Donate to the SDBFC Foundation just by shopping on Amazon!

Do You Love Shopping on Amazon?

Did you know that you can donate to the San Diego Breastfeeding Center Foundation with every purchase you make through Amazon?

You can help low-income women gain access to critical breastfeeding support just by purchasing Amazon items online.

Wondering how to do this?

We are asking you to take 60 seconds of your time today to designate the San Diego Breastfeeding Center Foundation as your charitable recipient for Amazon Smile.  All you have to do is go to their website (smile.amazon.com) and choose the San Diego Breastfeeding Center Foundation as your Amazon Smile recipient.  Or you can click on our direct charity link (https://smile.amazon.com/ch/81-1935497) Then as you make your diaper, nipple cream, baby toy, book, etc purchases from this site, the SDBFC Foundation will receive 0.5% of every purchase, at no extra cost to you.  This money will go directly to paying for lactation consultations for families in need.

“I came across the San Diego Breastfeeding Center thanks to Robin Kaplan, who taught my breastfeeding class during my pregnancy. I was worried I was not going to be able to breastfeed when I had my baby, and shared with her my questions and concerns. She pointed out to me that, when and if the time came, I should contact the Center for further assistance. 

After delivery, I discovered many challenges to successfully feed my baby: from painful latch to low milk supply, and I almost gave up on breastfeeding several times. The Center gave me the support, education and materials I needed to continue, in the most loving manner. Since I experienced several problems along the way and needed more than one appointment, it was very helpful for me and my family to have access to this resource for only $25. If this had been any different, I’m certain I would have stopped.

Thanks to the Foundation, my child is receiving the best nourishment I could provide and I am very grateful for that. Programs like this are silent saviors for women like me, since we don’t know we will need them until we do. Hence, the importance of making them affordable for families like mine, that may not be able to pay for the consultations full price. 

- Sofia

 

Amazon Smile Details:

AmazonSmile is a simple and automatic way for you to support your favorite charitable organization every time you shop, at no cost to you. When you shop at smile.amazon.com, you’ll find the exact same low prices, vast selection and convenient shopping experience as Amazon.com, with the added bonus that Amazon will donate a portion of the purchase price to your favorite charitable organization.

To donate to the San Diego Breastfeeding Center Foundation, you can send a check to:

San Diego Breastfeeding Center Foundation

3355 4th Ave.

San Diego, CA 92103

Donation Drive to Support the International Rescue Committee of San Diego

Anna Choi, BS, IBCLC

Here at the San Diego Breastfeeding Center, we love women; we love moms; we love our community. And perhaps most of all, we love helping the women and mothers in our community. When we heard about the recent travel ban put forth by President Trump’s Executive Order, we knew it was time to reach out to our friends at the International Rescue Committee of San Diego to see what we could do to help. In our discussions with IRC San Diego staff, we learned about the devastating effects the Executive Order was having [and would continue to have] on the ability of the IRC to provide support and basic necessities for refugee families who have resettled in San Diego.  As we read about the decision of the U.S. Appeals Court to uphold the suspension of the Trump travel ban, we celebrated with our friends at the IRC. 

David Miliband, President and CEO of the IRC, tells us:

“We are grateful that we can get back to work resettling refugees who have fled the terrors of war and violence, while also caring for those who remain trapped in conflict zones. As this ruling will almost certainly be appealed to the U.S. Supreme Court, in the meantime, the IRC remains committed to serving our refugee clients here in the U.S. and in more than 40 countries around the world.”

What does this decision mean for the IRC? It means that refugee resettlement cases that were put on hold due to the travel ban can now continue to move forward. Families who have spent years in refugee camps, fleeing war and oppression, can once again look forward to a new life in a safe community. For the IRC San Diego Resettlement Team specifically, it means the arrival of 78 new refugees in the coming days, weeks, and months. Those arriving in San Diego include wives reuniting with husbands, children with parents, brothers with sisters, and friends with friends. It also means an increased need for donations and support from the community. That’s where we, at the San Diego Breastfeeding Center, and you, come in!

Some of the more common needs of the IRC San Diego [aside from monetary donations, which you can contribute here: https://help.rescue.org/donate/us-san-diego-ca ] are diapers and women’s hygiene kits. Those arriving in San Diego include three 2-year olds, two 1-year olds, and several pregnant women. As mothers ourselves, we know firsthand how expensive diapers are, and what an impact the expense can make for those on a fixed income. The first few days in San Diego are very transitionary for newly arriving refugees, and as permanent housing and living expenses are arranged, it can be very helpful for IRC staff to have hygiene kits on hand to distribute, helping newly arrived refugees get through their first few days in a new place. 

