Possible Reasons for A Newborn’s Fussy Stomach

Newborns are born with immature digestive systems.  Breast milk is the absolute best thing for their immature system, but even under normal conditions, their bodies/bellies/guts/and little butts are learning how to digest (and poop out) food for the very first time, so some difficulty and a “learning curve” is normal and to be expected.

However, even Moms who are exclusively breastfeeding might observe digestive issues in her baby that she would consider greater than normal: frequent spitting up, watery, green and/or mucousy poop, gas, or discomfort which leads to frequent crying, reflux, etc.

There are two VERY COMMON (more common than not) issues that can cause these digestive problems, and even if you are aware of them, it can be difficult to tease out WHICH of these things is the true issue or if it could be both.

Oversupply

The first most common issue is oversupply which can be coupled with overactive letdown and typically a foremilk/hindmilk imbalance .  MOST Moms are made to nurse twins—evolutionarily it makes sense given the odds of twins and the fact that before formula, a baby who lost their mother during childbirth or who was separated from their mother for any length of time would need to be nursed by another mother also nursing her own baby.  It is literally more common than not to have SOME amount of oversupply; meaning that when the Mom’s milk comes fully in—usually between 5-10 days post-partum, they might find that they have much more than they need.

It is a common misconception that more milk is better.  In fact, it is best for your baby if you are making the exact right amount of milk and no more.

Oversupply causes a fussy stomach for several reasons:

One, the fast flow of the milk means that the baby is taking in extra air when he/she is nursing.  This extra air causes gas and discomfort. 

Two, the milk that comes out at the beginning of a feed (foremilk) is very different than the milk at the end of the feed (hindmilk).  The milk at the beginning is watery and sugary, almost like milk-juice.  This sweet milk gives baby energy and motivation to keep them nursing.  However, the milk which comes out when the breast is getting more empty is equally, if not more important.  The hindmilk is much thicker and fattier, the “cream”.   This thick milk sticks to the stomach and makes it easier to digest. 

The problem arises because oversupply means that often the baby gets full on the foremilk—they are already done nursing before they get to the “cream” which comes out of a more empty breast.  This foremilk is much higher in the sugar lactose, and lactose is much harder for a baby to digest.  This will cause watery, green poops, and stomach upset.

Additionally, babies whose Moms have oversupply will sometimes actually have LOW weight gain because they have so much trouble getting to the fatty milk. 

I think there is a further issue with oversupply which is rarely discussed—it is SUPPOSED to take WORK for the baby to extract milk from the breasts.  Babies who are used to a high supply do not have to work very hard to get milk out.  This can cause issues later when the supply regulates because the baby finds himself for the first time having to work hard to eat.  Many Moms at this point (3-5 months) will start to notice issues like bottle preference or fussiness at the breast. 

In my opinion it is GOOD for your baby to learn IMMEDIATELY that life isn’t easy and that you don’t get something for nothing.  You can think of this as the first way to build self-esteem and self-efficacy.  You are teaching your baby that working hard will reward them, a lesson that is never too early to teach in my opinion.  Babies whose Moms have a regulated supply have much more patience and determination, not only for nursing but I believe this translates into other areas of life as well.

Oversupply can also cause issues for the Mom:  nipple pain.  Because the milk is often flowing too fast for the baby, they will clamp down on the nipple to reduce the flow.  I can tell you from experience: OUCH.

Food Allergies and Sensitivities

Another very common issue is baby reacting to one or more foods in the Mom’s diet.  About half the time, the problem is dairy.  The next most likely culprit is wheat, after that, soy.  Some babies will have issues with caffeine, also, or you can have one like mine who basically reacts to EVERY food in existence. 

However, luckily, half the time, eliminating dairy in the Mom’s diet will solve the whole issue. 

Our society has a growing awareness of food sensitivities, and it is increasingly common to discover sensitivities to dairy, wheat, gluten, soy, etc.    Luckily it has never been easier to lie allergy-free.

Like oversupply, food sensitivities can cause watery poops, gassy stomach, frequent spitting up, and colic.

So if your baby has a fussy stomach and is exhibiting these symptoms, what is the problem?  Is it oversupply or food sensitivities?  It can be very difficult to tease apart the problem, but there are a few ways to tell.

Oversupply will often start causing symptoms from the first week or two.  Mom will often feel engorged, experience her milk leaking, letdowns when the baby isn’t hungry . . . the baby will often be satisfied with only one side.  If the Mom ever pumps and can get more than 4 ozs per side, that is a sure sign of oversupply.    Again, the nipple pain is also a very good sign.

Oversupply is often linked to an overactive letdown…this has many tell-tale signs.  After a minute or a few minutes of nursing,  the baby might start fussing—come unlatched and cry, or be sputtering and choking on the milk.  Mom sometimes sees her milk spraying at this time.  This is a definite sign of oversupply.

Oversupply will more often cause GREEN watery poops, sometimes in huge diaper blowouts.  The green is evidence of the excess lactose in the milk. 

Baby will have issues from the first or second week and the symptoms would usually get BETTER over time, though some Moms unknowingly make the problem worse by pumping off extra milk. 

Supply is highest in the morning and lowest at night.  If you have oversupply you might notice the most spitting up and discomfort in the morning and early afternoon, while the spitting up is less frequent at night.  HOWEVER MOST babies have fussy evenings and want to nurse frequently in the evenings, so this can be a hard thing to gauge.

Oversupply, especially in the absence of excess pumping, will get better over time instead of worse, often resolving itself between 3-5 months.

Meanwhile, food sensitivities look a little different.

Most food sensitivity issues will not be present immediately.  If oversupply is not an additional problem and it is ONLY food sensitivities, Mom probably would not see many digestive problems in the first month.  However, between months one and two she would notice an increasing problem.  Weeks 6-8 is the most frequent time for food sensitivities to start causing major issues.

Food sensitivities will also cause watery poop, and it can be green.  However it is much more likely to be mucousy, and BLOOD in the poop is a very good sign that it’s a food sensitivity issue.  It is less likely to see diaper blowouts.   With my son I NEVER saw “seedy” poops until we eliminated all problem foods.  It was VERY watery.

With food sensitivities, you would notice more of a variety in babies’ symptoms from day to day.  Instead of spitting up equally after every feed, you would more likely have occasional large amounts of spit-up and not as much on other days/times.  You would notice the digestive issues being worse after you eat certain meals and less of a problem on other days.   However, if you are someone who eats a LOT of dairy, wheat, and/or soy with every meal, it can again be difficult to tell if the issue is food-based. 

Food sensitivities can also cause other issues such as a rash (most typically on the face), and/or a flushed red blotchy look to the skin after nursing.  It is much more likely than oversupply to cause weight gain issues, colic, or reflux.

Food sensitivities from week 8 will typically get WORSE over time (from months 2-5 or longer).  Some babies do gain the ability to process the sensitive food eventually, though, so after getting worse it can start to get better.

Hopefully this will help some Moms figure out which of these things (if not both) is causing the baby’s issue!   I will write about dealing with each of these problems in a separate post.

Benefits to Toddler Nursing

James is still nursing. In fact, he's nursing more now than he has in many months.

He now nurses around 12 am, 5am, 7am
Nurses to sleep for one nap @12 or two naps--@10 and 2 ish
Nurses around 5pm if we are home/alone
Nurses to sleep around 6pm (if it's a one nap day) or 8pm (for a two nap day)

The 7am and 5pm sessions are new--though I have often given a bottle at 5pm to use up my milk stash, I could never get him to focus on nursing then before, but now he is re-interested.

