Foremilk vs. Hindmilk: The Unnecessary Controversy

Foremilk vs. hindmilk seems to be quite a popular topic among breastfeeding mothers.  If I switch the baby too soon to the other breast, will he get the hindmilk?  How do I ensure that my baby is getting all of the fatty milk that he needs?  Sometimes I feel like too much breastfeeding information can add stress to a new mom.  And this is why….

All breastmilk, whether it is 1 minute into the feeding session or 25 minutes into the feeding session, has both foremilk and hindmilk.  As your baby drinks from the breast, she/he gets both the low-fat milk (foremilk) and the cream (hindmilk.)  The better your baby drains your breast per feeding, the more hindmilk she/he has access to, as this creamier milk hangs out back further in the milk ducts, so it has further to travel.

Here are some ways to know that your baby is getting enough breastmilk in the first few months:

• Your baby is feeding 8 or more times in a 24 hour period
• Your baby is gaining 4-7 oz. per week
• Your baby is having several wet a day
• Your baby is having several yellow-poop diapers a day
• Your breasts feel softer and more pliable after your baby feeds

If your baby is meeting the above criteria, then there is really no need to look at the clock or worry about if she/he is getting enough of the creamy hindmilk.  Follow your baby’s cues….she/he will let you know when she/he is full or ready to feed from the other breast.

Now, what if your baby has green, frothy poops, lots of gas, and chokes while breastfeeding?

Looking at these symptoms, the first question I would ask is, “Do you have enough breastmilk to feed an entire village?”  If the answer is yes, then what we are probably working with is an oversupply.   If the answer is no, then it is probably time to look into your diet to see if your baby is intolerant to something you are eating. (We will discuss this next week in a different article)

If you have a tremendous supply, your baby is probably drinking a lot of breastmilk.  Since the cream (fat) hangs out further away from the nipple, your baby has to take in more milk to bring down that cream.   When this happens, lactase (an enzyme in your baby’s tummy) is overwhelmed by the sheer quantity of breastmilk lactose it has to digest, so that lactose starts to ferment, causing gas.  By gently slowing down your milk supply, your baby won’t feel so full before she/he gets to all of the milk fat she/he needs, thereby allowing the lactase to breakdown a manageable amount of lactose.

How do you gently slow down your milk supply?

Lean back

If your baby is choking and sputtering while breastfeeding, it is possible that your flow is overwhelming her/him.  It’s like the garden hose has been turned on and there is no reprieve!  So, lean back.  Picture yourself in a lazyboy chair, with your feet up, all relaxed.  When you lean back, gravity naturally slows down your fast flow, thereby helping your baby tolerate your flow and control how much she/he is taking in at a time.  For more information on laid back breastfeeding, see our article Laid-back Breastfeeding: Physically and Mentally and the Biological Nurturing Web site.

Place your baby in an upright position

When your baby is in a more upright position (head higher than bottom) your baby can tolerate a fast flow more easily.  You can do this in many ways:

• Have your baby straddle your leg, almost sitting up, and leaning into your breast
• If your baby likes to feed in more of a cradle position, lower her/his bottom into your lap so that she/he is more diagonal (head above bottom)
• If you are using a breastfeeding pillow, place a blanket under your baby’s head so that it elevates it above her/his bottom

Breastfeed one side per feeding

Feed your baby from one breast per feeding.  This will help to gently slow down your milk supply, as your milk supply is based on how much milk is emptied at each feeding.  Now your baby will pull all of that fatty milk down through your milk ducts, thereby helping him/her to feel more full and satisfied before he/she takes in too much milk. 

Please note: When breastfeeding from one side per feeding, it is important to pay attention to your breasts.  If they begin to feel overly full and uncomfortable, you will want to offer that side to reduce the pressure.  Think of that side as dessertJ  If your baby is not hungry anymore, you may need to hand express or pump the skipped side for a minute or two, just to relieve the pressure.  Once you have been doing this for a while, your milk supply should regulate. 

