Food Battles – One View on What to Do

Why, hello world.

I had to take a break from professional writing for a few months due to conflicts of interest, and although you’d think that meant I’d be more free to write for my poor unloved blog, I guess..not. Huh.

Wait But Why, my new favorite beloved, has a great post explaining, well, why, I can’t sometimes just get off my butt and write. Especially without a deadline, or (and this is important), the promise of money.

Hatas gonna hate.  Procrastinators gonna procrastinate.

Anyway..

Where was I?

I do have one pro-free range parenting article from earlier this year up on that other site:

Your Helicopter Parenting is Hurting My Kids

It’s not much of a controversial issue by this point.  It’s totally in vogue now to be all like, “Hey, those crazy overprotective parents, I mean, right?”  And, like I’ve said before, this blog is not for advocacy or controversies or opinions — just information. So instead I want to highlight some of the feeding and nutrition stuff mentioned in the article.

Ellyn Satter, a nutrition expert, has become famous for counseling parents on feeding their children and minimizing mealtime battles, beginning with newborns. We talk more and more about on-demand breastfeeding for infants, and thank goodness. Study after study has indicated that infants know when they are hungry and when they are full.

We young parents are starting to get that. But we still don’t get that the concept extends beyond infancy. We’re treating the infants with respect and then infantilizing our toddlers, instead of learning the mealtime division of responsibility:

  • The parent is responsible for what, when, where
  • The child is responsible for how much and whether

This means that if your kid doesn’t want to eat the healthy well-balanced meal you provided, even when considering their taste preferences, well, okay. They will live.

Even as a Satter devotee I don’t perfectly follow her rules. No food in between snacks and mealtimes? Nope. I’m theworst. My kids regularly ruin their dinner, even if they are eating healthy snacks. You know why I break that rule on a regular basis? Because after two babies who had weight issues, I’m still afraid I’m starving my kids. Yeah, those kids. The healthy ones over there currently trying to dismantle my bookshelf.

Our kids are so much more capable than we give them credit for.

I highly recommend reading Satter’s books, even if you don’t end up agreeing with everything in them. I found it very freeing to just chill out regarding toddler eating habits.

For more information regarding implementing the Satter method, check out the incomparable Amalah, who writes an advice column on AlphaMom.

..and so much more. Amy (Amalah) really really loves Satter.  And I love Amy. So it’s just a hippie circle of love over here.

Responses to Breastfeeding and Baby Friendly Hospitals

While we’re stoking the fires this week, here are two responses to my earlier breastfeeding article in The Federalist.

 

Slate: No, You Boob, Government Support For Breastfeeding Is Not a Threat to Our Freedom.

(Can I tell you how much I love this headline? Even though it’s directed at me? Snark for the win. There’s a reason I love Slate).

On a more serious note, upon reading this article, it seems as though Ms. Marcotte and I actually agree on a lot of things, and that she really didn’t take the time to read my article. We, of course, differ on the role of government, but that’s the main disconnect between both parties. I wish people would realize that.

Suzanne Barston responds: Of Nanny States and Nonesense

<begin self-conscious butt-covering>

I hesitated posted links here to my Federalist articles and the responses because I really really didn’t want to get all political here. I’m one of those people that think it’s totally okay to agree to disagree (and am non confrontational and want everyone to like me and am open minded and have changed my views often based on good arguments).  The articles have taken up a lot of my writing time, but I will try to go back to writing for this site as well.

</end self-conscious butt-covering>

Enough politics. Back to The Dreaded Sippy Cup Transition!

Okay, I still haven’t succeeded in moving 16 month old J to sippy cups, so maybe I can’t be the authority on that subject.

 

PostPartum: 40 Long Days and Nights

Welcome, Carnival of Evidence-Based Parenting readers! This month’s Carnival, in honor of Mother’s Day, is Transition to Motherhood. I will be linking to the full carnival and to individual posts as they come in during the day.

Marissa Meyer made headlines when she decided to take only a two week maternity leave before returning to work as the new Yahoo! CEO.   There’s a reason why.   The conventional wisdom is that the first 6 weeks after giving birth are critical to bonding, healing, and breastfeeding.

Ms. Meyer did end up increasing Yahoo’s maternity leave. I have far from any schadenfreude on this.  I believe she did so for business reasons, the same way her edict banning working from home was business-related. And so far I have seen no indications that she regretted her two week leave – especially as she had a nursery built in her office, allowing her to keep her baby close.

