Tag: Breastfeeding

Baby-led Weaning: Promoting Health and Independence

Posted on by rustyroamingandruthless
food1
Dinner for a 9 month old

Why we chose baby-led weaning…

There are few baby-rearing topics that are as controversial as the introduction of solid foods into a baby’s diet. Do I feed purees? Make my own organic baby food? Buy some jars? Feed solid table food? Won’t they choke? Do I start cereal? When do I start? How much should I feed them? What if they don’t want to eat? Your doctor said ________ but mine said _________ ?

Upon introducing solid foods, I have always tried my best to adhere to the following principles:

  • It must be food that is healthy, clean, and nourishing.
  • She has to want to eat it on her own, and be able to feed herself. No coercion to eat or anxiety at the family table. It must promote independence and self-esteem through learning.
  • I want to do as little extra work as possible. I am lazy.

Around the 6 month mark, we decided to introduce some solid foods into our daughter’s diet. She showed a strong interest in eating solid foods, and also showed the typical readiness signs such as sitting unassisted, lack of tongue-thrust reflex, and a developing pincer grasp. She just developed a solid pincer grasp at about 7.5-8 months, but I personally do not think that this skill is necessary in order to start exploring solid foods. However, she was totally able to hold food in her fingers and hands and feed herself easily at 6 months.

Just an FYI…

As mentioned in a previous post, we had serious issues with growth and weight gain at 6 months. All of our doctors were initially convinced that this must have been a nutritional issue and pushed us to start feeding infant cereal. I had a hard time believing that the problem was nutritional, as she would not ever nurse any more frequently and still didn’t gain weight. Once we found out that she had a urinary tract infection, I was so thrilled we never listened to their advice. Without the help of solid foods such as infant cereal, my daughter went from 14lbs at 6 months to 20lbs at 8 months. She did eat some solid foods during this time, but was eating so little that I could not consider this a contributing factor. The Centers for Disease Control and the American Academy of Pediatrics state that breast milk alone is sufficient to support optimal growth and development for the first six months, with introduction of complimentary solid foods happening after this point[1].

So what is baby-led weaning?

We decided that baby-led weaning, or what I think is more properly termed “baby-led feeding,” essentially means that your baby takes the lead in the introduction of solid foods. Instead of feeding your baby pureed baby food from a spoon, you offer them food your family is eating at a meal. For example, baby can be offered avocado slices, banana slices, toast slices, soft cooked fruits and vegetables, pasta, or anything that they can pick up and feed themselves. The baby must pick up the food and eat independently. I think that the most enduring and important aspect of baby led weaning is the idea that your baby is feeding themselves, as opposed to a parent feeding baby with a spoon and purees.

Benefits of Baby-Led Weaning

Choosing to ditch the purees and use baby-led weaning has a variety of amazing benefits for a baby’s development and learning. Firstly, baby-led weaning allows the baby to be in control of the food they eat. They are able to put the food into their own mouth and decide the quantity they want to eat, while working the food around in their mouth to chew it into safely edible sizes. In my experience, babies can easily learn how to chew and manipulate their own food (even with no teeth!) to break it into safe pieces for them to swallow and eat. When babies are fed with a spoon, they learn to suck the pureed food off of the spoon and often gag on any lumps. This is because spoon fed purees taught them to suck the food to the back of their mouth and swallow quickly, without discerning the size or shape of the food. When a baby is spoon fed, they are not in control of how much or how quickly they eat. Persistently persuading a child to eat more than they need can interfere with their ability to sense when they are full, leading to health problems later in life[2]. Also, if a baby is given more solid foods than they are nutritionally ready for, they may miss out on their most important nutrient dense food: breast milk. Babies who are fed using baby-led weaning are also able to experience a wider variety of tastes and textures of healthy and nutritious foods. Babies who feed themselves are able to learn about the look, taste, smell, and texture of a variety of foods and learn more through sensory stimuli[3]. Interestingly, a research study was recently published that also linked an infant’s early food experiences to their tastes later in life. The research states that there is a window between 4-7 months where a child’s tastes are extremely ripe for development, and introducing a variety of tastes (not necessarily quantities of food) during this time can lead them to have healthier eating habits as adults[4].