So, we’ve challenged ourselves to collect 500 diapers and 50 women’s hygiene kits in 50 days. Donated diapers can be any brand and any size, in unopened packages. Hygiene kits should include the following items: 

• 10+ sanitary pads
• wet nap towelettes
• kleenex
• deodorant
• soap
• lotion
• shampoo/conditioner
• toothbrush/toothpaste
• $10 Walmart Gift Card

Today is day 1. Here is a picture of the hygiene kit I created to give you an idea of what the finished product looks like. Kits can include travel sized portions of the above items, or full sized containers, packaged into a gallon ziploc bag or a grocery bag.

Having visited the IRC San Diego offices and spoken with staff members, I can’t tell you enough how much these donations are appreciated and needed. All donations can be dropped off at our weekly Breastfeeding Support Group, held at our office in Hillcrest {3355 4th Ave SD 92103} every Wednesday from 11:30am-1pm. We will also have a Saturday donation collection on Saturday, March 25th from 10am-12pm, also at our Hillcrest office {3355 4th Ave SD 92103}. The last day to drop off donated items is April 19, 2017.  We hope you will help us reach our goal and stand with us as we support the refugee women and mothers in our local community. 

Introducing the Top 8 Allergens to Infants

Written by Rachel Rothman, MS, RD, CLEC

A frequent question I encounter in my practice and in my Introduction to Solids classes, is how to introduce foods that may be allergenic to babies.  The last 15 years have brought significant attention to allergens, and most parents are now keenly aware of the risks.  However, a drumbeat of new research published on the causes of allergies and allergy prevention has brought new strategies to light and debunked old myths. Until 2008, the American Association of Pediatrics recommended that parents delay exposing infants to certain allergens until after one year of age. The guideline changed because after a review of research and patient outcomes, there was no evidence for waiting. I help many moms and dads make sense of this new world, as they are understandably cautious about what this all means for their child.

 

What are the top 8?

The “top eight allergens” are: cow’s milk, eggs, peanuts, tree nuts, fish, shellfish, soy and wheat.  These foods are associated with the eight most common food allergies, though it is possible for an allergy to occur with any food. 

So when can I introduce these foods?

Most pediatricians will tell you that you can begin to introduce these foods soon after starting solids. I usually recommend starting solids with foods not on the top 8 list, and getting 1-2 months of solids before introducing any of these more common allergens, just to note whether baby has any reactions to other foods.  That might mean you begin to offer the 'top 8' foods around 7-9 months of age.  And if your child is at a higher risk for food allergies, consult with your pediatrician.

When offering one of the top 8 allergens, it will be easiest if you only introduce one at a time, and that you observe and note any changes in baby in the first minutes, hours, or days.  If all goes well, wait a few days before offering another new food so you’ll be able to isolate any food that may be causing an issue.  If you’re concerned that something seems different, consult your pediatrician.

Let’s break down each of the allergens and discuss some ways to introduce:

Cow’s milk: Most of us have heard, no cow’s milk before one year of age.  This refers to the fact that cow’s milk should not be a replacement for breast milk or formula before the first year.  Why?  Cow’s milk has different nutrient properties than breast milk/ formula, primarily a higher proportion of protein and lower amount of fats and carbohydrates, including some differences in vitamins and minerals.  Breast milk contains the perfect proportion of all nutrients.  Cow’s milk should not be used as a replacement for breastmilk or formula. But, cow’s milk can be used in recipes, like soups, baked goods, or other foods before the first year.  Some families choose not to introduce cow’s milk, which is fine too.  This is a hot topic, so stay tuned for a post dedicated to the dairy debate!

Eggs:  Eggs are a staple in my house for my daughter, my husband, and myself.   It was previously thought to hold off on egg whites before one year of age, but like the recommendations for allergens, most pediatricians say you can introduce whole egg soon after starting solids- just be sure the egg is thoroughly cooked!  I love eggs as a finger food- they are so nutritious, and easy for baby to pick up and eat relatively early on.  Making an egg and vegetable scramble or frittata is a great way to include vegetables in baby’s breakfast as well.

Two-ingredient egg and banana pancakes: easy for baby to eat!
 

Peanuts and Tree nuts:  These are among the most highly allergenic foods, so be sure to monitor for reactions when introducing peanuts and tree nuts.  Keep in mind that whole nuts are a choking hazard for children until about 4 years of age.  When introducing nuts, try spreading a thin amount of nut butter on a piece of bread, mixing a bit of peanut butter into oatmeal or putting a very small amount of nut butter on a spoon (too large of a scoop can be a choking hazard, as well).  If your baby loves peanut butter as much as mine did, she’ll be well on her way to learning how to use a spoon!

Fish: Fish is great food for babies because of all of the nutrient benefits- just be sure fish is thoroughly cooked. Fatty fish is an excellent source of omega-3 fatty acids (specifically DHA) which baby needs for brain growth, especially under 2 years of age.  You will want to choose a fish type that is lower in mercury (some fish to avoid include King mackerel, marlin, orange roughy, shark, swordfish, tilefish, ahi tuna, and bigeye tuna).  The EPA has this great guide which lists the mercury content and sustainability level of many types of seafood. Flaked salmon can be a great finger food (or even mashed with avocado or sweet potato), or try making crab cakes or tilapia cakes.

