is one of our most basic human functions, it still takes some getting used to. There is some effort at the start get your nursing going smoothly.

It is best to get baby to latch on to you as soon as you’re both able – right after birth ideally. But do note that it takes about 3 or more days for you to feel that strong letdown of milk. Rest assured that until then, your baby is taking in colostrum and has enough nutrition stores to last until the breast milk starts flowing.

Milk follows the law of demand and supply. The more your baby suckles for milk, the more milk your body will produce. So hold off on the formula, even water, especially at the first few months. What your baby really needs is just your milk. Supplementing too early may affect your milk volume.

Good For Baby, Good For Mom

Breast feeding is the next natural physiological step after giving birth. The process of feeding your child naturally makes your uterus shrink faster and your body will morph back quicker into pre-pregnancy state.

Did you know it will also help you burn extra fat? To make milk, your body needs fat and will take it from your own fat stores. Milk production burns about 200 to 500 calories a day!

Breast feed for at least 6 months and your chances of getting breast, uterine and ovarian cancer goes down dramatically. This is based on data gathered by the Centers for Disease Control.

Watch out for future posts on some basic tips to get your breast feeding off to a good start!

The American University reviewed the school performance of siblings – one that was breast fed, and one that was not – and saw that an additional month of breast feeding indicated a higher grade-point-average (GPA) of .019 points. The same extra month of breast feeding also indicated a higher probability of attending college by .014 points.

American University researchers used data from the National Longitudinal Study of Adolescent Health. 59 families were studied, involving 126 siblings whose breast feeding histories and high school grades were examined. Data on high school completion and college attendance was taken from 191 siblings from 90 families.

This study of siblings is crucial because it was able to consider hard-to-measure conditions, particularly maternal intelligence and a good family environment.

It has often been argued that breast feeding is linked to smarter children, not necessarily because of the breast milk itself, but because most mothers who choose to go breast over bottle are college-educated. Those who breast feed also tend to provide better home environments for their children.

This would be the first study to use sibling data in connecting the effect of breast feeding on high school performance and college attendance. The results were published June 11 in the Journal of Human Capital.

American University Professor Joseph Sabia says, “The results of our study suggest that the cognitive and health benefits of breast feeding may lead to important long-run educational benefits for children.”

The professor was quick to say that, this study is just a start and that more research needs to be done to establish a definitive causal link between smarter kids and breast feeding.

But for pregnant mothers out there contemplating between breast or bottle, there’s really no need to wait for that definitive link. You have to give breast feeding a shot.

Breast feeding your baby for at least a few months to a year is a practical no brainer. You will be nourishing you child with food that was perfectly formulated for her at every stage of development. Did you know that the composition of breast milk changes as your baby grows? Your own milk will have ingredients no expensive formula could ever copy.

Nursing from the breast is also a wonderful way to bond with your child. Both my kids were breast fed for 13 months. After a bit of a rough start (especially with my first child), we got on with good feeding relationships. With my second baby, prior experience made it easier to get the milk flowing. Those memories of my babies giving me satisfied, thankful smiles after a good meal are… priceless. If it helps drive up their future GPAs… then that would just be the cherry on top!