Pumping Log: new guidelines for washing pump parts

According to the CDC’s new guidelines, here is how best to care for your pump parts:

  • Wash your hands before using your pump, and use disinfectant wipes to clean the outside of your pump.
  • After every use, take apart the pump parts and rinse them under running water. Don’t put them directly in the sink!
  • Clean your pump parts as soon as possible with hot, soapy water in a wash basin and brush used only for cleaning pump parts, or in the dishwasher.
  • Rinse in fresh water (don’t put them back in the same basin).
  • Air dry on a clean dish towel, but don’t rub the parts with the towel as this could spread germs.
  • Rinse your basin and brush, and leave them to air dry. Clean them as well at least every few days.
  • If you’re using the dishwasher, place on a hot water and heated drying cycle, or a sanitize cycle. Wash your hands before taking out the parts, and allow them to air dry.
  • Store items in a clean, protected area only after they’re completely dry.
  1. For the full article, click here.

Pumping Log: Medications and Breast Milk Supply

Ugh. Remember my last post about my horrible eye allergy? The doctor put me on steroid eye drops for a week. I looked up the medication the Hale’s book of medications and breastfeeding. Little had been studied in the drug and lactation, but the risk of it passing into my milk was in the safe zone. I never take a risk with eyes, so I diligently took the drops the prescribed 3x per day. But oooooooooh how it impacted my milk supply!!! If you’ve followed my blog, I was doing great Pumping. And average of 12-19 ounces during an 8 hour shift. With these eye drops on board, my supply dropped to barely 1-3 ounces per pump session for a total of 8 ounces of less per day. I was freaking out to say the least.

Two pump sessions worth in the middle of my eye drop treatment. ūüėϬ†Only four ounces total.

I added in two extra pump sessions, one before work and one before bed, to give us a little extra umph and getting us to around 12 ounces for while I was gone at work. Herbs, teas, and cookies were not going to do much if anything because this was being caused by a medication messing at a hormonal level. Pumping was my only hope to get through that week. Fortunately my daughter is on solids and is a champion eater. We just made sure to give her extra foods at meal times and she was waking at night more frequently to nurse. Normally I try not to nurse her at night, but this was an important exception. I was also fortunate to have a four day weekend and I just let her nurse on demand.

This is an entire days worth of pumping. Less than eight ounces for the day.

Two days after the drops were done, my supply came back. The take away is this: if you’re on medications that are altering your supply or if you suddenly notice a change in milk supply and are trying to figure out what changed while trying to breastfeed, don’t give up. Keep pumping and add extra pumps if you need to. If your baby is under six months or not on solid foods, you may need to supplement or nurse more frequently during the night until your supply increases or returns to normal.

First pump of the day today and pumping is back to my normal volume!!!

 

Fact of the Day: Fenugreek and lactation

Fenugreek is one of the most commonly used galactogogues (supplements taken that are known to increase milk production). Fenugreek seeds (per 100 g) are rich sources of protein (46% of DV), dietary fibre (98% DV), B vitamins, iron (186% DV) and several other dietary minerals. The flavorful herb may be found in many Indian, Persian, Turkish, and Egyptian dishes. It is often the key ingredient in mother’s milk teas and lactation bars. Most mothers typically notice an increase in production 24-72 hours after starting the herb, but it can take two weeks for others to see a change. Some mothers do not see a change in milk production when taking fenugreek.¬†Dosages of less than 3500 mg per DAY have been reported to produce no effect in many women. Interestingly enough, it’s been said if you want to know if you‚Äôre taking the correct dosage, you’re supposed to slowly increase the amount of fenugreek until your sweat and urine begin to smell like maple syrup. Got pancakes?

However, like any herb or supplement, be aware of what you are injesting. Some people are allergic to fenugreek, specifically people who have peanut allergy and chickpea allergy may have a reaction to fenugreek. Fenugreek seeds can cause diarrhea, dyspepsia, abdominal distention, flatulence, perspiration, and a maple-like smell to urine or breast milk. There is a risk of hypoglycemia particularly in people with diabetes; it may also interfere with the activity of anti-diabetic drugs. It may interfere with the activity and dosing of anticoagulants and antiplatelet drugs. You should not take it if you are pregnant as it may affect uterine contractions and may be unsafe for women with hormone-sensitive cancers. In summary, those with thyroid, blood sugar issues (such as diabetes), peanut allergies and those taking certain blood clotting medications should avoid fenugreek.

