Wednesday, March 31, 2010

On Car Seats

The search for a car seat is very closely tied to our emotions as mothers. After all, it is your baby's safety we are talking about here. I must admit that when we got our first car seat, I didn't really know the difference between most of them and honestly, I still don't, but I do know a bit more and most importantly, I know where to look for information.

My husband I had picked out a user friendly travel system that worked well for us, and as I soon found out, was a very popular choice for many moms I knew. It makes you feel a little better. At 6 months of age, my baby was rapidly reaching a size that he was getting too big for his carrier/car seat and it was time to upgrade his seat. Since he was still young, we needed to choose a convertible for him and after much research and confusion and more research, I found one I liked and ordered it. We are now happily in our new seat and it is working well.

So, here are a few things I learned on the way to getting our new seat.

- www.car-seat.org is a great site to get input from lots of different moms. They also have some certified technicians on the site that can help you with questions you may have. You can even search for threads that talk about your specific type of car and what car seats work well.

- Most state requirements say to keep a baby rear facing at the least until 20lbs and 1 year of age. I read somewhere that 35lbs is the updated recommendation, but states still say 20lbs. Mostly though, the recommendation is as long as possible. Most convertible car seats go up to 35lbs rear-facing, the one I got is actually rated for up to 45lbs rear-facing which I think is the highest available. Most likely I'll have to turn him around when his legs get too long, but at least I can keep him rear-facing for an extended time.

- All car seats have to meet certain safety standards. You may be able to find individual testing scores from each of the manufacturers, but I couldn't find any place that compares the safety of different seats. I was able to find ease of use comparisons, but that is about it.

- Never ever, buy a used seat from someone you don't know. A car seat should never be used if it has been in an accident. Even if it shows no sign of wear or damage, it is considered unsafe for use after an accident and any warranties will be void. Unfortunately, your best option is just to buy new.

- Car seats come with expiration dates. Yep, that is something I didn't know. Most last 5-6 years, so check the paperwork with the seat. My new seat has an extended usage of 8 years. Again, this is a reason to buy new, used seats may be past their date.

- Always register the seat. That way the manufacturer can contact you in case of recalls or problems. This is so important. It is your kid's safety after all.

I hope this info helps! Good luck with your search!

Thursday, March 25, 2010

On Cry-It-Out (CIO)

Cry it out is a common topic you hear in discussion with moms pretty frequently. It raises quite a bit of controversy too. For some, it is the only way to get some peace and quiet, for others it is neglect to let your child do it.

Growing up, I had always been indoctrinated with the concept that with kids, you can't just go to them every time they scream and cry. It will merely teach them that this type of behavior is acceptable, and even if you show displeasure, it still has the desired affect of giving the child attention. And this is true, to an extent. I will explain:

It is pretty much a well known fact that kids will try to get the attention of their parents. Kids don't always care if it is good or bad attention. They'll take it any way they can get it. Attention seeking behavior, in my opinion can be either on purpose or subconscious, but I think we all will do it, even as adults. Training a kid sometimes is like training a dog (you'd say the opposite if you had kids first, I had a dog first so for me, this is the order I choose). Positive reinforcement yields positive behaviors. Punishment is not always effective because it is often carried out inconsistently (enter shows like Super Nanny and Nanny 911). Attention is intangible and so when poor behavior attracts it, it is the same as giving a mouse a cookie, so to speak.

There is however, an age/developmental issue that people don't talk about. Probably because it is virtually impossible to pin point. What do I mean by that? Well, babies have no concept of what attention means. They simply have needs and as a baby, needs need to be met. Their only choice when it comes to communication is crying. They are telling their parents what they need. Yes, sometimes that includes attention and snuggling, but that is not always a bad thing. I've read in several places that in a baby that is left to cry (and I mean for an extended period of time), cortisol levels rise in the brain and can cause permanent psychological or physiological changes - such as an insecure person that lacks the ability to trust others. A baby whose needs are met when called for are more secure through their life.

So, what about all the questions of attention seeking behaviors and inability to be alone or self soothe? Well, that is where cry it out (CIO) come in as well as simple individual development.

I'll start with Cry It Out (CIO). When I was younger and of babysitting age, I believed that letting a cranky, fussing kid alone to figure out that their attention seeking behavior was not effective was the thing to do. Eventually, they'd realize it wasn't working and go to sleep on their own. I was told this by many a people and it seemed to make sense. This is not CIO, however, this is what most people think it is and they continue to do this. Now, there is a place and time, but this is not how it's done.

The official method of Cry It Out (CIO) means that the parent is actually teaching the baby to self soothe. When the baby is put down and starts crying, the parent goes through several steps that involve checking on the baby, letting the baby see them and feel secure that the parent  is close by but the baby is not picked up. The parent will then through multiple checks every so often while the baby is fussing check on the baby and ensure to be seen. The checks will lessen in frequency and the distance to the baby in the bed/crib will lengthen. Eventually, the child, knowing that mom or dad (or whoever) will come when called is secure and comfortable and will eventually fall asleep. This is the correct way to do CIO (more detailed information can be found online or in books. I am not an official teacher of this). The child is not simply left to cry to exhaustion.

