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January - February 2008
What's in this issue:
This years I am going to do a series of articles on pets. Dr Katrina Warren has kindly given Cradle 2 Kindy permission to publish her articles. Many thanks Dr Katrina, we are very grateful to be able to share your wealth of knowledge.
Thank you to all those who have give us your comments and suggestion, I hope you find something useful in this issue.
It was suggested by a client that I talk about formulas and their composition warning breastfeeding mothers of the danger of introducing bottles on a regular basis unless they have no other alternative. I have decided to let her tell her story followed by my comments. We shall look at her testimony in two parts the first being the introduction of a bottle while breastfeeding and the second being her concerns about formulas.
Concerned mothers testimony
Part 1. Breastfeeding and introducing a bottle.
I have had an eventful few weeks... at 9 weeks post baby, my obstetrician told me I have an infected and inflamed uterus, so I had to go on antibiotics for 10 days. Almost immediately after starting the medication, Lillie started to get very fussy during feeds and would not take a feed other than through a bottle. She would not take expressed milk, only formula or expressed milk mixed with formula. Over a period of 4 weeks, she decided she will only take the bottle. I have given up trying to breastfeed her now.
It is a shame as I am producing so much milk - which is now expressed and given to her via the bottle. She now weighs over 8 kls and drinks about 800-900mls of expressed milk per day (people are amazed I can express that much!) and I give her a bottle of formula last thing at night. So I guess I should consider myself lucky that I am expressing so much so she is still getting the benefits of breastmilk... but I was quite upset initially - I have subsequently heard that certain medication can make the milk taste yucky - I think that's what happened, which put her off feeding the normal way and because I was on antibiotics for 10 days, over that time she clearly decided that feeding through a bottle is preferable (i.e. easier).
As she received formula during that time, she also developed a taste for formula (which I have virtually phased out now thanks to expressing so much). [read more about this clients concerns with formula in our next edition]
Note from Cradle 2 Kindy
I have found breast refusal is a common problem once a bottle has been introduced. Babies choosing bottle over breast is basically due to our human nature which chooses the easy way out. It is much quicker and less effort to drink from a bottle then to slog away at the breast so why not wait for the bottle and eventually refuse the breast totally. This usually begins as a gradual process.
Babies often give less effort to drinking from the breast when they know the bottle will follow. Less stimulation and shorter feeds will over time reduce the amount of milk produced. The less milk the less time baby will stay on the breast, the less stimulation the less production and so it goes till baby refuses all together. If as in the above testimony mum keeps up her supply by expressing, baby has a good supply but due once again to our bias towards the easy way out she gives in to the bottle. At first baby refused the beast due to the ‘yucky taste’ she may then either refuse to go back for the same reason having decided formula was tastier and or the bottle is much quicker and less effort.
Babies may also refuse the breast if they have reflux. Often with reflux babies they begin to refuse the breast due to their association with feeding and pain. They will fuss on and off the breast crying or just totally refuse to go back on even though you know they have not taken enough. Again the breast is not stimulated enough to make the quantity baby needs so they begin to cut back and eventually mum loose her milk. Again you may start to top baby up after the feed to ensure he/she is getting his/her quota this will lead to the preference to the bottle. Reflux babies will prefer the bottle at first because it goes down quicker therefore pushing down the up serge of stomach contents keeping the milk in the tummy. As the reflux get worse the bottle will also be refused.
Another reason babies often refuse the breast is when they are being fed too frequently or have just had enough to drink. Some mothers are overly concerned that baby is not getting enough as they are not on the breast as long as they use to be. Newborns commonly feed for up to 45 mins every 3½ - 4 hourly, as babies get older they become more efficient and may only take ten minutes. If a newborn is taking less than 30 minutes every 3 ½ hours than, unless baby is under weight, he/she is probably snack feeding and cat napping. If baby is fed well at each feed having up time after every day feed they should sleep well and wake on time for the next 4 hourly feed. If given short feeds they will wake after an hour or so of sleep and look for another short feed, they are more tired than hungry and so will not feed well. If offered more they may cry or refuse. Stretching their feeds out and giving them a full feed will eliminate this problem.
Solution when introducing a bottle:
We suggest introducing a bottle early to prevent baby refusing a bottle when you are needing to give one such as returning to work, needing to attend a function, or God forbid you needed to go to hospital or take a drug which is harmful to baby. Choose the right bottle – our suggestion is using the Pigeon Peristaltic teat. (This can be used on other makes of bottles as they come in narrow and wide neck). Use the bottle sparingly eg. 20-50 mls once or twice a week or a full feed once a night. (this can be done from birth only if you express the full feed one hour before needed otherwise you may jeopardise you milk supply after six weeks this is not so crucial).
If needing to use the bottle more frequently due to baby’s poor weight gain. Express after every feed for 7 – 10 minutes to increase your supply and as it increases decrease the amount offered in the bottle. When expressing you should NOT get any milk out if you do it should be less than 30 mils if not baby is not draining you properly. Encourage him/her to stay on for longer or may be he/she has had sufficient and you no longer need to express.
