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What do I need to know about infant feeding?

by Maxine
Posted July 27 2010 01:27pm
Filed under:

In this age of information, separating facts from myths can be a challenge for anyone. 

In this age of information, separating facts from myths can be a challenge for anyone. This can cause confusion for expectant and new parents who have many decisions to make, not the least of which is how to feed their baby.

Fact: Newborns need to eat often - at least every 2 to 3 hours
Newborns need to feed at least every 2 to 3 hours because their stomachs are small. A day-old baby’s tummy can hold about 5-7 ml (1-2 tsp) of milk; by 3 days 22-30 ml (.75-1 oz); and by 7 days 22-60 ml (1.5-2 oz). So, it doesn’t take a lot to fill their tummies and their tummies need to be filled often because they empty often. As your baby gets older, feeding tends to be more like every 3 to 4 hours, but will become more frequent again during growth spurts—at 3 weeks, 6 weeks, 3 months and 6 months. Breast milk is also very easily digested and with small stomachs baby needs to eat frequently.

Fact: There are ways to determine that your baby is well fed and hydrated.
It’s true that you cannot measure the amount of milk your baby drinks during breastfeeding. But the important thing is recognizing that your baby is well-fed and hydrated. In the first months your baby will:

  • Eat every 2 to 3 hours.
  • Continuously suck and swallow for at least 10 to 20 minutes during breastfeeding.
  • Have at least one wet diaper for each day of age up to 3 days. After day 4, there should be at least 6 to 8 heavy wet diapers each day. A heavy diaper feels like 40-60 ml (2-3Tbsp) of liquid on a cloth or disposable diaper.
  • Have at least 2 to 3 stools each day; by day 3 there should be at least 3 stools per day. Some breastfed babies pass stool every time they’re fed, meaning 10 to 12 stools per day, which is normal, too.
  • Have a moist look to their mouth - as if they were wet.

If, your baby is not showing these signs, your baby is becoming dehydrated and needs immediate medical attention. Take your baby to the hospital emergency.

Fact: Dry skin, a sunken soft spot on baby’s head and dry mucus membranes are also signs of dehydration.
These are late signs of dehydration in your baby, your baby needs to be in hospital and getting medical care. The soft spot on the top of a well-fed baby’s head should be flat and not sunken. Skin that is dry and does not have much elasticity indicates that your baby is not getting enough fluid. Gently pinch the skin on your baby’s thigh or tummy and let it go: it should lie back down, not remain pinched together. Mucus membranes should be moist or wet.

Fact: Babies under six months do not need baby food.
The recommendations from Health Canada on infant feeding indicate that solid baby food be delayed until your baby is six months old. By six months, your baby’s stores of iron start to diminish. Before six months your baby’s bowels are still maturing and the muscle coordination in your baby’s mouth, head and neck are not developed enough to manage solid food. Giving solid food to early may lead to the development of food allergies and obesity.

Fact: Breastfeeding allows you to bond with your baby.
Breastfeeding is a good way to bond with your baby but it isn’t the only way. Dad or your partner can have the same skin-to-skin contact by placing your baby, dressed only in a diaper, on his bare chest. Include snuggling, talking, singing and reading in your everyday routines with your baby as these are other ways that you and others can use to bond.

Fact: Colostrum is baby’s most important first food.
Colostrum, the yellow or orangey-coloured first milk, is considered the perfect first food for babies. It is easily digested, low in fat, high in carbohydrates, high in proteins and contains antibodies to keep your baby from getting ill. This first milk helps to protect your baby’s tummy and bowels. It also helps her to poo in the first few days after birth and may help prevent jaundice.

Fact: Breastfeeding takes time for you and baby to learn.
Although breastfeeding seems like the most natural thing in the world, this doesn’t mean that it will all fall into place naturally for every mom and baby. It is a learned art and it may require time and patience to learn. However, there is a lot of support available to you, beginning with the nurses and lactation consultants in the hospital, to public health nurses and breastfeeding clinics in the community and the La Leche League hotline 24 hours a day. The payoff? Never having to wash, sterilize, prepare, store and transport bottles for the next year. Just breastfeed whenever and wherever your baby needs to feed. What could be easier?

Fact: Small-breasted women are able to breastfeed.
Breast size has nothing to do with a woman's ability to breastfeed. In fact, larger breasts are due to more fat tissue. Breast milk is made by special milk-producing cells, not fat cells.