So, even the official Cry It Out (CIO) method involves tending to the needs of the child, despite what many people believe. What about teaching the child to not fuss and scream just for the attention? Well, when CIO is practiced correctly, it does teach them this. If you don't know how to do CIO or you want to do your own method, the answer is easier, but more vague. Trust your instincts. You know your child better than anyone. You know if he or she is crying because he or she is hungry, needs a diaper change, or is tired. Maybe not at first, but you will come to realize that you actually have figured it out. Until then, be assured that you can't spoil a newborn. Being there to meet his or her every need is necessary with a newborn and this will help you to learn the source of the crying. The day will come when the baby is just tired and you will need to just let him or her cry for a short period of time, whether you use CIO or not. You will know when that is, because you have figured out, although in a very abstract manner, what your baby is telling you. Crying is necessary for communication and babies cry for a reason. Responding to that is not spoiling the child and teaching them to seek attention - it is meeting their needs and helping to ensure a secure, trusting future. Once again, it is all about trusting your instincts.

As far as my personal experience and my baby goes, I don't really use the official Cry It Out method because I haven't learned the specifics. I pretty much respond when he is crying. Sometimes he is just fussy and tired. I've been known to let him fuss for a little bit when putting him down. If at any point, it escalates to a screaming fit or goes on for more than 10-15 minutes, I usually will see to him and address what he needs. Sometimes he's just not ready to go down, sometimes he's hungry, sometimes it's a diaper issue. He doesn't always fuss when I put him down either. Sometimes he will go to sleep quietly and calmly. Sometimes he's already nursed to sleep when he is put down. Other times, he'll fuss for a little bit and then go to sleep on his own. My baby is able to self soothe back to sleep after awakening, so there are times when I can hear him moving around after he has gone down and if I leave him be after a couple of minutes, he'll go back to sleep. Other times when he awakens at night, he starts bawling - that is when I know he needs something. This is what has worked for us and I wish you all the luck with your little one.

Tuesday, March 23, 2010

On Starting Solids

So many opinions and ideas you could go crazy. I feel like I kinda did.

If ever there was a topic that you just have to go with your gut, this is one of them. I had some serious anxiety about starting solids with my little one. I had a whole list of questions to ask my pediatrician and I was reading a ton and asking my mom and a bunch of other moms what they did and I got lots of conflicting information, enough to drive you batty.

At first, I thought I was going to do what my mom did. I'm not sure at what age she started us on solids, but I know that the method was very regimented. First thing offered was rice cereal, then bland veggies, then sweet veggies, then fruits, then meats. Dairy was offered after the age of one and nuts after two. Each food got offered for 3-5 days before trying the next and the most common form was pureed, although, I didn't really get a sense of when to try other textures...

Other stuff I read starts with purees in any variety of foods, veggies, fruits, meats for babies around four months, and then when they are about six months they can try blends of foods and mushed foods that are not quite as fluid as purees.

Still other places I read would tell moms that there was no reason to feed baby cereals as they don't need to extra carbs and there is little nutritional value aside from carbohydrates. I've also heard from moms that rice is one of those foods that can cause constipation. Several places I read that the iron added to baby cereal can cause constipation.

One site I read, as well as listening to some moms that breastfed made sense to me and helped to clear up a lot of the confusion, but I was still anxious. This site was http://kellymom.com it is a site for breastfeeding and they go over all kinds of breastfeeding topics including starting solids. for babies that were breastfed.

The AAP (American Association of Pediatrics) recommends breastfeeding exclusively for six months before starting solids. I have no clue what that means for formula fed babies. After that, according to kellymom and a doctor that teaches breastfeeding information (as sent to me in a link from my lactation consultant mother-in-law), since iron stores start to deplete at six months, meats and other foods high in iron are good choices to give babies. They also say start with sweeter foods, since breast milk is sweet. One more thing they've mentioned, as well is that once babies are six months of age, they don't really need to be given pureed foods. They can handle thicker textures.

I've even heard from a lactation consultant (and a few other sources) that a baby's nutrition from 6 mo to a year is mostly from breast milk anyway and that foods are more about experiences and getting used to new textures and flavors (although, breast milk changes flavors with whatever the mom eats, so the baby should already be used to differing flavors). Aside from that, as long as they are introduced to something between 6 and 8 months, they shouldn't have problems with variety later in life.

So, all of this information made me really confused. I had no clue what to do. Did I go with the way my mom did it all those years ago? I still know people that feed this way. Do I follow some of the other places? I wasn't sure. I had planned on cooking my own baby food, pureeing it, freezing parts of it and going all out, but with all of the conflicting information, I started to question what I was going to do. I had a whole list of questions for my pediatrician when we went in for the baby's six month visit.

At our visit my pediatrician said one thing that made my anxiety melt away. He told me that the baby was doing well and if I continued to exclusively breastfeed until he saw him again at nine months that would be ok. He wasn't worried about the baby's nutrition.

So, I finally forgot it all. Ok, not everything, but the whole stress, and regimentation of feeding I could live without. I decided on a simple path. Give the baby whatever struck my fancy, be it something random or something we were eating. I had the ok to only breastfeed if that was my choice so whatever else he ate or didn't eat didn't matter. According to my pediatrician, the only things I needed to avoid were berries, citrus fruits, and egg whites until nine months; dairy until a year; nuts until much later. He wanted me to keep track of what things cause what diaper issues - in other words, give new foods one at a time so you can see how the kid reacts - and that was it.