 

References:

Kellymom.com

[Bingel 1991] Bingel AS, Farnsworth NR. Higher plants as potential sources of galactagogues, in Wagner H, Farnsworth NR, eds. Economic and Medicinal Plant Research, Volume 6, Academic Press Ltd, New York, 1994: 1-54.
[Brinker 1998] Brinker F. Herb Contradictions and Drug Interactions. Sandy, OR: Eclectic Medical Publications, 1998, 70‚Äď1.
[Dugue 1993] Dugue P, Bel J, Figueredo M. Fenugreek causing a new type of occupational asthma. Presse Med 1993 May 29;22(19):922.
[Hale 2002] Hale T. Medications and Mothers’ Milk, 10th Edition. Pharmasoft Medical Publishing, 2002, p.277-279.
[Heller] Heller L. Fenugreek: A Noteworthy Hypoglycemic
[Huggins] Huggins KE. Fenugreek: One Remedy for Low Milk Production.
[Korman 2001] Korman SH, Cohen E, Preminger A. Pseudo-maple syrup urine disease due to maternal prenatal ingestion of fenugreek. J Paediatr Child Health 2001 Aug;37(4):403-4.
[McGuffin 1997] McGuffin M., Hobbs C, Upton R, Goldberg A. American Herbal Product Association’s Botanical Safety Handbook. Boca Raton: CRC Press, 1997.
[Ody 1999] Ody P. Herbs to Avoid During Pregnancy from Herbs for a Healthy Pregnancy. Los Angeles, Calif: Keats; 1999.
[Ohnuma 1998] Ohnuma N, Yamaguchi E, Kawakami Y. Anaphylaxis to curry powder. Allergy 1998 Apr;53(4):452-4.
[Patil 1997] Patil SP, Niphadkar PV, Bapat MM. Allergy to fenugreek (Trigonella foenum graecum). Ann Allergy Asthma Immunol 1997 Mar;78(3):297-300.
[Reeder 2011] Reeder C, Legrand A, O’Conner-Von S. The Effect of Fenugreek on Milk Production and Prolactin Levels in Mothers of Premature Infants. J Human Lactation 2011;27(1):74. Abstract only.
[Rice] Rice LA. Fenugreek, in Herbal Supplements in Pregnancy
[Swafford 2000] Swafford S, Berens B. Effect of fenugreek on breast milk production. ABM News and Views 2000;6(3): Annual meeting abstracts Sept 11-13, 2000

 

Nipples; bits of tits.

These crocheted boobs were made by my coworker for my community breastfeeding classes!!!

Let’s talk honestly about nipples for a minute. Most basic breast-feeding classes talk about anatomy of the breast. They may touch briefly on anatomy of the nipple, but I don’t feel like it’s enough for us to fully understand the amazingness that is our nipples. In the anatomy of women, a nipple, mammary papilla or teat is a small projection of skin containing the outlets for 4-18 lactiferous ducts. The average woman has 9 of these ducts. They come in all shapes and sizes, but the average projection and size of human female nipples is slightly more than 3/8 of an inch (10mm) or the equivalent of about 5 stacked American quarters. Pregnancy and nursing tend to increase nipple size, sometimes permanently. Nipples are made of erection tissue.

They are actually made of the same erection tissue as the penis. It is why when these are stimulated by either a sexual partner or a baby, they perked up or erect. When nipples are stimulated, they send messages to the brain to release oxytocin, the cuddle hormone. This hormone is what makes you to feel all tingly, warm, secure, and in love with your spouse. But oxytocin released during breastfeeding is actually what causes your letdown reflex to happen. It’s basically what causes your milk to flow. As your newborn is stimulating your nipple, it sends a message to the brain “hey there’s a baby here! Send milk!” The brain then releases oxytocin which causes your letdown reflex to happen. It’s while your let down happens usually 1 to 2 minutes after your baby starts suckling at the breast. Erection tissue is never meant to bleed, crack, or scab.

Could you ever picture your husband letting you touch his penis if there was cracking, bleeding, or scabbing? And yet when new moms breast-feed, there is the stereotype that this is just a normal part of the breast-feeding process. Cracked, bleeding, and scabs nipples are caused by an incorrect latch of the baby or some other anatomical or physiological difference, such as a tongue or lip tie or an immature sucking pattern. Nipples were never designed to endure what so many women tolerate as “normal”. If you are experiencing any pain, cracking, or bleeding of your nipples during breast-feeding, please see me or another lactation consultant in your area as soon as possible. Let us help you correct the latch or look for a tongue tie that would be causing those problems. You deserve a pain-free, happy nipple breast-feeding story! Please also help stop the stereotype that it is OK for women to endure this. It is totally OK to experience initial discomfort when breast-feeding. Your nipples are not used to that kind of sensation at that frequency. But pinching or stabbing pain is never normal at any stage of breastfeeding.

