Category: Breastfeeding

Infant Colic – What Can You Do?

Posted by on in Baby Care, Breastfeeding, Comfort, Herbs, Homeopathy, Postpartum

Colic can make the new parenting journey grueling!  What can parents and care-providers do?

Babies are said to have colic if they cry for more than 3 hours daily on a regular basis. The cry is often high-pitched and relentless, accompanied by a red face and rigid body. It often happens later in the day or evening. Nothing seems to soothe the baby. Research shows 10-20% of babies experience colic. It’s heart-wrenching and exhausting for care-providers. 

There are theories about what causes colic but no certain answers. Colic resolves in most infants by 3-4 months, which is the entire “4th trimester”, when we expect babies to sleep a lot and when new families are typically bonding and getting to know each other.

The first thing to consider is your baby’s health. Is your baby gaining weight and soiling diapers as expected? Check out the handy Best Start Chart for signs that feeding is going well. Watch for signs of illness that require medical attention, such as lethargy (limp baby), fever, diarrhea, forceful vomiting.   

Is there a chance your baby is overstimulated? Some babies get overwhelmed by a seemingly low level of sounds, sights, and attention. Others can’t get enough. 

If your baby is fed, dry, healthy and the usual soothing techniques (rocking, walking, warmth, fresh air, holding, breastfeeding, singing etc) don’t help, then suspect colic. Here are some suggestions that can help an otherwise healthy baby who has colic. 

  • Infant Chiropractic care, from a Chiropractor who has specialized training and experience. Over 90% of colicky babies show improvement! It’s gentle and nothing like adult adjustments. I’ve heard countless stories from clients who’ve seen amazing results after only one or two treatments from their local baby-chiro.
  • Consult with a Lactation Consultant. Suggestions to help with latch and positioning can make a big difference, especially if the colic is related to swallowing gas while feeding. LCs spot all kinds of little or big things that can be easily corrected. 
  • Infant massage. There are classes and videos demonstrating how to do infant massage for colic. This can help move gas along, colic or not.  
  • Homeopathic remedies such as Cocyntal. I used to run the Vitamin & Supplement department of a busy health store and this was one product I could never run out of for fear of the pleas from desperate new parents. Many of our customers swore by this remedy. 
  • Fennel tea is a natural remedy for digestive issues such as gas, cramps, flatulence. It helps with colic too. Ready-to-use fennel tea is sold commercially; just add boiling water and steep for 5-10 minutes like any other tea. It can also be made by boiling fennel seeds (5ml seeds per 250ml water; 1 tsp per cup) for 10-minutes in a covered pot. The breastfeeding parent can drink 3 cups daily. For babies being formula fed, cooled fennel tea can be given to the baby orally with a dropper, 3-5ml (½ – 1 tsp) three times daily.
  • Break the stress cycle, if there is one. Never punish or shake a baby who won’t stop crying. Take 10. While it might go against your instincts, it’s better to put your baby down in a safe place and step away for 5-10 minutes to breathe slowly and deeply and regroup. Colic is one of the hardest parenting issues! 

I worked with one family who tried everything to no avail. Both parents were loving and kind but exhausted, distressed, anxious and at the end of their rope. Finally, in desperation, they asked a relative to come and stay for 2 nights so they could go sleep at a hotel. They figured they could go home to care for their screaming infant again once they’d restored some energy. When they went back home the colic was over. Done. Never came back. Coincidence or an environment of stress responses cleared up? We’ll never know but they sure were relieved. This is an extreme example but sometimes we have to ask for help and try something we’ve never done.

Angie The Doula – New Parent and Baby Essentials

Posted by on in Baby Care, Books, Breastfeeding, Comfort, Supplies

What are the most important items for new parents and their newborns? Everyone has different opinions about this. Stores and ads would have us buy all kinds of things. What do you really need? Think about what you have to do with your baby. For example, a travelling family will have different needs than a family at home.

This New Parent and Baby Essentials list is from my experience along with comments from families with whom I’ve worked.  It’s biased toward being kind to the environment and keeping life simple.

Before we get started, I want to let you know that really all you need (other than love, food, shelter) is a warm safe place for your baby to sleep when they’re not in your arms, diapers (unless you’re doing EC) and a system for cleaning your baby, and a safe and comfortable way to transport them.  Note that babies will go from laying stationary to rolling over in the blink of an eye.  Save your babe from a fall and potential injury by never leaving them unattended on a flat surface such as a bed or table, unless they’re surrounded by little rails or something that will both prevent rolling and suffocation.