My baby likes to play with the food and it wasn't until 7 months or so that he actually would put it to his mouth on his own. Some of it he eats, most of it ends up on the floor, on his tray, or on his clothing, but no matter. He's having fun and exploring. I don't bother much with feeding it to him on a spoon or anything. I figure he'll spit out the same amount if I put it in his mouth or he does. I also don't want to cause both of us stress by shoveling food in his mouth and making it a negative experience. I'll pop a piece in his mouth here or there, but otherwise, I leave it up to him.

So far at eight months he has tried the following foods: banana, chicken, sweet potatoes, ground turkey, broccoli, potatoes, rice, green peas, grapes, apple, and ground beef. There is, of course, a lot more to come in the near future and probably some things I've forgotten, but oh well. I'm not stressing. It's all about the experience.

In the end, it is what you are most comfortable with. All moms have to do what they think is right. My method may cause people to get upset or angry that I'm doing it wrong, but it is what I've decided, besides, I figure if at this point I had continued to not give him any food and he was still exclusively nursing, that's still ok according to the pediatrician - his health is not in jeopardy, so anything  he does get it just the cherry on the top. Good luck with your feeding experiences and read a lot, but do what feels right to you.

Monday, March 15, 2010

On Baby Clothes and Sizing

Well, baby clothing, just like adult clothing and shoes and diapers, etc. are very much dependent on manufacturer as far as how well they fit. Different companies have different ideas when it comes to particular sizes which makes it a little hard to figure out where your baby falls in.

One problem I ran in to with some of the clothes that we received for our little one, especially with some of the hand-me-down clothes was that if they were labeled an older or larger size, I'd set them aside for later use and then when our baby was that age, he didn't fit into them. It is a good idea to try things out and put them into your own stacks of what relative size they are rather than going simply based on the label. Once you get familiar with some of the popular brands out there, it becomes easier to separate them for use.

One more thing before I go into the specifics, my little one is on the larger size (he's always been over the 80th percentile in size), so my descriptions may be a little biased towards a larger baby. Babies also vary a lot (okay, so it was two things), some are long and lean, some are chubby and short, some are lean and short, some have long legs, some have long torsos... you get the idea. Keep your baby's shape in mind when sorting out clothes, it'll help a lot.

Here is a rough guide to sizes of popular brands:

Gerber: Fit small, especially the packaged outfits and clothing. They also are a narrow fit and ideal for leaner kids. You may have to use one size bigger according to the label than you kid actually is.

The Children's Place: These clothes fit pretty normally for the size labeled. They are a little wider than Gerber, but not overly so. You may find that some of the bodysuits (onesies) fit a little short in the torso, but most of the other clothes, like shirts and pants fit just fine.

Garanamals: These clothes have a regular fit. They are pretty wide when it comes to shirts and bodysuits.

Gymboree: Again, sizing is normal but may fit wide.

Old Navy/The Gap: These clothes for infants are sized 0-6 and 6-12 so they don't have the variety that most of the other companies do. I have found that the 6-12 size seem to fit closer to most 6-9 clothes and at least for my little one will make it no where near 12 months.

Miniwear: Again, pretty normal sizing as far as length. The bodysuits have a close-fitting shape for babies with narrow torsos.

Carter's/Just One Year/Child of Mine: These clothes fit large. The bodysuits are narrow fitting and long. These are some of my favorites, probably because I feel my baby can wear them longer and for the most part, fits into the correct size in this brand - but that is just because he is big.

Socks of any brand, use caution. In my experience and what I've heard from other moms, socks don't stay on very well. Some of this I've noticed with some because they get stretched out to fit the feet, even a slight amount, and then they slowly (or not so slowly) revert to their non-stretched configuration. Many socks are just super small and way off of the mark for foot size based on baby age. Most don't have enough elastic at the ankle area to keep them on the foot. I still have yet to find a brand that fit well and stay on reliably - with the exception of some that I got handed down from my sister... sadly, there is no brand name on them, so I can't go get more.

One last thing. Pajamas of any brand, especially those with feet seem to fit small. I have heard this from other moms too. I have always had to go up at least one size if not two on pajamas. This may be due to the fact that they are supposed to be close fitting for sleeping safety. I have some pajamas labeled for 18 mo. that my 7 mo. old is too big for so check the fit on these early on and do not set them aside just because of what the label tells you.

I hope this helps and good luck!

Wednesday, March 10, 2010

On Stuffy Noses and Sucking Out Snot

My baby experienced his first cold when he was about four months old. I could possibly be blamed for it, as I also had a cold. I felt so bad for the wee little baby. He sounded so congested when he slept - snoring like no other. He was able to nurse with no major issues and acting otherwise normally, so we just let it pass.

When he went in for his four month visit, his pediatrician said that if I hadn't mentioned anything, he wouldn't even know that the kid was congested, so that is a good thing. He also told me that by nursing him, I was already doing everything I could for him.

At about six months, when he was having some serious issues with teething, he had a resurgence of congestion. His nose was constantly running. He also developed his first fever a couple weeks after the congestion started up and luckily, I was given a couple options as far as what to do to help.

