The rooting reflex

The rooting reflex (RR) is a fascinating developmental milestone that begins even before birth and continues to evolve during infancy. RR is an automatic response in newborns characterized by turning their head toward a touch on their cheek or mouth. When you stroke or touch your baby's cheek or the corner of their mouth, they will instinctively turn their head in that direction, open their mouth, and make sucking motions. By turning towards a

touch, babies instinctively position themselves to find their food source and initiate feeding

The RR starts to develop in utero, typically around the 32nd week of pregnancy. During this time, baby's neurological and sensory systems are maturing rapidly. Once baby is born, the rooting reflex becomes more pronounced and functional. Immediately after birth, and often during the first few weeks of life, you can observe your baby's natural response to touch on their cheek or around their mouth. It’s a reflex, so this is also why they will try to root and latch to dad’s nose or even to grandma’s chest.

The RR is at its strongest during the newborn phase, the first 0-3 months. Babies rely heavily on this reflex to initiate feeding, whether at the breast or with a bottle. As baby's neurological system continues to mature, the rooting reflex gradually integrates with other feeding skills. By around 4 to 6 months of age, babies start to gain more head control and may rely less on the rooting reflex for feeding.

You can actively support baby's RR by:

- Positioning baby close during feeding. Their chin and cheeks should be physical touching your breast and your fingers can touch their cheeks during bottle feeding

- Let baby lay on both of their sides during tummy time, not just on their belly. As the floor triggers the reflex, it helps not only integrate it, but also will eventually help with rolling over and finding toys

- Being responsive to your baby's cues and feeding needs, especially during the early weeks and months.

Have you noticed the rooting reflex in your baby? Share your experiences and insights in the comments below! 💬🍼 #RootingReflex #NewbornDevelopment #ParentingJourney

”Feeding Advice”

Feeding “advice” we would never tell an adult:

⌚️It hasn’t been 3 hours yet. You can’t possibly be hungry again

⏱It hasn’t been 3 hours yet. You can’t possibly be thirsty again.

🧊You need to drink all 64oz of your daily water intake in 4 equally portioned cups. If you can’t drink 16 ounces in one sitting, something is wrong with you.

🍽Clean plate club. Finish everything on your plate regardless of how full your stomach feels.

🍏Eat food purely for their nutritional value. 🍦Never have food simply for the comfort or enjoyment of it.

🔦Eat alone in a dark room and never with anyone else

💡How could you get so distracted while eating? Focus and pay attention.

🪑Eat until you’re done then leave the table immediately. Don’t hang out at the table for longer than needed.

🛌Never eat a bed time snack

🛏Wake up in the middle of the night thirsty? Too bad. Go back to bed you can have some water in the morning

⏰You have 15 minutes to eat. Tic toc. When the clock hits 15 you need to stop whether you’re done or not

🍴3 meals, 2 snacks. That’s it. 7, 9, 12, 3 and 5. Hungry or thirsty at a different time? Here’s a pen cap to chew on

🍔There’s only one way to eat and if you don’t eat like me and my family you’re doing it wrong


Do you get where I’m going here? Too often we analyze the science of breastfeeding instead of considering the art of feeding and eating. We try to make a literal formula for how our baby should eat when some times we have to appreciate feeding for what it is: an enjoyable and pleasurable sensory experience that is social and includes more than just calorie intake.

 

Baby wearing and Tummy Time

IMG_2355

I love babywearing!! Humans are carry mammals and there are so many benefits to baby wearing! Baby wearing is great for bonding and convenience. Being held close to a caregiver’s body can help regulate a baby’s physiological systems, such as heart rate, temperature, and breathing. This can contribute to overall health and well-being. It also provides opportunities for baby to lift their head and neck and rotate them from side to side. It’s also one of the first tummy time activities we can do starting at birth! Laying flat on your back and having your newborn on their tummy is baby wearing at its most basic and a great place to start promoting tummy time. BUT babywearing (in a carrier or with a wrap or sling) is not a substitute for tummy time. It should be used to COMPLIMENT it. Both activities offer distinct benefits for your baby’s development. Tummy time helps strengthen the muscles in a baby’s neck, shoulders, arms, and back. This is crucial for achieving milestones such as lifting the head, rolling over, crawling, and eventually walking. It allows free movement of all of the major muscle groups as well as opportunities to move against gravity. While baby wearing, the trunk and shoulders are relatively supported and doesn’t allow baby to engage those muscles for strengthening. Being on their tummy allows babies to explore their surroundings from a different perspective. They can practice reaching and grasping objects, which enhances their visual and sensory development. On the other hand, baby wearing provides comfort and closeness, promoting emotional security and allowing caregivers to multitask while keeping baby content. It’s also a great way to help baby sleep longer in a contact nap!!