Fact: Most women make enough milk to breastfeed.
Most women make more than enough milk to breastfeed their babies. Early and ongoing breastfeeding guidance and support can help to avoid poor latching, the main reason for a low milk supply. Short and infrequent breastfeeding may also cause low milk supply. In rare cases, some women have a medical condition and may be unable to breastfeed.

Fact: Women who have flat or inverted nipples are able to breastfeed.
Latching your baby onto the breast may be more of a challenge with a flat or inverted nipple but it is possible. Your baby needs to have as much of the areola, the brown part around your nipple, in her mouth as possible in order to drink your breast milk. So, although your nipple helps to guide this process, it is not absolutely necessary to it. Once the areola is in your baby’s mouth, the nipple will come out as she sucks.

Fact: Breastfeeding should not cause pain.
Although the first weeks of breastfeeding may cause nipple tenderness – after all, this is new – there should be no pain during breastfeeding. Pain is usually the result of an incorrect latch. Correcting the latch should ease the pain. If pain persists during feeding, however, consult your a lactation consultant or your baby’s doctor. A lactation consultant is a specialist in breastfeeding. Some moms and babies share a yeast infection that requires both mom and baby to have treatment.

Fact: Women who have had breast surgery may be able to breastfeed.
A woman’s ability to breastfeed will depend on the type of surgery and the part of the breast that’s involved. For example, if the areola and/or nipple were affected, there is a greater chance of problems with breastfeeding than if the surgery was in a different area of the breast. Speak with the doctor who did the surgery they may help you to understand what part of the breast was affected from the surgery.

Fact: You do not need to wash your nipples before each feeding.
Washing your nipples before feeding your baby is not necessary. Frequent use of soap and water will dry your nipples out. Leaving breast milk on your nipples, on the other hand, protects your baby from infection and promotes healing of any soreness and cracks that may have developed.

Fact: Breastfeeding can be done at anytime, in anyplace and needs no special equipment.
In many ways, breastfeeding is liberating—it can be done anytime, anywhere and without any special equipment. It means you don’t have to clean and prepare bottles, which takes time. It means you can take your baby with you without having to carry formula. It is always at the right temperature, you do not need to worry about having to heat it or find a place to warm your baby’s food. It does mean you are the sole provider of food for your baby for the first 6 months. It all depends on your perspective.

Fact: Mothers are allowed to breastfeed their babies in public.
If you are comfortable breastfeeding your baby in public, there is no reason why you shouldn’t. In fact, it is a human right. This means that breastfeeding moms and babies are welcome to nurse anywhere, anytime. No one can tell them not to breastfeed. Some communities post signs to openly acknowledge that they are breastfeeding friendly.

Fact: Breastfed babies do not need extra fluids, like water and juice, in hot weather.
Breastfed babies do not need any other liquids, even in the summer heat. Breastfeed your baby more frequently to keep her hydrated in hot weather. Other liquids may fill your baby without providing the nutrients that breast milk provides and that your baby needs. It is especially recommended that babies under six months of age not be given juice and water.

Fact: A woman can use breastfeeding to help with child spacing.
This method is known as the Lactation Amenorrhea Method (LAM). Breastfeeding can be used for child spacing but only under the following conditions:

  • Your baby is under six months of age
    Your baby is exclusively breastfed and you are feeding her at least every 3-4 hours
    You have not had a menstrual period.

This is not fool-proof, though. Sometimes, your baby sleeping through the night can have an affect on this method. You may therefore want to use another type of birth control.

Fact: You do not need a special diet if you are breastfeeding.
It is recommended that nursing Moms eat a well-balanced diet, for their own health and for recovery from pregnancy and birth. Your body will produce milk, even if you occasionally consume fewer calories than recommended, provided this is not long-term.

Fact: You do not need to drink milk to breastfeed.
Although milk is a good source of calcium you will continue to make milk, even if you do not drink milk. There are other foods you can eat to obtain calcium. Continue to make sure you are drinking enough fluids during the day. If you are experiencing thirst, you are not taking in enough fluids.

Fact: In most cases you can breastfeed if you are ill.
With the exception of HIV, mom should continue to breastfeed during illness, even if this illness is mastitis. Generally speaking, people are contagious before they actually become ill, so that a baby would have already been exposed. Breast milk contains antibodies and other infection-fighting substances. By continuing to breastfeed your baby, you will continue to pass these on. If your baby becomes ill, chances are the illness will be mild due to the protection that breastfeeding offers.  

