Friday, September 29, 2006

Cooking for babies

I can cook. I'm not a great cook but I can cook a little bit more than just instant noodles and scrambled eggs.

However when the time came when my first born baby was ready for solids, I was stumped. I realised that I had no idea what or how to cook for a baby! And I had no idea how much to feed them and how often babies should be eating. I was totally lost.

To me cooking for adults is something simple, that I take for granted because I know how to cook for most of my life. My mum died when I was at the tender age of 10 and even from then, I could cook some dishes for the family dinner. My aunt and older sisters taught me. I took home science at school which taught us how to cook and bake and which I found enjoyable.

My husband said to me "You can cook can't you so how come you don't know how to cook for our baby?" Lol! Cooking for a baby was something entirely new to me and a different ball game altogether. Cooking for babies required a lot more knowledge, planning and careful thought put into it then cooking for adults!

The texture of the baby food has to be just right. The choice of food has to be right, avoiding foods that could cause allergies (no food containing eggs, honey or peanuts for very young babies). You also have to make sure you introduce more and more foods gradually to the baby. I knew I didn't want my baby to eat food from a jar. So I had to make my own. I had to do a lot of reading and experiment a lot before I finally got it right. Eventually, I made mostly porridge. My baby food recipes are here.

Its incredible how a baby so small requires so much attention and care right down to planning a complete and nutritious meal for them. At one time, it seemed to me that the baby ate all the time and all my days went by in a blur of continuous feedings. I searched for sample menus for a baby just starting solids to give me a rough idea. I recommend doing that (to new mothers) as a guide to help you plan your own baby menus.

Here are some sample baby meals or menu links:

Baby Menu Sample from wholesomebabyfood.com
Feeding your baby: 7-9 months (A Sample Menu Plan)

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Wednesday, September 27, 2006

Answer #5 & #6: Get his tongue clipped now!

Here are two more answers to my question Help! My baby is still not latching at 6 weeks! Both suggests that I get my baby's tongue clipped. I didn't do it as I was too nervous worrying about any complications that may arise, slim though it may be. However, I did receive useful links to comprehensive information about tongue-tie which helped me made a more informed decision.

Eventually my baby did learn to latch on, at exactly 8 weeks and 1 day! That was a happy and incredible moment for us!

Hello MG,

First, take that baby in to the office and get his tongue clipped NOW! This is a VERY minor procedure and can be done in seconds!! You and he do NOT need to continue suffering with this problem. Your LC is correct about the long term effects of not being able to suck and I know YOU want the wonderful closeness that comes with breastfeeding.

I also urge you to get going to La Leche League meetings and spend time with other nursing women and infants. Your LLL Leader is your BEST source of breastfeeding help. You can also contact the medical advisory board of doctors who will help LLL mothers with problems. Do this through your LLL Leader. Please do not delay connecting with LLL. All the best.


Hello,

There is hope, but it will require lots of work and determination. I suggest that you work directly with your lactation consultant there in your area for assistance. If you are not going to try and latch him on, then I would go on to pumping and bottle feeding but like cup feeding that is so much extra work. If he does have a short frenulum, get it clipped, it is a simple procedure, it takes about 1 minute and a drop of blood and it can work wonderfully and make the breastfeeding so much easier. A tongue-tie can cause speech problems when he begins to talk. The risks associated with a clipping are far less than the risks of giving your baby formula. Did you have him circumcised?

Here are some references for you
Tongue Tie and Breastfeeding
BRIAN PALMER, D.D.S.

On this web site are slide presentations and articles that cover; the significance of sleep apnea and how it might be prevented, the importance of breastfeeding for the proper development of our species, the issue of infacarriesies and breastfeeding, why tight frenulums need to be addressed, otiti media, SIDS, and basic dental issues.