The nurse at the pediatrician's office suggested two things that could help clear him up a little. One, was a cool mist humidifier. This was easy enough. I did find that humidifiers cost about twice as much when purchased at a drug store than at Target. I'm glad I checked, because I really didn't want to shell out as much as they were charging at Walgreen's. The second recommendation was saline drops and aspiration. This proved to be easy to get, but horrible to carry out. Babies apparently don't like it when you put things up their nose and they are almost even more determined not to let you suck anything out. Yay.

After fighting and fighting with the baby, because they can be very squirmy when attempting this procedure, I figured it out. The trick I found to work, is as follows. I propped my left leg on the tub and straddled the baby on that leg facing towards me. I then wrapped my left arm around the back of the baby's neck pinning his right arm under my arm and grabbing is left arm with my left hand. This secured his head in the crook of my elbow and held it more or less in place. By leaning over positioning the baby more on his back laying along the length of my thigh, I was able to apply the saline drops to his nostrils. I held him here for several moments to let the saline run up into his sinuses. He did squirm, quite a bit, even with this positioning, but I was at least able to get some drops in which is more than I can say for other attempts I had. I then stood up straighter, propping the baby straighter at the same time. Fluid flowed freely out of his nostrils as the saline helped to break up the mucous. Trying to keep his head as still as possible, I was able to suck out even more fluid from his nose with the aspirator. After doing this relatively successfully multiple times, he actually held still for the aspirator. Whoo hoo for mini wins.

I hope this method helps out if you are having the same sort of struggles.

Tuesday, March 9, 2010

On Temperature Regulation

Another funny strange and difficult aspect of child care is temperature regulation. Not that it is hard to adjust for temperature and comfort, but more that it is difficult to tell that there this is the problem. It does, however, need to be on the "What's wrong with the baby?" checklist.

There are some things that they do tell you early on about babies and temperature. One, newborn babies have difficulty with temperature regulation. When they are in the womb, they are kept at a nice toasty 98.7 degrees (more or less) and when they come out the temperature is likely 68-75 (this is roughly "room temperature"). That means the ambient temperature just dropped for a baby 15-20 degrees which is kinda harsh on a wee one. Second, they tell you that if you are comfortable, the baby probably is too. Now, this comes into play after a couple of weeks or so (it of course varies with every baby, but you get the idea).

It is however important to take into consideration what you are wearing too. If you are comfy in a tank and shorts, the baby probably doesn't need to be dressed in long sleeves and pants. Sadly, there is no set rule for this, it is merely a guideline.

I ran in to trouble very early with my baby. He was born in July in south Texas where the temperature varies between sauna and record breaking heat. Early on, he wore little more than a diaper. We always had a receiving blanket around him to protect him from drafts and such. As time went on, we realized that his feet seemed to get cold, so he often had socks on too. I had a little difficulty getting him to sleep at night and couldn't figure out why. After all, it was summer and hot, so I figured he'd be fine with just a light blanket swaddled around him, but he kept kicking it off. I almost thought he'd never be able to go to sleep in his bed very well. I tried to put him in full pajamas, feet, long sleeves, and even booties over his hands and what do you know, it worked! He slept like a dream. The problem was that he was too cold. Even in the hot Texas summer, apparently our temp inside the house was cool enough that when he stopped moving (well, squirming, as he was quite young) and no longer had another person close to his body, he got cold very easily. Since he didn't stay in a swaddle and kicked off every blanket we gave him, the only solution was to put him in pajamas and we no longer had to worry about the blanket (which was ok really, because of the suffocation hazard).

This worked so well and then recently, we had a turn of events. One night the baby awakened in the wee hours of the morning and would not go back down for anything. I tried nursing him down, I tried changing his diaper. Finally I felt how warm his hands were and figured maybe he was too hot. It was kind of a last resort because I had no clue what else to do. And surprisingly (to me anyway) he settled as soon as I took his pajamas off. I was so relieved to see him calm and go back to sleep with no problem. He was back to sleeping in a diaper with a blanket.

There are even more temperature concerns than just plain comfort. Eventually, all babies will get sick. it is just a matter of when. When my baby was six months old he got sick for the first time. He was so cranky and tired and wanted to cuddle and had up and down temperatures. He felt so warm, especially on his little head. I took his temperature several times over the five days or so that it lasted. I would take it under his arm which is not as accurate as a rectal, but a whole lot easier. The rule of thumb I've heard (from a several sources) is that you add one whole degree to an underarm temperature reading to determine the core body temperature. Fevers are of course, the body's way of killing off pathogens, however, sometimes the immune system doesn't realize that it can kill off the body too if the temperature is driven too high. So, the pediatrician's office told me I didn't have to worry about it too much unless his temperature was over 101.0 degrees and if the fever lasted for more than a certain number of days to go ahead and bring him in.

When his temperature did spike that high, I was able to give him some Tylenol to reduce it and it worked like a charm. I didn't have to give him more than one dose in a single day. His fever would go away and he would act happy again. He was still clingy and wanting to cuddle and sleep, but I'd get a random smile and his temperature was normal so I was able to relax some.