Anyway, I am appreciating some definite benefits:

1. The 7am session means he's hungry for breakfast a little later, giving me time to get up/dressed.
2. The 5pm session is the PERFECT solution to what my Mom calls "The ugly Hour" The ungodly time when tiredness of the day meets pre-dinner hunger and Dad isn't home yet to help out--baby clings whiny to Moms while she attempts to cook dinner . . . A little milk improves the mood of the ugly hour to manageable levels!
3. Smart baby. Breast milk is perfect nutrition. There are tons of fats and proteins that make up neurons and neural pathways in the brain and body. As I sit there and watch james' comprehensive vocabulary and his signing ability start to take off already at 14 months . . . well, who know if it is even related, but the Mylar sheaths coating and protecting his neurons are made exclusively of human (or maybe veggie, hehe) fats. I love that. He is my body delightfully re-purposed.
4. Magic relaxation comes with letdown. I might be about to pull my hair out at the end, or even the beginning, of the day. But if this frustration coincides with nursing, those love hormones just melt away all my bad mood/feelings.
5. No need to worry about nutrition. Many tots are picky eaters. And even though mine is not, he is vegan. Of course I worry about his nutrition, despite the fact that he seemingly eats a wider variety of fresh, healthy, and organic foods than most kids his age . . . but, as long as I am nursing him on demand, I can be assured that he is getting everything he needs nutritionally.
6. Wolverine Style healing ability for the very frequent bruises, cuts, rug burn, etc. James is pretty active and probably falls and seriously hits his head . . . at least a couple times a week. He also scratches himself on wood, paper, concrete, furniture, cats (ahem), etc. But he heals so fast . . . a minor cut will be scabbed one day and the scab will fall off on day two. A huge bang to the head will go from an egg one day to a bruise the next, and completely disappeared within a few days or a week . . .
7. Emergency snack for any situation. Though, james would have to be REALLY hungry to nurse in a non-home and non-quiet environment, but if we were really in a pinch (or even like a flood or dangerous situation) I know I always have clean, sterile, perfect nutrition for him whereever we are!

I'm sure there are more but those a just a few benefits of Toddler Nursing that I can think of! Some are nursing benefits at any age, I suppose, hehe.

PFB Weigh-In

Alright, so we got james weighed today.

If you haven't been following PFB (Project Fat Baby), get the back story here.

Or, to make a long story short, the doctor was slightly concerned about james weight at his 6 month appointment, so I made a plan to fatten him. My doc suggested feeding him two "meals" a day, but this basically immediately made him constipated, and seeing as he is eating just fruits and veggies, those aren't really very fattening anyway . . . especially compared to the alternative (whole human milk straight from the tap).

So my plan to fatten him was to breastfeed him more often for longer and to bed-share with him to allow frequent nighttime nursing.

So today we had his weigh-in!

He was 17 lbs even, up 1 pound 2 ozs from less than a month ago (5/18). I think we did pretty darn good, because he only gained 1 lb, 5 ozs between 4 and 6 months, so you could say that over the last month, he gained twice as quickly as he had been gained.

So I'm back looking on the growth charts, but I found more detailed ones, so I could get really down to the nitty gritty in terms of what was going on here.

Born November 19th, 2010; 8 lbs, 7 oz (80%)
Two Months Old: 12 lbs, 6 ozs (60%)
Four Months Old: 14 lbs, 9 ozs (30%)
Six Months Old: 15 lbs, 14 ozs (20%)
Seven Months Old: 17 lbs (30%)

I think the approximation I was doing off of the less detailed chart missed the real story here. His main percentile loss was between two and four months actually, NOT between four and six months. This makes PERFECT sense because that was the absolute worst time for us in terms of the food allergies. We didn't diagnose him and start treating him until he was around 3 months old, and then it took us another month at least to get things under control, so between 2-4 months he was basically spitting up and/or vomiting huge amounts of each meal. He probably would have lost even more weight than he did except I have a nice full supply so he was somewhat able to make up for all the spitting up . . .

Anyway, I succeeded in pulling his percentage up 10 points in less than a month, which is pretty darn good!

So if you have a baby who is not gaining well . . . FIRST rule out any food sensitivity or other health issues that could be a factor. SECOND breastfeed the baby more, especially during the night. (And THIRD, look at the baby as a whole person--losing percentiles can be NORMAL in a breastfed baby, especially between 4-12 months, while they find their "real" place on the chart.

Personally I think the size of a baby usually has to do with the Mom and the way her body builds a baby, but the size of the child (over one and definitely over 2) is a totally different thing. We all have a tiny friend that was a HUGE baby, and at some point he/she needed to transition from one to the other, right? Alternatively, sometimes babies are very small but then completely pork and grow up between 6-18 months. So I think adjustments to percentiles is NORMAL.

One other thing, though, is that I definitely was not being patient enough with james' nursing between 5-6 months. That lazy half-asleep sucking is where the MOST fat is, but when I have things I want to do it's easy to cut him off when he's so slow and leisurely. Furthermore, he was really distracted at this time, and I had the mentality at that point that if he needed to eat then he would. And while I still think that is true, making an effort to put more focus and importance on his nursing, I think, has caused him to do the same. Your baby gets signals from you, and if you want him/her to nurse more, better, and for longer, that will be very encouraging for them. Meanwhile, if you act like nursing is a chore to get through and are impatient with it (as I was being), your baby will get that signal too.

I honestly think if I'd continued the way I was going, especially if I was trying to get him to sleep through the night in his own room, and especially if I'd given him unlimited access to food, he definitely would have weaned early (as I did).

But since it is important to me to nurse him until he is at least two, I needed to change and do something different. So far it is working great! Next update on PFB for our nine month appointment. At this point I think the 30% is about where he needs to be, so my goal for 9 months is to keep him at that percentage, which may be a challenge as he begins to crawl and discover the world!

That's one great thing about bed-sharing, though, is that I have confidence that james will make up any calories he misses during the day by nursing more at night . . . so I'm not worried.

So for now I would declare PFB a great success! I honestly don't think it is very easy to make up 10 percentage points in a month, I'm proud of myself and "the ladies", hehe.

Combo Feeding: Poll, Caution, and Experiences

Last week I did a post on Combo Feeding . . . and I really loved and appreciated all the comments, so I wanted to re-post them here, along with other thoughts from Moms elsewhere. . . but first a couple other things.


One, a discussion about the results of the poll (please participate by leaving a comment on this post).

My thoughts are this . . . so far, with nearly 80 votes, it looks like 97% breastfeed their babies. That is pretty awesome. In my opinion, the most important thing is to try breastfeeding. Maybe it works, maybe it doesn't, maybe you love it, maybe you don't, but if you give it a try, that means at the very least, the baby has colostrum and you get the experience of nursing your baby.

And so 97% of people are already there . . . so the question isn't really to motivate people to breastfeed, the question is, how can we support women better so that they are more likely to continue breastfeeding after trying it out? I think this is a very critical question.

As I say on my breastfeeding page, the goal should be to get more women to give more breast milk for longer. Whether or not they also use formula or donor milk, pump and bottle feed, NIP (nurse in public) or not, breastfeed for one week or close to a decade, we need to support them--each other.

And what about our 3%? You know at the beginning of my pregnancy, I had a semi-heated argument with my now-friend Karen about whether women should feel like they HAVE to try it, whether they should feel guilty if they don't. At the time I insisted that yes, I thought that a Mom SHOULD feel guilty for not even attempting to give their kid the best. And Karen said I was being a Mommy-Judger.

I can see my point at the time still but at some point since I had James I came around to Karen's corner. It needs to be okay for a Mom to give all, some, or no breast milk. Every woman is different, every family is different, every situation is different, and best nutrition doesn't always equal best option.

Furthermore, over the last year I've become convinced that a lot of the time, a Mom will not breastfeed or stop breastfeeding, because of the guilt and other negative emotions that we have come to associate with the breastfeeding VERSUS formula feeding mentality . . .