Breastfeeding and Frenulums by Dr Brian Palmer


TONGUE-TIE: IMPACT ON BREASTFEEDING

Complete Management Including Frenotomy by Dr. Evelyn Jain

Examples of tongue-tie by Dr. Evelyn Jain

POTENTIAL IMPACT OF TONGUE-TIE

ANKYLOGLOSSIA or SHORT LINGUAL FRAENUM by Caroline Bowen

Note: The second letter above has some rather useful links and references giving comprehensive information about tongue-tie, its impact and what can be done about it (not just in relation to breastfeeding alone).

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Tuesday, September 26, 2006

Answer #4: Keep nursing every 2 hours or 8-10 times minimum every 24 hours

Here is another answer to my question Help! My baby is still not latching at 6 weeks! advising me to nurse as often as I can, which I did.

Hi MG,

There is absolutely hope for you and your baby. Try running your finger around the baby's mouth in a circular motion before each latch attempt. This will encourage the baby to open nice and big.

I also would suggest pumping for a few minutes before latching because this will help the nipple to protrude for the baby to latch correctly. I would not suggest using anything else for the baby to suck on because it will cause nipple confusion.

Has your milk supply seemed to be sufficient? If so, keep nursing him every 2 hours during the daytime. He should be nursing 8-10 times minimally every 24 hour block of time.

If you have access to a supplemental nursing system, I would also recommend you look into that. It is a small tubing that run to each breast and breastmilk is fed through the tubes to baby while they are increasing your milk supply. Ask your lc about it.

If you need further help please repost. I am having trouble with my PC but am retrieving my messages from work. Keep up the faith. It can work out with a bit of work. How is the baby peeing, pooping, gaining?

I would encourage every pregnant woman to find out all she can about breastfeeding beforehand. It should be something that most women try. There are so many benefits to breastfeeding that it is important to do it.

Take care.

My lactation consultant did eventually suggest the use of a supplemental nursing system as suggested in this letter. However, I found it difficult to use and cumbersome. This is only my personal opinion and may not be the case for other mums who have tried it.

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Monday, September 25, 2006

Answer # 3: Latch Technique for Infants with a tight frenulum

Here I am back to posting another one of the answers I received to my question Help! My baby is still not latching at 6 weeks!

MG,

I'm afraid that I can't be much help to you. If you are already working with a lactation consultant and probably have researched the matter yourself, then I probably can't give you better advice. I know very little about tongue-tie and have never dealt with it personally nor know anyone personally who has dealt with it.
Here is a study from Pediatrics, a publication of the AAP. They list a lot of previous studies, including those that talk about problems tongue-tie can cause as the child gets older. Difficulties swallowing, poor speech, poor oral hygiene, malformation of the teeth, malformation of the palate and dental arch, and gum recession have all been linked to tongue tie. I don't think that jaw recession is caused by tongue-tie except in extreme cases.

If it was my baby, I would have him evaluated by at least one expert, specifically an oral surgeon, pediatric surgeon or ears, nose and throat specialist (even better if it is one who has dealt with this in the past). They could better tell you how severe it is and if the potential for long term problems exist based on that severity.

Answer to Question 1: It is possible that the tongue tie will remedy itself with time, depending on how serious it is, and your baby may be able to breastfeed at some time. However, if work with the lactation consultant and repeated tries are failing, then I'm not terribly optimistic that the baby will be able to breastfeed anytime soon and possibly throughout the first year. Here is a latch technique you can try if you haven't already:

"Infants with a tight frenulum can often breastfeed with special attention to a deeper latch that maximizes tongue contact with the breast. An asymmetric latch, where the nipple is presented to the infant's upper lip so the baby extends the head back slightly, opens wide, and latches on with the lower lip and tongue tip as far away from the nipple as possible can help achieve this goal (Eastman 2000). It may also be helpful for the mother to position the lower lip on the areola, and roll or pivot the baby onto the breast. If the baby chokes or sputters during feeding, leaning back so baby is almost lying on mother's chest can improve his ability to handle the flow of milk. The mother can be encouraged to be patient with the baby and not expect him to be as efficient as other infants. A tongue-tied infant is especially vulnerable to failure to thrive if feedings are timed or rigidly scheduled."