It certainly is an interesting thing to see how the baby responds to temperatures. My baby happens to be a little radiator and gets hot very easily. It is just one of those things that we have to work with. Light, breathable clothing is important. Light colors also seem to keep him more comfortable than dark colors. Onesies seem to be the best clothing option if he wears anything other than a diaper. During the colder weather, he mostly wore light clothing and had blankets added. We did layers rather than heavy pieces of clothing so we had the option of removing layers if he got warm or the weather warmed up during the day. It's just one of those things you have to figure out on your own, but make sure to keep it in mind. A fussy baby could just be uncomfortably hot or cold. Who would of thought?

Monday, March 8, 2010

On Teething

I don't know if there is a stage more frustrating than teething. It can be insanely confusing.

When my baby first started teething I didn't really notice. My husband says that he was crankier than usual, but I didn't really notice anything terribly obvious. Besides, there was no way that his teeth were coming in because we had just been to the pediatrician for his four month visit and I was told the teeth wouldn't start pushing through for another couple of months. A few days later, two teeth were visible just under the lower gum line. Then they could be felt and less than a week after seeing the pediatrician, his teeth poked through, one right after the other.

At five and a half months the two middle teeth on the top came in, a little after six months, two more upper teeth broke through, and now at almost eight months, another lower tooth can be seen below the gums.

Tooth three and four caused some crankiness in excess of what the first ones had. Five and six were nightmarish. When the fifth one was coming in I spent three hours trying to calm a crying, fussy baby. It was horrible. He would cry and cry and finally calm and go to sleep. I'd put him down and he'd start up again immediately as he hit the bed. The poor thing. He was in so much pain and I felt I could do nothing to help.

Lately he's been drooling more, but no crankiness yet.

As far as helping with the pain, I'm not sure what to do and I feel like I've tried it all. Since the first two I was half in denial about and half oblivious, I didn't really do much. When three and four were coming in I tried rubbing some vanilla extract (due to the alcohol content and sweet taste) on his gums. I don't know if it actually helped. My husband wanted me to use some whiskey. For the next teeth, the ones that seemed to really bother him, I gave him a couple doses of Baby Tylenol (not at the same time, of course). I'm not sure if it helped much. I also picked up some Baby Orajel the following day and used that once when he was cranky again. Again, I'm not sure if it had much of an effect.

There are some other things to try, there is a night time Baby Orajel which is stronger than the regular and there are teething tablets which I have no experience with, but I know some moms that use them.

As best as I can tell, teething pain comes and goes or at least the intensity comes and goes because for the most part, the baby has had happy, smiling times as well as fussing, cranky times while teeth have been coming in. It is hard to tell the cause of the fussing, if it truly is teething or just crankiness due to tiredness. That is why I find it frustrating. I don't want to overuse pain control options if he is just tired and you can't always see the teeth when they are causing discomfort.

From what I have heard and experienced, you can't predict when the teeth are going to come in, nor can you know which teeth will be the ones to cause pain (because not all of them do). I wish good luck to all moms as they go through these difficult times.

Saturday, March 6, 2010

On Disposable Diapers

I am by no means an expert in this area as I mostly use cloth diapers. I did however receive several different brands as gifts when the baby was on his way and I feel lucky in that I've had the opportunity to try them and compare them.

Overall, my biggest complaint is leaks. Disposables don't hold as much as cloth diapers do so you really have to pay attention, especially if your baby doesn't always let you know when the diaper needs to be changed like mine. I experience a leak pretty much every time my baby is in disposable and it doesn't matter if it is pee or poo. They are much better at holding in pee. I don't know if it is just something they overlook or what, but I get some serious poo leaks around the legs and especially up the back - as if they are not designed to hold it in.

Ok, so here is my comparison of the brands I have tried.

Luvs - they run a little small. They have a pretty good fit over all, but they don't hold a ton of pee. I had these early on (they were given to me in diaper cakes) and I had pee leakages a lot.

Huggies - These run big. I've used Huggies at two different times, when the baby was first born and we used the newborn size since the cloth diapers were huge and now in size 3. The newborn ones were nice since they had the cut out for the belly button. I've also used them more recently since I was given a box of the larger size. I usually don't have issues with pee, but poo constantly leaks out the back - and it doesn't have to be a large amount either. They do fit well, they are narrower between the legs and the tops are wider so they fit better than some.

Parent's Choice - These are the Wal-Mart brand and I have to say I'm not a fan. These diapers size-wise are middle of the road, not big or small. They are a little boxy and straight, so they don't have a good fit in my opinion. The texture is weird too. It seems like a combination of plastic and paper and I can't imagine they are very comfortable against the skin. I also got leaks with these diapers pretty consistantly.

Pampers - Also middle of the road in size, not on the big side, not on the small side. They are not as curved as Huggies (in shape), but they still fit pretty well. If I had to argue, I'd say I've gotten a bit fewer leaks with these, but the poo leaks are pretty much inevitable.

If I try other brands, I'll be sure to add them to the list and let you know what I think. I hope this helps.

Wednesday, March 3, 2010

On Breastfeeding

I am a huge breastfeeding advocate and I encourage everyone to do it. I have learned though, that some people have unavoidable hurdles when it comes to breastfeeding and I have become more understanding of them than I started out.