As Karen says...
"I went and voted. When I transitioned James from breast to formula, I combo-fed for about a month. For some reason, that was really stressful for me. Every time I gave him a bottle, there was a little voice in my head that was like "you should be breastfeeding" but I hated BFing and wanted to stop. So then I started exclusively pumping, but was frustrated by how little I could produce."

So in my mind I have been convinced. The way to support women in feeding their babies is to support women in feeding their babies. Period.


Two, a word of caution and realism on combo feeding.

Unless the baby nurses the majority of the time, it may be difficult to maintain your supply on the long-term.

When I wrote the original post on combo feeding, I was looking at it as being beneficial in two ways:

1) Helping Moms who need to give the occasional formula or donor milk bottle feel acceptance with that very common situation and
2) Helping Moms who are about to give up nursing altogether and switch to formula and/or exclusively pumping a way to leave their hearts open to nursing part time for a little longer.

However, like I said before . . .

Unless the baby nurses the majority of the time, it may be difficult to maintain your supply on the long-term.

Now, the key word here is MAY. Many women are successful at exclusively pumping and bottle feeding on the long term. However, if you have a small baby who you start giving mostly formula to (especially through bottles), and only nurse once or twice a day, the odds are that your supply will diminish and eventually dry up with so little nursing. However, this could take a week, two weeks or longer, and in that time, it is very possible that the reason that caused you to start giving formula and/or pumping has changed (your nips are less sore, your mind is clearer, you've gotten some sleep, the baby's latch or milk transfer has improved, etc). At this point if you tried to go back to nursing more you might be totally successful.

The point here is that combo feeding with a MAJORITY of formula through bottles is a pretty temporary situation. Every woman is different, but I think most need to be expressing milk every 4-6 hours in order to maintain a supply on the long-term. So if you are doing less than that, it is going to slowly dry up--which might be exactly what you want, to wean a bit more gradually. I just wanted to make sure that people understood that unless the baby nurses the majority of the time, it may be difficult to maintain your supply on the long-term.

But in my option, if combo feeding extends your nursing relationship by even one day, one week, or one breastfeed, that is worth it!


And, last but far from least, here are some great thoughts on this topic from some fellow Moms (including comments on the previous post) . . .

Alyssa said...
Love this!!! I've never thought BF'ing was an all-or-nothing thing. I figured, as long as I could give Evan SOME breastmilk (even when it was down to 1-2 times a day), it's worth it.

Grace said...
I have a friend who combo fed for a really long time, and it worked great for their family, she actually continued to nurse her little boy well into toddler-hood, and I know she was really glad that she never switched all the way to formula.
While I think combo feeding is an awesome option when necessary(for whatever reason) If you primarily want to breastfeed, it's typically best not to supplement very much in those first few months when you're establishing breastfeeding.
Great post!

Aletta said...
Good post! Patrick only had formula from 10-12 months when I stopped pumping "extra" and decided he could just get forumla if he was a little extra hungry at daycare or if we were leaving him with a sitter. Next time, I think I'd relax and start using formula in this way around 7 or 8 months, once the baby's eating a good amount of solids.
I spent so much time stressing about pumping enough milk to make sure he never had to have formula. In retrospect, I feel like I was trying too hard to live up to other people's standard of being a "perfect" mother.

EricaG said...
This is such an important message, Adrienne. TOO many moms think breastfeeding is all or nothing. Then, when trouble comes along, they stop breastfeeding instead of getting support and/or considering a combo deal. Due to insufficient glandular tissue, I cannot create a full supply. With baby #1, I supplemented but really beat myself up. With baby #2, I was introduced to the Supplemental Nursing System (SNS). This was wonderful because I could supplement with formula, but feeding still happened AT the breast. A win-win for us! I'm so thankful that you are giving such great information on this topic.

Liz said...
Thanks so much for this, Adrienne. I've finally quit kicking myself for having to use some formula, but it's taken me awhile to get there. I also refuse to use bottles in public, but that's more for a lactivist post. :)
Combo feeding is hard, but it's worth it. When Peter grabs my hair and rubs it on his face while we're nursing, I remember why I have no intention of weaning anytime in the near future.

Hilary says...
With my first, I pumped and I stopped pumping because I couldn't make 100% of her needs so I just stopped and went to formula. She did know how to latch on, so looking back I wish I would have kept nursing at least 1 or 2 times a day, maybe before bed and nap or something. But for some reason I didn't even consider it!

Samantha says...
I voted combination, since CP started out BF and then switched to FF. I really wish I'd had some kind of guidance on how to transition from EBF to part-time BFing. I would have LOVED to nurse in the morning before work and in the evening after work with formula in between, but somehow or another I messed up the transitioning process and ended up with no supply at all. We had such a great/easy BFing experience--CP latched right on after 24+ hrs of labor, 10+hrs with an epidural, and ultimately a C-section delivery, lol, literally 30 minutes after she was born, she was nursing while I was still in the recovery room from the surgery:) I couldn't find ANY help searching online, and the ped just said, "you should be able to transition to part-time BF just fine." I didn't think it would be a big deal, but literally after three days of being back at work, my supply was GONE.

Kim says...
I am now exclusively using formula, but I started with just BF, but had a horrible time. Dylan never latched well and he was juandice and he didn't gaine weight for the first month and I didn't produce a lot so we went to a combination. It was rough because I would BF, pump, and then supplement with formula. He would want to eat every two hours at first and it would take me an hour to 1 1/2 to feed him with that whole process so then neither of us were really sleeping. I eventually moved on my own to switch off BF and FF every other feeding. I still pumped after every nursing session. If I had to do it over again, I would have tried to continue the combination when I went back to work, but I was nervous about leaking since I am a pre-K teacher and did not want to explain that to any of the kids :)

Jennifer B. says...
I did combo as well. Although now he its just BF we had a rough start. Tongue tied which resulted in two clippings. But I just couldn't give up.

Jennifer W. says...
Combo only because my milk came in after six days and by day four the lc and midwife were panicking telling me maybe my milk never would come in, etc. We did some organic formula with a supplemental system for two days until I was sure my milk was in. Sad to find out recently that 4-6 days can be totally normal. :(

Karen E. says...
With DS1 I went straight to formula because I was honestly scared to BF. It seemed foreign, uncomfortable and it grossed me out, in all honesty. I don't think a woman in my family has breastfed in generations. Between DS1 and DS2, I did a lot of research and soul-searching and decided to try. I actually loved it and one of my greatest sources of guilt is that DS1 didn't get a drop of BM. Now that's he's 8 and sees CP being BF, he's asked a lot of questions about it and if he did it. Sadly, when he found out he didn't, he asked why. That was hard to explain and like I said, it makes me feel guilty.

Adrienne (yep me) says...
Karen, someone recently told me that when people feel guilt, they should usually feel anger. You should NOT fee guilty for a second, you are AWESOME to have changed so much from #1 to #2, I know how much work that takes and you should feel PRIDE, not guilt, for putting all that work in.
You should feel ANGRY that you didn't grow up watching people breastfeed and learning and being comfortable with it as nature intended. You should be angry that our society has gotten so far away from normal that it felt foreign to you.

We should be celebrating a Mom who continues to breastfeed while giving formula but I think a Mom in that situation is either pressured to stop breastfeeding altogether or made to feel guilty for using formula, when the reality is the a LOT of the benefit of breast milk/breastfeeding can be gotten through one or two feedings a day, even if you are using formula the rest of the time . . . I just wish women were more supported to do that.

Combo Feeding: The Overlooked Option (Part 1)

In gathering info for this post, I got so much interesting feedback and thoughts from other Moms that I decided to make this a two-parter, so here is part one!

So I'm in a lot of online Mom groups and even in talking to Moms in person, the question is always: "Are you breastfeeding or formula feeding?"

I am guessing that even if your baby is now primarily eating breast milk, formula, or food, that at one point, they may very well have had some of the other. (Please participate in the poll if you haven't already, results will be discussed in Part 2).

