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Did everyone find their inner Irish this week? Of course my girls were dressed in green on Wednesday. Eva took it one step further and expelled a giant green poo that went out the diaper and up her back. I really admire her spirit. I was able to salvage the green onesie with a tuck and roll maneuver. Fortunately for her and me, little baby poo isn’t nearly as offensive as what comes out once a baby starts solids (my niece loves black beans. Ha ha on her parents!!) so I didn’t mind too much. But poop is absolutely a reflection of a baby’s diet and will be differ if a baby is formula fed or breastfed. Even what type of formula can make a difference, with many companies advertising that their milk is more like breast milk than others. Although what it really comes down to is that most of them are pretty much the same.
Some of you out there know that I’m such a big fan of breast milk for infants that I went so far as to do something called induced lactation. I’ll spare you the ugly (ugly!) details but I was successful in tricking my body into making milk even though I wasn’t pregnant with either baby. It wasn’t easy and I wasn’t able to make much milk but each baby got a couple weeks worth of antibodies and good stuff and for that I’m very proud. However, there came a point, very early on, when I had to accept that the majority of my children’s diet would be formula. And that’s okay. Plenty of perfectly successful, happy individuals were fed formula as infants and the stuff ain’t poison.
Of course the obvious next question is which formula do you choose? There are a million options out there, each one making a different claim. (Smarter! Less gassy! More like breast milk! Less colic! Better eyesight!) Here’s the honest truth: with few exceptions, infant formulas must adhere to strict government guidelines and their basic content is pretty much identical. Some have added this or that or break proteins down to make them “gentler.” The folks I’ve talked to who are “in the know” think that most of this is more marketing and less reality. The fact is that most infants should be on a cow’s milk-based formula, containing iron. The rest is up to you. Whether there is a role for soy formula is controversial. If an infant is truly allergic to cow’s milk, he’s probably going to be sensitive to the soy formula as well. Plus now there is concern that the plant-based estrogens in soy formula might be an issue for a developing infant. (This is a relatively new thought emanating from the federal National Toxicology Program expert committee. Just a thought, so don’t panic! They just want to get some research going to look at the question.) As for iron, unless your child has an extremely rare genetic liver condition, he needs iron in his formula. Low-iron formula has absolutely no role in the diet of an otherwise healthy infant and will not make him more or less constipated but will make him anemic and could affect his long-term health.
My decision was to defer to my pediatrician. Because of a family history of food allergies, we decided to put the babies on a partially broken down whey-only formula. Will this do any good? Probably not. The problem is that we don’t know enough about infant diets and allergy development. But it did mean that I could point to the can and tell my mom that my kids are already on “gas-free” formula so I can’t explain why they smell like a methane tank and emit loud noises with startling frequency. So what’s this all mean? Babies swallow air and get gas. They cry. They turn red when they poop. None of this likely has anything to do with the formula you choose. On the other hand, not every baby is the same and if you think your chosen brand isn’t agreeing with your little one, talk to your pediatrician about changing to a different type. Who knows, maybe it will make a difference. Of course, it might just be coincidence too. (Keep in mind that some babies really do need a specialized hypoallergenic formula and that is okay but should only be used on the advice of your doctor!) Either way, by the time you’ve worked your way through every type out there, your kid will be off the bottle and tossing back a hamburger and you won’t have to worry anymore.
Dr. Lara Zibners, Mar 18, 2010
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This is a good one because it’s just one more example of where my training and my reality don’t agree. My kids get a bath most days. For Eva, it’s part of her “bedtime routine” and for Zoe it’s part of her “stop screaming, kid, you’re driving me nuts” evening plan. But medically speaking, they really only need to go into the tub 2 to 3 times a week. After all, neither or them attends aerobics class or works in construction so they aren’t really that dirty. Bathing too often can dry out or irritate their skin. A quick face-butt swipe with a damp cloth once a day should be enough. However, if your little one likes her bath time, like mine do, then try to stick to just plain water and reserve the shampoo and soap for a couple times a week or when you find dried spit up in her neck folds or poop up his back. Then you might want to give her a good rubdown with a thick cream or emollient (such as Vaseline or Aquaphor) to help seal in the moisture when he comes out of the tub. But if you’re too tired, don’t worry about skipping her bath tonight.
Dr. Lara Zibners, Mar 18, 2010
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This Week’s Hot Topic
Did everyone watch Rachael Ray Thursday morning?! I have to say that I’m very pleased that they edited out a few of my more stupid comments but I probably would have preferred that they also not include me falling off the stage. It’s pretty weird seeing yourself on television (especially HD!) but overall I think it went pretty well. Please don’t tell me if you disagree. For those of you who missed it, I will do my best to get a tape and put the footage up on my website, so just hang on! As for the rest of what I wanted to talk about this week, I’m going to continue with last week’s sad tale of Zoe’s woefully bad attitude.
