My three-year-old, SB, didn't start really speaking until he was about 17 months old, old enough for a little concern from most people. However, NJ, the oldest, also didn't start really talking until that age, and he went from a few signs and pointing to complex sentences in the space of about six months, maybe less; I figured SB would follow a similar pattern, so I didn't worry. At his 18-month well checkup, the doctor asked if he spoke at least 10 words. I had counted seven the day before, which is quite low for a bright 18-month-old, but I explained about NJ having been the same way and that I wasn't worried. I didn't get him evaluated by an audiologist or speech pathologist. I didn't take my doctor's referral to Regional Center. By 19 months, these were his words:
1) Moo ("What does a cow say?")
2) Moooor (More)
3) Moooooo (Moon)
4) Baa ("What does a sheep say?")
5) Mo-mo (Remote)
6) Bapa (iPod)
7) Mama
8) Derrrr (Truck, switch (as in, switch sides when nursing), train, among other things)
(Yes, one of his early words was iPod. He still loves that thing, too.)
In fact, I was right. Just a couple months after this appointment, SB suddenly started really talking, putting together two- and three-word phrases. By the time he was two years old, he was building complex sentences. There was one problem, though. His words were terribly unclear. NJ almost from the start spoke remarkably clearly. Complete strangers could have a conversation with him before he was three. There were very few words he said in a funny "learning to talk" way. (We remember a fond few, such as "battached" for "attached," but really, he spoke incredibly well.) SB not so much. I assumed it was just him still trying to figure out how to make the sounds, and surely by the time he was two or 2-1/2, he'd be speaking more clearly.
Alas, not. Some words gradually improved, or he'd suddenly begin saying something more clearly than he used to, but, for the most part, if you didn't live with him, you couldn't understand him, and even if you did live with him, you had to work pretty hard to understand him. I and NJ are the best at deciphering his speech, and other people will randomly catch words and sentences that I don't, but the faster he goes, the less clearly he speaks. I didn't know how to fix that, or if I should worry, or when I should worry, or what I should do.
At his three-year checkup, with a kid who spoke in totally unintelligible paragraphs, I expressed my concerns to his pediatrician, who referred us to an audiologist and speech pathologist. His hearing tested fine, so we went to the speech pathologist where she confirmed that his grammar, vocabulary, and syntax were quite advanced, but his enunciation problem was "severe." The good news was, it appeared he could make the various sounds, he just didn't always use them properly. Most consonants were "m", "n", or "d", and even some of his vowels were distorted. "Big" and "bridge" sounded like "buuuuh," for example. The speech therapist said we'd see her once or twice a month and she'd send us home with exercises to try to form new speech habits.
We have quite the task ahead of us. The goal is to create new habits and break the old ones. We need to get him to say the ending consonants: "ha-T," not "ha';" "Po-P" not "Po'." And so on. Then we have to fix initial "s" and initial "f" (he uses "d" for both). Then we have to work on other strident sounds, and reduce the lisp, and fix some other initial "s", and so on.
Fortunately, SB is very bright and realizes that it's hard for people to understand him. He will repeat himself over and over again in the hopes that this time you'll get it, but he doesn't know how to fix it himself. But he's getting there. A few things, he's already fixed on his own, and others he corrects when he remembers to. I can see that eventually, he'll be speaking more clearly. I just feel so bad for him, because he has so much to say and so many questions to ask and so much bubbling in his head that he wants to get out there, and he trips over his own tongue trying to express all the wonders of the world that an almost 3-1/2-year-old has discovered. And after a long descriptive paragraph, our response, more often than not, is, "I'm sorry, but I have no idea what you said."
I think it's hard to be willing to seek help when you think your child might have a problem. No one wants to think their child isn't "normal." But realizing that we could help SB to be better understood, which would improve all of our quality of life, made getting him evaluated and starting treatment totally worthwhile. I think there's a lot less stigma to various kinds of therapy than there used to be, and, in the end, when you see the change in your child when he's getting the help he needs, you know you've done the right thing.
I'm a breastfeeding counselor with a side hobby in educating parents and caregivers in proper car seat use. I have four sons, one born by c-section and three born by VBAC. I blog about my life with four kids, pregnancy and birth, breastfeeding, and car seats.
Thursday, April 26, 2012
Monday, April 16, 2012
Let's Talk About Potty Training!
Though I mostly talk about birth and breastfeeding here, I figure other parenting topics certainly have their place, so today's discussion is about potty training or potty learning! I'm lucky enough to be in the midst of potty training my middle son, SB. He turned three in December, and though I had every intention of having him out of diapers before the baby was born, or at least before he turned three, we're only just now starting to have some success in that department.
First, I hear that boys are more difficult to potty train than girls, and that girls typically learn at a younger average age than boys. I have no idea if this is actually true, although from casual observation of friends, it seems to be the case. I think maybe girls are just more likely to be bothered by a wet and/or dirty diaper and are more interested in emulating mommy? I have no idea. All's I know is that neither NJ nor SB cared one bit about getting out of diapers until we forced the issue, and that both would happily walk around in a dirty diaper for hours, even lying about whether they needed a change, from about 2-1/2 until they were potty trained.
Before I had kids, I couldn't believe that parents would let their kids stay in diapers until they were three. I was aghast when I saw that they made diapers big enough for a three-year-old. Once NJ became a toddler, I realized quickly that it's not always up to the parent, and you can't force a kid to use the potty. Indeed, toileting is one of the few things a small child truly has control over. He has to decide that he wants to use the potty, that wearing underwear and being dry is way better than wearing a diaper. Whether that's through a reward system, simple maturity, or some combination of both, if the child doesn't want to use the potty, you'll be cleaning up a lot of "accidents." I'm amazed when a parent tells me their child was potty trained at two, or earlier, but I am certainly no longer enraged by parents who "let" their three-year-olds stay in diapers! Goodness me, I'm one of them!
So, let's start with NJ, my strong-minded, strong-willed child. By 2-1/2, he was very verbal and would willingly sit on the toilet at daycare. We thought, great, let's potty train! SB was a few months old, and we were already tired of having two in diapers. Plus, NJ was so big that he was in the largest size diapers there were, and we didn't know what we would do if he got much bigger and still wasn't using the toilet. For a week, we tried to help him learn to use the toilet, but he didn't seem to have the awareness of when he needed to go. Every other day, we sent him to daycare in underwear and he'd come back with three or four dirty pairs of underwear and no toilet success. The in-between days, he'd express that he just wanted to wear a diaper. It seemed to be very stressful for him. One day, he didn't pee all day and in the evening was complaining of pain. We thought he might have a UTI from holding his pee all day and took him to the ER. That was a traumatic experience all on its own, and we decided then and there to put off potty training.
It took a full year before we finally got fed up enough with his wearing diapers to give it another try. We wanted him to move up to the preschool room (and out of the toddler room) at school, which he couldn't do until he was potty trained. His teacher said he was totally ready, just needed a little push. Push we did. We had to force him to decide to try using the toilet, but once he did, it was about three days until he was in underwear all day, accident-free. The first day, a Thursday, was very hard, but by Monday he was using the toilet. And he was big enough to stand to pee at a regular toilet and to sit on a regular toilet without a potty seat or a stool, which made everything easier when he had to go to the bathroom when we were out and about. There are definite advantages to waiting until they're older!
At this point, SB was 16 months old, and we knew we wouldn't push him. We thought he might be ready sooner just because he had his older brother to emulate, but we didn't want a repeat of that tough, unsuccessful week. Plus, we quickly learned that diapers are way easier than the early months of toilet-using. For months, NJ would announce, in the middle of dinner at a restaurant, or at the far end of Walmart or Costco, that he had to go potty, and one of us would have to interrupt what we were doing to take him there. It can be annoying. At home, it wasn't so bad, because he became independent in the bathroom pretty quickly, so we could just send him off to use the bathroom on his own. But, obviously, we couldn't do this in public! Another reason not to rush SB, in our opinion.
Flash forward to 2011. Not long after GI was born, SB suddenly started showing interest in the potty. He wasn't yet three, so I was very excited that he'd be potty trained earlier than NJ had been. He did well for about a week or two, but we didn't push him at all, not wanting to scare him off from it. I have one memorable picture of coming downstairs to find SB sitting on his frog potty in the middle of the living room, playing with my iPod. It was hilarious. I promised him a big present when he was in underwear all day, cheered him on whenever he was successful on the potty, but after a week or two, he just as suddenly decided he wanted to go back to diapers. Since I had a newborn and didn't have the energy to argue the point, we allowed him to go back to using diapers. Every so often, we'd try to entice him back to the potty with promises of presents and new underwear and pointing out how babies wear diapers and wouldn't he rather be a big boy like NJ?
When he turned three, we tried again, briefly, by putting him in Pull-Ups instead of underwear (because I so didn't feel like cleaning up accidents), promising him rewards, etc. He had no interest whatsoever and was actually very defiant about it, refusing to try, insisting he didn't have to, then going in his Pull-Up five minutes later.