A bit of flaked salmon, sautéed zucchini rounds and potato wedges – a perfect dinner for a 9 month old!
 

Soy: Some pediatricians do recommend waiting to introduce soy until baby is tolerating other foods.  If your baby has already been diagnosed with a soy allergy, you will want to speak with your pediatrician on it’s introduction, and keep in mind many packaged foods contain soy-based ingredients.  Baked or sautéed tofu can be a great finger food, or try adding tofu into lasagna in place of ricotta cheese.  You may want to wait until baby is about 9 or so months of age before introducing soy.

Wheat: Research and opinions are mixed on the introduction of wheat.  Many pediatricians recommend waiting on introducing wheat until other grains have been introduced (like oats, rice, or barley) to see if baby has any reaction to grains.  Wheat does contain gluten, and some babies might have a gluten intolerance or sensitivity, but note this will be different than a true wheat allergy. 

And again, always follow your pediatrician’s recommendations and speak with your pediatrician if food allergies run in your family, as the recommendations may be different.  Families of babies that have a history of an allergic condition, including a food allergy, asthma, allergic rhinitis or eczema, should absolutely speak with their pediatrician before offering any of these foods. 

Want to learn more about introducing solid food to your little one?  Join me at the San Diego Breastfeeding Center for my next introduction to solids class on January 28th at 10:00-11:30am. Learn more here

Rachel Rothman, MS, RD, CLEC is a mom, pediatric dietitian, and instructor at the San Diego Breastfeeding Center.  Rachel specializes in working with children and families.  She lives in San Diego with her husband, Ben, and daughter, Sydney.  You can contact Rachel here.

References:

Introduction of Solids and Allergic Reactions. (2009, December 7). Retrieved from https://www.aap.org/en-us/about-the-aap/aap-press-room/pages/Introduction-of-Solid-Foods-and-Allergic-Reactions.aspx

Fliescher, D. M. (2013, January 28). Early introduction of allergenic foods may prevent food allergy in children. Retrieved from https://www.aappublications.org/

Greer, F. R., Sicherer, S. H., & Burks, A. W. (2008, January). Effects of Early Nutritional Interventions on the Development of Atopic Disease in Infants and Children: The Role of Maternal Dietary Restriction, Breastfeeding, Timing of Introduction of Complementary Foods, and Hydrolyzed Formulas. Retrieved from http://pediatrics.aappublications.org/content/121/1/183

Happy #GivingTuesday! Gift a Local Low-Income Mom with a Breastfeeding Consultation!

Happy #GivingTuesday!

Did you know.....

• While 93% of moms start breastfeeding exclusively at birth in San Diego, only 56% continue doing so at 3 months, largely due to a lack of access to ongoing lactation support.

• Lack of financial resources is reported as one of the main barriers for women to receive qualified breastfeeding support to help feed their babies.

You can help local low-income women gain access to critical breastfeeding support on this #GivingTuesday.

Wondering how your donation can help local breastfeeding moms?

We are asking you to help us #SupportSDMoms by donating your weekly coffee money! 

It’s that simple!  

If everyone reading this blog article donated $10-$20 today to the San Diego Breastfeeding Center Foundation.... the amount they would spend at a coffee shop this week... we would be able to raise over $40,000 on #GivingTuesday. 

Can you help us reach this goal?

All you have to do is click on this Paypal link to donate this week’s coffee allowance and help bring affordable breastfeeding support to hundreds of local low-income moms.

Age-appropriate Portions for Toddlers (and Moms)

This post is by Rachel Rothman, MS, RD, and is the third post in the three-part blog series about introducing solids to your little one.  Rachel is a mom to a toddler, a pediatric dietitian and instructor of “Introduction to Solids” and “Nutrition for Toddlers and Preschoolers” at the San Diego Breastfeeding Center.  Join us for the next Nutrition for Toddlers and Preschoolers class on October 29th at 10:00am.  More information and registration can be found here.

In case you missed it, I discussed the feeding relationship in my previous two posts, and these may be summarized using the division of responsibility. Parents are responsible for the “what, when, and where of feeding; children are responsible for the how much and whether of eating” [1].  In this third post we discuss age appropriate serving sizes – however, as with all nutrition advice, sustainably learning the behaviors associated with this division of responsibility will be as important, if not more influential, than simply choosing specific serving size, as all of our young ones progress at slightly different paces and individual ways.

Most of the food we eat- and the nutrient measurements we rely on – use the idea of serving sizes. But what does a serving look like?

Adults struggle with this because it’s hard to learn at home, and when we eat out, it’s nearly impossible to get consistent feedback.  As children, most parents did not learn to react this way, and an age of abundant and convenient food has limited the effects of our natural impulses.  