Another note: Always pay attention to your baby’s feeding cues.  Around 2-3 months of age, many babies end up needing to feed from both sides again.  This means it is time to start offering both breasts during a feed again.

Herbs

Sage tea is a great way to gently reduce your supply.  Since each mother reacts to herbs differently, it is important to try this slowly.  One mom I worked with noticed that her supply decreased by 50% every time she drank sage tea, so she only drank it when her supply had drastically increased over time.  Another mom I worked with drank a cup once a week and noticed that it kept her supply in balance.  Again, pay attention to your body and work with a Lactation Consultant if necessary. 

How Can I Support My Friend Whose Baby is in the NICU?

One of my favorite blogs out there is Secrets of Baby Behavior.  This is a research/experienced-based blog written by the very talented, well-educated, all-female staff at the UC Davis Human Lactation Center.  Their latest post, Supporting Parents of Preemies: Tips for Friends and Family, really struck a chord with me and I had the immediate urge to share with you all. 

While I have never had a preemie, nor a baby in the NICU, I have had several friends who have.  This list just illuminated all of the ways I wished I could have supported them better, and the ways in which I WILL support them if the situation arises in the future.  It is unbearable to watch a friend go through the heartbreak of having a child who is not well, but at least this list shares a few tools to help in a positive way.

As a side note, one of the coolest web sites I have seen lately is Food Tidings.  This is a site we used to organize dinner drop-offs for a friend whose baby was in the NICU.  Wouldn’t it be great if we set up a schedule for food drop-offs for all of our friends who just had babies?  BEST GIFT EVER!

Please click here to read the article about Supporting Parents of Preemies: Tips for Friends and Family.

How Going Gluten-Free Saved Our Family

As parents, we believe that our children are perfect.  Yes, they can be little monsters every once in a while, but it is a tough pill to swallow when we find out that our child may have some challenges that need to be addressed. 

My sweet little Ben was born after a long, arduous labor.  We had our share of breastfeeding challenges in the beginning, but after 2 weeks we had mastered our latch and I was flowing with breastmilk.  His massive amounts of spit-up were somewhat concerning to me, but he was gaining weight, so his pediatrician was not concerned.  When Ben was 6 weeks old, I went to a local breastfeeding support group to find out why he was so fussy, gassy, and constantly puking.  The lactation consultant recommended that I remove dairy from my diet, which I did haphazardly, to no avail (obviously!) 

 While my baby boy continued to gain weight, and actually grow out of his fussy-stage, he slowly began to miss his milestnes.  We thought it was because he had an enormous brain (i.e., head), or maybe was just too content to try anything new.  When Ben wasn’t crawling by 12 months, we asked for a referral for physical therapy to help him learn this new skill.  I was also 5 months pregnant with our second, and Ben was HUGE (over 25lbs) and a challenge to lug around.  Ben finally began to crawl at 15 months.  He didn’t walk until 21 months.  He didn’t talk until well over 2 years old, although he had over 50 signs, which helped us to communicate with one another (and I will be eternally grateful for.)

But, it wasn’t just the delay in developmental milestones that concerned us; it was the unique behaviors that manifested.  Temper tantrums were an understatement…I would prefer to call them massive explosions that lasted for up to an hour at a time, usually accompanied by kicking, hitting, screaming, and rolling around on the floor.  He wore his pants backwards for months because they were ‘more comfortable that way.’  Putting on socks and shoes took over 30 minutes for Ben would scream as if they were sharp knives cutting into his skin.  He refused to ride a bike or go swimming because the helmet and bathing suit ‘bothered’ him.  These behaviors were drastically affecting our lives, in a very negative way.

I was also starting to sink into a very significant depression.  I searched for every explanation for why my beautiful son was so much more challenging than my friends’ kids.  Why was my son so unhappy?  What had I done to cause this unhappiness?  Why was it that no matter what I tried, NOTHING worked???  My husband and I took a Redirecting Children’s Behavior parenting class, but our situation was so unique that the lessons were rarely applicable.  I spent hours at Target, Old Navy, Hanna Anderssen, Tea Collection, etc. looking for the most comfortable clothes I could find, yet I rarely found ones Ben would wear.  Even therapy wasn’t working for me.  I was utterly devastated.