You can also try pumping a little right before latching to draw your nipples out to help counteract the flat nipples.

Answer to Question 2: If you are concerned about developing oral skills of the typical baby, you can try a few things. You can try a special feeder along side your nipple, which could possibly be painful for you dependent on how your baby sucks. You could finger feed from time to time, or simply just give your baby your finger to suck on. You could also try giving your baby toys designed for mouthing, such as various teething toys. You may not want to start it in effort of having to break it later, but babies can happily suck their own thumb.

Because of your toddler to look after as well, don't feel guilty about using a bottle. I had difficulties nursing my baby during the first week, she had jaundice and she was very sleepy. I tried feeding her through a syringe and tube at my breast, but it was becoming tedious and she wasn't able to suck down breast milk through it. I gave her a bottle and cried and cried and cried. I felt like she would never breastfeed, and I was permanently sabotaging it. I would always try to latch her on first, and then give the bottle. Out of curiosity, I tied to latch her on AFTER giving her the bottle as well, and it worked. We successfully breastfed for two years after that point, although she always had latch issues. It is hard to take another strike against you by getting him to use the bottle, but at this point, I don't think it will make a significant difference. If you decide to see a specialist, then you might want to wait it out until the outcome.

I think tongue-tie can be hereditary, so maybe your daughter had a mild case of it that she was able to overcome, maybe it was the flat nipples.

I applaud you for trying so hard to get your baby to breastfeed and your willingness to continue to pump. Here is a link to several articles on tongue-tie from a breastfeeding site I think is great. You might find further info there

Notes on Related links:

Some of the links cited in the original letter are no longer active so I've removed them from the post. For example, I could not locate the study by the AAP on the probems of tongue-tie. However, here is the link to the breastfeeding topics page of the American Academy of Pediatrics.

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Thursday, September 21, 2006

Caring for two young children without help

Handling a baby is hard work. Handling a toddler is hard work. What more when you have to handle both and without much help too. Its makes you wonder how on earth you are going to cope handling both a baby and a toddler at the same time.

I received the following email from a mother worried about handling two when the new baby comes along. My reply is in green. By posting it here, hopefully, we can get more input from other mothers and perhaps it could also help other mothers who are wondering the same thing.


Hi MG,

I read about how you handle 2 kids (baby & toddler) on your own without any help in your blog. However, I find it difficult for me to search all the links in your blog. Apart from that, I have a few questions to ask you. Since I'm going to take care of 2 kids on my own, I need your advice.

You can easily find my posts by clicking on the categories button at the top of this page.

1) Labour: Who is taking care of your kid when you are in the hospital for labour? There was no one to watch the older kid for us so we simply took her along with us. Fortunately the hospital allowed visitors to stay the night but unfortunately they ran out of double rooms so that they (my husband and daughter) would be more comfortable. We made do with a single room and requested for an extra mattress to be placed on the floor. My husband and daughter slept on the mattress to accompany me and the baby. By involving her like this, she accepted the new baby straight away so that was another problem solved for us. During the labour, when hubby was with me, my sisters helped to entertain her at the hospital cafeteria. I've written about this in more detail under the following link:

How to make sure your firstborn child accept the new baby

2) Confinement: Do you engage a confinement lady for the first month? No I did not engage a confinement lady. We did however cater confinement food. My husband was around to help me for the first two weeks. After that I managed somehow. I really don't remember how my days went then, it is a blur to me now, so it must not have been that hard. Lol!

If yes, do you have any recommendation for a good confinement lady? What about confinement food? You can find the link for the confinement services in my old post on Postnatal Care and Confinement Nannies.

If not, how do you cope with a toddler and a baby? You cut corners and do only whats important. Other things can wait. Here's how I cut corners:

Life with a newborn and toddler
First time parents coping with a newborn and toddler

How do you manage to eat when you have 2 kids to take care?
Haha. You just eat. Sometimes you get interrupted, that is all.