Does a Mom who breast feeds for one week before deciding to stop "fail to breastfeed"? I don't think so! Any amount of breast feeding is wonderful, and the colostrum of the first week is the most important thing for the baby to get. In fact, that first week is the most critical week to breastfeed ever! The Mom succeeded in breastfeeding her baby during the most important time for the baby.

On the other hand, what about a Mom who breastfeeds for two months and then learns her baby isn't gaining because of a bad latch or because of low milk production. There are ways to fix these problems without using formula, but many Moms might feel more comfortable supplementing during this time--either on the short term or permanently, or even switching altogether to formula. Does THIS Mom "fail to breastfeed"? Again, I think not . . .

I think Combo feeding (feeding some combination of breast milk and formula) is not only one of the most common feeding methods, but one that also is under considered and under discussed.

There are many situations in which a Mom might feel like she needs to switch to formula:
-Low supply
-Going back to work
-Bad Latch
-Pain During Feeding
-Lack of Support
-Baby Blues or PPD

However, in all of these cases, combo feeding should at least be considered, but often I think it is overlooked.

Low Supply*: Mom can breastfeed for every feed (or as many as she feels comfortable with), and the supplement afterward with formula or donor milk if the baby still seems hungry. Another option is to use a Supplemental Nursing System to feed supplemented formula or donor milk AT the breast.

*true low supply is very rare and should be diagnosed by a Lactational Consultant or, ideally, two seperate ones, before deciding that supplementation or switching to formula is necessary

Going Back to Work: This is an IDEAL situation for combo feeding. If you do not want to pump while you are at work, you can wean your body from producing milk during the day. HOWEVER, in the evening/night/morning when you are at home with your baby, you can still breastfeed during the time you are together. When you are at work, a care provider can feed formula or donor milk with a bottle.

Bad Latch: A bad latch can be painful and can make it hard for the baby to remove enough milk from the breast. This can be improved with the help of lactation consultants, but it can also be heartbreaking and physically painful until the problem is fixed, and sometimes it can't always be. Moms in this situation can consider pumping and supplementing their own milk, or supplementing formula or donor milk.

If your problem is not pain but only weight gain, using a supplemental nursing system to supplement pumped milk, formula, or donor milk is ideal. You can do this for as many feeds as you need to in order to help the baby gain.

Pain During Nursing: If you are experiencing pain during nursing, because of a bad latch or other reasons, definitely talk to a Lactation Consultant or a doctor to look for thrush, bad latch, tongue tie, or other reasons for the pain.

Some pain during nursing is "normal" but bleeding nipples, or nipples that start to hurt again after feeling better, are a sign that something is wrong.

For someone that is about to stop breastfeeding because the pain is too bad, consider either pumping and bottle feeding, or combo feeding. Even if the pain is AWFUL, could you stand it ONCE a day (while you work on latch and search for solutions)? Twice? Weaning is also painful, so weaning slowly by allowing the baby to still nurse once, two, three times a day might actually make things less painful for you. For the other feedings, you can use pumped milk, donor milk, or formula. If the baby is still getting SOME breast milk, that is awesome!

Also, if you continue to nurse for some feedings, you might find that the pain improves, and that you are actually able to go back to nursing more later!

Lack of Support for Nursing: Maybe your partner is not supportive, or your parents or inlaws, and you feel so uncomfortable about it that you are considering switching to formula.

Consider combo feeding! If you are EVER alone with the baby during the day or night, that can be your special time to nurse. Your family doesn't even have to know about it if you don't want them to. Nursing is a personal thing between you and your baby, no matter when, where, or how you do it. But if you feel as if you aren't able to nurse your baby all of the time, that is okay.

As long as you nurse your baby every day, even if it's only a few times, your baby will still get a ton of benefit.

Baby Blues or PPD: Sometimes in the immediate post-partum period, nursing can be too overwhelming. And, in fact, the hormones associated with depression, if high enough, can actually PREVENT the letdown reflex. Meaning that your milk will not come out. So when people say that they can't nurse for this reason, it's actually one of the "best" excuses--in that it's no joke. People don't realize how hormones can have a physical effect on your body . . .

Firstly, there are anti-depressants and anti-anxiety meds that are safe to take while breastfeeding. Secondly, therapy is proven to be (nearly) as effective on the short term and even more effective on the long term for depression so that shouldn't be overlooked either.

But if you feel like you can't continue breastfeeding for another day, don't! It's okay to give donor milk or formula. However, after giving donor milk or formula for a few feeds, when your breasts start to get heavy, ask yourself if you've got one more feed in you. And see how you feel nursing for that one session. And then when your breasts start to feel heavy again, ask yourself the same question. And sometimes the answer will be no, but maybe sometimes it will be yes. If you are able to keep nursing for one or two feedings per day, your baby will get all the immune properties and wonderful benefits! Furthermore, breastfeeding produces hormones that actually help relax you and fight depression!

But sometimes the answer is no every time because you really need to stop for whatever reason. That is okay, formula and donor milk are both great feeding options even if you are not able to continue any amount of breastfeeding

One final thing to consider in any of these cases . . . until your baby is four months old, your body/breasts/baby remain "flexible".

That is, even a Mom who has been exclusively feeding formula out of a bottle from one to four months post-partum has the ability to go back to breastfeeding. It is hard and you might need to continue supplementing, but it's possible to breastfeed again and some people can actually get back to doing it exclusively.

And actually it is possible to re-lactate and nurse again regardless of the age of your baby/child, as in the case with breastfeeding an adopted baby.

So mothers of the world, take control of your feeding options. Figure out what is going to work for you and realize there are a million different options. It's not just breastfeeding or formula out of a bottle, it's a combo feeding world out there--there is donor milk, pumped milk; organic formula based on soy, cow, goat, amino acids; feeding from a bottle, breast, spoon, dropper, cup, from a supplemental nursing system . . . AND you can always decide to change what you've been doing and do something new.

Be successful at breast feeding by defining what success looks like to you, and when challenged, don't overlook the wonderful world of Combo feeding!

Preventing Early Weaning/Update on PFB

Mare Asks Q: I don't get it - isn't the point of baby led weaning for the baby to go at its own pace? So like if the child is exciting about eating and wants to eat more - why wouldn't you get them naturally do that if that is what they want to do? It seems like you are trying to force him to breastfeed more?

Couldn't he still get the benefits of breast milk through things like breastmilk "yogurt" (if you did that) and cereal with breastmilk, things like that? So he feels like he is "eating" but still with breastmilk involved?


A: The point of baby led weaning is for them to eat food at their own pace. However, like I said, there is a lot of evidence that too much solids too soon (especially with an active and interested in food sort of baby) can lead to early weaning (which to me means before 2 years old). I was, in fact, one such baby who had three meals of pureed food a day from 6 months and loved it, and also was extremely active. It was easy for me to decide not to nurse (I think around 9/10 months old). But I don't want james to wean early, so what interventions can I put into place now?

As he starts eating cereal with milk and more solids I will definitely give him breast milk that way, too, but I would prefer if I could keep him nursing as well until he is at least two--that is the ideal way for him to take at least some of his daily breast milk. If he wasn't still nursing I would feel like I needed to give him some other kind of milk which I don't want to do. If we weren't vegan MAYBE it wouldn't be such a big deal to me, but it still might be.

According to the WHO, 80-90% of a toddler's nutrition at one year should come from breast milk (ideally)--meaning nursing pretty much as often as you had always been, MAYBE dropping ONE feeding by a year; and 25% of their nutrition at TWO should STILL come from breast milk--which is nursing at least once or twice per day. So I'm going to do all I can to keep him nursing until then, including adding night feeds if I have to.

You cannot FORCE a child to breast feed, and just as an overtired child can refuse to sleep even though it's what he needs, an overstimulated and hungry baby can not initially seem interested in nursing, but it might be exactly what he needs. As parents, one responsibility is to anticipate and meet your child's needs even when your child doesn't know that that is what he needs/wants.