New Parent and Baby Essentials

Essentials:

  • For maternal postpartum recovery and wellness:
    • Bottom spray (postpartum perineum-saver!!)
    • Adult diapers for the first week – not pretty but awesome way to prevent postpartum leaks
    • See Breastfeeding section below
  • Something to wear or a way to hold the baby – sling, wrap, carrier or baby pack for newborn i.e. supports head
    • May need a couple of methods to accommodate different adults – sizes, abilities, preferences – and babies
  • For baby:
    • See Diaper section below
    • Car seat
    • Baby blanket or cover for car seat
    • Receiving blankets – 20
    • Mini-wash cloths can be used as wipes – 40-50 if you’re not using disposable wipes
    • Baby blanket for home
    • Digital thermometer
    • Q-tips, in case of care of umbilical cord
    • Baby nail clippers 
    • Saline-squirter or nose-sucker
    • Baby clothes – many people get much more than they need from family & friends
      • A few outfits including sleepers and undershirts
      • Socks & mitts
      • Outdoor clothing
      • For winter babes, outer clothing such as a fleece bunting-bag or something that covers hands and feet as part of the outfit.  Also a good hat that stays on.
      • For summer babes, a sun-hat, and thin clothing to cover up skin but not overheat
    • Baby ear-muffs (hearing protection), e.g. for music festivals, movie theatres
New Parent and Baby Essentials
  • For breastfeeding/chestfeeding:
    • Nipple cream or pharmaceutical grade lanolin (e.g. Lansinoh)
    • Nursing bras
    • Nursing pads (pref cotton, non-disposable)
    • For consideration: a little manual pump or milk collector device such as the Haakaa
    • Book: Womanly Art of Breastfeeding – quick answers for breastfeeding issues; easy to read and short fix-it suggestions
  • Diapering.  Set up a safe place and have supplies ready to use.
    • Change table with little rails, change pad (with sides) on a table or dresser, or towel on the floor
    • Diapers – what kind will you use?  Cloth or disposable (biodegradable, organic, or regular)
    • Wipes – washcloths / reusable, or disposable
    • If using cloth, you’ll need a storing, soaking and washing method.  Feel free to ask me.
  • Think about sleeping options:

CPS recommends baby sleeps in the same room as parents , ideally for the entire first year, but for a minimum of 6 months.

  • Baby blanket or quilt; no pillows needed
  • Some kind of washable pad for under baby – can be anything from a proper baby-pad to a folded sheet.  This goes under the baby-sheet to avoid scrunching and twisted bedding.
  • Family bed – a futon on floor, extra-wide bed against the wall, or 3 sided crib that attaches or goes against parents’ bed
  • Family room – a safe place for baby to sleep in your room but not necessarily attached to bed
  • Baby room – high quality crib with slats close enough so a pop-can won’t fit through 
  • In a pinch – box, drawer or laundry basket
New Parent and Baby Essentials

Other things that make life easier (and are worth every cent!)…

  • Really great nursing pillow 
  • Smart Medicine for Healthier Kids book has both allopathic and holistic advice on childcare from newborn to teens
  • Calms book – a short read with great tips for learning to communicate with your new baby
  • Medicine dropper – has many uses other than medicine
  • Stroller, or Burley/Chariot 
  • High quality and “clean” baby care soap and laundry soap

Nice to have but not essential

  • Swing or Rocker
  • Baby-bath or Tummy Tub but another option is to just have a bath with your babe to minimize buying stuff.
  • Baby monitor, depending on your lifestyle and home layout.
  • Breast pump and glass bottles in case of emergency or depending on lifestyle.
  • Playpen  

I teach a variety of Child Birth Education classes and prenatal workshops online for people all over.  I have been a birth doula since 2002, and have helped over 300 clients with their births and over 1000 through prenatal classes. Learn more about my birth doula services, and contact me with any questions you may have.

Use of Herbs During Pregnancy & Lactation

Posted by on in Birth Prep, Breastfeeding, Herbs, Nutrition, Postpartum, Pregnancy

Herbal medicine is specific category of health-care.  Many herbs, including essential oils, are safe and beneficial during the childbearing year, while others can be dangerous.  Pregnant women must be cautious with any remedies, especially during the first trimester when the fetus is most vulnerable.  There’s a lot of misinformation concerning herbs.  Here are lists of commonly used herbs that are considered safe and unsafe through pregnancy and postpartum.

Read More “Use of Herbs During Pregnancy & Lactation”

Drying Up Breastmilk

Posted by on in Breastfeeding, Postpartum, Recovery, Safety

While breastfeeding is actively promoted in almost all Canadian communities, a new mother may need or want to prevent further lactation or dry up her milk.  Reasons include still-born, surrogacy, medical conditions requiring treatment contraindicated with breastfeeding, past abuse, and lifestyle choices.  For many women it’s a very difficult decision.  Women need acceptance and supported in their choices.  To that end, here’s information to help a woman cease lactation in the safest and least painful way.