Before the baby was born I took a breastfeeding class which I recommend to anyone that has not breastfed before. Dads should take it too, just to know how to help out. I learned so much. I had no idea that there was so much involved so I am super thankful to have taken it. They also discussed what things were normal, how diapers should look, what a good latch is, and various ways you can position the baby. In the class they went over some not normal things like sore or cracking nipples and what to do, yeast infections and what to look for, and how to deal with a plugged duct and what it feels like if you have one - among other topics. I felt prepared when the class was over.

Breastfeeding is natural, but it is not easy or instinctual. I think this is why so many women have difficulties. You and the baby have to learn how it all works and for someone that has never done it before, help is often needed from an outside source. This sucks, because it means someone other than your husband and baby are seeing you exposed and it can be really uncomfortable. For me though, since it was a matter of that or not figuring it out, I'd rather deal with the exposure. After all, I had just gone through labor which is just about the most undignified thing ever, so what is exposing your boobs to a stranger after that?

I only remember highlights about our early days breastfeeding. I remember when my milk came in about three days after the baby was born and I was engorged and in pain. I think the baby had difficulty latching on because of it. I pumped off some (less than an ounce from both sides) just to get rid of the excess pressure which was a weird experience at the beginning. I have a Medela Pump In Style. It's a great pump, top of the line. It looks like a shoulder bag and it come with a cooler, ice pack and bottles, everything you need to get started.



The baby seemed to latch ok otherwise, but I was very sore, especially on the left side. My mother-in-law (a lactation consultant) told me the baby was latched correctly though. My mom told me that is normal (after all, she breastfed 9 kids) and that your nipples just have to toughen up. She was right eventually, but I did have trouble for a couple of weeks. I got through it with the use of some HydroGel pads (made by Medela) that helped cool my nipples and lanolin ointment which is a must for any breastfeeding mom. One time I had to use a nipple shield which just goes over the nipple to protect it and it helped because I was close to tears with him latching on that side without it.

Eventually though, my nipples toughened up and we were pretty successful. The baby nursed every 2-3 hours on demand. He never had a problem waking up to eat after we left the hospital. I do remember a night early on (within the first week) when he seemed to not be able to be satisfied. I don't know if it was a supply issue or what, but I remember we had just gone to bed and the baby awakened to eat. They told me in my breastfeeding class to always offer both sides, so after he seemed like he was done on the right, I switched him to the left, but when he detached from that side, he still was crying and acting hungry. I spent two hours switching him from one side to the next, back and forth. I was so tired and frustrated, but the baby needed to eat, so that is what I did. He eventually fell asleep and I was able to get a bit of sleep.

Before too long, the baby started spitting up. A lot. It looked as if he spit up as much as he was taking in. I had one mom tell me he might have reflux (as in, acid reflux). I had read about it before and he didn't show any symptoms of pain when it happened, so I wasn't terribly worried (and neither was his pediatrician when I mentioned it at his 2 mo. visit). Besides, he was still making dirty diapers and growing, so I didn't have to worry about nutrition. I switched to feeding him on only one side at each feeding session and his spitting up declined some. That of course means that I have to feed more frequently, but that is ok. He kept doing it predictably though - he'd spit up immediately after a feeding until he started to hiccup - and we just keep a lot of burp rags around. Lately though, he doesn't spit up immediately after a feeding, he may spit up a bit, but he holds onto his meal a bit longer and spits up at random times, sometimes large amounts, sometimes a few dribbles. His growth hasn't slowed. I have no clue what he takes in at a meal, but he is able to satisfy himself. We are still feeding every 2-4 hours, which is better considering is was every 1-1 1/2 when we first switched to one side per feeding.

When teeth entered the picture, it seemed as if some of the early problems resurfaced. Even though it isn't intentional, sometimes those teeth dig in and nursing is painful. Repositioning usually fixes this issue. I have to use the lanolin sometimes and this time, my right side is the sore one. He occasionally bites, but that happens typically at the end of a feeding. I cut him off when he does that. This habit has declined some.

I keep a stash of pumped milk in my freezer in case someone else needs to look after the baby which isn't often, but I have it just in case. Pumping is weird. I don't get much, especially if I pump after he has eaten (only about 1/2-1 oz). Since we only feed on one side, I can typically pump out of the other and get 3-4 oz. If I block feed (just on one side for several feedings) I can pump off 5-6 oz from one side.  He is more efficient than the pump and deflates me much more than the pump does. This I hear/read about from a lot of moms though. Here are my storage bags. They have a strap that wraps around the nozzle and you can pump directly into them and they are measured so you know how much you got out.



I have joined a breastfeeding support group which is cool. I sometimes feel guilty about going because I don't really need help with breastfeeding. We haven't had any major problems, but it does make me realize how easy we have had it and exposes me to a lot of things I never could have imagined and obstacles that moms have come across and have been able to overcome. I really encourage finding a support group, especially if you have any issues or concerns with breastfeeding. It is nice to know you aren't the only one with issues or that there are other people you can talk to about it. And it is nice to have someone there that is trained in breastfeeding and identifying and solving problems. There are tons of problems that can be overcome if you just have the right information and support.