I have seen many people wean sooner than they planned (which might end up working out for them, or they might have regrets and wonder what they could have done to keep the child nursing). So part of what I am having this intervention is to see, if you are in the position of seeing your baby begin to nurse less, if there are things you could do to turn them back to nursing more . . .

(Transitioning into an update on Project Fat Baby (PFB) now . . . )

So even though I've only been doing these things for a week or so now, I think it is already making a difference. Here's where I have implemented changes and what the effect has been:

1. I have stopped attempting to do anything else while nursing him. I have resigned myself to the fact that nursing is a two person job requiring both of our 100% focus. I have stopped attempting to (watch TV, read book or kindle, text, take pictures, go online, etc) while nursing. I stare at the baby so he can focus on eating.

Due to this intervention, I can more often get james to have a full feeding in between naps if he gets hungry. Before this intervention, he would only stick around for one letdown max--now I can get 2-4 into him.

2. I have started laying down to nurse him to sleep (or nearly) for every nap. I was doing this sometimes before, but if he's eaten recently I would skip it. Now I do it every time.

Due to this intervention, I have added some feeds to his day, and most importantly, these before nap/falling asleep feeds are usually really long. That's why it helps so much to lay down with him--I'm able to be patient and let him nurse as long as he wants. When I was holding him sitting up, I would cut him off at some point when he slowed down because I was tired, but this way he keeps eating for longer more often. The milk at the very end of the feed (when the breast feels empty) is the fattiest, so it should make a difference to get some WHOLE (fatty) milk into the boy.

3. We have started bed-sharing full time.

This helps a TON, I think. Specifically, it adds one feed when we go to bed (which I would sometimes do before, too), and he nurses sort of non-stop or over and over from like (5? 6? I couldn't even say), maybe every hour or half hour, until I decide to get up, usually like 9 or so. Before we were bed-sharing, we would move him over to his swing a lot for the early morning and he wouldn't nurse as much, though obviously at least still twice in that time (first wake up and again a couple hours later). Overall I would say he could be eating as much as twice during this time, and definitely more high-fat milk.

So, our next appointment is on June 15th--then we'll see if this has worked at all! ;-)

Project Fat Baby

So I never wrote about our six month appointment. It was good! We didn't get any vaccines this time because james was just sick and I didn't want to get them with his immune system compromised--so we go back in four weeks for that . . .

But as inevitably seems to happen a lot of the time with breastfed babies at their 6 month (or 12 month) appt, the doctor was concerned because james has lost percentiles.

Here's his stats, and if you look here on the chart for breastfed babies, you can see what percentage he is (I looked it up for you, hehe):

Born November 19th, 2010; 8 lbs, 7 oz (70%), 23 inches (99%)
One Week Old: 7 lbs, 12 ozs, 23 inches
Two Months Old: 12 lbs, 6 ozs(70%), 25 inches (99%)
Four Months Old: 14 lbs, 9 ozs(50%), 27 inches (99%)
Six Months Old: 15 lbs, 14 ozs(25%), 28 inches (99%) (Not on the same scale, which could make a difference)

But the Doc said he should be eating more solids . . . twice a day!

. . . however, I don't think that's really a good solution. Veggies and fruits have very few calories, and grains (apparently) make him constipated. His gut isn't really ready for that much solids . . . (in my opinion). Furthermore, there is definitely evidence that going too quickly with solids (especially if the baby is excited about them) may lead to early weaning, which I definitely want to avoid for my little vegan baby . . .

And while at first I was quite indignant with the doctor thinking that james wasn't gaining enough, now that I look at the percents I suppose I understand his concern. However, I'm also not surprised. james hasn't really stopped moving since his four month appointment, which means it's harder for him to eat a good meal (nurse), and that he is burning off a lot of calories, too!

I don't REALLY think that he is nutritionally starved or anything, or I doubt he would continue to stay in the 99% for length . . . but I am going to make some changes to help him gain more.

Commencing Project Fat Baby . . .

Our Mission: To help james gain percentiles.
Our Timeline: One Month

The Plan is very simple and consists of one step: Breastfeed james more.

For a baby under one year old, this is the number one way to fatten up a baby. Furthermore, I'm doing this as an experiment, because Doctors don't recommend this strategy--they say: give more food. So we'll see how this works out for us over the next month.

The plan really has a few parts:

1. During the day, make more of an effort to nurse james in a quiet and still environment that helps him focus.

2. Before naps, lay down and nurse him--to sleep if possible.

3. If he doesn't wake up on his own, dreamfeed him when you go to bed.

4. Start bed-sharing to allow him more opportunities to nurse during the night.

Of course we ALSO will be giving james food during this time and he ALSO is definitely getting better at eating. I'm not saying food isn't great for him at this stage, too, but it isn't the most important thing in terms of helping him gain weight.

So our next appointment is June 15th--I'll report on the progress of "Project Fat Baby" then.

Breast Milk as Cure-All in Poetry Form

Breast milk is basically an antibody juice

EVERYONE who is breastfeeding should take full advantage
for the entire family!

Put it in eyes
. . . . . . . . ears
.. . . . . . . . . . noses
heck, even drink it if you want
put it on cuts and they will heal faster
I always use it on james and
it cleared up his goopy eye and
it healed his rash and
it healed cuts and
scratches and
it has cleared up congestion and
prevented ear infections on
at least three occasions
I would say.

And him breastfeeding though this first cold made it EXTREMELY mild
Like, 20 coughs total over three days and
a runny nose.
That's it.

Breast (for your health) milk
For All!!!

Spread the Word.

Wordless Wednesday

Breastfeeding Twins

My nieces are twins, my good friend just became an uncle to twins, and another family member is currently pregnant with twins so the topic of breastfeeding twins has come up a lot lately.

My experience with breastfeeding twins is what I witnessed/heard from my sister-in-law, what I've researched about it (alongside breastfeeding in general) over the years, and what I can extrapolate from nursing one baby.

Here is my advice for how to successfully breastfeed twins. This is adapted from the general breastfeeding advice on my breastfeeding page--the parts in italics are where the advice differs from general tips with a singleton. I hope this is helpful!

Breastfeeding Twins

The majority of women have more than enough MILK to exclusively breastfeed twins; what ends up being the scare resources, more often than not, is time, food, and sleep for the Mom.

I firmly believe that breastfeeding is a socialized skill, much like using a fork. We were meant to grow up watching people breastfeed all the time, like using a fork. In this ideal environment, we would learn about breastfeeding by watching our Moms, Aunts, Sisters, and limitless women while out and about in public. However, this is not our environment, so breastfeeding goes from natural and easy to awkward and challenging very quickly.

Here is my advice for having a successful breastfeeding relationship with your twins. These things are in an ideal situation. Sometimes there are emergencies or unforeseen complications, but breastfeeding is resilient enough to work out great even if you can't do all of these things every time.

-If possible, have a natural birth. There is evidence that drugs such as pitocin and the narcotic drugs in an epidural can affect both your milk coming in, and the baby's ability to stimulate the breast early on. Sorry I'm too lazy to look up said evidence and link it but you can look it up yourself and/or use common sense to realize that it is probably true. With this said, a natural birth isn't everyone's first choice for a birth experience and plenty of medicated birth babies have zero issue with breastfeeding. However, I believe a natural birth is a great way to start out a breastfeeding relationship with every advantage on your side.

Some people mistakenly believe that you must have a c-section or an epidural when you are delivering twins. This is not true. As long as one twin is head down and engaged in the birth canal, you should be set to deliver your twins vaginally. Sometimes only one twin can be delivered vaginally but it's still better for that one to have avoided the c-section even if one is necessary for the second twin.

Some hospitals have policies about delivering twins. Fight for your birth rights if having a natural birth is important to you. You are always allowed to deny a medical test or procedure that they are offering.