3) Food: How do you make/feed your toddler's food when you have to breastfeed your baby? Do you pump and store the bm for baby or direct breastfeed? I make my toddler's food (mostly porridge) overnight using the crockpot (so that it'll be ready in the morning). Or sometimes I make the porridge using a rice cooker first thing in the morning. (I never use the stove since that requires more work of having to watch it. With two little ones in the house its not save to forget about the fire on the stove!) I make a big pot then store them fresh in the refrigerator for breakfast, lunch and dinner. Breakfast is fresh. I reheat the porridge for lunch and dinner. You can check out my porridge recipe here. As for the baby, I had a tough time breastfeeding so I did not use the bottle. I pumped and fed baby from a cup and tried direct breastfeeding at the same time. That was probably the toughest thing I had to do during the postnatal period.

4) Crying: How do you manage when 2 of them are crying at the same time? I cry along at the same time. Lol! Seriously, I felt like crying along with them. Even up till today, when one of them is crying, the other will cry too in sympathy (*rolls eyes*). Just don't let the crying get to you. If you think you need a break from it, after first checking to make sure they are okay, let them cry for a while. It won't hurt them. When you have regained your composure then pick them up and comfort them, sing to them, talk to them till they calm down, but first, calm yourself down.

5) Bath Time: How to take turns in bathing the toddler and baby? I find it much easier to bathe the toddler since she can stand on her own so I give her a shower instead of a bath. Its much easier and faster. I will place baby on a mat on the floor in front of the bathroom so I can keep an eye on him at the same time. As for the baby, I usually just give the baby daily sponge baths, that is topping and tailing using cotton balls and clean water in a container. I only give him a bath in a tub with hairwash etc once a week when hubby is around to help me with it. I'm hopeless in this area, so afraid to handle a wriggly, slippery baby so I preferred not to do it alone. Thats one of the areas I cut corners on. In fact, I bathed both my babies just once a week when they are newborns but don't worry, I always made sure they are clean especially their bottoms and they have never had any diaper rash before despite it. Breastfeeding helps.

6) Sleeping Routine: Does your baby sleep in the cot and toddler sleep on the bed at night? Yes, baby slept in the cot while toddler slept on the bed. If you're planning to do that, make sure you move your toddler to a bed now and not when baby arrives so that he won't feel that his cot has been taken over by the new baby. I gave them the same bedtime. It saved time for me. Usually I put baby in the cot after he has fallen asleep during his breastfeed. Some may tell you that its a bad idea to breastfeed baby to sleep but it worked fine for me. I try to put him in the cot only after he is in deep sleep, otherwise he will wake up and then I have to start all over again. Here's our sleep routine:

Bedtime routines when you have two kids

That's all for now. Will ask you more when something pops up my mind. Thanks in advance. Anytime. Hope that helps.

Hopefully some other mothers can join in to share their experiences too. That would be nice
.



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Answer # 2: Tips for Nursing With Flat Nipples

Hi MG!

First, congratulations on your new baby. I hope you are enjoying him. Now, on to your questions.

Flat nipples alone should not pose too great of an issue. There are things you can do to draw out the nipple. A tongue tie is slightly different. I do know one mother who worked very hard for 2 months, struggled with breastfeeding, but finally got her son to nurse at the breast. He nursed for almost 3 years.

However, this is the exception. Having your son’s tongue clipped is a minor procedure. You should be able to find a pediatrician, dentist, or ENT who will do it in the office with a local anesthetic cream. If you are not willing to have the tongue clipped, then there is still a great chance you can breastfeed.

As for the flat nipples, you can try to pump before nursing, for just a minute or two. This will help your nipples to become erect. The pumping will also begin to get your milk flowing which will make your let down come faster. This may help your son in that the milk will be there waiting and he will not have to work so hard to get a let down.

I am not sure about proper jaw development as the LC suggested. My expertise is not medical. I would consult with a pediatric dentist before I accepted something so far fetched. I would suggest, if you like, that you offer your pinky finger, nail side down, to your baby to suck on. This will also help to position his mouth correctly for latching on to the breast.