I have learned so much from the consultant that they have at the meetings such as risk factors for low supply like obesity and diabetes (both gestational and regular). I have also learned there are tons of supplements to help increase low supply and sometimes a combination of several is necessary. I've also learned that power-pumping (pumping for a few minutes every time you walk by your pump - meaning several times an hour between feedings) can help to increase stimulation and supply. And those are just a few things I've learned. Low supply and latch issues seem to be the most common. Some moms are able to overcome the problems, and some learn to work with them.

So, here are a few things I've figured out through breastfeeding:

Get comfy. Some of my nursing sessions have lasted 45 minutes, and yes, that was on one side. This happened much more when he was younger and would fall asleep nursing. Either way, you have to be comfortable or else it won't go well. If you are in an awkward position, you can end up sore at the end of a session. It is best if you get comfortable first and then settle in the baby.


The Boppy is a wonderful tool. I thought I wouldn't need one and just thought is was a luxury to have. I figured I'd just use pillows. Stupid me. Pillows slip. The Boppy is firm to support the baby and it stays in place. It will relieve your back by preventing you from slouching forward to nurse and give your arms a break so you don't have to hold and support the baby for the entire feeding session. I had to eat my words after I got mine and I thank my husband continuously for making me get it.


Cloth bra pads will save you money! Not every mom will leak, I do though. When you change out your bra pads every time they get milk in them, as they manufacturer recommends, you go through a large box in a month and a half. Cloth pads will absorb just as well, prevent you from leaking on your clothing, and save you money because you can just throw them in the washer. They can be a little lumpy if not positioned well, but that is easily overcome. You can find them at Babies R Us and they have several brands to choose from. If you are talented, you can sew your own with several layers of cotton fabric.

Nursing in public is not that big of a deal. I was never really bothered by people doing it, but I know it can make people uncomfortable. I figure, hey, the kid needs to eat and there is no reason I need to stay at home 24/7 just because I breastfeed. I was a little uncomfortable at first and went to the car once to feed the baby or would go to a room when visiting people, but I hated shutting myself off from the activity and it just isn't necessary. A blanket, or even better a nursing cover, is all you need to keep yourself covered and modest. When they get older and can bat the blanket out of the way, a cover is helpful because it doesn't fall down. You can get clips too to attach to a blanket if you don't want to spend the money on a cover - they just attach like the "bib" at the dentist.



Lanolin is a pain in the butt, but useful. It is thick and waterproof. Massage the tube to warm it up and make it less thick and help it spread easier. Also, make sure you have something to wipe it off of your hands with after you apply it because you won't be able to wash it off - even with soap. It is also helpful to put it on before showering if you have sensitive or sore nipples, it really does help.



Pumping is no where near as efficient as the baby - even if you have a top quality pump. If my baby only ate what I could pump, he'd be starving. It is so weird how he can empty me out and I still feel half full and the pump will be pulling out drops. Feed the baby when you can at the breast. It'll help to prevent plugged ducts and mastitis because the baby can empty you out completely and the pump doesn't always do that well. Plus, biology has a weird effect on milk content when the baby nurses directly so the milk is produced specifically for the baby's needs - weird, but true. Keep a stash of milk in the freezer for that "what if" factor. If you are going back to work, it is a good idea to start your stash early. Babies do all kinds of weird things when you are separated from them - you don't know if your baby will be super eater because the bottle is easier than nursing or if baby will go on a hunger strike until you see him again - better to be safe and have plenty.

Breast milk spit-up doesn't stain. A quick wipe to get the big stuff up is all you need when it happens. No stain remover is needed! Whoo-hoo! The clothes are good as new after a washing. Don't let wet, spit-up filled burp rags go in the laundry balled up though. Open them, let them air and dry or put them in the wash right away. Otherwise, it creates a great home for colonies of stuff to grow - ew.

Breastfed babies don't poop everyday when they are older. My baby started this at about 3.5 mo. He'd have a big poo every 2-3 days and small amount in between. I was told this could happen because breast milk is so much more digestible. It was great while it lasted (until 5.5 - 6 mo), but then teething caused gut issues and the multiple-times-a-day-pooping is back, but that is a discussion for another day.

Babies will comfort nurse. Babies are comforted by suckling. This is why pacifiers work. Though I don't advocate shoving a pacifier in their mouth just to shut them up, sometimes it does help comfort them and it is a good tool for bedtime. I don't use a pacifier at all, but I will let him latch on just to get that comfort and it works for going down at night too. They sometimes want to do this when they aren't hungry. They won't be pulling out much milk, just snuggling and suckling.


If you have problems, get help. I highly recommend getting help to see if there is a solution to the problem if you are having trouble. As I mentioned before, I have learned about a ton of things that can cause problems and how to fix them, even if I never experienced them. A lot of moms have problems nursing and there is no reason to be embarrassed or frustrated. You aren't the only one! There are tons of trained people out there and they can help - and I'm not talking about the pediatrician, because often they just say to supplement rather than help you figure out a solution, they just aren't always trained in the specifics of breastfeeding (no offense against them, they just aren't). And in the end if they can't find a solution, at least you know you exhausted all options. Also, a support group is essential, especially if there is no one to support you at home or in your day to day life. A good support network greatly increases a moms nursing success rate.

I hope my experiences and these bits of info are helpful. Good luck with breastfeeding!