Make mine a double! Caffeine and breastfeeding

This picture kinda reminds me of “the girls”… if you know what I mean…

“I’d like a skinny vanilla latt√©, extra foam extra whip cream!!” One of the first questions I get from a lot of nursing moms is, “when can I drink coffee again?!?” Some doctors don’t have a problem if moms drink one a ounce cup of coffee throughout the entirety of the pregnancy. Other moms because of risk factors are told not to have any until after the babies born. Whether you have coffee or not during your pregnancy, there are a few things to know before introducing it after your baby is born. The first is that it affects infants differently than adults. The following chart was taken from Kelly mom.com. It shows the half-life of caffeine in the bloodstream. I was surprised that Caffeine will stay in the bloodstream of the brand newborn for an average of up to five days!

Their sensitivity to caffeine decreases as they age. Signs of sensitivity are hyperactivity, difficulty sleeping or sleeping for long periods of time, jitteriness, irritability, and fussiness. If you drink coffee during your pregnancy, you might not see as much of an impact on activity levels in your baby if you continue to drink after birth. However if you have stained from college and your pregnancy, you may notice changes in your baby. Per Medications and Mother‚Äôs Milk (Hale 2017, p. 139-140) caffeine is in Lactation Risk Category L2 (safer); milk levels are quite low (0.06-1.5% of maternal dose) and usually peak 1-2 hours after ingestion. The American Academy of Pediatrics has classified caffeine as a ‚ÄúMaternal Medication Usually Compatible with Breastfeeding.‚ÄĚ If you’re iron deficient or iron deficiency rubs in your family, be extra careful. One study indicated that chronic coffee drinking might decrease iron content of breastmilk (Nehlig & Debry, 1994). We actually routinely give caffeine directly to premature babies in our neonatal unit for lung stimulation!

Remember caffeine isn’t just in coffee! Tea, soft drinks, sports/energy drinks (including the ‚Äúsports water‚ÄĚ products), some over-the-counter and prescription medications, and foods containing coffee or chocolate can also have caffeine!! I can’t have Haagen Daz coffee ice cream late at night because it keeps me up!!! Herbal products containing guarana/paullinea cupana, kola nut/cola nitida, yerba mat√©, or green tea also contain caffeine. Each food and liquid has varying amounts of caffeine. Different roasts of coffee and the way that the coffee is made also impacts caffeine level. Make sure to check the caffeine level you’re ingesting by serving size to see how much you’re getting!! According to Breastfeeding Answers Made Simple (Hale Publishing 2010, p. 521), excessive caffeine consumption by the mother (more than 750 mg per day) can result in a baby who shows signs of caffeine stimulation.

I typically recommend no more than one 8-ounce cup of coffee a day for nursing mothers (but as a note!! An 8-ounce Starbucks coffee has 250mg of caffeine while a non-gourmet brewed 8-ounce cup of coffee only has 120-160mg of caffeine!!!!!!) The important thing is to know your body and know your baby. Be informed of what you are putting into your body and what is going into your baby. Watch for how your baby reacts to that 1st cup of coffee and if you need to, cut out coffee for a little while longer or switch to decaf.

I personally have my one cup of Costa Rican drip coffee with almond milk every morning. If I’m really lucky, my husband will make me an Italian latte before I leave for work. I can only have one cup. The few times I’ve had a 2nd cup early afternoon, I am up all night. So far my daughter has never had a reaction to coffee. Although, I drink a cup of coffee through most of my pregnancy with the blessing of my midwife. As with anything you consume, if you have any concerns talk to your primary care physician or your pediatrician. You may still want to avoid the Unicorn Frap…

Product review

It finally came!! My Mrs. Patel’s mothers milk tea!!! I’ve used the grocery store brand but it didn’t really seem to have a big impact on my supply. In researching teas, I came across this brand. They’re Milk Water tea comes in two tasty flavors : herbal and Chai. The Chai has an amazing sweet taste and when I drink a cup consistently at night I do see an increase in milk the next morning. I just got the herbal blend and am so excited to try it!!! Check out the website here. Take note, the shipping is expensive, so if you have a friend or two who are also nursing it will help distribute the shipping costs.

