4-Month Well Visit and Cosleeping Commentary

I had an interesting visit to the doctor yesterday for GI's four-month physical. I like this doctor for reasons you will shortly understand.

First of all, GI was 26.75" long (tall?) and 17lbs., 7.7oz. This makes him slightly heavier and longer than SB was at the same age, but not nearly matching NJ's robust 18lbs., 14oz. SB's weight gain didn't level out until six months. GI may be slowing down sooner, possibly because he was born in his own time and was bigger to start with than SB was. SB had some catching up to do because he was a couple of weeks early. It will be interesting to see which brother's build GI's more resembles as he grows. My guess is that he's going to be a big, tall guy like his oldest brother, though. SB had his three-year physical last week and was in the 75th percentile for his age, but he always strikes me as being short and skinny, probably because NJ is just so big.

Anyway, back to the pediatrician.

First, he said obviously I'm doing fine with breastfeeding and to just keep doing that. (Not that I was worried!) He asked if I was giving Vitamin D supplements, which I'm not, mostly because I'm bad about it and not because I don't recognize that Vitamin D is important. I've been taking a supplement for myself, and we do get some sun every day. He then said that he's not so crazy about them, either. Ha!

Then he asked where GI is sleeping. I told him in my bed. He said the AAP is now recommending officially that babies not sleep in their parents' bed but in a crib nearby. I said the AAP is welcome to come and take care of GI at night if that's how they feel about it. He said that SIDS dropped to almost nonexistent after the back-to-sleep campaign in the '90s, but that the rates have been creeping back up, and that most of the babies who are dying of SIDS are in their parents' bed. He said he's supposed to tell me that but then admitted that all three of his kids slept with them (and sometimes still do) and that he loves cosleeping and understands why I do it. Ha!

According to my reading, in a controlled bed space with sober parents, especially if the baby is breastfeeding, cosleeping is quite safe and healthy for a normally developing baby. And mom gets a lot more sleep! But having the baby in the room with mom, whether in a bassinet, crib, cosleeper, or the same bed, has been demonstrated to be the healthiest way for a young infant to sleep, and the AAP does recommend room-sharing, if not bed-sharing! (Remember that in many other cultures, the family bed is the norm.)

This article by Dr. William Sears puts it very succinctly.

To be honest, I cosleep because it's convenient for me. Frankly, I don't love cosleeping. I find I wake up with a stiff neck and shoulder and feeling like my torso is twisted. It takes a hot shower and some time upright before I feel like I can move freely again. I'd rather him sleep in the crib which is currently wedged between my side of the bed and the wall. I had intended for him to sleep there, take him out when he woke to nurse, and put him back in when he was done. That lasted one night. I found myself getting totally confused when he'd rouse, take a while to realize that he was awake and looking for me, and then I'd fall asleep nursing him, so he wouldn't make it back into the crib. Ah well. The same thing happened with SB. Eventually the inconvenient squirminess of a mobile baby will outweigh the convenience of popping out a boob and going back to sleep, and GI will be in the crib more regularly.

GI is currently showing signs of the four-month sleep regression, so while he does sleep soundly, he's waking  more often to nurse and spending more time with my nipple in his mouth. The other night, I kept trying to roll to my back, only to find there was still a baby attached to me. The choice was to stay on my side or unlatch and risk a wake-up. My typical choice in that situation is to stay where I am. This is where cosleeping works out so well, because I'm not up and down and up and down all night. I wouldn't say I'm getting lots of quality sleep, but I'm getting more than I would if I couldn't "sleep-nurse."

In other news, GI is still showing dairy sensitivity, having spit up rather dramatically just now. I tried a smidge of dairy the last few days, and it seems I, well, shouldn't have. It does seem he now tolerates soy and caffeine better, so at least I have that. I'll get to have macaroni and cheese again one day. Just, not today. I did get an ice cream maker and have been making non-dairy ice cream, which is loads of fun and takes the edge off the whole dairy-free thing.

Sleep and Diet Changes: Interim Report

Forgive my lack of posts recently. I can't seem to find time for my paid work, my three kids with their various needs, and blogging. This will just be a quick post, because it's almost 11:30 and I want to go to bed. But I also wanted to make sure you all know that I'm still chugging along!

GI is three months old today, which means that he's making his way out of that "fourth trimester" and into "infancy." So far, I've definitely noticed an overall sunnier mood in the evenings, although he's still fussy for a few minutes around 8:00. He doesn't, however, want to go to sleep for the night before about 10:30. At least, I haven't managed to convince him to do so. His brother SB was kind enough to decide on his own that 8:00 was bedtime, so I'm having trouble figuring out how to shift GI's daily cycles so that he's ready for bed earlier.