Finally, two weeks ago, I'd had it. His Pull-Ups weren't holding his poos, so I was cleaning him up from poop-overflow every day. Plus, we've decided to try to send him for a couple of weeks to summer camp at my mom's preschool this summer, and for that he needs to be potty trained. So I said, that's it, we're doing it. I'm forcing the issue. I put him in underwear and kept reminding him to use the potty. I bought jelly beans, and after peeing in the potty, he'd get one jelly bean, and if he pooped in the potty, he'd get three. If he pooped in his underwear, I'd throw away the underwear, hoping that would upset him enough that he would try to go in the potty instead. He's basically good with pee at this point - even went at Walmart today! - but poop is still iffy. I've thrown away quite a few pairs of underwear and even a pair of pants that were not worth trying to salvage. Ew. I'm not sure if the poop issue is that he "can't" go or that he doesn't want to. I've seen him do it, so I know he can. He's so funny, though. He knows what he gets as a reward, so whenever he successfully uses the potty, even totally on his own, he'll go and take just one jelly bean (or last week, during Passover, it was macaroons - the kids loves macaroons. Heck, I'd go potty for macaroons, too). Honest kid. So cute.
My husband bought him a really big (literally) present to give him when he's accident-free for a day or two. If he doesn't poop at all during the day, he's pretty much accident-free. But if he poops, it's more likely to be in his pants than in the toilet, which is very, very frustrating. I'm hoping something clicks soon. I figure that by the time July rolls around, he'll be good to go (literally, ha!). Hey, he's only 3 years and 4 months. NJ was a full 3-1/2.
Of course, now we're back in the territory of reminding him to go to the bathroom constantly (but not too often - don't want to annoy him and risk regression), of being interrupted in the middle of shopping or dinner to help him in the bathroom, of bringing extra clothes and/or Pull-Ups wherever we go in case of accidents. And SB is considerably smaller than NJ was at this age, so he's not comfortable sitting on a "big toilet" on his own, without a potty seat. He can use a urinal, though, and the beauty of having an older boy too is that NJ takes SB to the bathroom! He showed him how to use the urinal. Love that. I'm not comfortable saying that SB is completely potty trained at this point, but we're surely going through fewer Pull-Ups, and he's been clean all day today (so far - it's 5:45pm as I write this). We still put him in a Pull-Up at night, as we did with NJ, although he's usually dry in the morning anyway. NJ started wearing underwear at night around when he started kindergarten, and that was totally fine with us. He rarely wets the bed, and even rarely wet when he was wearing a Pull-Up, but we let him wear it for his own peace of mind.
It will be interesting to see how GI does, with two big brothers to follow after. I wonder if using cloth diapers more with him will help him learn the sensations faster, if I'm still using cloth with him when the time comes. (I sure plan to - I bought some more!)
My basic feeling about potty training is thus: You do what works for your kid. For SB, he needs the cookie or the jelly bean as motivation. NJ didn't. He just needed a push, and then he pottied for potty's sake. SB needs that carrot of a BIG present. NJ got a big present, but we didn't have to have it sitting in Daddy's closet for him to see and wish for. SB needs to be reminded fairly often. NJ didn't. And it's interesting that I have NJ to help me potty train SB and to give him some tips of the trade. And he wants NJ to help him, which is pretty cool, too. (A lot of this has to do with their overall close relationship, and the fact that NJ just likes to help "parent" SB and GI anyway.)
So when my friends ask me for potty training advice, well, as with sleep, I can only say what worked for me. As far as I know, every person has a slightly different potty training experience, even with each kid. And then there are the lucky ones whose kids potty train themselves. I don't know what magic causes that, but it's pretty amazing when it happens.
I have to say, though, that the first time you see your little one's adorable tush in underwear instead of a diaper, it feels like a huge milestone. Suddenly, he's a big boy.
First, I hear that boys are more difficult to potty train than girls, and that girls typically learn at a younger average age than boys. I have no idea if this is actually true, although from casual observation of friends, it seems to be the case. I think maybe girls are just more likely to be bothered by a wet and/or dirty diaper and are more interested in emulating mommy? I have no idea. All's I know is that neither NJ nor SB cared one bit about getting out of diapers until we forced the issue, and that both would happily walk around in a dirty diaper for hours, even lying about whether they needed a change, from about 2-1/2 until they were potty trained.
Before I had kids, I couldn't believe that parents would let their kids stay in diapers until they were three. I was aghast when I saw that they made diapers big enough for a three-year-old. Once NJ became a toddler, I realized quickly that it's not always up to the parent, and you can't force a kid to use the potty. Indeed, toileting is one of the few things a small child truly has control over. He has to decide that he wants to use the potty, that wearing underwear and being dry is way better than wearing a diaper. Whether that's through a reward system, simple maturity, or some combination of both, if the child doesn't want to use the potty, you'll be cleaning up a lot of "accidents." I'm amazed when a parent tells me their child was potty trained at two, or earlier, but I am certainly no longer enraged by parents who "let" their three-year-olds stay in diapers! Goodness me, I'm one of them!
So, let's start with NJ, my strong-minded, strong-willed child. By 2-1/2, he was very verbal and would willingly sit on the toilet at daycare. We thought, great, let's potty train! SB was a few months old, and we were already tired of having two in diapers. Plus, NJ was so big that he was in the largest size diapers there were, and we didn't know what we would do if he got much bigger and still wasn't using the toilet. For a week, we tried to help him learn to use the toilet, but he didn't seem to have the awareness of when he needed to go. Every other day, we sent him to daycare in underwear and he'd come back with three or four dirty pairs of underwear and no toilet success. The in-between days, he'd express that he just wanted to wear a diaper. It seemed to be very stressful for him. One day, he didn't pee all day and in the evening was complaining of pain. We thought he might have a UTI from holding his pee all day and took him to the ER. That was a traumatic experience all on its own, and we decided then and there to put off potty training.
It took a full year before we finally got fed up enough with his wearing diapers to give it another try. We wanted him to move up to the preschool room (and out of the toddler room) at school, which he couldn't do until he was potty trained. His teacher said he was totally ready, just needed a little push. Push we did. We had to force him to decide to try using the toilet, but once he did, it was about three days until he was in underwear all day, accident-free. The first day, a Thursday, was very hard, but by Monday he was using the toilet. And he was big enough to stand to pee at a regular toilet and to sit on a regular toilet without a potty seat or a stool, which made everything easier when he had to go to the bathroom when we were out and about. There are definite advantages to waiting until they're older!
At this point, SB was 16 months old, and we knew we wouldn't push him. We thought he might be ready sooner just because he had his older brother to emulate, but we didn't want a repeat of that tough, unsuccessful week. Plus, we quickly learned that diapers are way easier than the early months of toilet-using. For months, NJ would announce, in the middle of dinner at a restaurant, or at the far end of Walmart or Costco, that he had to go potty, and one of us would have to interrupt what we were doing to take him there. It can be annoying. At home, it wasn't so bad, because he became independent in the bathroom pretty quickly, so we could just send him off to use the bathroom on his own. But, obviously, we couldn't do this in public! Another reason not to rush SB, in our opinion.
Flash forward to 2011. Not long after GI was born, SB suddenly started showing interest in the potty. He wasn't yet three, so I was very excited that he'd be potty trained earlier than NJ had been. He did well for about a week or two, but we didn't push him at all, not wanting to scare him off from it. I have one memorable picture of coming downstairs to find SB sitting on his frog potty in the middle of the living room, playing with my iPod. It was hilarious. I promised him a big present when he was in underwear all day, cheered him on whenever he was successful on the potty, but after a week or two, he just as suddenly decided he wanted to go back to diapers. Since I had a newborn and didn't have the energy to argue the point, we allowed him to go back to using diapers. Every so often, we'd try to entice him back to the potty with promises of presents and new underwear and pointing out how babies wear diapers and wouldn't he rather be a big boy like NJ?
When he turned three, we tried again, briefly, by putting him in Pull-Ups instead of underwear (because I so didn't feel like cleaning up accidents), promising him rewards, etc. He had no interest whatsoever and was actually very defiant about it, refusing to try, insisting he didn't have to, then going in his Pull-Up five minutes later.
Finally, two weeks ago, I'd had it. His Pull-Ups weren't holding his poos, so I was cleaning him up from poop-overflow every day. Plus, we've decided to try to send him for a couple of weeks to summer camp at my mom's preschool this summer, and for that he needs to be potty trained. So I said, that's it, we're doing it. I'm forcing the issue. I put him in underwear and kept reminding him to use the potty. I bought jelly beans, and after peeing in the potty, he'd get one jelly bean, and if he pooped in the potty, he'd get three. If he pooped in his underwear, I'd throw away the underwear, hoping that would upset him enough that he would try to go in the potty instead. He's basically good with pee at this point - even went at Walmart today! - but poop is still iffy. I've thrown away quite a few pairs of underwear and even a pair of pants that were not worth trying to salvage. Ew. I'm not sure if the poop issue is that he "can't" go or that he doesn't want to. I've seen him do it, so I know he can. He's so funny, though. He knows what he gets as a reward, so whenever he successfully uses the potty, even totally on his own, he'll go and take just one jelly bean (or last week, during Passover, it was macaroons - the kids loves macaroons. Heck, I'd go potty for macaroons, too). Honest kid. So cute.
My husband bought him a really big (literally) present to give him when he's accident-free for a day or two. If he doesn't poop at all during the day, he's pretty much accident-free. But if he poops, it's more likely to be in his pants than in the toilet, which is very, very frustrating. I'm hoping something clicks soon. I figure that by the time July rolls around, he'll be good to go (literally, ha!). Hey, he's only 3 years and 4 months. NJ was a full 3-1/2.