So even for twins, having a natural birth is a better way to go if you are able to do it!

-Immediately after birthing the first twin, put the baby on your belly/chest, and leave her/him there, skin-to-skin, until you have the other baby. Continue skin-to-skin care then for as long as possible--ideally 1-2 hours or more. You can allow the babies to initiate breastfeeding on their own by crawling to the breast, or you can help them. Keep the babies naked and your chest uncovered, and do this skin-to-skin kangaroo care for at least 1-2 hours after birth.

-My suggestions for a great pattern in which to nurse twins is this: Have one twin on one breast for all feedings and the other twin on the other for an entire week, then switch them. This will ensure that even if one twin is having a needy/fussy day, there will still be plenty of milk there for the other twin. The reason it might be a good idea to switch them weekly is that more often than not, one breast will produce more than the other breast, so this ensures that both twins get a chance at the more productive side.

-The first week should be a "nursing vacation." You, your babies, and ideally your husband, should pretty much stay in bed and be naked together to help the babies bond with both of you and establish proper breastfeeding.

-Expect the babies to pretty much nurse non-stop the first week--this is NORMAL, HEALTHY, and does NOT mean that the babies are not getting enough milk. This first week is CRITICAL in terms of your milk supply coming in well. Some people can take up to a week for the milk to come in. Colostrum is enough for your babies but only if they are able to nurse pretty much constantly. Some babies can go an hour or two between feeds, and most do that at least some of the time, but start out with the expectation that this first week your job is ONLY to nurse the babies. Hence the staying in bed/on the couch.

Even if you don't generally enjoy tandem breastfeeding (feeding both babies at once), you might want to just resign yourself to doing it for this first week or two.

-For at least the first six weeks, breastfeeding twins is (at least) a three person 24-hour a day job:
+The Mom should (for most of the day and night) be comfortably arranged on a couch or bed, with pillows set up so that when a twin is hungry, it is brought to the Mom's breast, arranged on the pillow, and allowed to nurse. In this way the Mom can nurse both babies at once on demand, even with twins.
+The Dad should be on diaper and baby comfort duty. Besides feedings, Dad should be the primary caretaker of the babies. He will do most diaper changes, clothes changes, will bring twins to and from Mom, will rock to sleep, etc.
+And there should be a third person, a family member or friend (or many in turn), with you 24/7 to take care of cooking and feeding both parents, doing all the laundry, and for back-up baby care.

-After the first week, continue to nurse the babies on demand--nurse at the first sign of hunger--rooting (chewing/sucking on hands, clothing, etc), open "searching" mouth, agitated movements, etc. During the day try to nurse at least every 2 hours. This will help the babies sleep longer at night if they are fed more often during the day.

-Expect the babies to be fussy and cluster nurse (feed very often/constantly), usually in the evening and during growth spurts. You will probably at some point feel like you are "out of milk" and that the babies seems hungry and unsatisfied. As long as this only happens for a day or two at a time (growth spurts), and/or during one part of the day, it is totally normal and DOES NOT MEAN the babies are overly hungry, starving, or that you need to supplement with f0rmula. Supplementing during times like these can be very dangerous and lead to a permanent (and spiraling) supply dip.

This cluster nursing usually lasts for the first 6-12 weeks.

-After the first six weeks, breastfeeding twins (just like with singletons) will become easier. By 6 weeks, the babies will usually be going at least two hours between feeds and sleeping longer stretches at night. Breastfeeding will become more routine and each nursing session will shorter. At this point it might be possible to only have two full-time adults taking care of: the twins, the Mom, and the house. ;-)

-Have CONFIDENCE in breastfeeding. It is difficult at times, but it really is perfect food for your babies, and a perfect "system" for Mom. There is no reason to question whether your babies are eating enough unless they aren't gaining weight. Otherwise, feed your babies at your breasts, watch the milk dribble from their chins, and KNOW that they will eat as much as they needs to eat, and your breasts will make it for him. Supply and demand. It's that simple, especially if you can do all of the things above.

-After the first 3 months, it can become REALLY easy. Most babies drop to 5-10 minute feedings every 2-3 hours and many are sleeping through the night, or only waking once or twice to nurse (again usually only for 5-10 mins). There is no warming bottles, mixing f0rmula, wondering if the baby ate enough or if you need more--you don't even have to get out of bed all night long! It is true that it can be challenging and demanding in the early days, but it totally pays off in the long run!

By 3/4 months, an energetic Mom (even an exclusively breastfeeding one) can probably handle her twins on her own with just a few hours of help (including a baby break) per week. As long as she has lots of snacks and isn't expected to do much else besides take care of the babies and feed herself. ;-)

-All problems can be solved. Seriously. Of course with twins more often than with singletons, supplementation with f0rmula or donor milk can be required, but this should not be seen as a failure. The goal should be to continue to provide as much breast milk as possible for as long as possible, and success shouldn't be judged on exclusively breastfeeding.

If you are pregnant with twins and would like to breastfeed, definitely get both Breastfeeding Made Simple (which I recommend to all pregnant ladies), and also Adventures in Tandem Nursing. This is an entire book about breastfeeding two: twins, while pregnant, an infant and a toddler, etc. There are personalized stories, photos and descriptions of good tandem positions, and general advice.

Generally, understand that exclusively breastfeeding twins is POSSIBLE most of the time--it is more normal than not for a Mom to have more than enough milk to feed two babies. What is going to make it really happen though is having the right help and support in the beginning. The Mom needs to be waited on hand and foot and should NOT be the primary caretaker of the babies. Her only job should be to breastfeed (for at least 6 weeks)--this approach will make success easier. With the appropriate support, even a Mom of twins can have a wonderful breastfeeding relationship with her babies!

Wordless Wednesday: Guest Post

Thanks to my good friend Clare for being my guest blogger today! Clare is an amazing artist/photographer/teacher/animal lover/friend.

Wordless Wednesday: Distracted Nursing

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Five Months Old!

My darling baby is five months old today.

I can't believe it. In one more month he will be half a year old! And so much is changing so quickly it's hard to imagine what he'll be like in 6 more months when he's nearly a year old!

Some of James' new things this month are blowing raspberries/spit bubbles. As if he didn't drool enough already, now he can send even more massive amounts of liquid out of his mouth. He sure is proud of himself when he does it, too, LOL!

While I wrote last month that he has just rolled over for the first time the day before, now a month later he still has yet to do it more than say, half a dozen times (from front to back). He has not yet rolled back to tummy either (but I think he is getting much closer!). He IS getting slightly more fond of tummy time but I've neglected to do it very often, so that's a goal for this month, hehe.

He is getting better at sitting, needing less and less support from us or cushions and chairs. I think he is THIS close to "tripod sitting" (supporting himself with his hands).

He now REALLY REALLY loves his bouncer, and has now figured out that he can turn it totally around to sample the different toys that are there--he is really into it. We still need to prop a book under him so he can reach the ground (and blankets around him so he doesn't topple), but he is really loving it.

And he LOVES "standing", with his legs straight and his arms and/or body supported. Sometimes when we try to make him sit he refuses to bend and will only stand, LOL.

He is also getting better and better at using his hands--he can grab, say, the handle of a cup with a targeted motion with both hands. And he LOVES his Tommee Tippee Sippy Cup. It's almost too stimulating for him--he gets frustrated and over excited with it after a while and I need to take it away to let him calm down, haha.

He is starting to get better at "playing" with food, as I wrote about before . . . he's still not really to the eating stage but he's nearly there!

We've continued his nap routine (change diaper, read books, nurse, rock to sleep/put in swing) with some diligence. At the very least he is definitely getting more patient and focused about reading. Now we can read for short periods from books with hardly any pictures. For example, I read him a mini-chapter of the Little Prince during many of the reading sessions. He really loves the simple squishy page books, or board books, though. James was telling me that he would even turn the pages himself if presented with them . . .