I would continue to offer the breast at every convenience. See if you can get him to latch on for comfort nursing as well as for meal times. You are clearly a dedicated mom and extraordinarily dedicated to breastfeeding. Offer the breast as often as you are able.

If you feel you need to supplement, check into getting a Supplementary Nursing Sytem or Lact-Aid. These are systems that have a small tube that is taped to the breast and runs alongside the nipple. When baby latches on, he will get milk from your breast as well as the tubing. You can fill the Lact-Aid with breastmilk, formula, or a goat’s milk which is much closer to human milk.

Also, I would suggest you find a La Leche League group in your area. There may be moms who have been in your situation and can offer you personal support. To find a group, you can go to http://www.lalecheleague.org/ and search for a group in your area.

Please feel free to ask anymore questions, and I offer you the best of luck!

This was another one of the answers I received to my question Help! My baby is still not latching at 6 weeks! I shall be posting more over the next few posts.

It was useful to receive many opinions and feedback especially at a time when I desperately needed help and support. However, it can also be confusing.

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Wednesday, September 06, 2006

Answer # 1: Horrible abrasions from latching on incorrectly

Dear MG,

Most of my experience is just personal as I nursed my two daughters for 3 years and 3 1/2 years. The nursing time overlapped a little so it was about 6 years 4 months of straight nursing. In that time and through asking questions when I had trouble and helping others when I could, I have learned quite a bit.

So when my first daughter was born, I knew I would nurse her and wasn't even prepared to consider any other options for feeding outside of some extreme, unforeseen reason arising. I think that's the only thing that kept me going! She was born naturally but the pushing phase was sort of difficult so she was really tired at birth and did not want to try to nurse right away.

That was my first clue that things don't always go the way you envision them. After about 5 hours or so of getting rest and just trying whenever she was awake, she finally took an interest. But she would suck in her lower lip, slide off the nipple, clamped down on the end of the nipple, you name it, she tried it (she is still that kind of person, always trying it her ways first, the advice of the experience means nothing to her!)

I got horrible abrasions from her latching on incorrectly. Both my nipples were totally scabbed and painful after just the first day of failing to get her on the breast correctly!

After a lot of adjusting, she seemed to be getting milk but it was killing me. My midwife helped me some and then I called the local La Leche League Leader. I'm not affiliated with them but they helped me so much that I always recommend them to women needing hands on assistance!

After recognizing that my daughter needed to open her mouth wider, take in more areola, stop sucking in her lip, and get her tongue under the nipple, we started to get on track. The LLL leader told me that after the baby began to get latch on correctly every time, the pain would stop immediately and the wound heal within a week or so.

Knowing this was what made me able to go on. I had to check that her tongue was down, start her again and again when she latched on at the end of the nipple, and manually adjust her lips to the correct position almost every time we nursed until about 4 months of age.

This meant my poor husband had to endure the closet light on in our room every night for the first several months so I could see what I was doing during night nursing. But he never had to get out of bed to heat a bottle either so I figured he could make the sacrifice!

My daughter finally became a pro nurser and went on to nurse through my pregnancy with the second one and tandem nurse with her sister for the first few months. She stayed with it until age 3 when I encouraged her to wean because I was very worn out with the two of them nursing!

I didn't have such trouble with my second child but it was partly because of my previous learning that I was able to avoid some of the pitfalls. I dealt with the sore nipples, pressure from family to wean early, breast infections, plugged milk ducts, thrush infections, exhaustion, etc. and it was the most precious experience of my life just knowing my daughter and I had that time together and she had the best possible start in life.

She's so independent already at age 6 1/2 it makes me realize it was worth it to be patient and stick by her so she could nurse. I hope it works out for you and you are able to nurse your baby. But whatever happens (and yours is a difficult obstacle to overcome) you are doing a great job, so you and your family will know you tried your best. If I can assist you more, let me know. I like to see it work and you seem so dedicated that if it can be made to work, I know it will.