She’s entitled to her choice. Running a Fortune 500 company, after all, portends all manner of sacrifices. Men make similar sacrifices too, at the expense of their families.

However, I’m glad I was not newly postpartum during the time Ms. Meyer was in the news. I felt bad enough that I couldn’t get the laundry done, my makeup on, the dishwasher running. I couldn’t even contemplate working a full day. And that sort of new mother stress – expecting to bounce back immediately – is the product of how we view motherhood and maternity in the Western world.

In fact, the Western world is unusual in how fast mothers are expected to return ‘to normal’ after giving birth. Even during 6+ weeks of maternity leave, mothers in the Western world generally go on outings, do the shopping, the cooking, and the cleaning.

In contrast, in many other cultures around the world, to include Chinese, Haitian, Cambodian, Thai, Indian, Bangladeshi, Ethiopian, Mexican, Guatemalan, Arab (to include in Jordan, Palestine, and Egypt), Indonesian, Malaysian, and Korean there is a 30-40 day ‘confinement period’ for a new mother.  Even the book of Leviticus describes a 40 day postpartum confinement period.

Many of the concerns regarding the postpartum period include protecting the mother and child from evil spirits and from the cold (including cold foods and showers). .

Fascinated by all this, I set out to write an article with research discussing the postpartum confinement period. What does the ban against cold food mean? Just how important is  the first 40 days anyway?

Sadly, there was not a lot of research at my fingertips. That is not to say I did a full literature review, but a typical Google search did not reveal the answers I wanted.

As a ‘conservative’ in the sense that I often trust the wisdom of those who come before me, I’m inclined to believe there is something to this 40 days/6 weeks number. Perhaps it has only to do with the fact that lochia (postpartum bleeding) can last up to 6 weeks, and then most cultures took that fact and extrapolated that the woman is weak. But given my discharge orders even banned vacuuming for the first 6 weeks (a ban I took to heart, believe me), there is probably something to the fact that gosh darn it, the mother needs as much care as the baby.  And, the prevalence of the hot/cold belief indicates there’s likely something to it.

Alas, without convincing research, all I can do is try to break down some of these cultural beliefs to the best of my ability.

Being Unclean

Being ritually unclean is a concept in many religions that often applies to bodily discharge. It’s no mystery then why a postpartum woman would be considered ritually unclean. Bodily discharge is an unavoidable side-effect of giving birth.  Lochia is the term for the discharge of blood, mucus, and placental tissue that may continue up to 6 weeks after delivery.

Best way to deal with this? Well, pads of course, but enterprising nurses and midwives have thought up various ways to maximize absorption and pain relief in one.

One way is the ice diapers – a newborn diaper cut open with ice placed inside. Maximum absorption + relief.

Frozen padsicles is another.  Take a maxi pad, and put some witch hazel on it. Freeze.

For more, check out these helpful and entertaining posts.

Needing Rest

Western medicine agrees with traditional medicine on this one.  Women need rest after giving birth. Definitely no exercise and no sex for the first six weeks, say most hospital discharge instructions.

Now, traditional cultures take it quite a bit further. In some, women’s feet cannot even hit the floor for 30 days. And, as the name implies, during confinement public outings are definitely banned.

The jury is out on whether postpartum confinement helps prevent PPD, exacerbates the possibility of PPD, or has no effect. However, a major difference I and many others have noticed is that there is a focus on the mother in addition to the baby. In the Western world, traditionally the postnatal period focuses primarily on the baby. The sore, tired, and overwhelmed mother is largely ignored.

It is possible an increased focus on the mother — to include normal household duties being largely taken over by others — could help prevent PPD.  In addition, successful breastfeeding, due to the time and focus the mother can dedicate to the baby, can perhaps also help hinder PPD — both because breastfeeding failures can lead to an increase in PPD symptoms and because hormones associated with breastfeeding can protect against PPD.   However, in traditional cultures, the very isolation of the woman for 30-40 days may be the thing to lead to depression.  Certainly, getting out of the house with the baby (taking strolls to Starbucks, for example) is anecdotally helpful to many women during the postpartum period.

To help get the rest one needs, I’d advise the Western mother to line up help for the first few weeks with baby – but productive help.  People who will take on tasks without being asked, for example. It’s a fine line, as the presence of relatives, no matter how helpful, can also be stressful.

Regardless, I, and most other experienced mothers, would advise women to not expect to get into a routine the first few weeks. Focus on bonding and feeding (whether formula feeding, breastfeeding, or combo feeding). Have meals pre-prepared or line up a meal train for help.