While baby wearing and tummy time offer unique benefits, they are not mutually exclusive. In fact, they complement each other in promoting a well-rounded approach to infant development.

#tummytime #tummytimeactivities #babywearing #babywrap #babywrapping #babywraps #babysling #skintoskinbaby


Let's delve into the distinct benefits of baby wearing and tummy time for infants:

**Benefits of Baby Wearing:**

1. **Bonding and Attachment:** Baby wearing fosters a strong bond between the caregiver and the baby. The close physical contact promotes feelings of security and comfort, which are crucial for emotional development.

2. **Convenience:** Carrying a baby in a carrier or wrap allows caregivers to have their hands free for other tasks while keeping the baby close. This can be especially helpful for parents who need to move around or engage in activities throughout the day.

3. **Regulation of Body Systems:**

4. **Observational Learning:** Babies in carriers are often at adult eye level, which can enhance their cognitive development through observing and interacting with the world around them.

**Benefits of Tummy Time:**

1. **Development of Motor Skills:** Tummy time helps strengthen the muscles in a baby's neck, shoulders, arms, and back. This is crucial for achieving milestones such as lifting the head, rolling over, crawling, and eventually walking.

2. **Prevention of Flat Head Syndrome:** Regular tummy time reduces the risk of flat spots developing on a baby's head, which can occur when they spend too much time on their backs.

3. **Visual and Sensory Stimulation:** Being on their tummy allows babies to explore their surroundings from a different perspective. They can practice reaching and grasping objects, which enhances their visual and sensory development.

4. **Encouragement of Independence:** Tummy time encourages babies to start exploring their own body movements and space, which is essential for developing independence and confidence.

**Complementary Relationship:**

While baby wearing and tummy time offer unique benefits, they are not mutually exclusive. In fact, they complement each other in promoting a well-rounded approach to infant development:

Muscle Development: Tummy time strengthens specific muscle groups needed for crawling and overall physical development. Baby wearing, meanwhile, supports muscle tone and posture by providing a secure and ergonomic position.

Emotional Bonding: Both activities promote emotional bonding and security, albeit in different ways. Baby wearing satisfies a baby's need for closeness and comfort, while tummy time encourages independence and exploration within a safe environment.

Variety of Stimulation: Alternating between baby wearing and tummy time exposes infants to diverse sensory and motor experiences, which are essential for holistic development.

In summary, incorporating both baby wearing and tummy time into a baby's routine ensures comprehensive support for their physical, emotional, and cognitive development. Each activity offers unique advantages that contribute to a well-rounded and enriched infancy.

Nursing aversions and breastfeeding strikes

NURSING AVERSION

My baby won’t take the breast and is completely refusing to eat. What do I do? I see cases like these occasionally and I feel like they’re some of my most challenging (and most rewarding) cases. If your infant under 6 months is displaying aversion to feeding, we need to figure out why. Aversion to feeding means screaming or crying when even offered the breast, taking very little from the breast, refusing to eat, or needing to be fed while moving or while drowsy/asleep. This is not a temporary nursing strike where baby refuses the breast/bottle for a few days because of periods returning, mom going back to work, teething, or illness, etc. A nursing strike that isn’t managed well can turn into a feeding aversion, though. The behaviors seen in baby are much more extreme for a true aversion. Here is my list of the most common culprits to a true breast aversion in order of most common cause in my experience.

👅Tongue tie/oral motor: Is there a visible tongue or lip tie? One of my biggest red flags for tongue tie is reflux and shutting down during breastfeeding (sleepy baby on the breast, popping on and off, refusing the breast and preferring the bottle but then shutting down on the bottle). Some babies with tongue or lip tie do fine for the first few months as they’re compensating from a full milk supply. The aversion comes around 3-4 months when moms supply regulates and is dictated by the efficiency and responsibility of baby removing milk from the breast. If there is no tie, what’s the baby’s sucking pattern like? Do they have an immature or disorganized suck? How is their latch? Are they possibly taking in too much air with poor latch causing discomfort? Would a different bottle nipple shape or pacing be more appropriate? Do they struggle at the breast but take a bottle occasionally? Address the ties and do oral motor exercises to strengthen and coordinate the system and the refusal goes away.