Keep up the good fight! Best of Luck!

This was one of the many replies I received for my desperate question Help! My Baby is still not latching on at 6 weeks! Imagine getting a thoughtful email like that from a total stranger. One whom I have never met and probably never will. The wonder of technology and the goodness of knowing that there are still people out there who care enough to give their time to help others. It really helped.... just knowing that I was not alone.

I shall post some of the other replies I received in my next few posts and hopefully this will help to support some other mothers facing similar breastfeeding difficulties. You are not alone and you can perservere!

Related links:

La Leche League International

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Monday, September 04, 2006

Help! My baby is still not latching on at 6 weeks!

This was my desperate question to the experts at AllExperts.com when I had difficulty latching my baby on during the early days of breastfeeding.

Dear ...........,

My baby is still not latching on at 6 weeks.

I think that I have flat nipples and my lactation consultant has suggested that my baby has a tongue tie and we should think about having baby's frenulum clipped.. At the moment I am pumping and feeding baby from a cup. I have never given him any pacifier or bottle to avoid nipple confusion.

My question is:
  1. Is there hope that baby will latch on? What else can I do? My baby can extend his tongue to his lower lip but not very much beyond. My husband and I do not wish to have his frenulum clipped because we are unwilling to take any risk or complications that may arise from the procedure. Does that mean that baby will be unable to breastfeed?
  2. My lactation consultant suggested that my baby's jaw will recede and he may have poor jaw and mouth development that may lead to speech problems because he is not latching and does not have anything to suck on. Is this true? Should I be giving him something to suck on? What can I do?

I am thinking of pumping and continue to try to latch baby for 3 months after which I will start offering him expressed breast milk from a bottle as the current situation of pumping, trying to latch baby and cup feeding schedule is too difficult to keep up since I also have a demanding toddler to look after. Whats is your opinion?

Incidentally my toddler also had difficulty latching on. She managed to latch on at around 2 1/4 weeks but had poor weight gain for several months and I was eventually advised by my lactation consultant to supplement with formula. I breastfed her for 1 1/2 years.

I hope you have some good advice and I thank you for your time.

Yours Sincerely,

MG




Here are some more breastfeeding links I find useful:

  1. A tongue-tie or ankyloglossia is caused when the membrane under the tongue (the frenulum) extends excessively toward the tip of tongue. Continue reading this article: Tongue tie: To clip or not to clip?
  2. It is easier to prevent nipple confusion than to fix it.
  3. Latching and Positioning Resources.
  4. Breastfeeding stories from other mums with difficulty breastfeeding which inspired me.

Here are the answers I received:

Answer # 1: Horrible abrasions from latching on incorrectly
Answer # 2: Tips for Nursing With Flat Nipples
Answer # 3: Latch Technique for Infants with a tight frenulum
Answer #4: Keep nursing every 2 hours or 8-10 times minimum every 24 hours
Answer #5 & #6: Get his tongue clipped now!

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Friday, September 01, 2006

Do you have a question to ask?

I remember when I had breastfeeding problems, I had no one to turn to and so I turned to the web to search for answers. I was desperate! I was stressed! I was about to give up.

Eventually I found AllExperts.com. This is an excellent site. I want to recommend it to new mothers who need to ask someone a question. You can ask a question on just about anything and get it answered via email by volunteers. Just pick your category, scroll through the biodatas or profiles of the volunteers, then ask your question.

I was so desperate I typed out a standard question and sent it to all the experts in the breastfeeding category. I got a reply between one to three days from the volunteers. Although it did not solve my problems immediately, it helped to have more ideas and views so I could make an informed decision and it helped to just have someone to "talk" to.

Before asking your question, you could also scroll through and view the past answers (the link I have provided is the past answers to breastfeeding questions but you could browse the categories for some other issues or areas which applies to you) then see if any of it helps you. There is a great amount of valuable information there. Do check it out.

Coming next: My desperate question to the experts on breastfeeding.

Help! My baby is still not latching on at 6 weeks!

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