Luckily there is more and more research on the postpartum depression and anxiety experienced by some mothers.  Check out Katherine Stone’s website Postpartum Progress for all the latest, and for resources.  However, there is much less research out there on the “Baby Blues”, commonly thought to be a result of the hormone changes occurring after birth.  Anecdotally, women talk about “Day 3”, or “Day 5” or some variation thereof in which extreme weepiness and hopelessness hit very forcefully – something that can be quite disconcerting if one does not expect it.

Does placenta encapsulation help avoid the baby blues and/or PPD? As expected, there is not much research out there. However, speculation exists that the placenta helps keep up levels of CRH – the corticotropin-releasing hormone — which in turn may protect against the stress of labor and delivery.

Needing Heat

A common confinement theme is the need for heat and fear of the cold – to include showers and ‘cold foods’ such as vegetables and sandwiches.

Like everything else, I can’t find much on this. However, a feeling of being constantly ‘cold’ postpartum could be related to thyroid problems, anemia, or just hormones — all things somewhat common for the postpartum mother.

Heat and a fear of showers also brings up the topic of needing heat to heal perineal wounds. Cold packs and ice are applied for the first few hours, but after that, western medicine recommends heat therapy, often in the form of a sitz bath – sitting in a few inches of very warm-but-not-hot-water.  You can also get special herbs for the bath.

One can do this by sitting in a regular bathtub, or there is a plastic device that sits on the toilet and constantly refreshes the water.  Why the plastic device? Because some health care providers are very against a real bath postpartum, for the fear that germs (such as foot germs!) may end up infecting wounds and the cervix.

How long do you need to wait before being able to take a real bath?  Oh, the difference between the traditional healthcare providers and the midwives on this one! It’s almost as bad as “Can you take a bath when in labor” question.

Some care providers say you can take a bath immediately. Others say wait two weeks. Others say wait 6 weeks. Still others say just wait until postpartum bleeding is over.

I am one of the few people in the universe that HATED that nifty little sitz bath device. The reason the first time around was that it hurt.  I had severe tearing and some other issues so the pressure it put on my stitches was not fun. So, despite my own discharge instructions (which said no bath until active red bleeding ended), I took a freakin’ bath.

Foods

When L was born, my South Asian grandmother started going on about how I needed to eat some kalo jeera. I had no idea what she was talking about, and I basically ignored her.

One failed breastfeeding attempt later, I was ready to listen. When J was born, I asked my mother what the heck kalo jeera was. It was basically black cumin seed, ground up.

Black cumin seed is a galactagogue, which means it is purported to help with lactation. Other galactagogues are fenugreek, brewer’s yeast, mulunggay, blessed thistle, goat’s rue, alfalfa, flaxseed, and steel-cut oats.

To maximize your galactagogue power, consider making lactation cookies, or drinking Mother’s Milk Tea, or buying More Milk Plus capsules. Also, since the over-drinking of water may at some point negatively affect lactation, try water with electrolytes, Gatorade, or coconut water to keep you hydrated.

Belly Wrapping

Like confinement and the eating of foods that serve as galactagogues, postpartum belly wrapping is common in many traditional cultures. My grandmother was distraught when she realized I wasn’t belly wrapping, and insisted my stomach would become flabby. (She was right). For the record, I did own a postpartum girdle-thingy, but despite trying to use it after both children, I hated it, and was just like, “screw it, I’ll be fat”.

Does it work? Anecdotally, yep.

The best-known belly binder is the Belly Bandit.  I had the Gabriella Band, which is much cheaper and still had good reviews.

To sum up: traditional cultures may have a few things right here. Rest. Eat foods that will help you heal (and increase milk, if you are breastfeeding). Take care of your body with heat therapy.

After all, it’s only 40 days.

 

Here’s a quick list of our contributors for  this second edition of the Carnival of Evidence-Based Parenting:

The Transition to New Motherhood (Momma, PhD)

Bonding in Early Motherhood:  When Angels Don’t Sing and the Earth Doesn’t Stand Still (Red Wine and Applesauce)

The Connection Between Poor Labour, Analgesia, and PTSD (The Adequate Mother)

For Love or Money:  What Makes Men Ready for New Fatherhood (Matt Shipman)

What the Science Says (and Doesn’t Say) About Breastfeeding Issues, Postpartum Adjustment, and Bonding (Fearless Formula Feeder)

No, Swaddling  Will Not Kill Your Baby (Melinda Wenner Moyer,  Slate)

Sleep Deprivation:  The Dark Side of Parenting (Science of Mom)

The Parenting Media and You (Momma Data)

Reassessing Happiness Research:  Are New Parents Really That Miserable? (Jessica Smock)

40 Long Days and Nights (Six Forty Nine)

Babywearing Part One: The Stretchy Wrap

Moby - a back view. What this beautiful scene doesn't show is that the baby got super overheated about five minutes later

Moby – a back view. What this beautiful scene doesn’t show is that the baby got super overheated about five minutes later

It’s been a while since I’ve done a simple, resource-y post.  So let’s start with something very simple – babywearing.