Read More “Drying Up Breastmilk”

Golden Nuggets for Breastfeeding Early Days

Posted by on in Baby Care, Breastfeeding, Education

Some little-known gold nuggets for breastfeeding in the first days (you may wish to print this and stick it on the fridge or by your feeding-nest):

  • Breastfeeding may take practise but is designed to work
  • Watch for feeding cues* and offer breast.  Crying is considered a late sign of a stressed babe.
  • Offer one cue, then pause to let babe work it out.  E.g. nipple to baby’s lips, then pause for 5 seconds to allow babe to sort out latch.  If she needs another cue, then give on, pause, and repeat if needed.  Baby is learning too.
  • Babies rest/pause with eyes closed.  If babe stops sucking but stays on breast, let him rest and resume feeding.  He’s likely not actually sleeping, so don’t take him off.  (Sleep test – lift and drop arm.  Sleeping baby’s arm will fall; wake baby’s arm will respond.)
  • You should feel a tug or pull, but no pinching.  Avoid the temptation to feed through a bad latch, no matter how demanding baby is.  Not even once!!  Break the seal (insert pinkie into babe’s mouth) and start again.  Even if it takes 10 tries.
  • Don’t hold baby’s head while feeding.  It may be sore from birth.  Sore or not, the stimulation causes baby to pull back from breast.  Hold head by putting hand on bones at top of neck if necessary.
  • Don’t “pet”, rub, stroke babe while feeding.  Holding and feeding baby is an act of big love in and of itself.  (Imagine if you were trying to enjoy a fine meal, and someone was petting and rubbing you all over.  Ok that might be fun, but not conducive to eating.)
  • After 3-6 weeks the effort of breastfeeding becomes way less than the effort of formula.  Keep going – it gets easier and is worth the early efforts.

Best Start has an excellent 1 page chart for the first days –  feeding guidelines, newborn stomach size, diapers and other info.  Print this!

* Here’s a great graphic to help you identify visual feeding cues.

 

 

Feeding Baby in the First Year

Posted by on in Baby Care, Breastfeeding

A baby’s nutrition in the first year has life-long effects.  Inadequate nutrition is responsible for more than 35% of child-deaths, and higher rates of illness and developmental delays (World Health Organization, 2009).  Even in affluent North America babies and children are malnourished, often due to misinformation and poor food choices.

Health Canada (2012):  Breastfeeding – exclusively for the first six months, and sustained for two years or longer with appropriate complementary feeding – is important for the nutrition, immunologic protection, growth, and development of infants and toddlers.  Several international health organizations such as UNICEF, WHO, and the American Academy of Pediatrics make the same recommendation. 

Birth to 6 months
Babies should be exclusively breastfed until at least 6 months of age. There are no nutritional benefits to early complimentary feeding, only risks.  Babies who are only partially breastfed (i.e. supplemented with formula or other liquids or solids) in the first 6 months are healthier than those who are not breastfed at all, but risks are significantly higher than in exclusively breastfed babies.

If you think your baby is ready for solids before 6 months then please see section below regarding signs.

Benefits of breastfeeding, i.e. why formula should be used only as medicine
Human breastmilk is uniquely designed for human babies and contains all the required nutrients.   It’s the only thing an infant’s gut is designed to digest and assimilate until at least 6 months of age.  Breastmilk contains substances that augment the immature immune system, and aid in digestion and absorption of nutrients.  Anything else is likely to ferment, lead to gas, colic, poor nutrient absorption (malnourishment), illness and food-allergies.

Babies who are breastfed:

  • Decreased risk of SIDS, less likely to die of other causes in first months
  • Lower rates and severity of diarrhea and pneumonia
  • Lower rates and severity of ear-aches, flu, meningitis, bladder infections, respiratory illness, and other acute infections
  • Decreased risk of childhood leukemia
  • Decreased risk of long term chronic illness such as asthma, diabetes, gastro-intestinal disease (celiac, ulcerative colitis, Crohn’s), cardiovascular disease, obesity
  • Higher cognitive function / greater intelligence

Benefits of breastfeeding to mother include decreased risk of post-partum hemorrhage, breast and ovarian cancers, late-onset diabetes, and heart disease; faster loss of weight gained in pregnancy, and delayed return of fertility (although this is not necessarily a birth-control method).