I'm not in a huge hurry. I don't expect to be able to "sleep train" a three-month-old. Nor, really, do I anticipate his falling into a more predictable sleep routine for a while yet. Every day is different, including when he finally drops all the way into the solid night-time sleep I'm so lucky he gives me. He really sleeps quite well at night for a small baby!

I use the adjective "small" loosely, as he's probably around 17 pounds now, making him bigger than some six-month-olds and even as big as a few petite one-year-olds! He's a little chunker.

I also haven't quite figured out if anything else I'm eating or drinking is affecting him. He's still gassy at times, enough to make him groan and whine and writhe some mornings before settling again. I definitely think this is mostly due to my oversupply/forceful letdown that I still haven't resolved. Now, instead of having it on just one side, I have it on both. So much for fixing it! I'm hoping that in the next few weeks, my supply will regulate to something more reasonable. That should solve that problem. Interestingly, this problem makes him generally not want to comfort-suck, which is good for me because it means I have not, in fact, become a "human pacifier." It also means he's become quite happy to take a pacifier (even from me!) and will even go to sleep sucking on that rather than my breast. I've decided to consider this a good thing! I don't know how I'll feel if he's still addicted to his paci at 2-1/2, but we'll cross that bridge when we come to it.

As for what I'm eating, I've cut out dairy completely and I try to keep soy reasonably low. I still have it, but I try not to have too much. I've also reduced caffeine to only what shows up in chocolate and decaf coffee (not much). I've found that a decaf in the morning at least gives me the psychological boost, if not the physical one, that a caffeinated coffee would, so I'm coping. What with avoiding milk, soy, and caffeine, there isn't much for me at Starbucks, though! I had to settle for an iced tea this weekend. I look forward to being able to ingest one of their overly sweet, calorie-laden, caffeinated drinks again one day, though.

I have concluded that dairy makes him spit up. I don't know if it causes any other problems, like fussiness. He still spits up sometimes, but not as much or as dramatically as when I've had dairy. There's definitely a difference. It's good to see results and know that these efforts have been effective. I do plan to try goat's-milk or sheep's-milk cheese at some point soon. If he's reacting to the proteins in cow's milk, I still may be able to get away with milk from a goat or sheep. I'm interested to see what happens.

I have a few topics in mind to cover in the next few weeks when I find the time. In the meantime, if anyone has any questions for or suggestions for topics, I'd love to hear them!

Oh, and one last thing! I've released a second edition of my book, The "Yes, It's Normal!" Guide to Breastfeeding, updated with some new information and experiences since having GI. Please check it out and recommend it to friends!

Going Dairy Free for a Happier Baby

First things first, a little housekeeping. I'm going to take the suggestion that I use my kids' initials to refer to them from now on. So, my oldest is NJ. He's five. Then comes SB, who'll be three next month. And finally, my newest little guy, GI, who's just two months old.

Pretty much everyone will agree that babies cry, they spit up, and many are fussy or "colicky" in the evenings. This is considered just a fact of life, they'll grow out of it, and you just have to make it through the first three months or so and everything will get better. This is essentially true. Babies do cry, to let you know that they need something, that they are uncomfortable, or that they are hurting. Babies do spit up. Many experts attribute occasional spit-up to the immature esophagus and epiglottis, which allow some of the stomach contents to come back up. Most of the time, we don't consider spit-up to be a cause for concern, unless it's really excessive. Often, the baby will then be diagnosed with "acid reflux." More and more babies are receiving this diagnosis and being prescribed medications such as Zantac or Nexium to reduce acid production and spit-up. For some babies, this works. For others, it makes no difference.

Similarly, many babies are fussy or "colicky" in the evenings. They cry for no apparent reason. They pull their knees in as if their stomachs hurt. They can't settle themselves to go to sleep. And we, the parents, have to carry them around, bounce them, swaddle them, or nurse them constantly in an attempt to keep them calm. And most of us are familiar with the last-ditch "put them in the car and drive" solution for colic or fussiness.

There's often a reason for the spit-up and fussiness, though, and it doesn't just have to be "because he's a baby." It's hard for us to admit that something the baby is eating might be upsetting his still-developing digestive system. After all, if I'm breastfeeding, then that means that something I'm eating is upsetting his little tummy, and that means I have to start the detective work of finding and eliminating said item.

My baby spit up sometimes, and some evenings he was very fussy and could take hours to finally calm down and fall asleep. Because I assumed this to be normal ("because he's a baby"), at first I didn't want to believe that there was something in my diet that he didn't like. I never had this problem with SB, or at least, I don't think I did. So I didn't anticipate any problems with GI. After all, I've read over and over again that it's very rare for a breastfed baby to truly be reacting to something in the mother's diet. Kellymom says so. Numerous other articles say so. I tend to believe what I read when it's written by a respected IBCLC!