To go even simpler, let’s start with a kind of babywearing apparatus most people are familiar with: the Moby Wrap. The Moby is a kind of stretchy wrap. Stretchy wraps – which are basically long pieces of stretchy t-shirt-like fabric –  are great for your itty bitty newborn, but a bit more difficult when dealing with older and heavier babies. Other kinds of babywearing devices are soft-structured carriers, woven wraps, ring slings, mei teis, and pouches.  (For a more detailed, ridiculously comprehensive overview of types of carriers, go here).

I’m going to start with the pros and cons of stretchy wraps, but remember, not all stretchy wraps are created equal. Most of my pros/cons refer to the Moby; other wraps may have some different characteristics. Therefore, I will also go through the information on each type of stretchy wrap to help you pick the best for you.

Pros of stretchy wraps:

Twin carry!

Great for newborns. Gives them a snuggly feeling

Great for kangaroo care of preemies

Very comfortable once you get it right. Spreads the weight over both your shoulders. You could wear a young baby in the wrap all day.

Cons of stretchy wraps:

Only safe for front carries! (Despite the fact that there are instructions and photos showing back carry in stretchy wraps, do not do this. If you want to use a wrap for back carry, get a woven wrap. The exception is some woven-stretchy hybrids. But not the Moby. Never the Moby.)

Can get hot in the summer

Somewhat more difficult to nurse in

Sometimes hard to get a hang of putting it on, especially when you’re dragging a long piece of cloth around in the parking lot of the grocery store trying to get a squalling newborn settled in it.

Most of them are only comfortable up to about 18 pounds (the exception being the Wrapsody and other hybrids)

Brands of stretchy wraps:

Moby Wrap – This is the kind of wrap with which most people are familiar.  They are about $45-$50 and come in all sorts of colors. The Moby gets HOT in the summer (I know from personal experience).

My personal review? I myself wasn’t a huge fan of the Moby. My babies loved the Moby when I finally got them situated, but it was really hard for me to get it ‘right’. I got the basic hug hold down pretty easily, but the issue was that sometimes I would have it set too tight, and sometimes I would have it set too loose. So I’d have to get the baby mad by taking him or her out and readjusting. And then, inevitably, the baby would have to  nurse. Since I could never figure out how to nurse in the Moby, I would have to take the baby out. Neither child liked having the Moby against my skin while I nursed, so I’d have to unwrap the whole thing. Then nurse. Then start all over, trying to get the Moby situated right.

Boba/Sleepytime Wrap

When a good friend asked about wraps, I told her about my Moby experience and recommended the Boba Wrap instead. The Boba (which was formerly known as a Sleepytime Wrap) isn’t as stretchy as the Moby, which means it’s easier to get the tightness/looseness right.

In addition, although I can’t attest to this personally, apparently the Boba doesn’t get as hot, making it much more ideal for warmer climates.

Calin Bleu (microfleece)  – no personal experience. The Calin Blue cool gauze wrap is a woven and the microfleece is a stretchy.

Kari-Me  – A UK brand similar to the Moby

Tricot-Slen – A Belgian brand similar to the Moby

Hug-a-Bub– An Australian brand similar to the Moby

Cot2Tot – a UK brand similar to the Boba

Wrapsody Bali Stretch* – This is a cross between a stretchy wrap and a woven wrap.  As such, it can hold heavier babies. It has a more difficult learning  curve than true stretchy wraps (woven wraps are harder to learn) but is more versatile,allowing for back and hip carries.  It is also more like a woven in that it stays cool in the summer.

Je Porte Mama Bebe* – another cross between a stretchy wrap and a woven wrap.  Similar to the Wrapsody and can also do back carries/toddlers.

Baby K’Tan* – The K’Tan isn’t a stretchy wrap per se; it is more like a cross between a sling and a wrap. But when worn, it looks similar enough to a Moby that some moms look at it as an alternative option, so I’m going to put it on this list.

