Robin's Page

 

Robin Barker's  regular granddaughter diary, and baby care column. Granddaughter Sage also joins us with a baby persepective on life.

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Diary - November, 2003

Sage and Kim have just returned from three weeks in New Zealand, Kim's home. Sage has arrived back twice the size (especially in the leg area), and with twice the charm (if that's possible). It must have been hard for Kim's parents to say goodbye; babies grow and change so much in just a few short weeks.

One of the disadvantages of our modern, mobile society is the distance grandparents are from their children and grandchildren. Admittedly for some families this might be an advantage (there is a bit of a tendency nowadays to idealise the joys of extended families) but for most of us the absence of involved grandparents makes the work of parenthood that much harder. So, it's important not only to mix with other like-minded parents but also to be tolerant and support each other's efforts (even if you wouldn't do 'control-crying' in a month of Sundays).

Sage is now eating real food and, so far, loves it. Recent infant feeding guidelines by the World Health Organisation and the Australian National Health and Medical Research Council recommend, as far as possible, breastmilk as the only food for the first six months. This recommendation is supported by research showing exclusive breastfeeding in the first six months to be advantageous for babies. (See NH&MRC Infant Feeding Guidelines 2003). And, for many mothers and babies this indeed works well.

Occasionally, however, extra food is needed, whether it is the mush we call 'solids' or formula. While the majority of babies thrive on breastmilk alone there are times when, often for reasons unknown, there is not enough breastmilk available to match the baby's growth rate before the magical six months mark.

Needless to say the advantages of breastmilk are somewhat diminished if a baby is malnourished (thin as a piece of string). In general, the only reliable way of checking that the breastmilk supply is adequate in an otherwise healthy baby is by weighing the baby. Hopefully with an informed health professional who doesn't go into panic mode and make all sorts of unhelpful suggestions like 'wean immediately' - or - 'keep breastfeeding no matter what.'

There is a range of situations that is often misinterpreted as 'not enough milk' . Click here to read more .

What about solids and babies having formula? Interestingly there are no official guidelines about starting solids for babies on formula, just a vague 'anytime between four and six months.' Some imaginative experts recommend starting these babies on solids at four months so they can, like breastfed babies, start to get a variety of tastes (the taste of breastmilk changes from feed to feed apparently). However I think the main reason it's all so vague is because, unlike breastmilk, there is no research to support any advantages in exclusively formula feeding for six months, unless (maybe) the baby has a family history of allergies or food intolerance. If your baby is having formula , click here , to see my suggestions for when to start solids.

Regardless of whether it's breastmilk or formula going down, all babies need to offered (doesn't necessarily mean they are going to take them) solids by six months if they are still only having milk because:

* Developmentally they are ready to eat food and, often, wildly interested (strike while the iron is hot). Babies from six months are starting to chew, their gag reflex has modified and they have efficient hand to mouth co-ordination.

* Learning to eat from a spoon and/or with the fingers, and to drink from a cup between six and twelve months provides a basis for healthy eating habits and diminishes the likelihood of over-dependence on milk in the toddler years, whether it be breastmilk or formula.

* Solid foods provide an increasing proportion of babies' energy intakes to match their rapid growth rates at this time. * Solids have the potential to provide extra iron, particularly important during this time of rapid growth.

However, as many of us find out - our delicious, nutritious offerings may be met with a stubborn glint in the eye and lips tightly pressed.

Next month: Introducing solids, and variations on the way babies handle them.

Robin

PS - Sage also has a tooth, a little pearl on the bottom gum. Pleased to report no diarrhoea, fever, sleep problems, red cheeks, extra dribbling, rashes, grizzling or any other strange behaviour. But then again, maybe Kim's not game to tell me.  (Kim's note, "about the grizzling....")

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The following are NOT signs of 'not enough breastmilk:

* Your baby keeps turning her head and opening her mouth as if she wants to suck on something even after several good feeds. This is called the rooting reflex and is present in all babies from birth, usually disappearing by 3-4 months of age. Babies do this when they are hungry but they also respond like this when they are awake for any length of time, restless, overstimulated, bored or overtired. Often wanting to suck on something is a sign of needing sleep, not food.

* No sensation of a let-down - Some women never feel a let-down , others find the let-down sensation fades or disappears as their baby grows older so not feeling a let-down is not a sign of low supply unless there are other indications.

* You can't express much milk - Many women who breastfeed well can't express. Your ability to express isn't a reflection of how much milk your baby takes.

* Your baby starts to suck her fists all the time. Between 8 and 12 weeks babies' hands are never out of their mouths. 'Hands in the mouth' is a normal part of their sensory/motor development and not a sign of hunger

* Your breasts change; they stop leaking, become softer and smaller and the 'full' feeling goes. Breast changes like this are normal and happen between 6 and 12 weeks. Breastfeeding becomes easy and efficient, the 'fullness' and leaking which happens in the early weeks is only temporary.

* Your baby stops pooing a lot and only goes once every few days. Most breastfed babies don't poo nearly as much after the first 6 weeks - a big soft poo less often does not mean your supply is low. * Your baby takes a lot less time at the breast. Breastfeeding is a body function and like all body functions, the more you do it the better you get. As your baby grows she becomes more skilled at removing the milk and your body responds so you become an efficient team.

* Your baby wakes a lot at night or suddenly starts waking a lot at night In general, unless there are obvious signs of 'not enough milk' (that is static weight or weight loss) night waking in itself is not a sign that babies need more food. go back

A guide for starting solids if your baby is on formula

* Any time between four and six months because you feel like trying it.

* Your baby is drinking excessive amounts (can't fill him/her up). Extra food might be needed but it's important to rule out boredom, over tiredness and incorrect preparation of the formula first. Your Early Childhood Health Nurse can help you with this.

* Your baby is six months of age and is still only having formula. go back

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