When we feed our children, many parents second-guess themselves and their children’s eating behaviors.  Is my child eating enough?  Is my child eating too much?  Here are some helpful guidelines when it comes to your children and serving sizes, starting from the beginning, when first introducing solids.

Tips and guidelines when thinking about the appropriate serving size for your infant and toddler:

- Around 6-7 months, as your baby is first starting solids, it’s important to remember serving sizes are very small.  If you are offering purees, you will want to start by offering 1-2 teaspoons, keeping in mind initially your baby may not take more than a small taste.  You will most likely be advancing to 1-3 tablespoons as your baby moves toward 7-8 months.

- From 6 months to around 1 year, breast milk or a breastmilk substitute should still make up the majority of your baby’s calorie intake.  Offer breast milk or a breastmilk substitute before solids, especially when starting out. 

- All babies are different.  Some babies love solids right off the bat and may take more than 2-3 tablespoons.  That’s okay!  It may take other babies some time to begin their solid intake and they may refuse for a while.  That’s okay, too! The important thing is to continue to offer solids, but let your child decide whether he/she wants to eat.

A typical toddler breakfast: 2-3 tablespoons of yogurt, 1/4 cup fruit and 2-3 small pancakes (and it’s okay if they don’t finish the whole thing!).

-Around 8-11 months your baby continues to grow, so does his/her appetite.  Solid intake may increase, but not by much.  A full day’s worth of solids might be: ¼ cup of fruit, ¼ cup vegetables, 1-3 tablespoons protein and ¼ cup whole grains.  A serving of vegetables, however, may still be closer to 2-3 tablespoons.  

- After one year of age, baby’s growth slows (most babies triple their birth weight over the first year!).  With a decrease in growth rate may also come a decrease in appetite.  Do not be alarmed if intake decreases after one year of age.  It’s most important to monitor your baby’s weight gain and growth. 

Snacks and lunch packed for daycare: 1/2 peanut butter and jelly sandwich, blueberries, oat and spinach muffin, string cheese and nectarine slices.

Additionally, after one year of age, your toddler may be eating more meals and snacks throughout the day.  When thinking about meals and snacks to serve, try to offer something from each food group.  Meals should consist of a fruit or vegetable, carbohydrate and protein, while a snack might consist of a fruit and vegetable and a carbohydrate. Don’t be afraid to think outside the box and try new things.   One of my daughter’s favorite on the go snacks is a mix of chick peas and green peas;  a combination of protein and carbohydrates with a healthy mix of vitamins and minerals.  

Stay positive! Picky eating behaviors often develop during this time and can persist as a phase many healthy kids go through.  If you stay positive and dedicated to offering a broad variety of healthy, whole foods, you have the best chance of continuing to nourish your little one while accommodating their tastes and preferences.

To learn more about introducing solids to your little one, join me at the SDBFC in one of my Introduction to Solidsor Nutrition for Toddlers and Preschoolers classes.  More information can be found here.

[1] Satter, Ellen M.,  Child of Mine: Feeding With Love and Good Sense, Bull Publishing Company; Revised edition (March 1, 2000) http://www.amazon.com/Child-Mine-Feeding-Revised-Updated/dp/0923521518 

Rachel Rothman, MS, RD is a mom, pediatric dietitian, and instructor at the San Diego Breastfeeding Center.  She lives in San Diego with her husband Ben and daughter Sydney. 

Fall Diaper Donation Drive to Benefit the IRC in San Diego

San Diego Breastfeeding Center is excited to announce our Fall Diaper Drive, which will benefit the International Rescue Committee in San Diego! Beginning on Wednesday, October 12th and continuing through Wednesday, November 30th, we will accept donations of new, unopened packages of diapers at our office in Hillcrest [3355 4th Avenue, San Diego, CA 92103]. Diapers can be dropped off during our weekly Breastfeeding Support Group, every Wednesday between 11:30am and 1pm. If you would like to make a diaper donation, but are unable to drop off during this time, please contact Anna Choi of the San Diego Breastfeeding Center to arrange a pick-up of your donation [annachoi@sdbfc.com].

Chris Williams, Resettlement Program Manager in San Diego, tells us:

The International Rescue Committee [IRC] welcomes more than 1,000 refugees to San Diego each year from war-torn nations around the world, including Syria, Iraq, Somalia, Afghanistan, the Democratic Republic of Congo, and others. Many such families have arrived in just the past few months, and after years, or even decades, in transition, they’re looking forward to a new life and a fresh start in San Diego. IRC provides assistance to these families in a number of different ways, however the first month after arrival can be very difficult, especially for families with young children. Families receive limited financial assistance through the federal government and as such, the IRC really relies on donations and support from the community to help provide for these newly arriving families. What may seem like a small donation of a package of diapers can go a long way in helping people feel safe, welcome, and comfortable in a new place.