When Ben was almost 5 years old, I took a trip to Portland for a Holistic Practices in Lactation Workshop.  By this time, Ben had not gained any weight in 2 years, nor had he really grown in height.  He had painful bowel movements every day and his sensory challenges were debilitating.  While at the workshop, we discussed food intolerances and how they could not only affect the gut, but the emotional wellbeing, as well.  I spoke with the workshop teacher in private and asked for her guidance with my son.  She immediately asked if I would consider taking him off gluten.  I was petrified.  I forgot to mention that Ben also refused to eat anything, but fruit and gluten-laden products.  What would my son eat?  Could I add one more battle to our relationship?  At this point, though, I was willing to try anything!

With my new knowledge, I made an appointment with a pediatric osteopath as soon as I returned to San Diego.  Within 30 minutes of going over my pregnancy history (during which I was severely gluten-intolerant) and Ben’s symptoms (both emotional and physical), she recommended that I take him off gluten as soon as possible.  Fortunately, she had a functional nutritionist in the office that helped us to figure out what to eat during this elimination diet. 

When we returned home from our appointment, I began to clean out our cabinets.  Anything with gluten in it was donated to other families.  I headed to Whole Foods, picked up the magazine, Living Without, and used their handy guide to help choose the foods we would be eating for the next three weeks.  In the beginning, the elimination diet was quite costly, mostly because Ben was so picky and we had to find just the right cracker, bread, pasta, etc. that he enjoyed.  Once we found which brand he preferred, the cost went down significantly.  I also purchased a really great cookbook (Whole Family Nutrition) and found a few wonderful web sites (Gluten Free Goddess, Fine Cooks, Gluten Free Girl and the Chef).  I also downloaded Trader Joe’s list of Gluten Free products.

After 3 weeks of eating completely gluten-free, we started to see a remarkable difference in Ben.  Suddenly, there were fewer temper tantrums over getting dressed.  He started to wear a bike helmet and bathing suit.  He no longer cried while having a bowel movement.  His overall demeanor had completely changed.  The defining moment was on Father’s Day.  Ben had spent about an hour in the pool, in his new bathing suit, using a kickboard for the first time.  He turned to my husband, with an enormous grin, and announced, “Daddy, this is the best day I have ever had.”  I just started to cry.  It was the first time I could remember that my son had truly enjoyed an entire day. 

Over the past 18 months, we have still had our ups and downs.  Ben still battles with sensory integration disorder, although the symptoms have lessened drastically.  Buying ‘comfortable’ clothes can still be quite a challenge.  Ben continues to be a very skinny child, although he has put on about 5 lbs. and grown 5 inches since going gluten-free.  Ben remains to be a fairly picky eater, although he will now eat salmon, chili, and a plethora of gluten-free products.  I constantly worry that he is not getting all of the nutrients he needs.

What amazes me the most, though, is Ben now plays t-ball, soccer, and Jiu Jitsu, which all have an array of uniforms I never imagined he would wear.  On good days, we can have conversations that include compromising and problem-solving, without tears.  He is getting physically stronger and stronger every day.  And, Ben has now met and surpassed many of his developmental milestones and is one of the smartest kids in his 1st grade class. 

Most importantly, my relationship with Ben grows stronger everyday.  We appreciate and have found a new understanding for one another.  Every morning I can't wait to see his smiling face and every evening I feel blessed to have such a wonderful child as my son.  He has taught me more than anyone I have ever known.

Going gluten-free has completely saved our family and I will be forever grateful for the practitioners who helped us along this journey.

Now, why have I shared this deeply personal story on my blog? 

One, I hope that other parents who are dealing with similar issues in their families will be inspired to try alternative therapies/diets to heal their children. 

Two, I hope that I can help to remove the fear parents feel when it is suggested that they try an elimination diet. 