Of course, now we're back in the territory of reminding him to go to the bathroom constantly (but not too often - don't want to annoy him and risk regression), of being interrupted in the middle of shopping or dinner to help him in the bathroom, of bringing extra clothes and/or Pull-Ups wherever we go in case of accidents. And SB is considerably smaller than NJ was at this age, so he's not comfortable sitting on a "big toilet" on his own, without a potty seat. He can use a urinal, though, and the beauty of having an older boy too is that NJ takes SB to the bathroom! He showed him how to use the urinal. Love that. I'm not comfortable saying that SB is completely potty trained at this point, but we're surely going through fewer Pull-Ups, and he's been clean all day today (so far - it's 5:45pm as I write this). We still put him in a Pull-Up at night, as we did with NJ, although he's usually dry in the morning anyway. NJ started wearing underwear at night around when he started kindergarten, and that was totally fine with us. He rarely wets the bed, and even rarely wet when he was wearing a Pull-Up, but we let him wear it for his own peace of mind.
It will be interesting to see how GI does, with two big brothers to follow after. I wonder if using cloth diapers more with him will help him learn the sensations faster, if I'm still using cloth with him when the time comes. (I sure plan to - I bought some more!)
My basic feeling about potty training is thus: You do what works for your kid. For SB, he needs the cookie or the jelly bean as motivation. NJ didn't. He just needed a push, and then he pottied for potty's sake. SB needs that carrot of a BIG present. NJ got a big present, but we didn't have to have it sitting in Daddy's closet for him to see and wish for. SB needs to be reminded fairly often. NJ didn't. And it's interesting that I have NJ to help me potty train SB and to give him some tips of the trade. And he wants NJ to help him, which is pretty cool, too. (A lot of this has to do with their overall close relationship, and the fact that NJ just likes to help "parent" SB and GI anyway.)
So when my friends ask me for potty training advice, well, as with sleep, I can only say what worked for me. As far as I know, every person has a slightly different potty training experience, even with each kid. And then there are the lucky ones whose kids potty train themselves. I don't know what magic causes that, but it's pretty amazing when it happens.
I have to say, though, that the first time you see your little one's adorable tush in underwear instead of a diaper, it feels like a huge milestone. Suddenly, he's a big boy.
Thursday, April 5, 2012
Starting Solids!
I promised a post about introducing solid foods, and here it is!
GI turned six months on March 5. I had been anxiously awaiting that day for several weeks, planning how we would introduce solids, what he should eat first, how we would balance nursing and eating. I should have known after three kids that things come together fairly naturally if you let them. I did know, after three kids, that there were many different ways to introduce solids, and many different theories about what is best. The only things I can see that anyone seems to agree on these days is that you should wait until the baby is six months old.
With NJ, we followed our pediatrician's advice and started solid foods at four months. We did rice cereal mixed with formula for a week or so to get him used to the spoon and see how he did. We then started on pureed vegetables and fruits, like sweet potato, squash, peas, banana, pears, and apples. We did one simple food at a time, starting a new food every three to four days, and slowly built up to the "stage 2" foods and mixtures by the time he was six months. From then on, he had at least one or two meals of solid foods per day in addition to his bottles. We went ever-so-slowly and carefully, and I was afraid to give him finger foods because I was sure he would choke. I did eventually start giving him finger foods, like Gerber's fantastic Puffs, Cheerios, pasta, and bits of bread. It was a long time before he was just eating regular food with the rest of us.
With SB, we were more experienced and less nervous about the whole thing. And a good thing we were, because SB wanted nothing to do with purees. We started at six months, attempting to give him rice cereal mixed with breastmilk. He didn't like it. I found it was way more trouble to prepare food for him and to figure out what to give him than it was to just nurse him when he was hungry. It's likely that if we had pushed it more, he would have gotten the idea and eaten more solids sooner. I'm not saying we should have, just that I was too lazy. He nursed a lot well into the second half of his first year. It wasn't until after he was a year old that he was actually replacing breastfeedings with solid foods. He would eat bits and pieces of solid foods, crackers, pasta, peas, Puffs, cereal, melon, and so on, but he wouldn't be satisfied until he'd nursed.
So with GI, I thought it might be nice to do a combination. Maybe he could have purees sometimes and finger foods other times, so that we'd have options. I wanted the freedom of being away from him for more than two hours without worrying if he was getting hungry, so I thought if my husband or a babysitter could give him a meal of a puree, that would help. So we started with rice cereal mixed with breastmilk, which he found yucky, of course. I then tried mixing rice cereal with purees instead, which he actually sort of took to. He was very interested in the spoon. I tried to make it a point to give him some puree at least once a day, but he didn't eat much of it. He kept trying to steal food off my plate. So I finally just started giving him bits and pieces of whatever we were eating - bread, a pea, cereal, etc. I stay away from anything too acidic - citrus, tomatoes - or things babies really shouldn't have, like honey, and I don't want him to have dairy yet, but almost anything else, I'll let him try. He had a bit of avocado today, and a few peas. Some days, he gets some tortilla or bread. My friend's son had a big birthday party the other day, and there were roasted vegetables, so GI got some scraped-out bits of squash and zucchini and a little carrot and a banana. Whatever seems soft and small enough for the toothless little guy to manage, I'll let him try. He seems to enjoy it, but he only takes a few bites before he starts refusing.
There is research to suggest that babies who are allowed to go at their own pace with finger foods are less picky and healthier eaters as they grow up. It seems that being fed purees means that the baby doesn't have control over what he eats, how much he eats, and he doesn't learn to differentiate foods by texture, shape, and color, since it's all just liquified. I'm not sure how much I agree with this, but it's interesting to think about. That's why I figured a combination of finger foods and purees might be the way to go this time. I'm not going to force-feed anything, and if he doesn't want something, he doesn't want it. He's still going to mostly nurse for a while. He's seven months old today, and I'm hoping to continue to slowly increase his solids intake.
I did try leaving him with a babysitter last week. I gave her about half a jar of squash puree mixed with a some rice cereal for texture, and he ate almost all of it for her. He'll eat solids for other people more than for me, which makes sense, since when he's with me, he just wants to nurse. I did find that he still practically leaped into my arms when I got home. It seemed like even though he wasn't necessarily terribly hungry, he didn't feel satisfied until he could nurse. It's kind of nice to be pounced upon like that. Makes you feel needed.
The process of introducing solid foods can be referred to as weaning, in the sense that you are slowly replacing breastfeedings (or bottle feedings) with other foods. By one year, babies can be taking in at least half of their caloric needs from solid foods, maybe more. It depends on your kid, of course. Some babies just aren't that interested in solids at 12 months, and that's okay too. Obviously, at some point, they're going to have to subsist solely on solids, but it doesn't have to be at one year, or even at two. Your breastmilk is still supplying vitamins, minerals, fats, proteins, and sugars, along with anti-inflammatory agents, antibacterial and antifungal substances, stem cells, and all the other things that make breastmilk so great.
And the realization will come, at some point after starting solids, that if you plan to replace nursing with solids, you'll actually have to prepare food for your baby instead of just sitting down and nursing! I'm realizing that I'll now have to cook for three kids, not just two. Why rush that?
GI turned six months on March 5. I had been anxiously awaiting that day for several weeks, planning how we would introduce solids, what he should eat first, how we would balance nursing and eating. I should have known after three kids that things come together fairly naturally if you let them. I did know, after three kids, that there were many different ways to introduce solids, and many different theories about what is best. The only things I can see that anyone seems to agree on these days is that you should wait until the baby is six months old.
With NJ, we followed our pediatrician's advice and started solid foods at four months. We did rice cereal mixed with formula for a week or so to get him used to the spoon and see how he did. We then started on pureed vegetables and fruits, like sweet potato, squash, peas, banana, pears, and apples. We did one simple food at a time, starting a new food every three to four days, and slowly built up to the "stage 2" foods and mixtures by the time he was six months. From then on, he had at least one or two meals of solid foods per day in addition to his bottles. We went ever-so-slowly and carefully, and I was afraid to give him finger foods because I was sure he would choke. I did eventually start giving him finger foods, like Gerber's fantastic Puffs, Cheerios, pasta, and bits of bread. It was a long time before he was just eating regular food with the rest of us.
With SB, we were more experienced and less nervous about the whole thing. And a good thing we were, because SB wanted nothing to do with purees. We started at six months, attempting to give him rice cereal mixed with breastmilk. He didn't like it. I found it was way more trouble to prepare food for him and to figure out what to give him than it was to just nurse him when he was hungry. It's likely that if we had pushed it more, he would have gotten the idea and eaten more solids sooner. I'm not saying we should have, just that I was too lazy. He nursed a lot well into the second half of his first year. It wasn't until after he was a year old that he was actually replacing breastfeedings with solid foods. He would eat bits and pieces of solid foods, crackers, pasta, peas, Puffs, cereal, melon, and so on, but he wouldn't be satisfied until he'd nursed.
So with GI, I thought it might be nice to do a combination. Maybe he could have purees sometimes and finger foods other times, so that we'd have options. I wanted the freedom of being away from him for more than two hours without worrying if he was getting hungry, so I thought if my husband or a babysitter could give him a meal of a puree, that would help. So we started with rice cereal mixed with breastmilk, which he found yucky, of course. I then tried mixing rice cereal with purees instead, which he actually sort of took to. He was very interested in the spoon. I tried to make it a point to give him some puree at least once a day, but he didn't eat much of it. He kept trying to steal food off my plate. So I finally just started giving him bits and pieces of whatever we were eating - bread, a pea, cereal, etc. I stay away from anything too acidic - citrus, tomatoes - or things babies really shouldn't have, like honey, and I don't want him to have dairy yet, but almost anything else, I'll let him try. He had a bit of avocado today, and a few peas. Some days, he gets some tortilla or bread. My friend's son had a big birthday party the other day, and there were roasted vegetables, so GI got some scraped-out bits of squash and zucchini and a little carrot and a banana. Whatever seems soft and small enough for the toothless little guy to manage, I'll let him try. He seems to enjoy it, but he only takes a few bites before he starts refusing.