As a mother myself, I know how quickly the cost of diapers can add up, and I can’t imagine what it must feel like for these parents to arrive in a new country with uncertainty about how they will provide for their little ones. With that being said, I encourage everyone reading this blog, who has the means to, to consider making a small donation {or a large one!} by purchasing an extra package or box of diapers the next time they are at the store, to donate to the IRC. The IRC has a particular need for diapers in sizes 3 and up and would greatly appreciate donations in these sizes.

For more information about the diaper drive, or to arrange a pick-up, please contact Anna Choi at annachoi@sdbfc.com. Thank you!

How to Help Your Little One Feel Full with Solids

This post is by Rachel Rothman, MS, RD, and is the second post of a three-part series about introducing solids to your little one.  Rachel is a mom to a toddler and a pediatric dietitian. Rachel is the instructor of "Toddler Nutrition" and “Introduction to Solids” classes at the San Diego Breastfeeding Center. Join us for the next Toddler Nutrition class on October 29th at 10:00am.  More information and registration can be found here.

In my previous post, I addressed a parent’s responsibilities for the “when” (setting meal time) and the “what” (the food to be served) of feeding.  This approach is generally referred to as the feeding relationship: Parents are responsible for the “what, when, and where of feeding; children are responsible for the how much and whether of eating” [1].   The relationship is between parent and child, and between the child and the food they eat.  Now that we’ve established the parent’s responsibilities, we can move to the child’s responsibilities – whether to eat, and how much to eat.  

By controlling the WHAT, parents introduce foods, and should be actively monitoring how children respond. Getting started is fairly simple: you offer the food, and your child decides how much and WHETHER they want to eat it.  Yep, that’s it.  

However, this will surely bring a challenge (and for some, the harder obstacle to overcome) to be okay with how much and whether your child accepts the food.  

 

Start Small

When introducing solids to your little ones, starting small is essential to help him learn to physically accept solid food and learn to taste, chew, and swallow effectively.  If you choose to start by offering purees, offer a small amount of a pureed food to your little one.  If the child opens his/her mouth toward the spoon, help guide the food into his/her mouth.  If the child turns away from the spoon, trust his/her instincts that he/she does not want that food or is simply not ready.   If you choose to use the baby led weaning approach, start by placing food in front of your child on his/her high chair tray or the table. Trust that your baby knows what he/she needs.  And keep in mind, especially when starting out, breast milk or a breastmilk substitute will make up the majority of your little one’s calories and nutrition until he/she is close to a year old.  Your job is to help them learn how to eat.  You are letting them know they can choose how much and whether they would like to eat.  

When you move beyond purees and toward more complex foods, offered more frequently, this approach can, and often will, get more challenging.   As your child gets older and enters toddlerhood less of his/her nutrition may come from breast milk or a breastmilk substitute.  However, this is when it is more important than ever to keep in mind your child’s ability to self regulate.  As you offer more food at a given meal, you’ll be looking for signs that your child feels hungry.  That feeling (rather than a specific amount of food) helps your child to learn appropriate eating habits.

 

Experiencing Hunger and Feeling Full

Allow your child to experience the physical and cognitive effects of being hungry before eating - his/her young body’s regulatory reflexes come from feeling hungry and then knowing when he/she full.  

Research shows that children who are taught in this manner develop positive food attitudes, interest in eating a variety of foods, an intuitive sense of how much to eat, and long term skills for healthy eating and meal planning.[2]

There are a few things you can do to encourage your child to feel hungry and full, such as only offering a meal or snack every 2-3 hours (allow your child to feel hunger and sensation of fullness) and only offering water in between meals (rather than juice or sugary beverages).  

Eat Meals Together

Sit and have meals with your child, as time allows, and eat the same foods as they eat.  Not only will you be in a better position to monitor your baby’s preferences, but you can encourage her choices and ease her frustrations through words and sounds.  When your child tries a new food or enjoys an old favorite, you can show him that his choices matter to you.  Another benefit is cognitive: take the opportunity to teach your child the names of the foods he’s eating!

Lots of Exposure to the Same Foods

Keep in mind it can take up to 20 exposures of a new food before a child accepts it.  This is true when introducing solids to an infant as well as more complex foods to a toddler.  Before you rule out a food and dismiss your child as disliking it, keep offering it.  Chances are, after enough exposures, your child may have a change of heart.   While some degree of pickiness is normal, if you feel concerned with your child’s feeding habits, consult your pediatrician or a registered dietitian.

With the principles above, you’ll be on your way to raising a healthy eater!  Stay tuned for our next post, “Age-appropriate portions”.  If you’d like to keep exploring this topic with us, we’d love to see you in our next  Introduction to Solids class.