Three, I want to break the cycle of gluten-free diets being seen as a fad or a weight loss program. 

Four, I hope to set the foundation for a few future articles about Breastfeeding and Food Intolerances.

So, You're Going Back To Work?

A few months ago, this spunky, firecracker mama started attending our weekly breastfeeding support group and I knew from the start that she was amazing!  Over these past months, Jessica has warmed the hearts of all of the moms in the group, as well as lifted their spirits with her quick wit and sass.  Well, Miss Jessica landed this fabulous new job a few weeks ago and ended her maternity leave a little sooner than she had planned for.  I have missed her parenting insight, so I thought I would interview her about her return to work, as a breastfeeding and pumping mama.  Well, as you can see, her insight prevails!

Thanks, Jessica for your candor and advice for those breastfeeding mamas returning to work!

First day back at work

What did you do to prepare for going back to work?

Finding a good childcare provider was a huge part of overcoming my fear of returning. I don't have family here and my partner works full-time as well. I probably went to a dozen home daycares and a handful of corporate ones. You have to find someone who has a philosophy similar to your own and you feel comfortable with. As I went to providers, I discovered there were alarm bells for me: if the television was on the entire time I was there, if the provider interacted with a child in a way that I didn't like, if the terms of the contract were suspicious. I went with my gut. In the end, I found a nanny I could trust.

Breastfeeding was the surprise stressor. I was depressed I wouldn't get to breastfeed Ellie during the day and I was worried about pumping. To get used to pumping, I started pumping at home. It helped me stockpile a supply. Since I was starting a brand-new job, I made sure to thoroughly read their policies on pumping. Read the laws and understand your rights. You don't have to go in waving a boob flag or anything but you can gently inform and educate employers. Be ready to offer options like suggestions for places to pump. My employer did not know I was pumping when I was made the offer and I didn't ask any questions until I had accepted. After that, when I ran into a snag, I made sure to ask the HR rep.

What worked? Would you do anything differently?

Ask about your work schedule! The biggest surprise to me was that my employer let me have a flexible schedule. I found that getting to work by 6:30am worked very well for my family. My daughter wakes at 5AM, I nurse her and put her back down to sleep. Then I get ready and leave. My partner then takes over the morning routine until the nanny get there. My daughter doesn't have an emotional separation from me in the morning and neither do I! Then, I come home early so we can hang out most of the afternoon.

I also can't say enough about BabyConnect. It's an app on my smart phone. It tracks feeding, sleeping, diapers, medication, etc. I used it religiously before I went back to work and my nanny has the app on his smartphone as well. There is something very comforting about glancing at my phone and seeing that she went down for her nap. It tracks how much breast milk she's taking by bottle so I know if what I am pumping at work is on par with what she's eating.

What advice can you offer to a breastfeeding mom going back to work?

For breastfeeding moms, whether they plan to go back to work or not, I recommend finding a way to have a relationship with your pump. In the same vein, let your child take a bottle once in a while. You may want to leave the house one day. You might not think so in the beginning, but eventually, you will. And the more practice you and your baby have, the less stressed both of you will be.

I had a very negative relationship with the pump because of some difficulties when I first started breastfeeding but I had to get over it. I started by letting myself eat chocolate while pumping, then moved to trashy magazines. At work, I run through my to-do list for the week or look at pictures of my daughter. My point is the pump is a tool to help you continue breastfeeding.

Jessica Hilt is fiction writer that works in the technology field. In the BC era (Before Child), I hosted elaborate dinner parties, drank heavily, and stayed up late. Now I love my slow cooker, drink more water than a fish, and think 9PM is late. But it's all worth it when my seven-month-old Ellie gives me that big, gummy smile.

Also, check out Jessica's video about why she loves going to a breastfeeding support group!

Breastfeeding Multiples

Every time I meet a mom with twins, I am completely in awe of how she is functioning on a day to day basis.  While my boys were practically Irish twins, I still had mastered breastfeeding and sleep by the time my second son arrived.  So when I stumbled upon this article, 10 Tips for Breastfeeding Multiples, I just had to share with my readers.