Monday, March 1, 2010

On Cloth Diapering

Telling people you are cloth diapering gets all kinds of responses. I was excited to discover that more people are supportive of it than not, even if most people don't use cloth diapers themselves. Most people just ask how it's working for us. I have gotten some negative feedback with people that seem to think that I couldn't keep it up or that I'm crazy for doing it, but I truly believe it has saved us money and it is not all that difficult... once you have it figured out.

Let me start by saying, I do not do cloth diapering full time. We are part time cloth diaper users and it works well for us. Since I stay at home, cloth diapering is easy when we are at home, but we do use disposable when we go out or run errands. This makes it easy to change a diaper when we are in public and just toss it. That way we don't worry about carrying the dirty or wet diaper with us. It also makes it easier to leave the baby with child care at places like the YMCA where I take my yoga classes.

There are so many options out there when you choose to use cloth diapers. At first I was lost. I didn't know what supplies I'd need or even what diapers to get. I tried to read in forums and such, but was confused by words like pocket diapers, all in ones (AIO), and prefolds. In the end, I chose a diapering system based on a sample pack that my mother-in-law sent me (it had a diaper, liner, and cover) and it seemed pretty basic. More research on the company website made me feel comfortable with their products and their care so I ordered a whole set of 24 diapers, 12 liners, and four covers.

This is my diapering system:

I use Mother-Ease diapers. The diapers are one-size (OS) that close with snaps so I don't have to deal with pins. They are a terry cloth material, so they are kind of like towels. The liners snap into the inside of the diapers for added absorption. The covers have elastic edges and a plastic type lining that keep messes in. I actually have fewer leaks with the cloth diapers than I have experienced with the disposable - and that goes for wet and dirty leaks - and brand doesn't seem to make much difference.

My diaper pail:
 
Who needs a fancy diaper pail? With the diapers I have, I can have a wet pail. We just went and picked up a 5 gallon bucket with a lid at the hardware store. It works great. I fill the bucket about 2/3-3/4 full of water and add some stain fighter. The diapers soak until the bucket is full and it is time to wash. This happens about every 2-3 days. Some cloth diapers do not allow the use of a wet pail, so they use a dry pail. The same type of bucket can be used, just line it with a mesh bag to keep the diapers in until they are ready to wash. The mesh liner bag helps to aerate the diapers and is a must if you have a dry pail.

My wipes:

 
I figured since I was using cloth diapers I might as well use cloth wipes too. This system is pretty cool. The wipes are kept wet in the warmer so they are moist and warm for wiping dirty and wet bottoms. The warmer has a pad that goes in the bottom to keep bacteria, mold, and mildew from growing and gets changed every three months. As long as the liner is kept wet too, it all works out. The wipes are bamboo, but washcloths can be used too. The bamboo ones don't go in the dryer so as soon as they are done washing with the diapers, they get rolled and put back in the warmer.

Washing: Washing the diapers can be a little challenging/frustrating. I haven't figured out a good way to rinse the diapers before putting them in the pail, so they go in and soak as is. When time comes to wash them, I simply pour the dirty water down the toilet. I then wash the diapers in a regular cycle with regular detergent. I do make sure that an extra rinse cycle runs. Because I am very particular about stains, nothing goes in the dryer that isn't spot free. I use Clorox 2 to spot treat stains that didn't come out and let it set for at least 5 minutes. If I have enough diapers that didn't come clean the first time, I let them set and rewash. If there are just a few, I'll let them set and put them back in the pail until it is full again. I rarely have to send diapers through three or more washes.

So, that is how I do it. I'll go ahead and share some info that I have learned from my research and from talking to other moms. First, a guide to the different type of diapers!

Flat fold - flat fold diapers are just a piece of flat cloth. They must be folded to size and pinned into place with diaper pins. These were more commonly used many years ago. (I use these for burp rags, they are great for that purpose!) These diapers need a cover or "rubber" pants to protect clothing.
Prefold - prefold diapers are sewn with a thicker area down the center for absorbency and can just be pinned in place without folding for sizing. Sizes vary and you will probably need to have a variety of sizes and change as the baby grows.
One-size (OS) - one-size diapers grow with the baby. They are adjustable for size to fit the baby at any stage of growth. Newer one-size diapers have plastic snaps around the legs or waist for easy adjustment as the baby grows to achieve the best fit for whatever size the baby is.
Pocket diapers - pocket diapers have a space sewn in between layers to add a liner for added absorbency. This keeps the liner from moving or shifting.
All-in-One (AIO) - all-in-one diapers are very popular for modern cloth diapering moms. These diapers have the cover incorporated into the diaper so a separate protective cover is not needed. They will protect leaks all on their own. These diapers typically can not be soaked in a wet pail.

Modern cloth diapers often have velcro or snaps for closures so pins aren't always needed, but they are still available for flat fold and prefold diaper users.

There are many brands out there that are available, but they can be hard to find. They can be ordered online or found at smaller boutiques or consignment shops. One type, G-diapers, are available at baby and grocery stores. They are midway between cloth and disposable use since they have a reusable cover and a disposable liner.

I am happy with the choice I made about the diapers I use. If you are interested, I'd talk to other moms and try different types to see what you like. Most of the moms that I talk to on a regular basis have tried different ones before finding the brand and style they like. Good luck!