[1] Satter, Ellen M.,  Child of Mine: Feeding With Love and Good Sense, Bull Publishing Company; Revised edition (March 1, 2000) http://www.amazon.com/Child-Mine-Feeding-Revised-Updated/dp/0923521518

[2] Satter, “Eating Competence: Definition and Evidence for the Satter Eating Competence Model” Journal of Nutrition Education and Behavior ● Volume 39, Number 5S, September/October 2007  http://www.ellynsatterinstitute.org/cms-assets/documents/101150-596171.ecdefandev.pdf

Rachel Rothman, MS, RD is a mom, pediatric dietitian, and instructor at the San Diego Breastfeeding Center.  She lives in San Diego with her husband, Ben, and daughter, Sydney.  You can contact Rachel here.

Nighttime Weaning

Written by Anna Choi, IBCLC

A few months ago, when my youngest daughter was between 15 and 18 months old, I found myself hitting a rough patch in terms of sleep deprivation. After almost a year and half of waking up throughout the night to nurse her back to sleep, I was exhausted and frustrated. “It’s time to night wean,” I told my husband. I had been hoping and hoping she would start sleeping through the night on her own after her first birthday, but it hadn’t happened yet and I was at the end of my rope. I loved the amazing breastfeeding relationship we had built and was nervous to make a change, but knew it was needed.

Talking with a good friend whose breastfed daughter was the same age as my little one, and also not sleeping through the night, reassured me that there was nothing “wrong” about our situation. We agreed though that we were ready for more consistent sleep stretches and began researching gentle night-weaning strategies, thinking we might approach this next big step together so we could support one another through the ups and downs. We spent two months researching and delaying [trying to choose the best time to start – when the littles were not sick or teething, we had a few days off work, not during a trip out of town, etc], and then, as luck would have it, both of our girls began sleeping through the night on their own around 18 months old. How’s that for irony?

Even though I ended up not needing to move forward with a night-weaning strategy, I thought it would be helpful to share what I learned with my fellow sleep-deprived mamas of toddlers, as well as answer some of the most common questions we get as Lactation Consultants regarding nighttime breastfeeding of a toddler over 12 months old.

Why is my 1-2 year old waking at night?

It’s important to remember that there are a variety of reasons your little one may continue to wake throughout the night. These reasons can include hunger, a need for comfort, pain from teething/illness, and external factors such as noise, just to name a few. Even though you may be using breastfeeding as the primary means to settle your toddler back to sleep, it may not be the reason your little one is waking in the first place. If you are able to pinpoint a cause for the night waking [such as your little one being too hot/cold], then you can oftentimes make a simple change [adjust the temperature of their room by using a fan/space heater] to decrease nighttime wake-ups.

What are some options for approaching nighttime weaning?

Once you have addressed outside variables such as room temperature, teething, etc, and feel as though baby primarily needs comfort and assistance transitioning back to sleep during nighttime wake-ups, there are several choices for how to move away from using breastfeeding as the means to settling your toddler back to sleep. These are a few of the gentle nighttime weaning methods and links to more detailed information about each one:

Jay Gordon Technique

This method uses gentle behavior modification by slowly reducing the total time spent breastfeeding at night, while replacing the nighttime nursing sessions with another comfort measure.

http://drjaygordon.com/attachment/sleeppattern.html    

Cues For “Bye-Bye Milk”

Depending on the age of your toddler and their understanding of verbal cues, some mothers find that using a verbal cue [and possibly ASL sign] for the end of a nursing session can help transition baby off the breast more smoothly. Many toddlers already use a sign or word to ask for milk, and this idea flips that routine to the ending of the nursing session. Once your toddler responds well to mommy saying, “bye-bye milk” or “all done milk,” or another phrase that works for you, this technique can usually be transitioned into explaining that when it’s dark, or nighttime, mama’s milk goes night-night too.

http://www.mommypotamus.com/so-you-want-to-night-wean-your-toddler/    

Will my milk supply decrease if I choose to night wean?

The short answer is, yes it probably will. However, for most breastfeeding mothers, the dip in supply will not be drastic enough to cause any adverse effects on the breastfeeding relationship. Now that your little one is a toddler and should be eating plenty of solid foods throughout the day, the small dip in supply will likely go unnoticed. As long as your toddler continues to nurse during the day, you will continue to produce breastmilk for him/her.

General tips for approaching nighttime weaning:

1. Enlist the help of a support person. No matter which path you take, nighttime weaning will involve providing comfort for your toddler in another way besides breastfeeding. Having another adult, whether this is your partner, a grandparent, your best friend, or a postpartum doula, available at night to help provide this comfort and/or support you through this change will be immensely helpful.

2. Create a bedtime routine and stick with it. If you haven’t already, I highly recommend you come up with a simple bedtime routine that you do with your toddler each night. Consistency is important for helping to establish boundaries and teach your little one what to expect during the night. Bedtime routines do not have to be elaborate. Something basic such as: bath, pajamas, story or song time, breastfeeding, toddler laid down in their sleep space, is all it takes.