All rights reserved by viernulvier via FlickrFor those with singletons, there are a few gems for you, like ‘find your breastfeeding cheerleaders’ and ‘set up a nursing station’…which, by the way, I like to refer to as the Breastfeeding Basket.

For those with multiples, I love that this article breaks breastfeeding down into a few critical tips to get breastfeeding off to a great start.

In my humble opinion, the only other thing I would add to this list is to find a Breastfeeding Multiples class, if there is one in your area.  While a typical prenatal breastfeeding class is helpful, one specifically for multiples should also cover breastfeeding premature babies, as well as the unique situations that breastfeeding mothers of multiples may face.

And, definitely don’t forget to:

• Pick up Karen Kerkhoff Gromada’s book, Mothering Multiples, and check out her website.
• Find a lactation consultant in your area that you can speak to prenatally, if possible.
• Find a twins club in your area

What is Weaning and When Should I Wean my Baby?

Weaning is a very personal and emotional topic for all breastfeeding moms.  My personal experience with weaning my two boys was not what I expected nor anticipated.  As my milk started to dwindle when my boys turned three months, I didn’t have the breastfeeding support or knowledge I needed to ramp up my supply.  At that time, I was not a lactation consultant.  Instead I was a full-time working mom, breastfeeding while with my son and pumping, 2 times a day, while at work. 

I was devastated that my milk supply was ‘failing’ me, but I did the best I could to eek it out as long as I could.  I made it to 7 months with my first son and to 8 months with my second son.  I had hoped to breastfeed until my boys were at least a year, but my body had another plan in mind.  I weaned as slowly as I could, for I didn’t want to let go of breastfeeding completely.  The emotional tie was too great for me to let go of.

So, what is weaning?  What does it really mean?

Some women feel that anytime the baby is sucking on something other than a breast, it is considered weaning (i.e., pacifier, bottle, complementary foods starting after 6 months).  However, in the United States, I would say that most women consider weaning to be when a mother begins to breastfeed less, with the end result being that she is no longer breastfeeding.

How do you know when to start weaning?  Is there a right time to wean?

This is a very personal decision – one which mom, partner, and baby need to figure out on their own.  I recommend to all of the pregnant mothers I work with to talk with their partners about what their goals are for breastfeeding, prenatally.  How long would they like to try to breastfeed for?  This is not something that should be influenced by family members, friends, in-laws, media, etc.  Everyone has an opinion about breastfeeding duration, but no one’s opinion is truly that important as the mother’s, partner’s, and the eventual baby.  Once this decision is made, this is now your minimum goal.  If you reach your goal and you and your baby want to continue, then keep going!  If you reach this goal and are ready to wean, then you can be incredibly proud of yourself that you met this wonderful goal of breastfeeding your baby. 

Sometimes, a woman’s body begins to produce less milk, as in my situation, before she and her baby are ready to wean.  This is definitely a time to seek out the help of a lactation consultant.  Knowing what I know now, there are quite a few ways that I may have been able to increase my supply, to help me meet that goal of breastfeeding my boys for a full year.  It is all about support and knowledge.

When a mother doesn’t feel pressure to wean her baby, her baby would most likely breastfeed for at least 2 years.  This is very biological.  Remember, breastfeeding is not only something that is done for the nutritional value, but also for comfort and illness protection. 

So, what is a good process for gentle weaning? 

What are some helpful techniques, which take into account the needs of you and your baby?

My Newborn Is So Sleepy!

How am I supposed to breastfeed my newborn, 8+ times in 24 hours, if I can barely keep her awake?

Why does my newborn fall asleep as soon as he starts to breastfeed?
How can I keep my newborn awake while breastfeeding?

These are very common questions that I get asked from moms on a weekly basis.  Newborns are so sleepy.  And if they've had a long, challenging journey into the world, they are often even sleepier!

So, what is a new mom to do to keep her little one active and efficient while breastfeeding?