And yet.

I have several friends who are experienced breastfeeding mothers. And they all insist that they had happier babies when they stopped eating certain foods. For one, it was cabbage, eggplant, and broccoli. For another, it was dairy, eggs, and wheat.

Could this be my baby's problem? Could I be eating something that isn't agreeing with him? Was it worth the effort to identify and cull out this item, or could we live with the fussiness (and could he live with the fussiness!) for a few months until he grew out of it? It just didn't seem fair for the baby to be in such distress if there was something to be done about it. One of the most common culprits is dairy, so I decided to try to see if dairy might be causing a problem.

One evening, I ate quite a few pieces of pizza. Not only was my stomach a little upset (I don't have pizza very often), but GI was definitely more unhappy the next day.

Oops.

I wondered if caffeine might also be causing him not to sleep as well. One day, I had coffee in the morning, and then forgot I'd had the coffee and had a 20-ounce Diet Coke at lunch time. Wow, was he wired that evening. Yes, caffeine appeared to make a difference, too!

I decided, let me try avoiding caffeine and dairy for a while and see what happens. It's not so hard. And while I do pine for my Starbucks here and there, it's really not been that big of a deal. I noticed improvement within three days! And the change is so incredible! I'll do this until he's three months old and then try some dairy again and see what happens. Sometimes once the digestive track matures, you can re-introduce foods that were previously bothersome. I can wait. My family went out for pizza the other night, and I got the salad bar. Carefully. I did break down one rainy day this week and get a hot chocolate from Starbucks. Not much caffeine, but covered with dairy. (I forgot I could order soy.) I had a fussier baby that evening, although not too bad after just the one exposure.

The clincher was this Sunday. My husband and I had a renewal of vows/wedding ceremony, and I knew I wouldn't be able to nurse the baby on demand. (Have you ever tried to nurse a baby in a wedding dress? Because I have!) So I took along some expressed milk and bottles, just in case I wasn't available when he got hungry. Sure enough, he chose the moment when we were standing under the chuppah to express his desire to eat. So someone gave him a bottle from one of the bags of expressed milk I'd brought along. Fortunately, we had tried giving him a bottle a few evenings before, and he'd taken it happily, so we knew he would drink it if offered. (Some babies won't. It would have been a problem if GI were such a baby!)

Well. Sunday night and Monday he was a major fusspot and kept spitting up. The milk he drank on Sunday came from before I was avoiding dairy and caffeine. Today, Tuesday, he's been all smiles and took a three-hour nap in the middle of the day! Definitely makes a difference!

How do I avoid dairy? Well, I admit it's a bit easier for me than for some people, because I'm kind of used to not having much dairy in the house anyway. We only buy foods that have a kosher label on them as it is, and kosher labels make it very easy to identify if there are dairy products in packaged foods. Kosher items are labeled not only as kosher, but whether they contain dairy or meat or neither. We don't buy any products marked with a "D" or listed as "dairy" next to the kosher symbol. When I go out to eat, I just try to be extra careful. (See below for more detail about these symbols.)

We use a lot of soy and rice milk in place of cow's milk. We use Earth Balance or Fleishman's margarine instead of butter. Also, we use a lot of Pam spray, canola oil, or olive oil for cooking. No parmesean cheese with our pasta. No pizza for me. It's really not as hard or as terrible as it sounds, and this comes from someone who loves a good mac & cheese as much as the next five-year-old.

I tell you, it's stressful having a fussy baby. The change that has come over this guy since I've made these slight changes to my diet makes it all worthwhile. He sleeps better, he smiles more, and he's just generally more content. It's worth the effort. Especially since I know it's not forever! I'll try some dairy and some caffeine in a month or so, if I feel the need, and see how he is. If he's fine, then I'll go back to eating what I feel like eating, but I'll probably try not to overdo it. If he seems to react, I'll wait until he's six months and try again. It's not so long.

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Using Kosher Symbols to Help You Avoid Dairy


When you shop, look for one of the following symbols on the food packaging. Not all foods will have a kosher symbol, of course, but you'll find many common items that do.

These are a few of the many kosher symbols out there, but these are easy to remember and some of the most common ones. If there is no word or letter under or next to the symbol, or you see the word "parve" or "pareve," then that means that the product is guaranteed (under strict rabbinical supervision) to have no dairy in it, so you can eat it to your heart's content. If you see a letter 'D' or the word "dairy" along with the symbol, avoid it! If you see the word "meat," then it will also certainly have no dairy in it.

Of course, there are many other non-dairy products out there that don't have a kosher symbol. You can find many tips on the web for reading ingredient lists in order to determine if a packaged item has any dairy in it.

I hope this helps!