He continues to be an interminably happy baby. He barely ever cries and just laughs and smiles and plays and is a baby all day long. Cutie.

He is starting to be a distracted nurser...

...(look for my Wordless Wednesday post tomorrow for more), which means that for a lot of his feeds he is not getting a full bellyful. I guess he makes up for it at other times? Unfortunately that often means during the night, but it's okay.

I am now a pro at nursing lying down and pretty much exclusively do that at night. We are still swaddling him but I'm THIS close to stopping swaddling and starting to transition to full-time bed-sharing (he's up until now been in an on-the-bed co-sleeper, swaddled).

Everyone just loves him so so much.

I've been falling more and more in love with him recently, as his personality grows and his good humor shows through more and more. Sometimes we snuggle and he just laughs and touches my hair and face, I LOVE HIM!!

Cosleeping: Why Could Cosby get Away with it?

I feel like there are a lot of ideas and things packed into this blog post. Sorry if it's a bit fragmented but I think there's a common thread . . .

My sister and her roommates and my Mother-in-law were all over here the other day and someone brought up the case of a 7 or 8 (they weren't quite sure) year old boy who was still breastfeeding and how shocking this was. Now, I am a huge advocate of extended breastfeeding, and so, some part of me wanted to (and did) defend this family. But I am forced to admit that 8 is quite old--would be too old for me. Still, I have heard of cases (in more supportive cultures than the US) of children breastfeeding until age 9. That seems to be pretty much the oldest that I've ever heard of.

The story about the family continued, though, that the father of the child had been complaining because he'd been kicked out of the bed and the Mom and child were cosleeping in their bed. "So clearly," I expressed to the group, "there are issues there beyond breastfeeding." Which there are, because the father was unhappy . . .

However, when did cosleeping (especially with an older child) get such a bad rap? I'm totally all about cosleeping in general and yet THIS was the thing about the story that I had the most judgement in my heart about, and why?

This morning I was thinking about this, and about the Cosby show, which I've watched recently with much enjoyment. Cliff Huxtable was an Obstetrician and known far and wide as THE parent. The one raising his kids right and sending them to college and keeping them out of trouble and honest. And what happened almost every night of the show? 5, 6, 7, 8 year old Rudy would be there at the door saying: "I had a bad dream, can I sleep with you?" and climbing in bed with her parents and snuggling up. More than that, 10, 11, and 12 year old Vanessa was sometimes accompanying her. Or her father would come home from delivering a baby and find one or two of his young daughters in his place in bed next to his wife, and he would retire to the couch or carry them into their beds or snuggle up in the bed with them.

But he was never ASHAMED about it. At a time not that long after the first TV COUPLE shared a bed, very scandalously, we have a whole family bed-sharing together, and not on "Married with Children", on the freaking Cosby Show.

So why the judgement? I'm asking myself as much as the next guy.

I think for some reason now-a-days, co-sleeping and bed-sharing and especially "the Family Bed" is so looked down upon. Of all the parenting decisions I have made, the fact that I don't yet own a crib and pretty much plan to bedshare with my baby (he currently sleeps in an on-the-bed cosleeper) is the one I have gotten the MOST flack over.

Yet? I'm pretty sure that like the 75% of the world cosleeps for the first 2-5 years of the baby's life. I know in China they do, and let's be honest, that's like half the population right there. But seriously, cribs are not a worldwide thing--or if they are it's only the richest 25% of people worldwide.

Honestly, I, myself, am nervous about cosleeping because of the aggressive campaigns against it in the United States, claiming that it is unsafe.

Of course as with any other infant sleeping arrangement, it has to conform to certain rules--a firm, flat mattress, no excess pillows or blankets around the baby (and none around the baby while it is tiny). Neither parent (sharing the bed) should smoke or be under the influence, and the Mom should be breastfeeding. All these things make cosleeping 100% safe.

Honestly since seeing the video I posted a while back about how 100% of bedsharing deaths were in the case of f0rmula fed babies (in whatever studies they examined, I don't know if that is UNIVERSALLY true), I have been able to put in check the fear caused by those smear campaigns. Personally I'm waiting for James to start rolling over more consistently (before I let him stay directly in the bed with us, unswaddled, instead of in the cosleeper, swaddled) because I want to make sure that he'd be able to right himself if he somehow rolled over, but even this is being excessively cautious. I have sleep shared with him a bit here and there, getting ready to do it full time, and from what I have observed it is 100% safe. My body is 100% aware of James even when I am asleep. Furthermore, I LOVE IT!

I can't tell you how ridiculously sweet it is to snuggle up to my baby in the morning or the middle of the night, and be able to kiss him little face and breathe in his little smell and have his little hands touch my face or his little eyes look into mine and his little body all calm or wiggly . . . It's just like being bathed in love.

So I'm not going to judge this (other) family for what they are choosing to do. Hopefully things work out for them. And just wanted to give a last shout out to extended breastfeeding, which has many health and emotional benefits (for the Mom and child) for as long as it lasts, has never been shown to have ANY negative effect on the child or mother. (Emotional/family problems, like babying your son and ignoring your husband, are going to be problems whether extended breastfeeding is present or not, but breastfeeding is always blamed in situations like that.)

I think as always it comes down to personal preference--parents should (and probably do) do what makes them most comfortable, and who are any of us to judge . . . every kid is different and every parent is different, so every parent-kid relationship is unique and has it's own dynamics.

(And if anyone who was present at this conversation reads this, I'm speaking as much to what I thought/felt/said as to what you said, I didn't think anyone was being mean or overly judgmental, it just gave me something to think about!)

Covering Up While Breastfeeding

I don't get what all the hubbub is about covering up while breastfeeding. A friend described her sister-in-law trying to breastfeed to me saying that she would go into a different room, and then use a cover, but she couldn't see the baby and was having trouble latching her, so it just looked like a super hassle. This same Mom could not keep up breastfeeding on the long term, especially after going back to work.

I have to say that I come from the place of having small breasts. Before getting pregnant they were B's (and when engorged they might be D's) but they are C's generally now and when I've been heavier, so pretty small and my aureoles are small. So pretty much unless I am just hanging them out of the top of my shirt you can't see much. Maybe if my breasts were bigger I might feel more exposed Breastfeeding in Public? But honestly I feel like the more I breastfeed around people, the more I am teaching them about how to breastfeed, how to respect a breastfeeding women, and that it is normal, natural, and even beautiful and so special to see. So I try to do it. But for other people, they don't want to do it, and that's fine, too.

Anyway, I couldn't agree more with this backlogged blog entry at PhD in Parenting. . . Covering up is a Feminist Issue

And honestly I think if you don't make a big deal about it, a lot of times people can't even tell! I pretty much breastfeed James where-ever I am in whatever company I am in right there in the middle of everything. When I was visiting my Grandma once I fed him while my Grandma's friend was there and helping her decide how to paint her living room. My Grandma said later she said something to her friend about me feeding him and she didn't even notice. "Not a lot gets past her!" My Grandma said, about her friend, "but you were just so nonchalant". Yeah totally. It's just not a big deal, in my opinion. Normal.

Birth should be that way too, in fact! Nonchalant/special/wonderful/natural. Sometimes it hurts, sometimes it's annoying, sometimes it doesn't work out the way we planned. But the attempt/our version of success/and aftermath can be an important part of transforming a woman into a mother. It binds us together and lets us know and find our strength. So it's at once a part of life and something spectacular. Cover up if you want to, but I'm enjoying it in all it's glory, hehe.

Baby Led Weaning--and when to start solids . . .

Before I had James, I thought that the professional medical guidelines on when to start solids said 6 months, and I would wait until 6 months, gosh darn it, and couldn't understand why people were so eager to start sooner.