How we introduced baby-led weaning…

We introduced our daughter to her first solid foods around 6 months. We offered her avocado, sweet potato, and banana slices to work with in her high chair. We gave her a slice that she could easily hold in her hand and manipulate in her mouth. We also used a pocket bib for catching anything that drops. I started offering her a slice or two of soft foods during our family dinner time for the first few weeks. She practiced biting off slices of food and chewing. She did gag on pieces of food every so often, but very infrequently. Gagging is part of the process of learning how to manipulate food inside the mouth and actually protects a baby from choking.

For about the first month, from 6-8 months, she generally ate very little. But she did not need to eat solid foods for nutrition. We breastfeed for nutrition and add solid foods for fun, learning, and enjoyment. We introduced all the major food groups during this time. I simply offered her a small portion of whatever my family was eating at the time using soft pieces that she could hold and pick up. Now at around 9-10 months, it is slowly becoming more of a source of nutrition as she consumes more solid foods throughout the day. Currently, she is eating three meals a day that consist of whatever healthy foods we are eating at the time. She is also in the process of learning how to use a spoon to feed herself foods like chia oatmeal and yogurt.

Overall, I am so happy that we decided on introducing solid foods using baby-led weaning for our daughter. I can clearly see the connection between her experience with handing, chewing, and manipulating food and her motor skill and sensory development. I also am absolutely thrilled with the amount of control of her own body she is able to develop at such a young age and the independence it brings into her life.

[1] http://www.cdc.gov/breastfeeding/faq/

[2] Murkett, T. & Rapley, G., (2008). Baby-led weaning: The essential guide to introducing solid foods and helping your baby to grow up a happy and confident eater. New York, NY: The Experiment, LLC.

[3] (Murkett & Rapley, 2008, p. 20)

[4] http://www.npr.org/sections/thesalt/2016/02/04/465305656/in-babys-first-bite-a-chance-to-shape-a-childs-taste

Our Journey With Hydronephrosis

Posted on by rustyroamingandruthless

hydronephrosis_series

Around 20 weeks into my pregnancy, we embarked upon our appointment for the standard anatomy scan. I was feeling a little anxious but mostly excited to see our baby. Having previous pregnancy loss, I felt certain anxieties upon beginning the scan. I have found that pregnancy loss can really affect thinking and emotions surrounding pregnancy, but that is a post for another time. At about 20 weeks gestation, we learned that our baby had a condition called hydronephrosis. I went into a panic about it, searching desperately to find out information about the condition and anecdotes to find assurance that my baby would be safe and healthy. After a few weeks, I felt better about it, but I wish there were more personal accounts with the condition available to assure families and provide education based on their experiences. I remember that I was able to find a ton of clinical information about the condition, but very little recounts of actual experiences. Experiences matter because the condition can mean nothing at all, or it can potentially be serious and cause many challenges for children.

Hydro-what? What is hydronephrosis?

Hydronephrosis occurs when the kidneys become swelled with fluid. If you break down the word, it means something like “water kidney.” The kidneys can swell with fluid as a result of many conditions, most commonly a blockage in the ureter or reflux, where urine flows backwards up into the kidneys. It is not a common condition in infants, and is found in 1-2% of all pregnancies[1] but accounts for at least half of all abnormalities found at a 20 week anatomy scan[2]. The condition essentially affects how urine drains from the kidneys, which can make infants and children more likely to develop urinary tract infections of the bladder and kidneys. Most commonly, the condition resolves on its own with no intervention necessary and does not cause any complications. Sometimes children will develop urinary tract infections as a result of poor urine drainage.

How did the diagnosis affect my pregnancy?

After the initial diagnosis, I was referred to an obstetric specialist for follow up ultrasounds. I had a few extra ultrasounds from about 20-37 weeks to check on the condition and determine whether it was resolving or progressing. One of the main concerns with hydronephrosis in utero is that it (rarely) can lead to low amniotic fluid levels because the baby may not be producing enough urine. Throughout the ultrasounds, the condition worsened from mild dilation in one kidney into hydronephrosis in both kidneys. The specialists termed this mild to moderate. During pregnancy, this is all that I needed to follow up on and it did not cause any health complications for us.