🥛Intolerances/Allergy: This can look similar to reflux, but there is often a component of bowel issues involved as well (constipation with uncomfortable bowel movements, diarrhea, or mucousy/foamy poops). Look for patterns with formula changes- sometimes parents will say one formula works better than another, and if we look at the formula ingredients we might understand which ingredients baby is sensitive to. Babies who’s digestive tracts are uncomfortable don’t want to eat. They learn really quickly to associate feeding with pain, so they shut down on feeding. Finding the allergens clears the gut and makes feeding pleasant again.

🤮Reflux: Easiest culprit to blame and mask with medication. To be honest, putting baby on reflux meds rarely makes a difference. The medication may mask the pain but won’t actually take the reflux away. Don’t get me wrong, for some babies it can make a big difference, but let’s get to the root of the reflux. And medications should always be a last resort. Is the baby spitting up (doesn’t always happen with reflux)? Is there pain associated with the spit up? Is it projectile and frequent? Does the refusal stop once the bottle is removed or are there signs of discomfort even after the bottle is removed? Wanting small, frequent feedings is my classic tell tale of reflux. Continually swallowing helps keep acid in the stomach and reduces the pain. True reflux is usually caused by food allergy/intolerance, gut issues, or tongue tie. Address the issue, resolve the reflux.

🥵Aspiration: Milk going into the lungs instead of to the stomach. Is the baby stressed during feeding? Do their nostrils flare and their body get stiff or arch? Do the cough and choke throughout the feeding and not just during let down? Do they have noising breathing or feeding? Do you need to be super careful with position change/flow rate changes? Do they have a respiratory history (not just pneumonia- does the baby take long periods to get over any illness)? Further assessment by a speech pathologist is always needed.

🤯Behavioral: I’m not sure if “behavioral” is the correct word, but it’s the best way to describe it. The number one concern of parents is feeding the baby. When feeding isn’t going well, it causes extreme stress, which can cause us as parents to do extreme things to try to fix the problem. It’s easy to spiral out when you’ve tried everything and it’s not working out of stress and desperation (or not being able to figure out the why in the first place). Occasionally the reason for the refusal is not longer there, but it was so stressful in the moment, the panic that it could happen again sets in and perpetuates the problem unnecessarily. Some times the root issue is still there, but you’ve compensated and it’s causing a behavioral manifestation in both you and the baby. Are you just trying to push past baby’s stress signs due to your own stress with trying to get baby fed? Are you just trying a bunch of different things to see what works? Are you trying to feed based off of old information? You are just trying to do your best and are scared for baby, but sometimes the compensatory things we do can cause more problems or cause it to persist. Having an outside observer come in to help see what’s going on can help bring everyone back to baseline.

When trying to figure out which of these culprits is the cause of the aversion, know that you don’t have to figure it out alone. Finding a trained lactation consultant (🙋🏽‍♀️) can help ask the right questions to get to the root of the issue and get feeding back on track.

Why can’t I put my baby down to sleep?

SLEEP IN THE FOURTH TRIMESTER

I was going back through pictures when peach was a tiny baby. I have so many pictures of her sleeping on me. Babies don’t like to be put down, especially in the first 3-4 months. All their instincts and reflexes are designed to get them on a body. Their neurological system is immature at birth and still needs time to develop. Being on your body:

🧠 Accelerates Brain Development: Holding baby on your body increases the development of essential neural pathways, which accelerates brain maturation

🧘🏽‍♀️ Calms, Soothes & Reduces Stress: Having your baby on your body soothes baby so much that babies’ cortisol levels (stress hormone) are measurably lowered after only 20 minutes of being held skin to skin. Babies who are held cry less

🛌 Improves Quality of Sleep: Development of mature brain function in infants depends on the quality of their sleep cycling. During skin to skin, most infants fall asleep easier and achieve “Quiet Sleep” for longer

⚖️Stimulates Digestion & Weight Gain: Reduces cortisol and somatostatin in babies, allowing for better absorption and digestion of nutrients. With a reduction of these hormones, baby’s bodies preserve brown fat (the healthy fat baby was born with), helping to maintain birth weight and maintain body temperature. As a result, baby’s body does not have to burn its own fat stores to stay warm, leading to in better weight gain

💪🏻 Enhances Immune System: Your mature immune system passes antibodies through your skin to baby. Being on your skin also increases baby’s skin hydration