3. Remember, it doesn’t have to be all or nothing. If your little one is waking multiple times throughout the night, you may wish to focus on eliminating one nighttime breastfeeding session at a time. Taking this slower approach can be helpful for avoiding engorgement as well.

4. If at any time during the night weaning process you have second thoughts or feel as though this isn’t the best decision for you and your family, then stop. You aren’t signing a contract when you embark down this path, and it’s okay to stop the process and wait to start again in a few weeks or a few months. Trust your gut and your mama instincts.

Understanding Infant Sleep - 6 weeks to 4 months

In our previous sleep article, we discussed normal sleep patterns and realistic sleep expectations for infants up to 6 weeks.  By the time we hit 6 weeks, our children have gone through so many developmental changes, including what shapes their sleep patterns.  What do these patterns look like now and when will you start to actually get some sleep?  

What does research tell us about sleep patterns for 6 week - 4 month old infants?

• Babies this age still receive about a ⅓ of their food during the middle of the night.

• Between 6 weeks and 4 months, babies begin ‘sleep consolidation’, which means that they start to combine 2 or more sleep cycles together without waking in between.

• Babies at the age tend to falls asleep more easily after eating in the middle of the night, which is a welcomed trend after the first 6 weeks of your child wanting to party after each meal in the middle of the night.

Take home message:  Your baby is still going to wake up in the middle of the night to feed, but he/she should be able to fall back asleep much more quickly after eating.  This means less walking around the house, singing lullabyes at 3am.  Whoo hoo!

What does science tell us about how babies sleep at this age?

• 6-12 week old babies still fall asleep in active sleep, i.e. dreaming, hence the eye movements, silly smiles, and sporadic arm movements. However, active sleep time becomes shorter and shorter at the beginning of the sleep cycle, which means you may only have to wait a few minutes before you can put your baby down without waking him/her.

• A baby’s circadian rhythm is settling in now, which means deeper sleep at night, with less jarring movements, allowing baby to stay asleep much more easily.

• 12-16 week old babies now fall asleep in quiet sleep, similar to adults. This means that your baby doesn’t fall asleep dreaming (REM), but rather begins to drift to sleep and stay asleep.

• Patterns vary from baby to baby, therefore it is not a lack of parenting skills if your baby is still waking every 2-3 hours in the middle of the night. It is important to remember that every baby is different and has different needs.

Take home message:  Your baby is going to start to fall asleep and stay asleep more easily.  His/her days and nights will no longer be mixed up and he/she will start to fall into a deeper sleep in the middle of the night.

What are common sleep patterns for a 6 week to 4 month old baby?

• Daytime naps are still sporadic and frequent. Some babies fall asleep right after eating, while others are awake after eating and then fall asleep after some alert time.

• Daytime naps can range from 20 minutes to several hours, while some of the longest naps can take place while you are out and about.

• Babies love to nap while being worn or out on a walk. The fresh air seems to lull them to sleep.

• Evening sleep will be all over the place, especially during the ‘witching hour.’ What this will most likely look like is eat, sleep for 20 minutes, eat, sleep for 20 minutes, and repeat for a few hours. Here are some great ways to survive the witching hour!

• Nighttime sleep is starting to get better. Your baby might have one longer chunk of sleep for the first half of the night (for example, like a 4-5 hour stretch between 8pm and 1am). Then your baby might continue to wake every 2-4 hours after that. Remember, your baby’s stomach is still really small and this frequent waking in the middle of the night is protective against SIDS.

Take home message: Babies at this age still have fairly unpredictable sleep patterns. Since your baby may start to sleep longer in the beginning of the night, you might consider going to bed earlier than usual, to take advantage of this long stretch of sleep.

What are some tips for parents to get more sleep?

• Mastering the sidelying position can be a game changer. Your baby is much sturdier than he/she used to be, therefore sidelying can be much easier and comfortable now, for both of you.

• Look into safe co-sleeping guidelines, as research has shown that families who safely co-sleep or bedshare get more sleep than those whose babies sleep in a different room.

• If you are uncomfortable with bedsharing for the whole night, consider setting your alarm for 20 minutes, while nursing in the sidelying position in bed. Then, if you end up falling asleep, your quiet alarm will wake you and then you can place your baby in his/her own bed, bassinet, or sidecar.