What medical care was necessary after birth?

Before my daughter was born, I contacted our pediatrician and set up the initial paperwork to be referred to a specialist for some newborn testing. I also had an appointment with a great urologist to discuss the condition and the treatment plan after birth. As soon as possible after she was born, we needed to have a kidney ultrasound and VCUG (voiding cystourethrogram) to get a clear picture of her kidneys and determine if she had reflux. We had our pediatrician set up referrals for these tests that were sent out right after she was born. Within the first two weeks after birth, we were able to have a kidney ultrasound and VCUG done. The kidney ultrasound is really easy, and the baby needs to lie on the table on their tummy and back while the technician takes images of the kidneys, ureters, and bladder. The VCUG is more intensive and tests for reflux of urine back into the kidneys. In this test, a catheter is inserted into the urethra and liquid is inserted into the bladder. As the bladder fills and empties, the technician takes x-rays of the bladder as it functions. This imaging reveals how the urine moves through the urinary tract. This test was hard to go through with a new baby, but once it was completed she was totally fine and I nursed her right after in the office. It is not painful, but is uncomfortable. This test was worthwhile to rule out the possibility of urine reflux and other abnormalities.

The ultrasound at this time revealed moderate hydronephrosis and the VCUG revealed that there is no reflux. Our urologist urged us to schedule appointments every 3 months or so to follow up and make sure the condition is not worsening. He stated that he will not recommend any intervention unless the condition gets considerably worse. We currently visit the office for periodic kidney ultrasounds, which she seems annoyed with nowadays but are really no big deal.

How has it affected my baby?

Overall, it never affected my daughter until she was about 4-6 months old. We were having challenges with weight gain, and she was the same weight at 2 months as she was at 6 months old (she was 14lbs). I worked with a lactation consultant and our pediatrician, as well as a GI specialist and nothing nutritional was making any difference. She wouldn’t nurse more often and generally seemed uninterested in eating. I always felt like I had to convince her to be interested in nursing, day and night. It was exhausting. I had many experiences where I was told I must not be making enough milk for her and that it was “okay to supplement, many women have to at this age.” It was a very hard time for me, because I never felt at all that I didn’t make enough milk for her. I had the opposite problem, where she would not take any more milk. So my body was doing what it was supposed to do by making the amount of milk that baby will drink. It is basic supply and demand. Essentially, I felt like I was losing it and my postpartum anxiety kicked into overdrive and it was a really terrible and dark time for us. The GI specialist labeled my daughter with a diagnosis of “failure to thrive” and wanted us to complete a wide array of testing. We ran some blood work and noticed that her white blood cell count was high. With knowledge of her hydronephrosis, the specialist recommended we test her urine for a urinary tract infection. Sure enough, the urinalysis test strip lit up like a Christmas tree for nitrites, which revealed that she had an infection. We went to our local children’s hospital and completed a catheterized urine sample to submit for a culture, which then revealed very high amounts of many bacteria – primarily E. coli. Finally, after months of what was thought to be a breastfeeding or nutrition problem, we had a solution!

Since we now know that she can potentially continue to have urinary tract infections because of this condition, we decided to purchase urinalysis test strips to test at home. When she is fussier than usual, I place a bag inside her diaper cover to catch urine to test. It’s very easy and can be done quickly and cheaply. It is easier to test at home than to bring her in to a doctor’s office to test on suspicion. It is important to remember that children with hydronephrosis often have white blood cells and trace amounts of blood in their urine as a result of inflammation. We did a baseline urinalysis as soon as she was healed to understand what levels are normal for her in order to track any changes. When bacteria are present that cause a UTI, they convert nitrates in the urine into nitrites. In urinalysis, high nitrite levels reveal a strong probability of an infection. If she has high levels of nitrites, then we will take her to see our pediatrician. We will then have a “clean catch” catheterized urine sample taken (uncomfortable but necessary) to determine the bacteria causing the infection to match with an antibiotic. I am not a proponent of taking antibiotics liberally, but at this time I am unaware of a natural solution that will help cure a strong urinary tract infection and prevent it from spreading to kidneys and causing damage. We use natural medicine to try and boost immune health and avoid infections through nutrition and chiropractic care.