There is research to suggest that babies who are allowed to go at their own pace with finger foods are less picky and healthier eaters as they grow up. It seems that being fed purees means that the baby doesn't have control over what he eats, how much he eats, and he doesn't learn to differentiate foods by texture, shape, and color, since it's all just liquified. I'm not sure how much I agree with this, but it's interesting to think about. That's why I figured a combination of finger foods and purees might be the way to go this time. I'm not going to force-feed anything, and if he doesn't want something, he doesn't want it. He's still going to mostly nurse for a while. He's seven months old today, and I'm hoping to continue to slowly increase his solids intake.
I did try leaving him with a babysitter last week. I gave her about half a jar of squash puree mixed with a some rice cereal for texture, and he ate almost all of it for her. He'll eat solids for other people more than for me, which makes sense, since when he's with me, he just wants to nurse. I did find that he still practically leaped into my arms when I got home. It seemed like even though he wasn't necessarily terribly hungry, he didn't feel satisfied until he could nurse. It's kind of nice to be pounced upon like that. Makes you feel needed.
The process of introducing solid foods can be referred to as weaning, in the sense that you are slowly replacing breastfeedings (or bottle feedings) with other foods. By one year, babies can be taking in at least half of their caloric needs from solid foods, maybe more. It depends on your kid, of course. Some babies just aren't that interested in solids at 12 months, and that's okay too. Obviously, at some point, they're going to have to subsist solely on solids, but it doesn't have to be at one year, or even at two. Your breastmilk is still supplying vitamins, minerals, fats, proteins, and sugars, along with anti-inflammatory agents, antibacterial and antifungal substances, stem cells, and all the other things that make breastmilk so great.
And the realization will come, at some point after starting solids, that if you plan to replace nursing with solids, you'll actually have to prepare food for your baby instead of just sitting down and nursing! I'm realizing that I'll now have to cook for three kids, not just two. Why rush that?
Saturday, March 24, 2012
Breastfeeding: All or Nothing?
I read an interesting point in a blog post recently, and I only wish I could remember which blog, because I read so many and rarely keep track of who said what (bad blog reading, I know). In any case, the point was that while you can choose not to breastfeed, you can't then later choose to switch to breastfeeding. However, you can choose not to formula-feed and then later choose to switch to formula if your situation calls for it. Basically, you've got to start out breastfeeding, and then make the choice either to continue or let your milk dry up and switch to formula.
This isn't exactly true, of course. It is both possible to relactate - that is, ask your breasts to start making milk again after having let your milk dry up - or to induce lactation - that is, ask your breasts to start making milk even if you never even had a baby. Some adoptive mothers do the latter, inducing lactation by tricking the body into thinking it's pregnant and then tricking the body into thinking it's delivered a baby through the use of hormone therapy and 'round-the-clock pumping. It's not easy, and it doesn't work for everybody, but it can be a very rewarding effort if you wanted to go that route. As for relactation, it's nearly as difficult. It's possible to bring your milk back in within the first few months after giving birth if you pump about every two to three hours around the clock for several weeks, as well as putting baby to breast as often as possible (if possible), but it takes serious dedication. After my first son was born and had been on exclusively formula for about four weeks, I thought about relactating. I spoke with a La Leche League leader about it, and she said I'd basically need to treat my breastpump like a newborn, pumping at least eight times in a 24-hour period (including in the middle of the night). She also said that since I had never established a full supply to begin with, it might never be possible to do so. I gave it a half-hearted effort, but never really was able to extract more than a few drops of milk, and I gave up after a couple of weeks of seeing no change.
So if you think you probably do want to breastfeed but you're not sure, you should start out doing so. Bring in your milk, breastfeed your new baby, and if for whatever reason you decide you don't want to do it, or there is a medical or psychiatric reason that you shouldn't or can't do it, you can always stop, wean to formula or bottles of donated breastmilk, and let your milk dry up. But, if you don't bring in your milk and start breastfeeding, it's pretty darn difficult, if not impossible, to change your mind six weeks in.
So in the beginning, yes, breastfeeding is "all or nothing." That is, either you do it or you don't. But, once you've established your supply and the baby has learned to feed effectively, and you give it a few weeks, or months, or years, things become a bit more flexible. For example, let's say that after six weeks, your maternity leave ends and you have to go back to work full time. You intend to pump and have your baby drink your milk from a bottle while you're separated from her. This would be ideal if you can't be with your baby all day, which many, many women can't. But, what if you just can't pump enough milk? Some women's bodies just don't respond well to the breast pump, and they can't produce enough, or they can't produce anything at all, or they can't keep up with their baby's needs by pumping. Other women's jobs are not ideal for pumping milk. Even though new federal law requires most workplaces to provide adequate break times and space for pumping milk, it still may not be entirely possible. Does this mean you have to stop breastfeeding and give your baby formula?
No!
Certainly, and I stress this because I believe it, it is most desireable to feed exclusively breastmilk for at least the first six months of your baby's life. That is the general recommendation from the AAP, the WHO, and other health services. Breastmilk is the best food for your young baby, and if you can provide it, and you will provide it, then you should provide it. The enormous benefits to your baby's (and your!) health, from nutrition to immune system to brain development to priming the digestive system, make exclusive breastfeeding the natural choice for every baby.
However, some breastmilk is better than no breastmilk. If you simply cannot provide exclusively breastmilk to your under-six-month-old baby, then continuing to nurse as much as you can is still good! Even if that means you only nurse at night, or in the morning and evening before and after work, or three times a day, or just for bedtime, some breastmilk is better than no breastmilk.
After six months or so, once you've introduced solid foods, you are no longer exclusively breastfeeding anyway. The benefits of breastmilk never go away, of course, so if you can continue to breastfeed as your baby's major source of nutrition, you should go on doing so. But, if you've given it six months and you're going a little nuts, backing off at this point is not as harmful, since your baby is eating other foods anyway. Remember that solid foods cannot and should not replace breastmilk and/or formula as your baby's major source of nutrition until after 12 months of age. Especially early on, six or seven months of age, solid foods shouldn't be more than 5 to 10% of your baby's daily intake. By one year, solid foods may be up to closer to 50% of your baby's intake. After one year, solid foods can be the majority of your baby's caloric and nutritional intake. Between six and 12 months, if you do decide to breastfeed less, you should replace most of the feedings with donated breastmilk or formula, not solid foods. One to three small meals of solids should be fine, but babies still need breastmilk or formula to thrive at that young age.
The AAP recommends breastfeeding for at minimum of one year. The WHO says two years. By one year of age, many babies are eating a fair amount of solid foods. At this point, you can choose to wean without taking away a significant portion of your baby's diet. However, if you want to continue to nurse, you certainly can. There is no psychological or physical harm to continuing to nurse to two years or beyond. The value of breastmilk and breastfeeding is not diminished just because the Earth has circled the sun one time since your baby was born. But, toddlers can survive on solid foods, assuming you are providing a variety of foods to create a balanced diet for your child. Children under two still need milk fats for brain development, either from your own milk, cow's milk, other dairy products, or another source. I am not a nutritionist or pediatrician, so I can't make a recommendation about what sort of milk to feed your toddler to replace breastmilk, but most pediatricians will tell you to give whole cow's milk to replace breastmilk or formula after one year of age.
If you do decide you want to wean at one year, you may need to start cutting back slowly. What you may find is that once you're down to two or three feedings a day, instead of six or seven, for example, or once you find that you no longer need to pump at work, breastfeeding may become an enjoyable break, rather than a burden or responsibility. Cuddling up with your toddler to nurse at bedtime or for an afternoon snack may be a time of closeness you and your toddler need during your otherwise hectic days. At this point, breastfeeding really isn't all or nothing. Weaning doesn't have to mean stopping completely, and weaning can be a slow, gentle process. I know of women who continue to nurse just once a day for months before they or their child finally drop that last feeding. I also know of women who continue to nurse six times a day, or more, throughout the second year. I found that SB gradually cut back over the course of his second year, until he was really only comfort-nursing at night. By the time I cut him off at 25 months, I didn't even get engorged, he was nursing so rarely and so little. A slow weaning process is more comfortable for both mother and child.
I don't really feel comfortable encouraging anyone to cut back on breastfeeding until her baby is at least one year of age. I wouldn't be writing this blog if I didn't feel that women should be supported and encouraged to choose exclusive breastfeeding. However, I also don't think it's fair to insist on breastfeeding as the only right choice, as if you either breastfeed or you don't. I think that places a lot of burden and blame on women who, for whatever reason, choose to use some formula. I also think it's important to let women know that breastfeeding some of the time is better than not breastfeeding at all. Just like some exercise is better than no exercise, and eating some vegetables is better than eating no vegetables, and getting some sleep is better than getting no sleep, breastfeeding some of the time is better than breastfeeding none of the time. To keep some supply, you have to breastfeed regularly, but if, for whatever reason, you don't breastfeed all of the time, that doesn't mean you have to stop completely.
I've been thinking about NJ's early weeks on this Earth, where he was getting perhaps 3 ounces of breastmilk per day when I pumped for him. I asked my LiveJournal audience if that measly 3 ounces a day mattered. I wish someone had said, "YES! Any breastmilk is better than no breastmilk!" I wish someone had said to me, "Try just nursing once a day. Maybe you'll find you want to try for a second feeding, and then a third." I wish I had known I could combination feed, or bring up my supply over time, as I healed, rather than just stopping. I wish I had known how important it could be in the future. I wish I had known how badly I would feel about stopping.