• Try what the authors of Sweet Sleep call ‘Front Loading:’ do more work early in the day and start to unwind earlier in the evening.  If you can unwind earlier, that means you can fall asleep earlier and easier, as well.  Check out this Huffington Post article about 15 Science-Backed Ways to Falls Asleep Faster

Resources for evidence-based info about normal infant sleep:

http://www.secretsofbabybehavior.com/2010/04/science-of-infant-sleep-part-ii-big.html

http://www.amazon.com/Sweet-Sleep-Nighttime-Strategies-Breastfeeding/dp/0345518470

https://www.psychologytoday.com/blog/moral-landscapes/201302/normal-human-infant-sleep-feeding-method-and-development

Breastfeeding the Older Baby: 12-18 Months

Written by Anna Choi, BS, IBCLC

Thank you for joining us for our third and final article in our blog series, Breastfeeding the Older Baby – What to Expect and How to Adjust. I’ve enjoyed writing these articles, as we have explored the evolving breastfeeding relationship between mama and baby, and I hope to have provided some insight for you about what this evolution might look like for you and your little one. In this final article, we will look at months 12 through 18 of your toddler’s life.

PHOTO CREDIT CHRIS WOJDAK

How often do toddlers breastfeed?

This answer varies greatly from one toddler to the next. Some mothers and nurslings have slowly decreased the number of breastfeeding sessions they have each day and may find that at this age, their toddler is breastfeeding as little as once or twice a day. Others may have a toddler who nurses like a newborn and goes to breast frequently throughout the day, nursing as many as 10 or more times in 24 hours. What’s important to remember is that there is no one “right” way to nurse a toddler and no magic number for how many times each day your toddler should or shouldn’t nurse. As long as mama and baby are happy with their nursing relationship and have found a rhythm and balance that works for them, then breastfeeding is going well.

Now that my little one has celebrated his/her first birthday, do I need to introduce cow’s milk or another milk alternative?

Such a great question – and one that we find ourselves answering frequently! In order to provide you with the most educated answer to this question, I enlisted the help of one of San Diego Breastfeeding Center’s favorite Registered Dieticians, Rachel Rothman. Here is what Rachel had to say:

Cow's milk is a good source of fat, protein, calcium and vitamin D, though it is not the only potential source of such nutrition. As infants become toddlers, many pediatricians make the recommendation to start baby on cow’s milk in order to meet baby’s specific nutrient needs.   If your baby is consuming a sufficient amount of these nutrients (in other forms), there is no reason he/she needs cow's milk or an alternate milk source.   One note I always give to my patients is that for children up to at least 2 years of age it’s advisable to give them full-fat / whole milk dairy products (cheese, yogurt, or milk) to ensure they receive enough fat to satisfy their needs. Keep in mind -  breast milk is an excellent source of fat and other nutrients.

- Rachel Rothman, MS. RD

If you find yourself having further questions about your little one’s diet, I encourage you to reach out to Rachel, as she possesses a wonderful wealth of information on nutrition {http://rachelrothman.com}.

I’ve reached my goal of breastfeeding for one year and I am ready to wean, what is the best method?

Congratulations on reaching your goal! If you are ready to wean from breastfeeding, there are several methods to choose from. Weaning gradually often makes for the smoothest transition for you and your little one {and your breasts!}. To start the weaning process, choose one breastfeeding session and replace it with something else {such as previously pumped breastmilk, water, solid food, etc}. After a few days, you’ll choose another breastfeeding session to replace with something else, and so on. Usually the nursing sessions before naps and bedtime are the hardest to wean from, and therefore the last to go. Your little one will appreciate extra snuggles as they adjust to this big change in their life. Depending on the temperament of your child, and how often they are currently nursing, the weaning process may take a few weeks or a few months. If you’d like more information on weaning, check out this link to a previous blog series all aboutweaning an older child

Can I stop pumping at work and continue to breastfeed when I’m with my toddler?

Absolutely! As a working mom myself, I was eager to put away the pump after my little one turned one year old. I knew I’d miss that lovely womp womp womp sound and getting undressed and redressed in the middle of my workday, but figured I’d somehow survive. How soon you can stop pumping at work will depend on your work schedule, baby’s solid food intake, and what you have decided baby will consume in place of the pumped breastmilk you’ve been supplying. If you stop pumping at work and continue to breastfeed your toddler when you are with them, your supply should adjust to meet the needs of this new routine. Some moms find that their supply decreases as a result, but this usually isn’t a huge concern since your toddler should be eating plenty of table foods at this point. If you decide to stop pumping at work, remember to drop pumping sessions and reduce the amount of time spent pumping gradually, to reduce your risk of engorgement and plugged ducts.

 

How do I handle unsolicited advice about my toddler being “too old to breastfeed?”

The short answer is, don’t feel the need to defend yourself. When someone makes a comment about your toddler breastfeeding, simply say, “We are doing what’s best for our family. Thank you.” And then, walk away.

If you’d like to get a little more detailed with your response, or perhaps provide some breastfeeding education to the person, you can reference the American Academy of Pediatrics and the World Health Organization’s recommendations, which advocate continued breastfeeding past twelve months of age. You can also let them know that nursing toddlers are generally sick less often and have fewer allergies than non-breastfeeding toddlers.

What did breastfeeding look like for YOU during months 12-18?