❤️Synchronizes Heart Rate + Breathing: You are a pace maker and a respirator. Your body sets the pace for baby’s body

🔑Promotes Psychological Well-Being: As our babies touch our skin, oxytocin levels rise and stress hormones fall, causing us adults to relax

🥛Milk production: Placing baby in skin to skin on your body for 1 hour a day will show an immediate increase in milk supply

🔥Regulation of Body Temperature: Woman’s breast tissue regulates a baby’s temperature, and can either cool OR heat, a man’s breast tissue only heats baby. Female is thermostat and male is radiator

Tandem breastfeeding

It’s common for a toddler, or an even older child, to ask to breastfeed after a new sibling is born. Toddlers who were weaned immediately before or during pregnancy may be especially curious. Many just want to know if you’ll say yes – or they may just want your attention or “babied” themselves. Continuing to breastfeed, or letting them try to breastfeed again after weaning, can ease the transition of gaining a sibling. They are less likely to be jealous of the baby who is always with mommy if they can nurse alongside them. Nursing your older child once the new baby arrives can reduce engorgement when colostrum transitions to mature milk and can protect milk production if your newborn is not feeding effectively. If you say yes to a weaned child, many will just touch, lick or kiss the nipple, some will have forgotten the mechanics of how to breastfeed and won’t have further interest. Others can successfully breastfeed again. If you are happy to nurse your toddler, go for it. If it is overwhelming, it is still your body and you get to decide when and for how long toddler is allowed to breastfeed. You may prefer nursing your baby and your toddler separately or together. Breastfeeding is normal and it is normal for children to be curious and want to breastfeed at 2, 3, or even 4 years old.

When you give birth your body will continue to produce colostrum, with milk becoming plentiful after around 3-5 days. As with your first baby, breastfeed at least 8-12 times per day to establish your milk supply. Some will feed their newborn baby first or encourage the older sibling to nurse less until breastfeeding has been well established to ensure the newborn has full access to breast milk. Look out for feeding cues and give your newborn unrestricted breast access to help ensure they get plenty of milk.

Some times if your toddler is breastfeeding frequently, they may lose interest in solid foods for a while from increased milk intake. They may have looser stools. This is normal and should regulate with time.

It can take a while before your body adapts to the needs of two different feeders. You may feel lopsided if one breast drains more than the other. Eventually things will even out and you’ll find your rhythm. Alternating breasts for each feed helps with development of newborn vision and keeps the size of your breasts balanced. However, some mums find that giving a toddler his ‘own side’ works for them.

You will not run out of milk, your body will make more to accommodate however many nurslings there are.

Vernix, delayed bathing, and breastfeeding

My little Peach right after birth

The vernix caseosa is a greasy, cheese-like coating that covers baby’s skin in the womb to protect their skin from getting pickled by amniotic fluid prior to birth. According to present knowledge, vernix production is unique to humans. At birth, vernix may cover the entire skin surface or only be found in body folds. Its color may actually help indicate intra-uterine problems or disease.

😳In utero: When swallowed by baby in utero, vernix helps:

• Develop the gut

• Prevents loss of electrolytes and fluids

• Seals the skin to prevent the amniotic fluid from turning baby into a raisin

• Acts as a microbial barrier from pathogens

• Protects skin growing underneath it

😳In birth: The oily texture may naturally lubricate the birth canal to reduce friction as baby makes their exit. It can also help with mother’s perineal healing!

😳 In postpartum:

• Vernix protects baby’s skin from drying out

• Reduced risk of bacterial infections

• Help baby retain heat

😳 In breastfeeding: The scent of vernix might be involved in triggering neural connections in babies’ brain needed for breastfeeding. The immune proteins found in vernix and amniotic fluid are similar to those found in breastmilk. Swallowing vernix and amniotic fluid in utero help coat baby’s lungs and digestive tract, preparing the digestive tract for the similar peptides found in breastmilk. The smell may also help baby find the breast!

The majority of the vernix is absorbed within the first day, so so it’s recommended to wait until after the first 24 hours to bathe baby. Vernix doesn’t fully absorb until day 5 or 6, so it’s best to wait until then.

Perspectives on breastfeeding

PERSPECTIVE

“My hospital nurse told me to feed baby every 2 hours with 15mL and my pediatrician told me to feed baby every 3 hours with 30mL.”

“My IBCLC told me there is a tongue tie but the ENT said there wasn’t one.”