 

Growth charts

Did you know that breast-fed babies and formula fed babies have different growth charts? Breast-fed babies tend to be leaner and gain weight at a slower rate than artificially¬†fed babies. Make sure your pediatrician uses the correct growth chart when weighing and measuring your little one. Many a well meaning pediatrician has inadvertently recommended supplementation to exclusively breast-fed babies bexcuse they’re using the CDC growth chart which was standardized on formula fed babies.¬†In 2006, the World Health Organization released revised growth charts that are representative of healthy breastfed babies throughout the world. Until our doctors are familiar with them, we need to keep ourselves informed so that doctors don‚Äôt undermine our confidence to breastfeed our babies.

Healthy breastfed infants tend to grow more rapidly than their formula-fed peers in the first 2-3 months of life and less rapidly from 3 to 12 months. All growth charts available before 2006 (which are still used by many health care providers in the US) included data from infants who were not exclusively breastfed for the first 6 months (includes infants fed artificial baby milk, AKA formula, and those starting solids before the recommended 6 months. The American Academy of Pediatrics revised their ¬†guidelines on introducing solids for parents to wait until 6 months. A lot of. pediatricians will push to start solids at 4 months because they’re not current on the latest guidelines). Since¬†many doctors are not aware of this difference in growth, they see the baby dropping in percentiles on the growth chart and often jump¬†to the wrong¬†conclusion that the baby is not growing adequately. At this point they often unnecessarily recommend that the mother supplement with formula or solids, and sometimes recommend that they stop breastfeeding altogether. This is often a cause of unneeded stress. Next time you’re at your peds office, ask which chart they’re using. For more information on growth charts, see kellymom.com

Make it a double

They say you can’t over feed a breast fed baby. They’re usually pretty good about taking what they need and stopping when they’re full. This is because of stomach and breast anatomy. Remember how sucking and milk flow rate at the breast are different than the bottle? This directly links to stomach anatomy.

There are two kinds of receptors in the stomach: density and stretch. Density receptors tell you how calorically dense or fat-rich your food is. It’s why at the Cheesecake Factory your belly starts to feel really full after about ten bites of Godiva chocolate Cheesecake but you can eat 3 bags of popcorn at the theater. Chocolate is much richer and calorically denser than popcorn. Stretch receptors tell you how full your stomach is from a volume perspective. Your stomach at rest is on average the size of your fist. That’s true throughout your entire life. But the stomach can stretch. Just like my stretchy pants at Thanksgiving. It can still only fill to a certain capacity. The only problem is, it takes approximately 20 minutes for your stretch receptors to tell your brain that the stomach had stretched to capacity. This is what I call the twenty minute phenomenon. You know, when a group of college boys order a pizza, they each eat a whole pizza in ten minutes and then twenty minutes later feel over full and sick. They as much as they could as fast as they could but paid for it in the twenty minute window. Exclusively breast fed babies don’t typically over eat because again, breast milk flow varies over a feeding. It starts slow, mommy goes into let down, then milk shows, mommy changes the baby to the other side, milk starts slow, mommy goes into let down, 15-20 minutes later the baby’s stomach tells the brain it’s full and the baby stops eating. Anatomy and physiology in perfect harmony.

Unfortunately bottle fed can be over fed. Bottles have these lovely ounce markers on them that tell us how much the baby needs to eat to be full. At every feeding my baby NEEDS to get a full 5 ounces of she will be hungry. She NEEDS to eat 24 ounces in a day or she will starve to death. And when baby stops eating at 3.5 ounces, I just jiggle the bottle or wait a few minutes and jiggle the bottle until baby takes that full feeding. Jiggle, wiggle, look at that she took the full feeding. Instead of listen to baby’s cuts that she’s full, we let the bottle dictate how much baby needs. And we wonder why formula feed babies have a significantly higher rate of obesity. Here’s the thing. Bottles are not the enemy. My daughter takes breast milk from a bottle five days a week while I’m at work. They are lovely devices that do an essential job. But we need to be mindful to not over feed our bottle fed babies.

Tips to not over feed a bottle fed baby (regardless of what’s in the bottle)

1. Always use a show flow nipple until 1 year of age. Slow flow most closely mimicks the flow at the breast. It also shows a baby down so the brain can keep up with the stomach (aka be mindful of those stretch receptors).

2. Watch your baby’s cues. Does he push the bottle away? Did he become sleepy? Do his hands and body relax? Does he release his iron grip on the nipple? These are signs he’s done. Over fed babies tend to spit up or vomit more because their tummies are at capacity. Don’t try to force in that last half an ounce. Respect your baby and stop feeding. Your baby will let you know if he’s still hungry.