It is those regrets that drove me to two successful VBACs and two successful subsequent nursing relationships. (I've officially made it to six months of breastfeeding with GI, and we started solids a couple of weeks ago but are still mostly nursing. I'll be blogging about that soon.) It is also those regrets, and my subsequent successes, that drive me to write this blog. So I say, Yes! Do breastfeed! Give it a shot. Give it six weeks. Breastfeeding some is better than not breastfeeding at all. Some breastmilk is better than no breastmilk. And it is not all or nothing.
Most importantly, find help and support so that you can meet whatever goals you have set for yourself. Knowing that you've reached or surpassed those goals will allow you to look back with pride rather than with regret or guilt.
This isn't exactly true, of course. It is both possible to relactate - that is, ask your breasts to start making milk again after having let your milk dry up - or to induce lactation - that is, ask your breasts to start making milk even if you never even had a baby. Some adoptive mothers do the latter, inducing lactation by tricking the body into thinking it's pregnant and then tricking the body into thinking it's delivered a baby through the use of hormone therapy and 'round-the-clock pumping. It's not easy, and it doesn't work for everybody, but it can be a very rewarding effort if you wanted to go that route. As for relactation, it's nearly as difficult. It's possible to bring your milk back in within the first few months after giving birth if you pump about every two to three hours around the clock for several weeks, as well as putting baby to breast as often as possible (if possible), but it takes serious dedication. After my first son was born and had been on exclusively formula for about four weeks, I thought about relactating. I spoke with a La Leche League leader about it, and she said I'd basically need to treat my breastpump like a newborn, pumping at least eight times in a 24-hour period (including in the middle of the night). She also said that since I had never established a full supply to begin with, it might never be possible to do so. I gave it a half-hearted effort, but never really was able to extract more than a few drops of milk, and I gave up after a couple of weeks of seeing no change.
So if you think you probably do want to breastfeed but you're not sure, you should start out doing so. Bring in your milk, breastfeed your new baby, and if for whatever reason you decide you don't want to do it, or there is a medical or psychiatric reason that you shouldn't or can't do it, you can always stop, wean to formula or bottles of donated breastmilk, and let your milk dry up. But, if you don't bring in your milk and start breastfeeding, it's pretty darn difficult, if not impossible, to change your mind six weeks in.
So in the beginning, yes, breastfeeding is "all or nothing." That is, either you do it or you don't. But, once you've established your supply and the baby has learned to feed effectively, and you give it a few weeks, or months, or years, things become a bit more flexible. For example, let's say that after six weeks, your maternity leave ends and you have to go back to work full time. You intend to pump and have your baby drink your milk from a bottle while you're separated from her. This would be ideal if you can't be with your baby all day, which many, many women can't. But, what if you just can't pump enough milk? Some women's bodies just don't respond well to the breast pump, and they can't produce enough, or they can't produce anything at all, or they can't keep up with their baby's needs by pumping. Other women's jobs are not ideal for pumping milk. Even though new federal law requires most workplaces to provide adequate break times and space for pumping milk, it still may not be entirely possible. Does this mean you have to stop breastfeeding and give your baby formula?
No!
Certainly, and I stress this because I believe it, it is most desireable to feed exclusively breastmilk for at least the first six months of your baby's life. That is the general recommendation from the AAP, the WHO, and other health services. Breastmilk is the best food for your young baby, and if you can provide it, and you will provide it, then you should provide it. The enormous benefits to your baby's (and your!) health, from nutrition to immune system to brain development to priming the digestive system, make exclusive breastfeeding the natural choice for every baby.
However, some breastmilk is better than no breastmilk. If you simply cannot provide exclusively breastmilk to your under-six-month-old baby, then continuing to nurse as much as you can is still good! Even if that means you only nurse at night, or in the morning and evening before and after work, or three times a day, or just for bedtime, some breastmilk is better than no breastmilk.
After six months or so, once you've introduced solid foods, you are no longer exclusively breastfeeding anyway. The benefits of breastmilk never go away, of course, so if you can continue to breastfeed as your baby's major source of nutrition, you should go on doing so. But, if you've given it six months and you're going a little nuts, backing off at this point is not as harmful, since your baby is eating other foods anyway. Remember that solid foods cannot and should not replace breastmilk and/or formula as your baby's major source of nutrition until after 12 months of age. Especially early on, six or seven months of age, solid foods shouldn't be more than 5 to 10% of your baby's daily intake. By one year, solid foods may be up to closer to 50% of your baby's intake. After one year, solid foods can be the majority of your baby's caloric and nutritional intake. Between six and 12 months, if you do decide to breastfeed less, you should replace most of the feedings with donated breastmilk or formula, not solid foods. One to three small meals of solids should be fine, but babies still need breastmilk or formula to thrive at that young age.
The AAP recommends breastfeeding for at minimum of one year. The WHO says two years. By one year of age, many babies are eating a fair amount of solid foods. At this point, you can choose to wean without taking away a significant portion of your baby's diet. However, if you want to continue to nurse, you certainly can. There is no psychological or physical harm to continuing to nurse to two years or beyond. The value of breastmilk and breastfeeding is not diminished just because the Earth has circled the sun one time since your baby was born. But, toddlers can survive on solid foods, assuming you are providing a variety of foods to create a balanced diet for your child. Children under two still need milk fats for brain development, either from your own milk, cow's milk, other dairy products, or another source. I am not a nutritionist or pediatrician, so I can't make a recommendation about what sort of milk to feed your toddler to replace breastmilk, but most pediatricians will tell you to give whole cow's milk to replace breastmilk or formula after one year of age.
If you do decide you want to wean at one year, you may need to start cutting back slowly. What you may find is that once you're down to two or three feedings a day, instead of six or seven, for example, or once you find that you no longer need to pump at work, breastfeeding may become an enjoyable break, rather than a burden or responsibility. Cuddling up with your toddler to nurse at bedtime or for an afternoon snack may be a time of closeness you and your toddler need during your otherwise hectic days. At this point, breastfeeding really isn't all or nothing. Weaning doesn't have to mean stopping completely, and weaning can be a slow, gentle process. I know of women who continue to nurse just once a day for months before they or their child finally drop that last feeding. I also know of women who continue to nurse six times a day, or more, throughout the second year. I found that SB gradually cut back over the course of his second year, until he was really only comfort-nursing at night. By the time I cut him off at 25 months, I didn't even get engorged, he was nursing so rarely and so little. A slow weaning process is more comfortable for both mother and child.
I don't really feel comfortable encouraging anyone to cut back on breastfeeding until her baby is at least one year of age. I wouldn't be writing this blog if I didn't feel that women should be supported and encouraged to choose exclusive breastfeeding. However, I also don't think it's fair to insist on breastfeeding as the only right choice, as if you either breastfeed or you don't. I think that places a lot of burden and blame on women who, for whatever reason, choose to use some formula. I also think it's important to let women know that breastfeeding some of the time is better than not breastfeeding at all. Just like some exercise is better than no exercise, and eating some vegetables is better than eating no vegetables, and getting some sleep is better than getting no sleep, breastfeeding some of the time is better than breastfeeding none of the time. To keep some supply, you have to breastfeed regularly, but if, for whatever reason, you don't breastfeed all of the time, that doesn't mean you have to stop completely.
I've been thinking about NJ's early weeks on this Earth, where he was getting perhaps 3 ounces of breastmilk per day when I pumped for him. I asked my LiveJournal audience if that measly 3 ounces a day mattered. I wish someone had said, "YES! Any breastmilk is better than no breastmilk!" I wish someone had said to me, "Try just nursing once a day. Maybe you'll find you want to try for a second feeding, and then a third." I wish I had known I could combination feed, or bring up my supply over time, as I healed, rather than just stopping. I wish I had known how important it could be in the future. I wish I had known how badly I would feel about stopping.
It is those regrets that drove me to two successful VBACs and two successful subsequent nursing relationships. (I've officially made it to six months of breastfeeding with GI, and we started solids a couple of weeks ago but are still mostly nursing. I'll be blogging about that soon.) It is also those regrets, and my subsequent successes, that drive me to write this blog. So I say, Yes! Do breastfeed! Give it a shot. Give it six weeks. Breastfeeding some is better than not breastfeeding at all. Some breastmilk is better than no breastmilk. And it is not all or nothing.
Most importantly, find help and support so that you can meet whatever goals you have set for yourself. Knowing that you've reached or surpassed those goals will allow you to look back with pride rather than with regret or guilt.
Saturday, March 17, 2012
Sick Baby
GI has been sick for a week. It started as a mild cough last Friday, then evolved into a not-so-mild cough with congestion and fever, until I finally called the doctor on Wednesday, where he was diagnosed with bronchiolitis. The problem with bronchiolitis is there's not much to do about it but wait for the baby to get better. It's caused by one of several viruses, including rhinovirus (the common cold) or RSV (respiratory syncytial virus) or the flu virus. Since it's a virus, you can really only treat the symptoms and wait. The symptoms are basically cough with wheezing and fever and congestion. Ibuprofen or acetaminophen for fever works well, and for the wheezing, sometimes albuterol by inhaler or nebulizer can help open the airways a bit and ease the coughing. I have no doubt that GI caught a cold from one or the other of his brothers. He's actually had several colds, thanks to the aforementioned older brothers, but this is the first time it's evolved into anything more serious. Really, bronchiolitis typically sounds worse than it is, but some babies do end up in the hospital to be put on oxygen and regular nebulizer treatments because of the lung congestion and wheezing. Fortunately, GI isn't that bad off, but I'm frustrated because breastfeeding is the number one defense against bronchiolitis, and, well, it didn't work. I tend to like to think positively, that if he weren't breastfed, maybe he'd be even worse off. NJ had RSV at four months of age and was nearly hospitalized for it. That was a very crazy week and a story which deserves its own post, so maybe I'll treat you all to NJ's RSV story one of these days. But not today.