Since she never had a fever with her infection, it is important for us to look at behavioral signs. We have been working to learn sign language with her so she can communicate her feelings with us more easily. We have also been using chiropractic care monthly to help ensure that her spine and nervous system are aligned to promote immune system health. My hope is that we remain infection free and she outgrows the condition over time.

Hopefully this post can shed some light on what the condition may be like for your child and help put your mind at ease. Do you have experience with hydronephrosis? What was your experience like?

[1][1] http://www.childrenshospital.org/conditions-and-treatments/conditions/hydronephrosis

[2] http://urology.ucla.edu/body.cfm?id=478&ref=14&action=detail

Yes, You CAN Travel With Your Baby!

Posted on by rustyroamingandruthless

Our cross-country road trip with a 7 month old became the most stress free trip we’ve ever taken. Here’s how:

“Somebody give that baby a bottle!” proclaimed the 1960’s classic television show, The Honeymooners. The comedic legacy lives on today, where many moms lament the challenges of having an exclusively breastfed baby. This holiday season, my family embarked on a cross-country road trip with my 7 month old breastfed baby and 50lb dog in our tiny Ford Fiesta. Many people told me that I must be crazy or courageous to take such a trip with an infant. However, our cross-country road trip with our 7 month old became the most stress free trip we’ve ever taken.

My Thoughts on Packing

Packing for a trip has always been a stressful, last-minute rush for me and is usually a pretty dramatic experience. I decided that I didn’t want to live on the last-minute edge anymore and created a packing list for each person. This helped me to see the things we needed and pack only the necessities. We traveled in a Ford Fiesta, which is a tiny subcompact car. With very little space to carry luggage, packing light became a necessity.

For the adults, my husband and I, we packed about five to seven days of clothing, basic toiletries, and some cold-climate gear. We knew we had access to laundry, so we didn’t worry about packing too much clothing. We only packed the basic natural toiletries that we all use, and skipped anything we don’t use every day. For the babe, we packed 8 outfits, onesies, pajamas, socks, and a coat. In the car, she wore knitted legwarmers or a sleeper rather than pants for quick diaper changes. I also brought her blankey, although it was probably not necessary. This all fit into two carry-on sized suitcases in the trunk.

For diapering, we brought 2-3 days’ worth of cloth diapers (prefolds and covers) and made a gallon sized freezer bag full of wet cloth wipes. We also brought a few disposables for backup in case we needed them. We also brought our small travel wet bag for our stops and a larger laundry wet bag to store dirty diapers in the trunk. We put all of this, including our laundry detergent, into a cloth shopping bag.

Many people believe that kids need to be entertained constantly with technology to be content on a long car trip. I remember being plugged into headphones constantly in the car as a teenager (we didn’t have the fancy digital toys that are available today, but I see this as a predecessor to today’s technology). In the past, when my daughter was really struggling in the car, I used some baby sign language videos on my phone to cease the endless screaming and fussing. However, I thought about how that sets up a precedent of expectation for a young child. If they are exposed to dvd’s and digital media in the car as a way to stay occupied, they may come to expect that level of stimulation while traveling and develop a need for this technology. The American Academy of Pediatrics recommends that television and other media should be avoided for children under 2 years of age, as children learn best through interaction with people rather than screen time[i]. The AAP also links the use of infant screen time to language learning delays[ii].

I want my children to be able to be focused on the present and live in a connected way, not zoned out into a screen while traveling with family. I want my daughter to experience her surroundings through movement, play, and human interaction. However, I am not a luddite. As our children grow older, it will be increasingly important for them to make smart independent decisions about their technology usage and we can set this example in our family life. I don’t think there is any harm in trying some educational media if your older child is exceptionally fussy or cranky in the car, but I don’t want to set the precedent for my children as infants. If you have a cranky kid, you do what you gotta do to get through it and drive safely.

Instead, I allowed us to bring one electronic toy. We brought the top of her play table with us because we were able to set it up on her lap to play with. It has a few lights, plays music, and makes different sounds while interacting with buttons and spinners. However, I saved this toy for times when she really had a hard time focusing on anything else and became really restless in the car. The electronic script talks about colors and animals in songs, so it also had a bit of educational value.