But now I get it. One thing I've realized and didn't quite understand before is that baby skillz develop continually. You see them put together a little piece here and there and all of a sudden they have gone from spontaneous movements, to controlling their legs and arms, to controlling their hands, to their fingers and when the pincer grasp begins it's all these months of effort since birth that have made it possible.

And every baby is unique. At this point I seriously think that some babies are ready to start solids a little earlier--4, 4.5, 5 months, and some, obviously, are not interested until later--9/10 months. Six months is just an average and while babies don't NEED food sooner than six months (or even a year or longer, if breastfeeding), some may be ready and willing sooner.

Here are the signs of readiness for solids from Kellymom:

Signs that indicate baby is developmentally ready for solids include:

* Baby can sit up well without support. (James sits with support)
* Baby has lost the tongue-thrust reflex and does not automatically push solids out of his mouth with his tongue. (Still has this)
* Baby is ready and willing to chew. (He has this! He chews on everything!)
* Baby is developing a “pincer” grasp, where he picks up food or other objects between thumb and forefinger. Using the fingers and scraping the food into the palm of the hand (palmar grasp) does not substitute for pincer grasp development. (He doesn't have a pincer grasp yet, but he's close. Definitely has the Palmar.)
* Baby is eager to participate in mealtime and may try to grab food and put it in his mouth. (Yep!)

So at 4.5 months, James isn't quite ready to start solids, but he's pretty close.

I believe in baby-led weaning . . . this is perhaps a misleading name--it basically means feeding foods in their whole natural form, not feeding purees, rice cereals, etc. So baby's first foods become a banana, an avocado, a sweet potato, steamed broccoli, (or homemade rice or oatmeal porridge with breastmilk), etc. By six months, many babies will pick up a banana and eat away quite successfully. By four months, many babies (such as mine) will have a sincere interest and desire to ingest the banana. This is where the readiness to start solids is seeded--in desire, so he will WANT the banana first. And he does.

So, if given the banana, he will try to pick it up. After many tries, he will succeed! He will try to bring it to his mouth . . . and he will succeed! He will try to eat it--and here he will fail. He can lick the banana and may ingest a few banana molecules but his mouth is still hard-wired to breastfeed--the tongue thrust reflex, that sends purees right out of the mouth, too, is still present. So to me, this means that he's not REALLY ready to EAT food yet. His gut is as immature as his tongue thrust reflex, and they protect his body from all but the most perfect nutrition.

However, he's pretty close, right? If I follow baby-led weaning and just let him keep trying to eat, he will eventually succeed. Will it be the day he turns 6 months old? Probably not--it might be sooner. I'm just going to relax and let his skillz dictate his own pace.

This confidence I can feel in him being able to pace himself is one of many many advantages to Baby Led Weaning, in my opinion. Here's a few others:

-Baby learns a variety of food textures from the beginning, which may lead to less picky toddler eating
-Baby learns how to manipulate food in his mouth and chew in a natural way
-Baby learns ABOUT different foods--what they look like in their whole food form and what they taste like, which helps to develop a trust in food
-It is cheap. Baby food is so expensive and after reading the baby led weaning book I almost feel like it's a scam.
-It is easy. You can just let your baby try the food that you are eating. No making separate food for baby, no sitting there with a spoon coaxing the baby to eat.
-Baby controls his eating, just like with breastfeeding. Anyone who has ever breastfed knows it's impossible to force a baby to breastfeed. Therefore, babies control their eating from birth and naturally know when they are hungry and when foods they like and don't like. Babies often instinctively avoid allergic foods. So letting a baby pick and choose what foods to eat means that you don't turn eating into a power struggle.
-And more. I highly recommend Baby Led Weaning to anyone!

With this being said, some babies who are sensitive to textures may not be into eating whole foods until they are much older--10 months, a year, etc. Which means a lot of people find purees work for them, too, if they want to start solids before the baby gets into textures. Whatevs I think.

I think this is one of many areas that a Mom is the expert on her own baby. Especially a Mom that does her research and makes an informed decision, regardless of what it is.

Breastfeeding an Adopted Baby

I have several friends and family members hoping to adopt. When we were trying to conceive James, I thought about what would happen if we ended up building our family primarily through adoption, and the number one regret I had at this idea was missing out on breastfeeding.

However, in the time since then, I've discovered that it is actually possible to breastfeed even if you have adopted your baby. Here is a basic outline of how you could proceed if you would like to try to breastfeed your adopted baby. You actually don't need to do ALL of these things, you can pick and choose which parts are going to work for you.

1. Before your bring your baby home (several months before, if possible), buy a high-quality, double electric breast pump. Start spending time every day stimulating your breasts by pumping them. You will not get any milk at first, but the stimulation builds up the prolactin levels in your body, which will start to stimulate your breasts to produce milk. It might be uncomfortable, especially at first, but the more and the longer you can do it, the better off you'll be. After a while, you might start to see tiny drops of milk coming from your breasts--this is a great sign!

If you have the time to do it, the goal should be to pump for 120 mins per day. You could do four 30 min sessions, five 25 min session, six 20 min sessions, etc. However, even if you can't get to this 120 min goal, as much as you can do will help.

If you start to get more than a couple of drops of breast milk, save and freeze the breast milk so that you can use it later on!

2. Start taking supplements to help your body produce more milk. Fenugreek, blessed thistle, and alfalfa, plus eat as much oatmeal as you can. The old-fashioned steel cut oats work best. You can also drink oat milk as an easy way to get more oats.

There is also a prescription medication that can be extremely helpful--domperidone. Talk to your doctor (ideally, at least three months before you bring your baby home) about getting a prescription.

3. Buy a supplemental nursing system. You can see how it works here. Basically, it allows you to supplement saved breastmilk and f0rmula AT the breast. So even if you decide NOT to do parts 1 and 2 above, you can still give f0rmula while providing you and baby the bonding experience of suckling at your breast.

4. Buy a nipple shield (especially if your baby is not a newborn). Babies who have gotten used to bottles will have a harder time feeling comfortable at the breast. A nipple shield can help the breast seem more like a bottle to your baby, which might help you transition them to the breast.

5. Offer your baby's birth mother the opportunity to sell you her breast milk. Some birth mothers are interested in pumping their milk and providing it to you for feeding your baby, at a negotiated cost. This can be beneficial for both parties. If your birth mother is willing to do this on the short or long term (even a week or two of breast milk can give your baby needed immunities), make sure she is educated on the proper handling and storage of breast milk.

This milk can be given in a bottle or through the supplemental nursing system.

6. Look on Milkshare, Eats on Feets, or another milk bank to see if you are able to get donor milk from a Mom other than your birth mother.

P.S. If you are a breastfeeding Mom and you find yourself with extra frozen breast milk, donors to milk banks are badly needed. Preemies and other babies with health issues are the first to benefit from donated milk!

7. Expect it to feel strange or unnatural at first. Even with my biological son, I have to admit there was a week or so of getting used to regarding my breasts as feeding implements. There can definitely be an initial weird-out factor. However, your love for your baby will quickly change the way you think about your breasts. Just stick with it and soon it could feel quite natural!

Be flexible, persistent, and have reasonable expectations. Most adopted Moms do need to supplement with f0rmula or donor milk, but every drop of your own milk you are able to give to your baby is going to feel awesome! Plus the experience of your baby suckling at your breast is really like no other--even if his/her main nutrition is actually coming through the supplemental nursing system!

Also, this is going to be more of a challenge the older your baby is. A newborn baby is pre-programmed to latch at the breast (though even for biological parents this can also be challenging), but the older a baby is, and the more bottles he/she has had, the harder it might be to get him/her comfortable at the breast.

Finally, here are some tips from Kellymom that might help--especially for an older baby.

There are also a great amount of resources out there on the web!

I hope this is helpful to someone--anyone who reads who has additional tips, please share in the comments! All experience and info wanted!