I read up on bronchiolitis, and it said the breathing difficulty should ease after two to three days but that the cough could last up to two weeks. So he should have been getting better. He was noticeably better yesterday, until bedtime. He coughed through the night, moaned, wouldn't nurse, and was generally very unhappy. I didn't understand this at all. My husband suggested calling the doctor again this morning, and they saw us promptly, where *drumroll* he was diagnosed with an ear infection! Lucky guy, getting a cough, congestion, and an ear infection! Again, breastfeeding is supposed to be a major defense against ear infections, so, again, I like to think that he would have had a lot more ear infections, or worse ones, if he weren't breast-fed. But that's small consolation right now. Anyway, he's on amoxicillin for that, and I hope to see a baby truly on the mend by tomorrow or Monday.
Having a sick baby is very stressful. Since babies (well, everyone actually) tend to feel worse at night, you don't get enough sleep, so dealing with anything during the day is more difficult. Plus, you feel so bad for the baby and wish there was something you could do to make him feel better, but there isn't. Plus, you try to give him medicine, and he doesn't want it, and he fights it, and you feel terrible that you're torturing him, and you can't explain that the medicine will make him feel better. Plus, because he doesn't feel well, he needs to be held and comforted more, so you don't have time to do anything else that needs doing, like paid work, laundry, dishes, cooking, and, oh, tending to your other children. Then, because of all of that stress, the other children, who really are not behaving any worse than usual, drive you crazy, and you're more short with them, and you feel bad about that, and that causes even more stress. I don't handle stress well, can you tell? Also, because the baby is sick, he vomits and snots all over you, which means you have even more laundry that you can't find time to do.
Deep breath.
I can usually handle up to three days of illness in any given child before I go a little batty. GI has pushed beyond that limit into "Oh my G-d I can't take this anymore" territory. Also, one of the cats decided to pee on NJ's bed the other morning and I nearly snapped. (That generated more laundry and necessitated changing sheets. I hate changing sheets.) I almost burst into tears in front of my older boys, but I didn't want to scare them. Trying to explain why I was crying would have been difficult. Instead, I tried to tell them in a very calm voice that mommy is very tired and irritable at the moment, and could they please try to be gentle with me. The boys, being 5 and 3, didn't show as much empathy as I had hoped for.
My husband took the two older ones out this morning, so it's quiet right now. GI is sleeping, hopefully for a while. I was able to throw in a load of laundry and write this post, and I found the willpower to fold a load that's been sitting in the dryer for two days. NJ couldn't find pants this morning.
I always remind myself that this, too, shall pass. And it shall. I am grateful that a cold here and there is usually all I have to deal with, and I feel deeply for those of you who are dealing with more chronic illnesses in your children. I can't imagine the stress of having an always-sick baby. At least I know that by this time next week, everything should be back to its normal level of craziness.
I will look back on this and realize that I can handle what comes my way. It doesn't always feel like it in the moment, but we get through it. The baby will feel better, we'll all get some sleep, the sun will come out (did I mention, it's pouring down rain today?), and the world will seem brighter. And in the meantime, we muddle through, hour-by-hour, day-by-day, and take great pleasure in the quiet moments, like this one, that come our way.
Happy Spring, everyone.
I read up on bronchiolitis, and it said the breathing difficulty should ease after two to three days but that the cough could last up to two weeks. So he should have been getting better. He was noticeably better yesterday, until bedtime. He coughed through the night, moaned, wouldn't nurse, and was generally very unhappy. I didn't understand this at all. My husband suggested calling the doctor again this morning, and they saw us promptly, where *drumroll* he was diagnosed with an ear infection! Lucky guy, getting a cough, congestion, and an ear infection! Again, breastfeeding is supposed to be a major defense against ear infections, so, again, I like to think that he would have had a lot more ear infections, or worse ones, if he weren't breast-fed. But that's small consolation right now. Anyway, he's on amoxicillin for that, and I hope to see a baby truly on the mend by tomorrow or Monday.
Having a sick baby is very stressful. Since babies (well, everyone actually) tend to feel worse at night, you don't get enough sleep, so dealing with anything during the day is more difficult. Plus, you feel so bad for the baby and wish there was something you could do to make him feel better, but there isn't. Plus, you try to give him medicine, and he doesn't want it, and he fights it, and you feel terrible that you're torturing him, and you can't explain that the medicine will make him feel better. Plus, because he doesn't feel well, he needs to be held and comforted more, so you don't have time to do anything else that needs doing, like paid work, laundry, dishes, cooking, and, oh, tending to your other children. Then, because of all of that stress, the other children, who really are not behaving any worse than usual, drive you crazy, and you're more short with them, and you feel bad about that, and that causes even more stress. I don't handle stress well, can you tell? Also, because the baby is sick, he vomits and snots all over you, which means you have even more laundry that you can't find time to do.
Deep breath.
I can usually handle up to three days of illness in any given child before I go a little batty. GI has pushed beyond that limit into "Oh my G-d I can't take this anymore" territory. Also, one of the cats decided to pee on NJ's bed the other morning and I nearly snapped. (That generated more laundry and necessitated changing sheets. I hate changing sheets.) I almost burst into tears in front of my older boys, but I didn't want to scare them. Trying to explain why I was crying would have been difficult. Instead, I tried to tell them in a very calm voice that mommy is very tired and irritable at the moment, and could they please try to be gentle with me. The boys, being 5 and 3, didn't show as much empathy as I had hoped for.
My husband took the two older ones out this morning, so it's quiet right now. GI is sleeping, hopefully for a while. I was able to throw in a load of laundry and write this post, and I found the willpower to fold a load that's been sitting in the dryer for two days. NJ couldn't find pants this morning.
I always remind myself that this, too, shall pass. And it shall. I am grateful that a cold here and there is usually all I have to deal with, and I feel deeply for those of you who are dealing with more chronic illnesses in your children. I can't imagine the stress of having an always-sick baby. At least I know that by this time next week, everything should be back to its normal level of craziness.
I will look back on this and realize that I can handle what comes my way. It doesn't always feel like it in the moment, but we get through it. The baby will feel better, we'll all get some sleep, the sun will come out (did I mention, it's pouring down rain today?), and the world will seem brighter. And in the meantime, we muddle through, hour-by-hour, day-by-day, and take great pleasure in the quiet moments, like this one, that come our way.
Happy Spring, everyone.
Saturday, March 10, 2012
Cloth Diapering...ish
I've never considered myself "crunchy," but I realize I've taken on more and more "crunchy" traits. After all, I *gasp* breastfeed, and I *gasp* babywear(ish), and recently I've taken an interest in *gasp* cloth diapering! Still, I know I don't really fit the "crunchy" mold at all. I guess that's the point. You can do some things that others might consider to be a little out there or a little non-cosmopolitan, or a little old-fashioned, or a little "crunchy," but that isn't the whole of who you are or how you live or how you parent. I can tell you for certain that we are not "crunchy" folk. I just want to do what's best for my family and my budget that works with my worldview, time, and patience.
As a result, I've found it's more convenient to babywear, cheaper to breastfeed, and now this cloth diaper business. It started innocently enough. I've been hoping my three-year-old will start using the potty, although I suppose I haven't pushed the issue as hard as I could. NJ didn't potty train until he was 3-1/2. In fact, it was on his half-birthday exactly that we finally said, "That's IT! NO MORE DIAPERS." And in three days, he was fully potty trained. Go figure. I was hoping it would be that easy with SB, but I've been trying it on and off for a few months, and I just can't seem to get him to stick with it. Frustrating. So when my favorite little local baby boutique, Babies In Bloom, advertised on their Facebook page that they had these fancy schmancy cloth training pants in stock, I thought I might investigate. Maybe SB would care more if he could feel that he was wet, or may he wouldn't want to mess up some cool cloth pants. He's willing to wear underwear, but I very quickly got sick of cleaning up his "accidents." So we went to Babies In Bloom and spent some time with one of their amazing and knowledgeable employees going over some cloth diaper basics so that I could invest in a Flip Training Pants system. Surely within a week, he'd be potty trained! Ha!
Well, the cloth, while interesting and cute, did not encourage SB to use the toilet any more than "Yo Gabba Gabba" themed underwear or "Cars" themed Pull-Ups did. However, in the process, I found out that cloth diapering is not so arcane or esoteric or difficult or time-consuming or complicated or gross as I had imagined. Once someone spent some time going over it with me, it actually seemed...surmountable. So, thought I, I have a little one in diapers for a few more years, plus, who knows, there may be another in the future, and if I had a few cloth diapers, maybe that would save me a box of disposables here and there. And what I've found is, cloth diapering is actually pretty fun and you can do it at whatever level you want, from using a few cloth diapers a week to full-time, 24/7 diapering, to anything in between. If you're crafty, you can even make your own diapers. I, however, am not. I don't have a sewing machine anyway.