If needing to use formula mix this with any expressed breast milk and again as your supply increases decrease the amount offered in the bottle. For occasions when baby refused the breast due to it’s ‘yucky’ taste express the milk and mix in a little pre made formula just to get her through this feed. Try her back to the breast at every feed and only use a bottle once or twice a day to ensure baby is not going to dehydrate. Baby will eventually get hungry and adapt to the flavour. If bottles are offered after every feed you will have the same problem as the client in the testimony.
Q. How long can I keep up my milk production if I continue to express (currently about 6 times per day and I haven't noticed a drop-off in the amount I am expressing for the last 2 weeks)? I really want to provide Lillie with the benefits of my milk for as long as possible, even if she will only take it via the bottle.
A. Keeping up milk production all depends on the mother and her supply. Many mums loose their supply very quickly once the stimulation from baby ceases. This is usually because a baby is more efficient than the pump. Other mums are able to keep up a good supply with pumping until they choose to cease. If you choose to express you will need to be diligent and express 5-6 times per 24 hours and drain each side at each expressing. This can be done quicker with an electric double attachment pump which Medela has. Make sure you ask for the double attachment at the pharmacy. As a baby get older and mothers return to work a baby may be able to adapt and be able to breast feed morning and night and take the bottle during the day while mum is at work. If mum’s express once or twice during the day this may be added to the formula to replacing the missed feeds.
Pets and children can share a remarkable relationship–there is something extraordinary about the bond that develops between a child and their special playmate. Apart from companionship, there are many other benefits for children sharing their lives with a pet.
Pets teach responsibility
Children learn responsibility by helping with the caretaking of a pet. They learn about the requirements of a living being- such as food, water and exercise.
Fish are a great first pet because it is easy to give children and active role in feeding them. Pets that require more attention, like a cat or dog, can present an ideal opportunity for parent and child to spend time together doing activities such as walking the dog or preparing the food.
Pets are a friend to children
Children turn to pets when they need a friend, confidante or protector. In fact, studies have shown that pets often hold a similar status in children's lives to parents, grandparents, siblings, aunts and uncles, teachers, best friends, and childminders. The study found that dogs, in particular, often superseded humans as a child's 'best friend'.
Pets do not judge children or get angry at them which can help with self esteem. Children often trust their pets with their secrets and private thoughts.
Pets aid childhood development
Pets help children develop nurturing and social skills. Developing positive feelings about pets can aid self-esteem and help children develop non-verbal communication and compassion. Studies of school children have shown that pet owners are not only more popular with their classmates but seem to be more empathetic as well.
Pets teach life lessons
Pets are often the first experience a child has with death and grieving. Pets also help kids to learn about health and illness and visits to the veterinarian reinforce that pets need good health care too.
Pets help teach respect for other living beings.
Pets are fun
Pets provide unconditional love, affection and comfort. Children can participate in safe games with their pets and those who participate in walking/exercising the family dog have the added benefit of extra physical activity. Kids enjoy helping with tasks like washing the dog or brushing the cat (always under supervision).
Pets encourage children to exercise
Physical activity in children results in social, mental and physical health benefits, to maximise these benefits it’s important to promote physical activity and reduce sedentary behaviour in Australian children.
The Children’s Leisure Activities Study (CLASS) was undertaken to look at the family environment and its influence on children’s physical activity and sedentary behaviours. Preliminary findings indicate that playing with pets is in the top ten physical activity choices for children and families; owning a dog may encourage children to exercise and help reduce childhood obesity.
Pets may help to reduce allergies and asthma- western cultures report increasing rates of asthma and allergic disease, with pets often implicated as a causal factor. An interesting development in research in recent years, however, has demonstrated the opposite may in fact be the case: the presence of cats and dogs in the home from an early age may actually ‘acclimatise’ the developing immune system so that it is less sensitive to allergens in later life.
For more information on pets www.drkatrina.com
Cradle 2 Kindy was absolutely wonderful. So many things I didn't know. I'm much more confident now as my knowledge has increased ten-fold. All my questions were answered it's just incredible what I've learned in one day.
Initially I was mislead about a baby's routine which had my son in an incorrect routine. I was shown within one day how to extend from a 3 - 4 hour routine, how to lengthen tummy time from 10 mins to an hour, how to break the 45 min intruder and how to sleep through the night. Cradle 2 Kindy has changed our life - I am now a confident mother with a happy baby. thank you.
Cradle 2 Kindy's service was outstanding, the information provided was clear, practical, useful and spot on. My questions were answered before I even asked them, due to the thorough information provided, this has enabled me to truly understand my baby and his needs.
Within half an hour of meeting my husband and I, our coach suggested that our baby may have reflux as he has hardly slept for 6 weeks since he was born. she was correct and since her practical help and advice, and medication from our peadiatrician, our baby is sleeping well and is much happier. The support information and ability to call for follow up advice is invaluable. My only regret is not calling sooner! Fantastic! I highly recommend their service.
Having my third child I thought this child would be easier. We were wrong. Our coach picked up that our son had reflux and told me exactly how to handle it. I follow her routine by the book and now we are enjoying our child. The session was very informative and a real eye opener even for someone with prior experience. Our parenting coach's really felt for me and our situation.
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