The babywearing experts at BabyCenter are not Baby K’Tan fans because of its price and because instructions from older versions show back carry pictures, which is a dangerous proposition in the K’Tan.

Caboo Carrier by Close Parent – this is like a cross between a ring sling, a wrap, and a soft-structured carrier. It’s really a wrap, but it’s already put together for you, and then adjustable via rings on the back.

Go here for some comparison between the types of stretchy wraps

Make your own:

http://www.make-baby-stuff.com/make-a-baby-sling.html

http://www.wearyourbaby.com/Default.aspx?tabid=121

Carries:

The Hug Hold is the recommended carry by Babywearers International. This has different names in different products. Unlike the cradle carry, the hug hold keeps the baby up near your chest where you can safely kiss the top of his or her head and see that he or she is breathing.

Moby Wrap instructions

Moby Wrap video

Boba Wrap instructions

Kari-Me instructions

Calin Bleu instructions

Tricot Slen instructions

Caboo instructions

Tips and Tweaks for stretchy wraps

Safety:

http://babywearerscircle.wordpress.com/2012/05/09/the-ultimate-guide-to-babywearing-safety-starting-out-safely/

Nursing in the stretchy wrap:

http://www.youtube.com/watch?v=gbalsUY408k

http://www.youtube.com/watch?v=eE6gq978Ze0

Basics: The First Six Weeks – a Breastfed Baby Goal Chart

newborn

click here for PDF

Sources and additional information:

Breastfed Baby Weight Gain:

http://kellymom.com/health/growth/weight-gain-calculator/

http://www.cdc.gov/growthcharts/who_charts.htm

http://www.babycenter.com/0_your-childs-size-and-growth-timeline_10357633.bc

Clinical Resources for Pregnancy, Birth, and Breastfeeding:

http://www.breastfeedingoutlook.com/index.php?pageID=35

http://kellymom.com/professional-handouts-set-1/

http://www.childbirthgraphics.com/index.php/

Basics: Low Milk Supply Part One – do you really have a low supply?

Aka: I just link a lot to KellyMom and Nurshable

Do you have a low milk supply? First, is it actually low? KellyMom has an amazing resource page regarding whether or not a mom’s supply is actually low, and if it is, possible causes and solutions. I really can’t add more, as it is very comprehensive. However, some key highlights: If the baby is cluster feeding (nursing off and on for hours), it may just be a growth spurt. If the baby is fussy at the breast, it may just be a new awareness of the world around her, or a need to burp, or just plain baby fussiness. It may be related to the milk – a lower milk supply or letdown is common in the evening, but even that isn’t often a big deal.

Other things to consider – if the baby is moving down the percentile chart, it may just be the chart your pediatrician is using or just a regular slowdown that will later catch up at the next growth spurt.  If the baby is slowing down on diaper output (fewer BM diapers, for example), it may just be an age-related change.  And remember, birth-6 weeks is different than an older baby.

Please keep in mind that not all babies fit prescribed patterns – be safe and weigh your baby just in case, but personal experience indicates a two week old can go two days without pooping and be going UP the percentile chart. In fact, many knowledgeable moms indicate during a growth spurt that BMs slow down during a growth spurt because the baby is using the milk more efficiently. I would love to find actual research on this (or ask one of our contributors, the Lactation Chic at Holistic Mothering), but it fits my personal experience.

Here is another article on our site with useful information on newborn weight gain and stooling.

In general, there is a wide range of normal for poopy diapers for breastfed babies.  And, in general, there is a wide range of normal for breastfed baby behavior.  In fact, check out AlphaParent’s Timeline of a Breastfed Baby to ease your mind. Or, buy Breastfeeding Made Simple, a seriously easy, basic read on breastfeeding without all the complicated rules.

However, a combination of these things may indicate a low milk supply. If your baby is increasingly fussing at the breast, feeds for a long time (past the first few weeks, and for more days than an average growth spurt), has low diaper output, and is going down the percentile chart, then you might want to consider trying to increase your milk supply (and/or supplement either permanently or while trying to boost your supply).

So what can you do? What are the myths and what actually works? Later, we will be going over (or, er, linking a lot to the above sources) combo feeding/supplementing, pumping/nursing tips, prescriptions, and galactagogues.

For more discussion on low milk supply, check out http://www.lowmilksupply.org/ and the Breastfeeding with Low Supply forums.

If you have a medical issue (ex: Breast Hypoplasia/Insufficient Glandular Tissue) check out this podcast.