Other items I brought for her in the car included a selection of books (especially touch and feel books) from our local library, some wooden toys like the Skwish and blocks with patterns, cloth books, teethers, rattles, music CD’s that we can sing along to and practice our signing, and some stuffed toys. The key was to select some new things for the trip that she hadn’t explored yet, and to keep a good rotation of some toys handy. She especially liked the new touch and feel books from the library, giving her new items to explore. We didn’t have any fancy car toys or new products.

On the Road

Overall, I was really surprised that it took us about the same travel time overall with the whole family as it did with just the two of us adults in the past. We stopped on average every 2-3 hours or so. We found ourselves getting into a routine in the car. I sat in the back seat with my daughter for most of the car riding time. She would start out hanging out in her car seat with her blankey for a while and taking in the environment. Once she seemed bored, I would offer her toys, books, and music to play until she got fussy. When she was fussy and upset, that became a sign that she was tired and wanted to fall asleep. I would tuck her in with her blankey and sing to her gently until she fell asleep for a nap in her car seat. She would sleep for about an hour or 2. When she woke up from a nap, we would make a stop to rest, nurse, eat food, walk the dog, and change her diaper.

One of the most irritating challenges we encountered on this trip was the lack of changing stations in public restrooms. In the south, we encountered very few baby changing stations. I do give credit to Georgia though for having a changing station in their trailer-style welcome center. I ended up changing her in the car (ugh), on counters, across sinks, and other random places. On the way back, I learned it was much easier to leave her in a fleece footed sleeper for the car trip to make changes easier. Then we didn’t have to struggle with a coat and pants while changing a diaper.

Like most moms, I tend to get stressed out about my baby getting upset and fussy. While she was sleeping in her car seat, I used breathing and meditation techniques to make sure that I was not carrying any tension around with me while we were traveling. I also brought a book for myself to read while she slept, keeping me engaged in thoughts and ideas aside from baby keeping along the way. I think this helped me keep my energy up so that if she did become cranky or unhappy, I was able to soothe her without becoming stressed.

During our breaks from driving, it was really important to make sure that everyone got out of the car and stretched. I set my daughter down to play in the grass or on the ground as much as possible. I allowed her to play with leaves, sticks, and dirt while roaming around. I feel that this connection with the earth is really important for grounding, especially having a baby away from home for the first time. She was able to feel the earth before we were held captive in the car for a few hours. It helped the adults feel connected and refreshed also, as we stretched and walked with the dog outside.

Breastfeeding

My daughter has been exclusively breastfed since birth, and started eating some solid foods around 6 months. She still doesn’t consume very much solid food and doesn’t need it right now because breast milk supplies all the nutrition she needs. While traveling, we didn’t worry about giving her solid foods unless we were stopped somewhere at a restaurant and we happened to have something healthy for her to eat. We do baby led weaning, so she has never eaten a puree at all, making it really easy to go out and travel. No need to bring jars of baby food or spoons. Many people believe that babies need to eat solid foods at this stage, but it is a “nice to have” and not a “must have.” Traveling with a breast fed baby is really easy, since you don’t have to worry about washing or sterilizing bottles or pump parts, or mixing formula. My daughter never wanted to take a bottle anyway, as well as a pacifier. Potentially, this led is to making stops more often at times for nursing breaks. But really the best thing is that I was able to provide her with warmth, comfort, and nourishing milk during these breaks which kept her really content through the stretches of driving. The car cuddles were invaluable in between riding in her car seat for long stretches, and I saw this as nature’s way of making sure we all were rested, comfortable, and loved throughout the trip. In the past, I traveled with a manual breast pump and a bottle just in case of anything, but this time I just left it all behind.

This cross country road trip was one of the most stress free travel experiences I have ever had. Using minimalist principles helped us to feel connected and bond with each other throughout the trip as well. If we ever take this trip again, I hope that it goes just as smoothly. Also, this trip was a huge confidence booster for me also. It convinced me that I am able to easily travel with my daughter, and helped me to feel more confident as a parent. Happy travels!

[i] https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/Pages/Media-and-Children.aspx

[ii] https://www.healthychildren.org/English/family-life/Media/Pages/Tablets-and-Smartphones-Not-for-Babies.aspx