Fact: You should check if it is safe to take medicine when you are breastfeeding.
There are few medications that may require you to stop breastfeeding. Most medications are not a concern. Check with Motherrisk if you have concerns about any drugs. They have the most current information. Read medication information and consult your pharmacist with any questions or concerns

Fact: Exercise does not affect the breast milk.
Exercise does not affect breast milk in any way. Therefore, you can breastfeed after exercise.

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Crying: Red Flags

by Maxine
Posted August 5 2010 11:46am
Filed under:

“Uh oh—Alex is crying—again! I wonder what‘s the matter.”

Does this sound familiar?

A baby’s crying often makes parents feel helpless or frustrated—asking, “Why is she crying?”

Babies cry because it’s the only way they have of verbally communicating. It’s their way of saying, “I need you to...” It’s up to you, as parents, to figure out the rest of the sentence. Over time, you will learn just what your baby is trying to tell you.

Babies between birth and 6 months old can cry for 15 minutes at a stretch and for a total of 3 hours each day. Even a strong, hearty cry is normal.

Here's a list of the most common reasons babies cry. Use it as a guide or checklist:

  • Hungry or thirsty
  • Wet or soiled diaper
  • Lonely
  • Too hot or too cold
  • Pain
  • Gas
  • Tired
  • Bored
  • Overstimulation
  • Sick
  • Sometimes, no apparent reason

Still concerned?

Call your doctor if your baby displays any of the following signs:

  • High-pitched cry
  • Weak or feeble cry
  • Inconsolable cry that lasts longer than 3 hours

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Shaken Baby Syndrome

by Maxine
Posted August 25 2010 05:50pm
Filed under:

It may be hard for you to believe, but some parents, grandparents, babysitters, nannies and other caregivers can become so unnerved by a baby's inconsolable crying that they can lose control and shake a baby to try to stop the crying. And the outcome is often damaging, and sometimes fatal. Below, you'll learn more about Shaken Baby Syndrome, including some of the dangerous results, how it occurs and what you can do to reduce the chance of it happening to your baby.

 

What is Shaken Baby Syndrome?

Shaken Baby Syndrome occurs when a baby is violently shaken, which results in traumatic injury, usually to the brain or spinal cord. The shaking is not accidental, but an intentional form of child abuse. The injuries are a result of violent force and can result in permanent brain or spinal cord injury or even death.

Still not sure what activities are capable of causing Shaken Baby Syndrome? Read through the list of everyday activities below. These do not result in the types of injuries that Shaken Baby Syndrome does. 

  • Bouncing your baby on your knee
  • Swinging him in a baby swing 
  • Carrying her in a backpack while running 
  • Tossing him in the air
  • Vigorous use of these activities could scare your child and/or could cause harm if they are done before a child has good control of their head and neck muscles or able to control their balance. Use caution when you do these activities and watch your baby’s cues to determine if they like the activity or have had enough of it. 

 

What are the results?

Your baby's brain contains more water than yours does and is not yet as insulated as your brain is. It is actually more like jelly and, therefore, more easily damaged.

During a violent shaking, a baby's head turns and flops uncontrollably, causing the brain to strike and push against the inside of the skull. This causes internal bleeding and a great deal of damage. The results, both short- and long-term, are usually severe and permanent. It can result in death.

In the short-term, a shaken baby or child displays some or all of the following symptoms:

  • Stops breathing
  • Becomes extremely irritable 
  • Has seizures 
  • Becomes very limp or very rigid 
  • Becomes very drowsy or unconscious 
  • Vomits 
  • Becomes unable to suck, swallow, eat or drink

In the long-term, if a baby survives a violent shaking, the following results can occur:

  • Learning disabilities
  • Physical disabilities 
  • Trouble seeing or blindness 
  • Trouble hearing or deafness 
  • Trouble speaking or inability to speak 
  • Paralysis 
  • Cerebral Palsy 
  • Seizures 
  • Behavioural problems

Many times, along with head and spinal cord injuries, there are bruises, broken ribs and broken bones in the arms and legs, depending on how the baby was grabbed.

 

How does it happen?

The most common reason given for shaking a baby is the baby's crying. A typical baby under the age of 9 months may cry up to 3 hours a day. It is not uncommon for a baby of this age to cry more than this or to have a sensitive temperament. Not all crying has a specific cause like hunger or a soiled diaper and it can take a lot of time and patience to console your baby.