So here's my newbie-for-newbies intro to cloth diapers. This is not comprehensive, since I haven't (yet?) experienced the full range of diapering options, but here's what I've figured out so far.
The purpose of a diaper is to absorb pee and catch poop. So cloth diapers are just absorbent cloth with something relatively waterproof over it to keep the wet and stinky from escaping. The most basic type of cloth diaper is a big-ish piece of fabric, usually cotton, folded a few times and secured around the baby to catch said wet and stinkies. Once it is wet and/or stinky, you wash it and put a different clean cloth on the baby so he can wet and/or stinkify it. Then you wash that one. (Well, you don't have to wash them one at a time. You can get a little collection of wet and stinky pieces of cloth and wash them all at once, of course.)
What I've just started using is called a "prefold." This is basically your aforementioned absorbent cloth that's already been folded over a few times and then sewn into a rectangle with two seams. You fold this in thirds along the seams, flare out the top, put the baby on top, and fold it up over him. You can then secure this with various methods, or simply put a cover over the whole thing and allow the cover to hold it all in place.
The covers are what make the whole thing fun. They come in all sorts of colors and patterns, so you get to pick different ones that appeal to you. These will either have snaps or Velcro or some combination to hold it around the baby. The best part is that many of them can be adjusted to grow with your baby so you can use them from birth to potty training and then back down to your next baby. In other words, once you've bought your diapers, you've bought them, and you never have to buy more (unless you want to!).
There are also "All-in-One" diapers, which are the cover and the absorbent part all put together, so you just put that on and change it like a disposable. These are good for when you're out and about or for cloth-o-phobes or daycare or whatever, who don't want to deal with a two-part system. I don't have any All-in-Ones yet, but I assume that if my cloth diaper adventure continues, I'll end up with some eventually.
Then there's something in between the All-in-One and the prefold+covers called a pocket diaper. These are covers with a lining, and you slip however many absorbent pieces of cloth between the cover and the lining. I don't have any of these yet, either, but, er, I probably will at some point. You know. If I happen to see one I like.
The thing I like about using the prefold+cover method is that if the cover doesn't get wet and/or stinky, you can just change the prefold and reuse the cover a couple of times. So you need fewer covers than prefolds.
To give you an idea of the pricing, the covers I have were about $12 or $13 each, and the prefolds were $20 for 6 of them. I've been told an initial investment of about $200 buys you all the diapers you'll ever need, and that sounds about right. It also depends if you're buying more All-in-Ones or more covers or whatnot, and how many kids you have in diapers at once, obviously. The beauty of the one-size diapers is that if you have a toddler and an infant both in diapers, they can both use the same diapers (but not at the same time, haha). So you don't need two separate collections.
I'm not buying my cloth diapers all at once. Instead, yesterday I was on my way to Costco, which happens to be about a minute and a half from Babies In Bloom. I had intended to buy a box of diapers at Costco, but then I decided to buy cloth diapers instead at Babies In Bloom. I spent $35 on the cloth diapers, which is almost exactly what I would have spent for a box disposables at Costco. I figure if I change about four diapers a day, then they pay for themselves in about two months. The more cloth I have, the fewer disposables I'll use, and the more money I'll save. Because after they've paid for themselves, I'm basically diapering for free. Kinda cool. Also, no diaper trash. Yum.
And now the part you're really worried about. Well, the part I was worried about. Washing them. When you read the instructions for washing cloth, it seems so complicated. I'm going to make it easy on you. First of all, there's the poop issue. Breastmilk poop washes out without any special work. I promise. I've been doing it. Solids poop is a little grosser. Okay, a lot grosser, and is the only thing I don't enjoy about cloth diapering. With disposables, you just wrap the whole offensive pile inside the diaper with the dirty wipes and throw the whole thing away. You can't do this with cloth. You have to dump the excess solid poop into the toilet and then wash the diaper. So you have to figure out what to do with the dirty wipes, which is not very much fun. You can buy a diaper sprayer that attaches to your toilet to rinse the poop more if you want, but it isn't wholly necessary.
Okay, so when you first buy a diaper, look at the instructions for the initial wash. Typically, you need to wash it three times before you can use it. You wash on Hot with a Cold rinse. You shouldn't use laundry detergent with any of the following: dyes, fragrances, enzymes, fabric softeners. You want a very very basic detergent. Fabric softeners will repel water, not what you want in an absorbent diaper. Fragrances, dyes, and enzymes might irritate the baby's skin. So, none of that. A quick Google search will find you a big ol' list of good laundry detergents for cloth diapers. You can dry the diapers in your dryer. Except you may want to hang-dry the covers to keep the Velcro or snaps lasting longer.
Now you can use the diapers. And then, of course, once you've used them, you have to wash them again. This is actually pretty simple. Throw your dirty diapers into the washing machine and first run a cold rinse cycle. Then wash them with detergent, a hot wash with a cold rinse and add an extra rinse. Most modern washers will do all of this for you without you having to come back until it's all done. It's really not that much trouble.
Most people have a storage solution for dirty diapers - a bucket or pail or something to put them in until they can be washed. I've been using an otherwise-unused Diaper Champ that I stuck in the laundry room. You'll probably want to do your diaper laundry reasonably frequently so your diaper storage area does not become too stinky (and so you don't run out of diapers!).
Sometimes things happen to your diapers, like they become stained or retain an unpleasant odor or lose absorbency. There are ways to deal with these problems, which another quick Google search will show you. There's a technique called "stripping" the diapers to take off accumulated oils and buildup that could be causing them to be less absorbent (as far as I can tell, this just involves doing three hot rinses in your washing machine). You can also use baking soda to help reduce odor, hang the diapers in the sun to reduce stains and odor, and so on. Lot's of people who know more about this have written detailed treatises on the use and maintenance of cloth diapers. My goal here was to give you a simple intro so that it doesn't seem so scary anymore.
Happy diapering!
As a result, I've found it's more convenient to babywear, cheaper to breastfeed, and now this cloth diaper business. It started innocently enough. I've been hoping my three-year-old will start using the potty, although I suppose I haven't pushed the issue as hard as I could. NJ didn't potty train until he was 3-1/2. In fact, it was on his half-birthday exactly that we finally said, "That's IT! NO MORE DIAPERS." And in three days, he was fully potty trained. Go figure. I was hoping it would be that easy with SB, but I've been trying it on and off for a few months, and I just can't seem to get him to stick with it. Frustrating. So when my favorite little local baby boutique, Babies In Bloom, advertised on their Facebook page that they had these fancy schmancy cloth training pants in stock, I thought I might investigate. Maybe SB would care more if he could feel that he was wet, or may he wouldn't want to mess up some cool cloth pants. He's willing to wear underwear, but I very quickly got sick of cleaning up his "accidents." So we went to Babies In Bloom and spent some time with one of their amazing and knowledgeable employees going over some cloth diaper basics so that I could invest in a Flip Training Pants system. Surely within a week, he'd be potty trained! Ha!
Well, the cloth, while interesting and cute, did not encourage SB to use the toilet any more than "Yo Gabba Gabba" themed underwear or "Cars" themed Pull-Ups did. However, in the process, I found out that cloth diapering is not so arcane or esoteric or difficult or time-consuming or complicated or gross as I had imagined. Once someone spent some time going over it with me, it actually seemed...surmountable. So, thought I, I have a little one in diapers for a few more years, plus, who knows, there may be another in the future, and if I had a few cloth diapers, maybe that would save me a box of disposables here and there. And what I've found is, cloth diapering is actually pretty fun and you can do it at whatever level you want, from using a few cloth diapers a week to full-time, 24/7 diapering, to anything in between. If you're crafty, you can even make your own diapers. I, however, am not. I don't have a sewing machine anyway.
So here's my newbie-for-newbies intro to cloth diapers. This is not comprehensive, since I haven't (yet?) experienced the full range of diapering options, but here's what I've figured out so far.
The purpose of a diaper is to absorb pee and catch poop. So cloth diapers are just absorbent cloth with something relatively waterproof over it to keep the wet and stinky from escaping. The most basic type of cloth diaper is a big-ish piece of fabric, usually cotton, folded a few times and secured around the baby to catch said wet and stinkies. Once it is wet and/or stinky, you wash it and put a different clean cloth on the baby so he can wet and/or stinkify it. Then you wash that one. (Well, you don't have to wash them one at a time. You can get a little collection of wet and stinky pieces of cloth and wash them all at once, of course.)
What I've just started using is called a "prefold." This is basically your aforementioned absorbent cloth that's already been folded over a few times and then sewn into a rectangle with two seams. You fold this in thirds along the seams, flare out the top, put the baby on top, and fold it up over him. You can then secure this with various methods, or simply put a cover over the whole thing and allow the cover to hold it all in place.
The covers are what make the whole thing fun. They come in all sorts of colors and patterns, so you get to pick different ones that appeal to you. These will either have snaps or Velcro or some combination to hold it around the baby. The best part is that many of them can be adjusted to grow with your baby so you can use them from birth to potty training and then back down to your next baby. In other words, once you've bought your diapers, you've bought them, and you never have to buy more (unless you want to!).
There are also "All-in-One" diapers, which are the cover and the absorbent part all put together, so you just put that on and change it like a disposable. These are good for when you're out and about or for cloth-o-phobes or daycare or whatever, who don't want to deal with a two-part system. I don't have any All-in-Ones yet, but I assume that if my cloth diaper adventure continues, I'll end up with some eventually.