3. In reality, babies only ever need 3-5 ounces of milk per feeding. In the first four to six months when your baby isn’t eating any solids, here’s a simple rule of thumb: Offer 2.5 ounces of formula per pound of body weight each day. For example, if your baby weighs 6 pounds, you’ll give her about 15 ounces of formula in a 24-hour period. Once a baby is six months of age and starting solid foods, offer the breast or bottle first (3-5 ounces), then offer well balanced, nutritious, solids. The solids will provide them the additional nutrition they need. (**Disclaimer : if your baby is not ready for solids at six months, that’s FINE. Your baby is ready to start solids when they can sit unsupported for a good amount of time, uses a pintcher grasp, and has the hand eye coordination of hand to mouth. If your baby is over six months and not taking solids, your baby may need additional milk per feeding.)

4. It is OK for volumes of feedings to be didn’t throughout the day. We take for granted that babies can know their bodies. They can tell us when they’re hungry and when they’re full. Sometimes I’m really hungry in the morning and I eat a Grand Slam breakfast. Other times I only want a piece of toast. It’s OK to have your baby eat a ton one meal and very little the next. Remember, there are no ounce markers on the breast. Exclusively breast fed babies do this all the time. And there’s no amount of nipple jigging that will get them to take more in a feeding.

Here’s the big take away: it’s OK to take the pressure off feeding, especially if your a working mom trying to keep up with pumping. As long as your baby is following their growth curve, making enough wet and dirty diapers, and happy, keep doing what you’re doing. If your baby is not getting enough nutrition, not gaining weight, or unhappy, please have your pediatrician write a referral to a pediatric clinic ASAP or give me a call and we can dialogue through a plan of action.

Happy feeding!!

Tongue Tie and Breastfeeding

Tongue tie, technically known as ankyloglossia,¬†is¬†a condition present at birth that affects an estimated 2-5% of all babies born. It is¬†characterized by a short, thickened, or abnormally tight lingual frenulum, which¬†is the tissue that connects the tongue to the floor of the mouth. Depending on the severity of the tongue tie, range of motion of the tongue can be restricted. In very severe cases, the tip of the tongue can appear to be heart shaped.¬†Because of this anatomical difference,¬†sometimes tongue tied babies can‚Äôt maintain a latch for long enough to take in a full feeding. Others may appear to breastfeed for long periods of time without actually¬†be effectively transferring¬†milk. Some tongue tied babies will successfully breastfeed only during ‚Äúlet-down‚ÄĚ, when the milk flows on its own from the breast into the babies’ mouths, but won‚Äôt¬†be able to actively express¬†milk out of the breast on their own. Many babies with tongue tie also have a lip tie, an abnormally tight membrane attaching their upper lip to their upper gums. This¬†can be seen by rolling the upper lip upward.¬†Babies with lip tie often have difficulty flanging their lips properly to feed which impacts their ability to latch well. This can cause them to take in excess air during breastfeeding which often makes these babies gassy and fussy.

While many pediatricians do not see tongue tie as an issue, current research and literature suggests that it can have a significant impact on breastfeeding. However, the American Academy of Pediatrics, among others, have documented the negative effects of tongue tie on breastfeeding. The most common complaint of mothers with tongue tied babies is sore nipples, which is due to poor latch and inefficient sucking. Other breastfeeding problems for the mother can include recurrent plugged ducts, mastitis or thrush, vasospasm, and supply difficulties. Babies with tongue ties typically have difficulty latching, make click sounds while nursing, may be gassy and fussy during feedings, and have slow weight gain despite having mothers who use correct positioning and nurse frequently.

Some babies with very short or thick lingual frenulums are able to compensate well and breastfeed without difficulty. Tongue tie needs to be diagnosed by function and not just appearance, so what the baby’s tongue looks like is not as important than what it can do. According to one study, simple inspection of a tongue-tie is not enough to determine which infants will need medical intervention. However skilled professionals will complete a clinical assessment which includes observation and measurement of the effectiveness of feeding to help determine appropriate action to improve breastfeeding skills. This is not a comprehensive list for tongue function, but it may give you an idea for why your baby is having breastfeeding difficulties:

  • Does the tongue elevate? When the baby cries¬†the front edge of the tongue should come up at least as high as the corners of the baby‚Äôs mouth.
  • Does the tongue extend? The baby’s tongue should be able to protrude or stick out at least past the lower gum¬† if not to the border of the lower lip
  • Does the tongue lateralize, or move side to side? Tracing the baby’s bottom gums triggers a reflex for the tongue to follow the finger..
  • The baby‚Äôs tongue should be able to lift towards the roof of the mouth and touch behind where the upper teeth will come in. Is there¬†a membrane there¬†that prevents the tongue from lifting? When very tight from tension, the membrane may appear white.