In order for your baby to gain sufficient weight and to stimulate an adequate (and hopefully copious!) milk supply, your baby needs to breast feed 8 or more times in a 24-hour period.  Many newborns are very sleepy in the first few weeks, making it difficult to keep them awake to have really ‘efficient’ feeding sessions.  An 'efficient’ feeding session may be characterized by active sucking at breast for a total of 15-20 minutes, with less-vigorous sucking throughout the rest of the feeding.  You should hear swallowing throughout the feeding, as well.  Your baby should also be meeting his/her diaper counts and gaining weight that is appropriate for his/her age.

If your baby seems to fall asleep often at the breast and is not having 8 or more ‘efficient’ breastfeeding sessions 8 or more times in 24 hours, you can use the following techniques to help him/her until he/she begins to stay awake on his/her own.

Tips fo keep your newborn awake while breastfeeding:

1. Loosen his/her clothes or undress him/her down to his/her diaper.  Skin-to-skin contact will keep him/her warm while feeding.
2. Dim the lights in the room.  Newborn babies are very sensitive to bright lights and they may cause him/her to close his/her eyes and fall asleep.
3. Gently rub the palm of his/her hand with your thumb.  Babies have a feeding reflex there and this stimulation often helps to rouse them and remind them to keep feeding.  This also works if you rub along your baby's backbone or his/her foot.
4. Use breast compressions (picture squeezing your breast like an orange and holding it for 10 seconds at a time.) This should give your baby a squirt of milk in his/her mouth and wake him/her up.
5. Switch to the other breast when your baby begins to lose interest in active nursing (this is called switch nursing.)  As soon as your breast is removed from his/her mouth, this should wake him/her up.  Also, when he/she latches on the other breast he/she should get the benefit of another let-down as he/she vigorously sucks.  You can do this every few minutes, if needed.  Your baby should eventually begin to stay awake on his/her own.
6. Burp and change your baby’s diaper.  Sometimes this change of position will rouse him/her enough to go back to breast and try again.

If your baby continues to have difficulties staying awake for a full feeding at breast, it is worth it to have a lactation consultant observe your breastfeeding session.  

Most of this sleepiness is very temporary and you will be amazed by how efficiently your baby will breastfeed as he/she becomes older and stronger

Managing a Toddler and a Newborn

This is Kim, Robin’s sister-in-law. I have three amazing daughters, one which was just born 4 days ago. In my 4.5 years of being a mom, I’ve read a fair amount about parenting and have gotten some really great (and some really terrible, uninvited, and/or borderline-criminal) advice along the way. I thought I’d share some of the highlights with you from time to time.

When my second daughter was born, my first was 22 months old. Like most moms adding another child to the family, I was concerned about how I would manage two little ones and how my first would react to a new baby joining our family. I sought out tons of advice and suggestions, and I’ve included the ones I found most helpful below. Now, as a caveat, I think these suggestions are great when the older sibling is a toddler. Some of them probably work no matter what the age, but obviously some will not apply if you have a preschooler or older, or if you’re having your kids super close together. So, try what makes sense to you, and disregard what won’t work - which, incidentally, is my approach to all parenting advice.

Before the baby is born:
Quick summary: Before the baby was born, we had two main objectives: We wanted to make sure that our first child 1) was aware she was getting a new sister and viewed it as a positive experience and 2) had already learned concepts like patience and independence.

Introducing the concept
We wanted our first child to understand that our lives were going to change, but to view this change positively. So, we made sure she was prepared, had some sense of exactly what would change, and knew that her role as big sister was important and appreciated. Here are some things we did:

* Once I started showing, we told my first about the baby coming. She didn’t really understand what we were talking about, but it was good to start getting the thought in her head and introduce her to the idea gradually.

* We talked about the new baby when it made sense, but not constantly. A toddler’s concept of time is different than ours, so spending so much time talking about something that’s not happening for months would most likely have bored, annoyed, and confused her. However, if we saw a baby at the park, I would say, “Your baby sister is going to be small like that!” or “When your baby sister comes, Grandma is going to come visit! Won’t that be fun?” We always kept the conversation positive.

