Barb's Daily Dose

Breastfeeding a Baby With Food Allergies

I saw this question on the CNN website. The pediatrician who answered did a great job going over all the different issues.  Here’s a link for the question and answer:

What’s tricky for some babies is that the foods that mom eats can lead to allergy symptoms in the baby that range from a red rash on their cheeks to blood in the stool.  Most moms need to talk to their Pediatric NP or Pediatrician to help decide whether an elimination diet is necessary.  If there is a family history, many families chose to use the hypo allergenic formulas from the beginning.  Breast milk has so many benefits that this has to be evaluated by a licensed professional.

Many babies will “grow out of allergies” if they are allowed a long time ( 3-6 months up to 2 years) without exposure to the offending food.  Some children who develop eczema or a skin rash from a food allergy will go on to develop asthma too.  My niece Amanda had an early allergy to milk proteins and had to be on a Soy formula.  She is now allergic to all nuts and has asthma.

In these cases, be sure to get advice from your health care provider.

Help, My Baby Won’t Take a Bottle!

Hi, this is difficult. We nurses call this scenario the "bottle wars" because if a baby hasn't been introduced to a bottle within the window of 3-6 weeks, they often will refuse to drink from anything other than their mama when offered other options later. It leads to lots of crying, from Mom to Baby and the unlucky caregiver who has to try to feed a very unhappy, screaming, hungry customer.

Prevention Strategy

If you’re going back to work and can’t feed your baby yourself, then here are a few tips:

• Absolutely, positively, do NOT wait until the day before you head out the door you’re your briefcase. To ease everyone’s transition back to work, offer your baby a bottle of pumped milk or formula between weeks 3-6, after breastfeeding is well established.
• If breastfeeding is going well, one bottle of pumped milk or formula will not interfere at this time.

Breastfeeding Myth Busting, Part II

It’s OK to Give the Baby Juice No it’s not.

Until babies are over 1 year, giving an infant juice is not a good idea. It’s loaded with fructose (fruit sugar), and is more likely to cause a child to develop a “taste” for sweets a little early. Babies need all the nutrition in breast milk or formula, not empty calories in juice. When they are over 1, limit juice and mix it with water in this ratio: 1 part juice to 3 parts water.

Colostrum is Bad for Babies

It’s hard to believe it, but some moms have been told, that their first milk, the Colostrum is actually bad for the baby, and must be pumped and discarded. Nothing could be further from the truth. There are many important immunities in the Colostrum and it’s essential for moms to put the baby to the breast frequently so that the Colostrum helps the baby pass their Meconium and also to stimulate the milk to come in. Check back for more myth busting and send in your questions.

Breastfeeding Myth Busting

Give Colicky Babies Tea

The other day I was asked if it was ok for a mother to give her 3 month old baby tea instead of one feeding. I was a little surprised, but did remember that in some cultures, if a baby has a bit of gas or lots of stomach cramps that giving the baby tea is considered a safe remedy. This is not recommended as a treatment from the American Academy of Pediatrics.

In Hot Weather, Give the Baby Water Instead of a Feeding

In other cultures, it’s common to substitute water for a feeding. Unless you live in a place where it’s over 105 degrees routinely, this is also not a good idea. Babies need more than just fluids. They need the calcium, protein and other nutrients in breast milk or formula. So don’t substitute water for breast milk or formula.

Check back for more myth busting and send in your questions.

Supporting Moms Who Don't Breastfeed

I watched this segment with Dr. Nancy Snyderman from the Today Show about breastfeeding.  There was a recent article in the Atlantic by Hanna Rosin, who was also on the show, and who is breastfeeding her 3rd child. They discussed how hard it is to keep up with the American Academy of Pediatrics recommendation that moms breastfeed exclusively for the baby's first year.

I write about this a lot, because I see so many moms who can't breastfeed for a variety of issues and they feel guilty. Some develop postpartum depression. As I've written many times before, each baby and each mom is different, one size doesn't fit all.

I Liked What Was Said:

• Not enough is being done to support women who want to breastfeed
• Women should be supported no matter what their choice and circumstances
• If moms need to supplement with formula, they shouldn't be made to feel guilty

To view the video of the Today Show's segment click on Dr. Nancy Synderman.

Mastitis

One of my patients came in the other day with a very red and sore breast. There was a large lump and she was having flu like symptoms.

Mastitis is no picnic.  It is caused by an infection in the breast or when a plugged duct becomes infected. This develops quickly, is usually only on one side, and can be extremely painful.

When to Call Your Provider:

• For a fever over 101
• If you notice a breast that is painful, red, hot to the touch, or swollen
• If you have flu like symptoms or feel achy all over
• There is blood or pus coming out of the nipple

Feeding a Baby

            

• What should I feed my baby?
• How should I feed my baby?
• When should I feed my baby?

Wow, they’re universal and they’re important. Every family has their own set of circumstances that determine the optimal answer to these questions. After 20 years, I’ve learned, one size doesn’t fit all, and the way I approach these questions is to start by listening, then asking more questions, then listening again. 

The Milk Fairy

Here's a question I received this week:

My baby is 5 days old, and my milk hasn't come in yet. She's latching on, but wasn't having any wet or poopy diapers so the pediatrician suggested that we supplement with formula.  How do I get my milk to come in?

It sounds like the Milk fairy hasn't made an appearance at your house yet.

Here's what I recommend:

• Please, as much as possible try to get plenty of rest

• Offer the baby your breast at each feeding, and after 10 minutes or so, offer her a bottle, to make sure that she's getting nutrition 

• Try to pump 4-6 times each day, after feedings and see if you're producing

• Most moms get the highest volume in the morning, when they've had a chance to rest a bit

• Try a safe herb, Fenugreek, 3 times/day to help increase supply

When to Call Your Pediatrician

I write lots of blogs, and advice columns for a variety of websites, like this one and receive questions every day from moms who need advice about their babies. Often, the best advice I can give is to:

Call Your Pediatrician

Here’s a short list of when to call them:

• Your Baby is spitting up all the time
• You’re thinking of switching formulas, and need a recommendation
• You don’t think your baby is getting enough to eat and isn’t gaining weight.

There are countless other questions. But these are ones, that are best discussed with your baby’s own health care provider. Please do give them a call.  Often you can get advice from a nurse in the practice or a phone call, without having to make an appointment.

The Unexpected

I saw a mom the other day who is pregnant with her 2^nd child.  Her first baby is 16 months old and she’s excited to be pregnant again. As we went over her previous pregnancy, she related that she was much more relaxed this time.  I was curious about that statement and asked her to elaborate further.  Well, she explained, with her 1^st pregnancy, she had to go on bedrest for 10 weeks and that experience caused a huge and almost immediate shift in how she felt about her life. 

 “You see,” she explained, “I was definitely a Type A person. I had everything planned and did everything in my life perfectly.  I had no time or patience for anyone who didn’t measure up to my standards.  Then life threw me a curve ball and I woke up.”