If it is determined that the tongue tie is indeed the culprit for breastfeeding difficulties, some pediatricians, ENTs and dentists can perform a frenotomy or frenectomy. This is a quick procedure to cut the frenulum which returns the full range of motion of the tongue and upper lip. Specialized scissors may be use to simply cut the tongue or lip tie. Some prefer to use lasers, which have the benefit of minimizing the amount of bleeding during and after the procedure and decrease the chance that the frenulum will grow back. Many practitioners use a local topical anesthetic to numb the area before the procedure and some use an injection of anesthetic as well. Babies can breastfeed as soon as the procedure is done. Post-procedure care should be done to minimize the frenulum from growing back. Current research shows this is a safe, easy procedure with minimal risk to the baby. The majority of mothers notice an immediate difference in breastfeeding effectiveness and a significant reduction in nipple pain.

When should the frenotomy be done? Current research shown between 2-6 days after birth to establish proper breastfeeding patterns. This same study showed that waiting more than four weeks for frenotomy drastically increased the likelihood that mothers would abandon breastfeeding all together.

If you suspect your baby has a tongue or lip tie, set up a consultation for a full assessment of your baby’s oral motor skills.

For more resources and articles, see Breastfeeding a Baby with Tongue-Tie or Lip-Tie at kellymom.com

  1. Lalakea, M. Lauren; Messner, Anna H. (2002). “Frenotomy and frenuloplasty: If, when, and how”. Operative Techniques in Otolaryngology-Head and Neck Surgery. 13: 93. doi:10.1053/otot.2002.32157.¬†
  2. Wallace, Helen; Clarke, Susan (2006). “Tongue tie division in infants with breast feeding difficulties”. International journal of pediatric otorhinolaryngology. 70 (7): 1257‚Äď61. doi:10.1016/j.ijporl.2006.01.004. PMID¬†16527363.
  3. ¬†Emond A1, Ingram J, Johnson D, Blair P, Whitelaw A, Copeland M, Sutcliffe A. “Randomized controlled trial of early frenotomy in breastfed infants with mild to moderate tongue-tie.” Arch Dis Child Fetal Neonatal Ed. 2014 May;99(3):F189-95.
  4. Jack Donati-Bourne, Zainab Batool, Charles Hendrickse, Douglas Bowley “Tongue-Tie Assessment and Division:¬†A Time-Critical¬†Intervention to Optimise Breastfeeding/”¬†Journal of Neonatal Surgery 2015; 4(1):3
  5.  Jain E. Tongue-tie: its impact on breastfeeding. AARN News Lett.1995;51 :18
  6. Huggins K. Ankyloglossia: one lactation consultant‚Äôs personal experience. J Hum Lact.1990;6 :123‚Äď 124
  7. Messner, Anna H.; Lalakea, M. Lauren; Aby, Janelle; Macmahon, James; Bair, Ellen (2000). “Ankyloglossia: Incidence and associated feeding difficulties”. Archives of otolaryngology‚ÄĒhead & neck surgery. 126 (1): 36‚Äď9. doi:10.1001/archotol.126.1.36. PMID¬†10628708.¬†
  8. Tongue Tie – What Do Parents Need To Know? Submitted by jessicabarton on
  9. ¬†Rosegger H, Rollett HR, Arrunategui M. [Routine examination of the mature newborn infant. Incidence of frequent ‚Äúminor findings‚ÄĚ]. Wien Klin Wochenschr.1990;102 :294‚Äď 299

Food for Thought

How long should I breastfeed my baby?

The American Academy of Pediatrics recommends that babies be EXCLUSIVELY breastfed for about the first six months of life. This means that your baby needs no additional food (except Vitamin D) or fluids unless medically necessary. Babies should continue to breastfeed for one to two years or for as long as is mutually desired by the mother and baby.

When should I start solid foods with my baby?

How do you know when your baby is ready for solid food? After six months of age, they should be able to do these three things:

  1. They sit unsupported for an extended length of time
  2. They are starting to use a pincher grasp (thumb and forefinger together to grab little objects)
  3. They start to have eye-hand coordination to bring their hands to their mouth