* We got some positive books about being a big sibling and read them every now and then. Our two favorite titles: My New Baby and I’m a Big Sister (also comes in Brother). I really like the first book because it doesn’t have any words. You can make up your own story about what it’s like to have a new baby, and more importantly, you can let your child narrate and get a sense of how they’re approaching becoming a big sibling. I enjoy both books because they are POSITIVE about the experience and don’t assume that the older child will have feelings of jealousy or anger. If that ends up happening after the baby is born, deal with it then. Don’t put the idea in the kid’s head before it’s even a problem!

* We encouraged my first to be a part of the preparations for the new baby. We let her “try out” the bouncy chair and sit in the crib. She picked which books would stay in her room and which would go into the bookcase for the new baby. This will helped foster the idea that being a big sib is an important and fun job, and reassured her that she was still very much a valued member of our family.

Tomorrow’s post will be the continuation of Kim’s journey of managing her toddler and newborn.

Encouraging Independence and Patience:
The fact is that when there’s a newborn in the house, everyone else takes a back seat. Since I was either nursing or attached to a pump for like 80% of the day, I needed my first to be able to entertain herself and do things for herself. However, I didn’t want her to feel displaced by the baby or feel like the baby caused all the changes (even though she basically did). So, we started practicing patience and independence before the baby came. Here are some things we did:

* We introduced and practiced activities that she could do independently, such as drawing, puzzles, and playdough. This way she got used to playing on her own for an extended period of time before it was directly related to me being busy with her sister. If she asked for help, I would kindly redirect her to doing it herself. ESPECIALLY IMPORTANT both before and after baby: when my daughter was doing activities herself, I was always watching and providing specific feedback and praise that let her know I was paying attention and still interacting with her. An example: “Wow, you drew a red truck! Do you want to add some wheels?”

* I started taking a while to do things and asking her to wait. At first, this seemed silly since I could have done when she asked immediately, but again, this was getting her used to the concept of having to wait for things. I didn’t have to frame it negatively. For example, if she asked, “Mommy, can I have some juice?” I would say, “Yes, in one second. Just let me finish this article I’m reading.” Then if she waited patiently, I would be genuinely appreciative (again, with specific feedback): “Thank you so much for waiting. I really appreciate how patient you were.”

* We started working on independent self-care. Anything I could think of that she could do herself, we started practicing. This included: putting on her own shoes, climbing into her carseat and buckling the top buckle, getting cups and utensils herself from a low-level cabinet, filling her own water cup from the fridge. Again, specific and genuine praise whenever possible. “Did you buckle your carseat yourself? Wow, you are such a big girl! I’m really impressed!” My daughter LOVED to do things herself, so this wasn’t a tough sell. And when her sister arrived, she was already well-practiced at these tasks and it saved me a ton of time and energy when I was suddenly trying to take two kids to Safeway.

After the Baby is Born
Quick Summary: After our second was born, our goal was to integrate her into the family while changing our oldest’s life as little as possible. We felt this would minimize any feelings of jealousy and would lead to a strong bond between them. This started when my oldest first came to meet her sister at the hospital and continues today.

At the hospital:
* We had a framed picture of our family of 3 displayed prominently in the room to show our oldest we were thinking of her while we were away.
* When our oldest came to visit for the first time, Grandma came in first and took the baby, then Dad brought our oldest in. That way, when she came in to see me for the first time, my arms were open to hug her and give her attention. Her first visual was not “I’ve been replaced by a baby.”
* We had a present for her on-hand that was “from her sister” (for us it was a book). At first I thought this was totally patronizing to her, but man did she LOVE it! Baby sister made quite the first impression!