“One consultant told me to use a nipple shield as lo as needed. The other said get off as quick as possible”

“They said don’t let baby feed more than 10 minutes per side, but my baby won’t stay latched that long.”

I hear this all the time in my practice and it can be confusing for families. Why did I get different advice from different people? Perspective. Doulas, midwives, pediatricians, even lactation consultants all come from their own training, education, clinical practice and personal experience. When in doubt, the best person to get lactation advice from is an IBCLC. They have had to go through extensive training and mentoring to become certified in the study of human lactation. But remember: even lactation consultants come from different perspectives.

A hospital based IBCLC typically only works with babies in the first 2-4 days after birth and may see dozens of babies in a week, getting only a short amount of time with each family. A private practice IBCLC may have more time to spend with you but experience and expertise may vary. An IBCLC who is also a nurse will approach breastfeeding differently than one who is also a feeding therapist or who started out as a mother who struggled to breastfeed and became passionate to help others going through what she went through. My best advice is find some one who listens to you, educates on why they want you to do something, and supports you in your journey. Because you have a unique perspective, too.

Lauren Archer, Love of a Little One doula, takes a picture of my midwife and newborn
This is the same image from Lauren’s perspective

Caffeine and Breast Milk

Caffeine is safe to take while breastfeeding in moderation (up to 300mg per day). Only about 1.5% actually enters breast milk. Caffeine enters your bloodstream about 15 minutes. It peaks in your blood within 60 minutes and has a half-life of 3-5 hours. The half-life is the time it takes for your body to eliminate half of the drug. The remaining caffeine can stay in your body for a long time. The half-life of caffeine is about 97.5 hours in a newborn, 14 hours in a 3-5 month old baby and 3-5 hours in a baby older than 6 months. Because caffeine takes much longer to clear out of a young baby’s system it is possible that high caffeine intake can make a baby irritable. If baby is sensitive to the caffeine now, they may not be when they’re older. Cut caffeine now and try again in a few months.

So if you drink a cup of coffee with 100mg of caffeine at 7am, you’ll have 50mg of caffeine in your bloodstream at 10am. Your baby would get 1.5mg of caffeine.

Every baby is different in how they react to caffeine. If you drank coffee while pregnant, your baby had an IV of caffeine (called the umbilical cord) and is already used to having it in their blood stream. If you didn’t drink coffee or switched to decaf, your baby may have a more noticeable reaction when you drink coffee. When drinking coffee after birth, go low and slow. There’s nothing you can do to decrease caffeine in your system except time. Start with a very small cup first thing in the morning and see how your baby reacts. Drinking your morning cup of coffee while your breastfeeding gives you the most time for the caffeine to peak and start decreasing before your next feeding.

Paced bottle feeding

Paced bottle feeding (meaning you’re setting the pace for how fast/slow baby drinks) helps prevent over feeding baby: it takes 20 minutes for the stomach to tell the brain that it’s full. If a baby takes a bottle too quickly, the mouth can still be “hungry” and wanting to suck when the stomach is actually full. Like going to an all you can eat buffet and eating a lot of food quickly and then realizing half hour later you ate way too much. A baby that happily sucks down too much milk from a bottle can make you think you don’t have enough breast milk even if you make a normal amount. It can also make baby frustrated by the flow of milk from the breast and inadvertently sabotage breastfeeding

These pictures are the same baby in two different positions for paced feeding: semi upright and side lying. Side lying is my favorite position to use as it puts baby in the same position as breastfeeding. Many parents feel baby is more supported in this position. Baby is supported by your leg or breastfeeding pillow.

Tips:

🍼Never feed baby on their back

🍼Keep the bottle parallel with the floor with about half the nipple filled with milk

🍼Use the slowest flow nipple baby will tolerate

🍼Rub the nipple gently on baby’s lips, allow baby to latch at their own pace, don’t force it into their mouth

🍼It should take 15-20 minutes to finish the bottle

🍼Watch the baby and not the bottle, stop when they show signs of being full

🍼Resist the urge to finish the bottle, even if there is only a little left, when baby is showing signs their tummy is full

🍼Take short breaks to burp and give the tummy time to fill naturally

🍼If baby is gulping or chugging, slow down

🍼If baby has taken a good volume of milk (2-4oz) in a short amount of time and is still acting hungry, offer a pacifier for a few minutes to help them digest and give the tummy to to tell the brain it’s full. If they’re still hungry, slowly offer more in 1/2oz increments