6 to 12 months
Baby’s weight / size has nothing to do with readiness for solids.  At 6 months a baby’s digestive & immune systems have developed enough to introduce solids.  Earlier is correlated with allergies, digestive problems, immune problems, and obesity.  After 6-8 months caloric and nutrient needs exceed those provided by exclusive breastfeeding.  Further delay of complementary foods may stunt growth.  Start with breastmilk then finish with solids from 6-12 months.  Do encourage – but do not force nor coerce – the baby to eat.

STEP-1:  6 months, or whenever baby shows interest in food (whichever is later)
Offer breast-milk first then finish the meal with solids.  Introduce 1 food at a time for a few days, in small amounts, and then try another.  This helps the caregiver be aware of allergies or intolerances.  Simple, natural, pureed, unprocessed, organic – whole foods, like they came from earth.  There’s no need to buy special baby food – healthy family food, properly prepared, is just fine.

  • 200 kcal/day (in addition to about 400 kcal breastmilk) of mushy or runny foods
  • Offer 30-45 ml (2-3 tbsp) food per feed, at 2-3 meals daily
  • Pureed, raw or lightly cooked, non-citrus fruits e.g. apples, pears, bananas, blueberries
  • Cooked & pureed veggies – start with avocados, roots (carrots, yams, beets) and squashes
  • Cooked whole gluten-free grains (rice, quinoa) or oatmeal
  • Egg -yolks (yolks are usually not an allergen; whites may be)

STEP-2:  7-8 months, or 1 month after beginning step-1 (which-ever is later)
Continue with step-1.  Increase portions gradually up to 125-250 ml (1/2-1 cup) per meal and the following:

  • As child grows used to solids can also offer 1-2 snacks daily
  • Organic meats, pureed
  • Other cooked, pureed veggies
  • Can start combining foods that are tolerated

STEP-3:  8-10 months, or 1 month after beginning step-2 (which-ever is later)
Continue with step-2 and add:

  • 300 kcal/day (in addition to about 400 kcal breastmilk) of mashed food or finely chopped that baby can pick up
  • Offer 125-250 ml (1/2-1 cup) per feed at 3-4 meals daily, and 1-2 snacks if needed
  • Whole eggs
  • More variety

12 months and beyond … or 2 months after beginning step-3 (whichever is later)

  • See general recommendations below
  • Baby can eat regular family foods but watch for allergy or sensitivity
  • 550 kcal daily (in addition to about 350 kcal breastmilk)
  • 175-250 ml (3/4-1 cup) per meal for 3-4 meals daily and 1-2 snacks
  • Continue to breastfeed until 2 years of age

Signs that baby’s ready to start complimentary feeding
Solids can be introduced when baby shows signs of being ready, but only after 6 months of age.  Some babies take longer than 6 months but most are ready for solids by 8 months.

  • 6 to 8 months of age
  • Can sit unsupported
  • Doesn’t automatically push solids out of mouth with tongue (a reflex present until at least 6m in most babies)
  • Willing and able to chew
  • Can pinch or pick up food or other objects between thumb and forefinger
  • Eager to participate in mealtime
  • Shows interest in food – e.g. reaches for food at mealtime, crawls to dog’s dish to steal food
  • Long-term increased need to nurse, unrelated to illness, teething pain, stress or growth spurt
    Note: this is only an indication if other signs are present; not a sign on its own

If baby shows signs before 6 months

Eagerness to engage in mealtimes doesn’t mean ready for solids.  It’s likely a social behaviour rather than a physiological one.  Baby can be included in family mealtimes without eating solid foods.

  • Join the family at mealtime in a lap, booster seat or high chair
  • Give a sippy-cup containing some expressed milk (if baby is more interested in playing with the cup than drinking the contents, you may wish to use water instead of valuable pumped milk)
  • Provide baby-safe cutlery and dishes to play with
  • Give baby an ice cube (baby-safe size & shape) or ice chips to play with
  • Offer a cube, popsicle or slushy frozen breastmilk to eat with a spoon

Food intolerance or sensitivity, allergy
Common allergens include soy, wheat, dairy, peanuts, egg-whites, food colouring, corn, citrus, strawberries, raspberries, kiwis, pork and shellfish.

The following correlate with food intolerance or allergy:  mucous conditions, ear infections, runny nose, rashes (including diaper rash), colic, green stools, digestive issues (diarrhea, constipation, gas, vomiting), undigested food in diaper, asthma, wheezing, and /or behavioural changes after eating given food.