At home and beyond:
* We made every effort to keep the normal routine. Big sister still went to school even though I was on maternity leave, and we kept up our regular playdates.
* I wore the baby whenever possible in a baby carrier so that I still had hands free to interact with my oldest. (“Why yes, lady at the park, my boob is out since I’m nursing a newborn in a wrap and using my free hands to help my daughter off the swing! Your point is....”)
* Continued specific feedback and praise for all examples of patience and independence.
* One-on-one time with our oldest as much as possible, both with Dad and with Mom. We wanted to make sure that our oldest felt special for being a big sister, not forgotten.


So, there you have it folks. Again, these are the suggestions and tactics that worked best for our family. Our girls have a great relationship. I could, of course, conclude 100% that it was my “excellent parenting and preparation” that led us to this point, but it’s also possible that we could have done none of this and they’d still be best friends, or we could have done all of it and we’d still be trying to prevent the oldest from smothering the youngest in her sleep. But you have to start somewhere, right?

Laid-back Breastfeeding: Physically and Mentally

Breastfeeding has gotten way too complicated!  As mothers, we second guess everything and voraciously search for advice on the Internet, in books, and from friends and family.  Sometimes we receive unsolicited advice, which is a whole different story!  But, when it comes to breastfeeding, there is so much information out there about what to do and what NOT to do, it can drive a mom batty!

Which pillow should I buy?  
Should I use the cradle hold or the football hold?  
Do I need to start pumping in the hospital?

I was so pleased when I saw this article on the Best for Babes blog entitled, The Latest on Latching.  The gist of this article is this:

• Relaxed breastfeeding!Moms should lay back and relax (think lazy-boy chair)
• Bring your baby onto your chest, with his/her whole body turned to you
• Snuggle your baby to your breast and watch the magic happen

Yes, this may sound too easy to be true and sometime it is.  Sometimes moms are born with babies that need a little extra assistance in the breastfeeding realm.....that's a perfect time to call in a lactation consultant for help.  But, it is worth a try to start off calm, relaxed, positive, and see what your baby can do.  You might be pleasantly surprised!

And you can most likely forget about the nursing pillow.  Bed pillows are cheaper and less complicated.  Just my opinion!

Did you find that the advice you received about breastfeeding made things more complicated then they had to be?  What would you recommend to a pregnant friend to help get breastfeeding off to a great start?

Does Breastmilk Have Nutritional Value After a Year?

Continuing the conversation about unsolicited advice, a friend of mine wrote me an email a few days ago, sharing with me the latest unsolicited advice she received, from a ‘friendly’ neighbor!

“So I have to tell you this because you're a lactation consultant.   I just had someone tell me today that breastfeeding my son at 17 months has no nutritional value for him.  She also told me that I should have stopped at six months, because after that they don't need it and that I'm only doing it for me. 

I was thinking WOW! She doesn't think breastfeeding has nutritional value.  How crazy is that?”

Well, my dear friend, it is just that….CRAZY!  Clearly, this lady has not read any research about breastmilk in the past 10 years or she would know the following…

• "Human milk expressed by mothers who have been lactating for >1 year has significantly increased fat and energy contents, compared with milk expressed by women who have been lactating for shorter periods. During prolonged lactation, the fat energy contribution of breast milk to the infant diet might be significant."  -- Mandel 2005, Pediatrics
• In the second year (12-23 months), 448 mL of breastmilk provides:
  • 29% of energy requirements
  • 43% of protein requirements
  • 36% of calcium requirements
  • 75% of vitamin A requirements
  • 76% of folate requirements
  • 94% of vitamin B12 requirements
  • 60% of vitamin C requirements  -- Dewey 2001, Pediatr Clin North Am.

But, even beyond that, breastfeeding a child over a year old also has many additional benefits:

• Nursing toddlers are less sick
• Nursing toddlers have fewer allergies
• Mothers nursing beyond one year reduce their risks of breast, ovarian, uterine, and endometrial cancer

Let’s just put it this way….breastfeeding beyond a year is NORMAL!  So keep it up, my friend!  And once again, feel free to use my favorite reply, “How sweet of you to be concerned about me and my baby/toddler/kiddo.  We are doing just fine.”

Why do you enjoy breastfeeding your toddler?