Babies are born not knowing how to soothe themselves. They need their parents to help them learn how. Some babies learn relatively quickly while others are more high strung; periods of intense crying can be part of how they communicate for several years.

A baby that cries and cries can make anyone feel frustrated and helpless. Sometimes, inconsolable crying makes adults feel inadequate, guilty or angry. Some parents or other caregivers have no one to give them a break at a critical point in a crying episode. By now, you've probably had a taste of how tiring it is to take care of a baby and when you or anyone caring for your baby is tired, these feelings can be harder to control. All of these feelings put a baby at risk of being shaken.

 

What other factors put babies at risk?

The following situations put babies at risk because they generally cry a lot and/or they require caregivers to have lots of patience:

  • Born a twin, triplet, etc.
  • Born prematurely 
  • Born with a low birth weight (less than 2500 grams or 5.5 pounds) 
  • Born with a medical or congenital condition 
  • Are withdrawing from their mother’s substance abuse
  • Lack good bonding with parents or caregivers 
  • Are boys under 2 years of age

Babies are also at risk if the parents, or other caregivers, such as nannies or in-home care providers, are in the following situations:

  • Lack support from family, friends or the community
  • Face challenges, such as low education, low income or other money problems 
  • Are experiencing marital or family difficulties 
  • Are violent with others or other children 
  • Have mental health problems, such as anxiety or depression 
  • Have substance abuse issues 
  • Are single parents 
  • Are experiencing stress

 

How can it be prevented?

You're taking the first step right now by learning all about Shaken Baby Syndrome!

Now, take the next step and think about how you feel when your baby cries for a long time. Do you feel unable to cope to the point where you feel almost out of control? Do you feel as if you have tried everything you know how to do? If the answer is yes, then keep your baby safe!

Guidelines for yourself, when your baby is inconsolable, or you are nearing the end of your patience:

  • Stop, take a deep breath and count to 10.
  • Put your baby in the crib or another safe place. 
  • Leave the room. 
  • Find a place to take a time out for yourself. 
  • Ask for help. Try to call a friend or relative to come over and be with you, to provide a little relief. 
  • Call a crisis hotline or your doctor. 
  • Check in on your baby every 3 to 5 minutes. If you're upset and can't concentrate, use a timer to remind you. 
  • Wait until you are calm and in control before going back to your baby.

Good advice for your baby's caregiver:

  • Remind sitters, nannies and other caregivers that it is even more likely that your baby will become inconsolable with them or anyone besides you, the parents.
  • Write out instructions on how you want the caregiver to respond if your baby starts crying inconsolably. 
  • Arrange for a backup or support person to be available during an emergency, and encourage your baby's caregiver to call that person, should your baby become inconsolable. 
  • Try to remain available to return early, should that become necessary.

 

Do you have more questions about Shaken Baby Syndrome? Ask our expert, Dr. Richard Volpe for more information on Inflicted Infant Head Trauma (a.k.a. Shaken Baby Syndrome). 

 

Where can I get more information or help?

Hotline:

EMERGENCY CHILD ABUSE: 1-800-422-4453 (1-800-4-A-CHILD)
Child Abuse Prevention Centre: 1-888-273-0071
National Centre on Shaken Baby Syndrome
Canadian Paediatric Society

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Safety: Are Our Bedrooms Safe for Our Child?

by Guest
Posted August 26 2010 09:40am
Filed under:

Here is a basic safety checklist for bedrooms. In addition to the points below, be sure to look carefully around your bedroom for yourself, to see if there are any additional actions you can take to safety proof it for you and your child. But begin by making sure that:

 

  • There are no "cute" decorator night lights - they look like toys to be played with.

  • Beds and cribs are located away from windows and radiators. Windows can break, and if they are open, children can fall out of the window. Radiators can burn small children.

  • Children are not allowed to jump on beds, because they can lose control and be bounced onto the floor or into the corners of hard bedroom furniture.

  • Babies should not be placed on waterbeds because little ones do not have the strength to turn their head into a position where they can easily breathe.  Babies should not be placed on adult beds to sleep as they may roll or suffocate in the bedding and pillows.  The Canadian Pediatric Society recommends that a baby sleeps in a safety-approved crib, on their back and close to their parent. 

  • Pillows are not used for children under two year of age.

More information on safe sleep can be found on Health Canada's Website.

 

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