Then there's something in between the All-in-One and the prefold+covers called a pocket diaper. These are covers with a lining, and you slip however many absorbent pieces of cloth between the cover and the lining. I don't have any of these yet, either, but, er, I probably will at some point. You know. If I happen to see one I like.
The thing I like about using the prefold+cover method is that if the cover doesn't get wet and/or stinky, you can just change the prefold and reuse the cover a couple of times. So you need fewer covers than prefolds.
To give you an idea of the pricing, the covers I have were about $12 or $13 each, and the prefolds were $20 for 6 of them. I've been told an initial investment of about $200 buys you all the diapers you'll ever need, and that sounds about right. It also depends if you're buying more All-in-Ones or more covers or whatnot, and how many kids you have in diapers at once, obviously. The beauty of the one-size diapers is that if you have a toddler and an infant both in diapers, they can both use the same diapers (but not at the same time, haha). So you don't need two separate collections.
I'm not buying my cloth diapers all at once. Instead, yesterday I was on my way to Costco, which happens to be about a minute and a half from Babies In Bloom. I had intended to buy a box of diapers at Costco, but then I decided to buy cloth diapers instead at Babies In Bloom. I spent $35 on the cloth diapers, which is almost exactly what I would have spent for a box disposables at Costco. I figure if I change about four diapers a day, then they pay for themselves in about two months. The more cloth I have, the fewer disposables I'll use, and the more money I'll save. Because after they've paid for themselves, I'm basically diapering for free. Kinda cool. Also, no diaper trash. Yum.
And now the part you're really worried about. Well, the part I was worried about. Washing them. When you read the instructions for washing cloth, it seems so complicated. I'm going to make it easy on you. First of all, there's the poop issue. Breastmilk poop washes out without any special work. I promise. I've been doing it. Solids poop is a little grosser. Okay, a lot grosser, and is the only thing I don't enjoy about cloth diapering. With disposables, you just wrap the whole offensive pile inside the diaper with the dirty wipes and throw the whole thing away. You can't do this with cloth. You have to dump the excess solid poop into the toilet and then wash the diaper. So you have to figure out what to do with the dirty wipes, which is not very much fun. You can buy a diaper sprayer that attaches to your toilet to rinse the poop more if you want, but it isn't wholly necessary.
Okay, so when you first buy a diaper, look at the instructions for the initial wash. Typically, you need to wash it three times before you can use it. You wash on Hot with a Cold rinse. You shouldn't use laundry detergent with any of the following: dyes, fragrances, enzymes, fabric softeners. You want a very very basic detergent. Fabric softeners will repel water, not what you want in an absorbent diaper. Fragrances, dyes, and enzymes might irritate the baby's skin. So, none of that. A quick Google search will find you a big ol' list of good laundry detergents for cloth diapers. You can dry the diapers in your dryer. Except you may want to hang-dry the covers to keep the Velcro or snaps lasting longer.
Now you can use the diapers. And then, of course, once you've used them, you have to wash them again. This is actually pretty simple. Throw your dirty diapers into the washing machine and first run a cold rinse cycle. Then wash them with detergent, a hot wash with a cold rinse and add an extra rinse. Most modern washers will do all of this for you without you having to come back until it's all done. It's really not that much trouble.
Most people have a storage solution for dirty diapers - a bucket or pail or something to put them in until they can be washed. I've been using an otherwise-unused Diaper Champ that I stuck in the laundry room. You'll probably want to do your diaper laundry reasonably frequently so your diaper storage area does not become too stinky (and so you don't run out of diapers!).
Sometimes things happen to your diapers, like they become stained or retain an unpleasant odor or lose absorbency. There are ways to deal with these problems, which another quick Google search will show you. There's a technique called "stripping" the diapers to take off accumulated oils and buildup that could be causing them to be less absorbent (as far as I can tell, this just involves doing three hot rinses in your washing machine). You can also use baking soda to help reduce odor, hang the diapers in the sun to reduce stains and odor, and so on. Lot's of people who know more about this have written detailed treatises on the use and maintenance of cloth diapers. My goal here was to give you a simple intro so that it doesn't seem so scary anymore.
Happy diapering!
Monday, March 5, 2012
Is It Really About What's "Easier?"
First of all, happy birthday to Jessica on Babies! This blog is officially a year old as of Saturday. I thank my loyal readers for keeping me writing, and my kids for giving me ever more to write about! I expressed interest in conducting a giveaway of my Kindle book in celebration of this milestone, but I need to know if people will participate in the sweepstakes if I run one. If you think you'd want to enter for a chance to win a free copy of my book for yourself or someone you know, please comment below or on my previous post and say so! Thanks! If I don't get any comments, I'll scrap the idea.
I often read and hear people debating about which is "easier," formula-feeding or breast-feeding, with fair points on both sides. There are ways in which feeding formula from a bottle is "easier," and there are ways in which feeding human milk directly from the breast is "easier." I'll even outline a few of each for you here, from my own experience.
Some ways in which formula-feeding is "easier" than breast-feeding:
I don't mean to cause you any terrible anxiety about what you feed your kid for breakfast tomorrow or whether you send them to preschool or what brand of jeans you purchase for them. I firmly believe that, for the most part, as long as we follow our instincts as parents, stick to our own moral codes, and, most of all, show our children that we love them, most of our other choices probably will not have lasting impact. However, the choices that are more likely to have long-term consequences for your child's health and well-being should be considered more deeply. So, while having French fries for all three meals one day is not likely to be a big problem, you probably don't want to get your child in the habit of eating that way on a regular basis. (Hey, I have a three-year-old. I sympathize!)
Since studies and statistics and research have shown that there is clearly a difference between breastmilk and formula in the long-term, this is a parenting decision that we need to think longer and harder about and educate ourselves about more, rather than choosing based on what's "easier."
***
The great debate in infant feeding rages on, especially now that the AAP has updated and clarified its guidelines on infant feeding:
The strong statement about breastfeeding as a public health issue, and not just a "choice," is a huge step forward in breastfeeding language and thought within the medical community, and I think the AAP should be commended for taking such a stand."Breastfeeding and human milk are the normative standards for infant feeding and nutrition. Given the documented short- and long-term medical and neurodevelopmental advantages of breastfeeding, infant nutrition should be considered a public health issue and not only a lifestyle choice. The American Academy of Pediatrics reaffirms its recommendation of exclusive breastfeeding for about 6 months, followed by continued breastfeeding as complementary foods are introduced, with continuation of breastfeeding for 1 year or longer as mutually desired by mother and infant."
I often read and hear people debating about which is "easier," formula-feeding or breast-feeding, with fair points on both sides. There are ways in which feeding formula from a bottle is "easier," and there are ways in which feeding human milk directly from the breast is "easier." I'll even outline a few of each for you here, from my own experience.
Some ways in which formula-feeding is "easier" than breast-feeding:
- Other people can feed the baby without mom having to pump.
- There is a very short learning curve.
- You can see how much the baby is eating.
- Mom doesn't have to worry about what she eats and drinks.
- Mom can be away from the baby for an extended period of time.
Some ways in which breast-feeding is "easier" than formula-feeding:
- No bottles to wash or prepare.
- You don't have to wake up all the way for the middle-of-the-night feedings.
- Never have to worry about running out of food for the baby.
- Food is always the right temperature, quantity, and composition.
- It's cheaper.
When you look at it, it's kind of a silly list. It's all about the bottles and the preparation and who feeds the baby. Is that really what's most important? Is that really what the "choice" is about? What's easier? It's also "easier" to plop our kids in front of the TV all day instead of engaging with them. It's easier to take them to McDonald's every day instead of cooking healthy meals for them. It's easier to let them roll around in the back seat than install car seats and buckle them in every time. It's easier to let them do whatever they want than to try to discipline them. Heck, it's easier to keep them in diapers than to potty train them (believe me). But we wouldn't dream of making any of those choices just because they're "easier," would we? (Gosh, I hope not!)
How and what we feed our children, not just as infants but throughout their childhood, is a small percentage of the enormous body of choices we make for them as they grow. All of these decisions matter, some maybe more than others, but every choice we make for our children affects their health, well-being, happiness, and future. We have absolutely no way of knowing whether a particular choice we make is going to have a long-term consequence or benefit for our particular child, but we can look at statistics and research to make as informed a decision as possible based on overall trends. For example, it is quite clear that, when looking at a total population, people who were fed formula as babies are more prone to a host of diseases and problems, from food allergies to ear infections to diabetes and cancer, than people who were breastfed as babies. Evidence mounts. The risk for your specific child may be somewhat small, and perhaps it is a risk you are willing to - or must - take, given a medical, emotional, or family situation that makes breastfeeding an insurmountable challenge or undesirable option. However, it is important to admit that every choice you make has the potential to deeply affect your child's life.
I don't mean to cause you any terrible anxiety about what you feed your kid for breakfast tomorrow or whether you send them to preschool or what brand of jeans you purchase for them. I firmly believe that, for the most part, as long as we follow our instincts as parents, stick to our own moral codes, and, most of all, show our children that we love them, most of our other choices probably will not have lasting impact. However, the choices that are more likely to have long-term consequences for your child's health and well-being should be considered more deeply. So, while having French fries for all three meals one day is not likely to be a big problem, you probably don't want to get your child in the habit of eating that way on a regular basis. (Hey, I have a three-year-old. I sympathize!)
Since studies and statistics and research have shown that there is clearly a difference between breastmilk and formula in the long-term, this is a parenting decision that we need to think longer and harder about and educate ourselves about more, rather than choosing based on what's "easier."
Subscribe to:
Comments (Atom)