Safety precautions

  • Proper food storage and handling
  • Foods that are choking hazards; can block or wedge into wind-pipe
    • Hard and small sized, smooth / sticky solids g. popcorn, meat chunks meat, hard pieces of fruit / veggies, candies, hot dogs (unless cut lengthwise and cubed), gum, whole nuts and seeds, fruit-pits or seeds, cough drops, raisins, fish-bones, food on toothpicks or skewers.
    • Thick creamy texture e.g. a blob of nut-butter
  • Always supervise infants when they eat or drink
  • Mealtime supervisor should be familiar with baby’s chewing and swallowing abilities
  • Upright and secured position
  • Do not allow baby to eat while laying, running, walking, distracted, nor eat in the car
  • Avoid sharp objects
  • Take an infant / child choking & CPR class to be prepared in case of choking

General Recommendations

  • Organic, whole foods i.e. how they come from nature e.g. baked potato rather than French-fries
  • Purified water, if water is used
  • If juice is used, then fresh & home-made
  • Baby stomach is about the size of her/his fist – portion accordingly, considering breastmilk
  • Take time for eating patiently – meal time should be enjoyable
  • Feed infants directly and assist older children when they feed themselves
  • Feed slowly and patiently, and encourage children to eat, but do not force them
  • Variety of foods
  • Iron fortified food or easily digestible supplement (e.g. Floradix) in case of immediate cord clamping or anemia
  • Whole spectrum salt – Himalayan, Celtic
  • The Kidco Food Mill is a brilliant device for creating baby food on the fly. It’s affordable, simple to use and easy to clean.
  • Ice-cube trays make perfect infant-sized meals – nice to have on hand for child-care or those busy days that run away from us. Puree a few foods and freeze for later use.  Best for 1-3 months in fridge-freezer, and 6 months in chest-freezer.

Avoid

  • Foods that are choking hazards; can block or wedge into wind-pipe (see “Safety”)
  • Common allergens (see intolerance section), foods with family history or allergies, or that baby reacted to in mother’s breastmilk
  • Processed foods – fried, unhealthy fats, high-sugar e.g. chips, crackers, French-fries
  • Chemical additives
    • Fluoridated water, artificial colours & flavours, MSG, aspartame & derivatives
  • Unpasteurized honey, as it may contain spores that can be life-threatening to baby (after 1 year these have no effect on a mature digestive system)
  • Sugary drinks – pop, store-bought fruit-juices
  • Caffeine – coffee, tea, chocolate
  • Under-feeding – babies let us know when they’re hungry (crying, fussing, listless); avoid portion-control as needs change e.g. growth-spurt, immune system fighting a bug
  • Rushing through eating
  • Avoid distractions
  • Strong tastes – spicy, salty, overly sweet
  • No store-bought goat/cow milk until 8-10m of age, and only if child has no sensitivities (but it’s best to avoid non-human milk at all stages of life)

Special Circumstances
In the rare case that a mother is not able to breastfeed her baby, the following options can be considered.  They’re listed in order of healthiest to least.

  1. Pumped mother’s milk, if inability to breastfeed is due to a “mechanical problem” e.g. cleft-palate
  2. Fresh donor milk e.g. close relative, friend in the community (not recommended by public health due to worries about disease transmission)
  3. Frozen human milk from milk-bank
  4. Home-made formula (this is not recommended by public health regions) with added high quality probiotics and fish-oil / ω-3 EFA
  5. Organic formula from a reputable company with added high quality probiotics and fish-oil / ω-3 EFA
  6. Regular store-bought formula with added high quality probiotics and fish-oil / ω-3 EFA

Note: if the inability to breastfeed happens after 6m (e.g. medical problem) then it’s preferable to start on real food and purified water rather than store bought formula (World Health Organization, 2009).

 

References

Gaskin, I. M. (2009). Ina May’s guide to breastfeeding. New York: Bantam Books.

Hass, E. M. (2006). Staying healthy with nutrition. Toronto: Celestial Arts.

Health Canada. (2012). Infant feeding. Retrieved from Health Canada (Government of Canada): http://www.hc-sc.gc.ca/fn-an/nutrition/infant-nourisson/index-eng.php

KellyMom. (2011). Is my baby ready for solid foods? Retrieved from Kelly Mom Parenting & Breastfeeding: http://kellymom.com/nutrition/starting-solids/solids-when/

La Leche Leage International. (2010). The womanly art of breastfeeding. Ballantine Books: New York.

Ochoa, S., & Kline, A. (2011). BIOL404 Chemistry & nutrition student syllabus. SLC: Midwives College of Utah.

Stuebe, A. (2009). The risks of not breastfeeding for mothers and infants. Reviews in Obstetrics & Gynecology , 2 (4), 222-231.

World Health Organization. (2009). Infant and young child feeding – Model Chapter for textbooks for medical students and allied health professionals. Geneva: WHO Press.