Of course, she’s not angry all the time. In the morning, she’s delightful and sweet. And some evenings aren’t all that bad. But then there are those nights when she seems to be completely possessed. I didn’t know a baby could cry that loud or turn that purple. Anyway, I know you’ve got the point. I won’t beat a dead horse and I certainly am not complaining. Instead, I thought I would pass along some of the things we’ve done at our house to make a screaming infant slightly less irritating. We’ve received lots of suggestions, ranging from chamomile tea to special blankets to earplugs. I really shy away from giving my kids medications or other ingestables that I don’t think will be helpful so we’ve not gone down that road. I’m also scared to use many scents or oils on them because their skin is so delicate and I had such bad eczema as a baby. However, a really great suggestion was to switch Zoe’s bath time to the evening since water seems to really calm her down. So now, as soon as the witches sneak through the front door and send her screaming (anytime from 4 to 6pm), into the tub she goes. I’ve left her in there for as long as 20 minutes although I coated her little body in Aquaphor as soon as she came out so I wouldn’t dry her poor little skin up. Some nights the bath just calms her temporarily but other nights it seems to really help her find her center and stay happy.
**Word of advice: babies have a very strong gastrocolic reflex. This is the need to poop immediately after eating. If you have a baby who is so fussy she can barely eat and you try to feed her while she’s sitting calmly in the tub, she may poop. Then when you clean it out and refill the tub and put her back, she might poop a second time. Just a thought.**
Since Zoe likes water so much, we also found that just running the tap while she’s lying on a blanket on the counter next to the sink will often quiet her down as well. Of course I’m always standing right next to her so she doesn’t plunge to the floor. And yes, I do feel guilty about wasting water, but I try to keep it on as slow a trickle as will do the trick and soak the dishes at the same time. One more thing is a different room. Just walking into another space with different lighting and a slightly different temperature seems will occasionally work although the effect is often fleeting. Naturally, all these tricks I’m am doing in addition to swaddling, binky, loud ssshhhing in the ear, swinging and jiggling.
Finally, when all else fails, get another person involved if at all possible. I know not everyone has a neighbor, Grandma or babysitter experienced in colicky infants at their disposal, but if you can rope someone into helping you, go for it and don’t feel guilty for a second! I once flew to Boston to give my friend a hand with her colicky baby for the weekend and it seemed to help all of them turn the corner. Often a third party will be calmer themselves and less frustrated and they may find it easier to calm a screaming infant than a tired and stressed parent can. I had someone come in the other evening to give us time to eat dinner and when the sitter arrived, my husband and I ran to our bedroom, closed the door and sat on the floor laughing. (House rule is Zoe gets the living room. If you want the TV, you take the baby) We were able to get a meal into our mouths, using both our hands, (I cut my own meat!!) and have a half hour to regroup and refresh. Crying babies can suck the life out of you so if you are unfortunate enough to have a fussy little one, don’t think twice about taking time to make sure you can hear your own thoughts. If you can’t find anyone to help you and you feel as if you are really at the end of your rope, leave the baby in the other room and go hide in the bathroom for 5 minutes. She won’t die from crying and as long as you can hear her, you know she’s breathing! And remember that it won’t last forever. I promise. I know this week is a particularly long-winded message but if you have a fussy baby or know someone who does, I really want you to know that you aren’t alone and it will be okay.
Tales of The Truly Advanced Infant
My brother-in-law was watching my 10 month-old niece the other day and handed her his cell phone to keep her entertained while he did the dishes. The house phone rang and the caller ID said it was his cell. He answered and was greeting by his screaming daughter who had apparently speed dialed the house and was letting her father know that she was none too happy about playing alone on the floor in the other room.
Dr. Lara Zibners, Mar 11, 2010
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Ooh this is a good one since Eva seems to spend most of her day with her arms pinned to her sides. She’s so high-strung that sometimes the only way to get her to calm down is a quick, tight swaddle. I’m not looking forward to the day coming very soon when I can’t let her sleep that way though. Once a baby is able to roll over, it’s time for the swaddle to go bye-bye. You can use a blanket sleeper, but the arms need to be free so that she can push her face away from the mattress and side of the crib. If she rolls while swaddled, she may not be able to free her nose and mouth. Of course, as long as you are holding her, she can stay wrapped tightly until she is through adolescence! If she remains the drama queen that she is, I envision many evenings wrapping a beach towel around my 15 year-old and telling her to get ahold of herself.
Dr. Lara Zibners, Mar 11, 2010
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It’s finally warming up and the snow is almost gone! It should make me feel like skipping and singing. Which I do from morning until about 5pm. And at 5:01 the singing stops and the tears start. Mostly from Zoe, some from Eva and a few from me. Because my kid has colic and that sucks. Big time.
I know you’ve all heard of colic but just so we are on the same page, “colic” in babies is unexplained crying for several hours a day, usually worse in the evening. Not to be confused with “colic” in horses which is a stomach ailment and is the number one natural killer of our equestrian friends. A lot of people think that colic in infants is also the result of a belly ache but most pediatricians disagree. Colic is probably best described as an immature brain freaking out. The evidence for this is that colicky babies respond to actions that imitate the conditions of the womb, such as rhythmic movement, tight swaddling and loud constant noise. What’s more, colic tends to go away around the same time (3-4 months) that a baby starts to hold its head up and be more social and act more like a real person and not a tiny baby.
I’ve been explaining colic to parents for years and trying to give them both sympathy and support and also real techniques to use to stop the crying. And now I’m living with it. Oh boy. Zoe will stop crying when I do all “the moves:” tight swaddle, binki, loud “sssshhhhhhing,” walking, jiggling and holding her on her side or belly. Okay so that is fine but what about when I need to put her down? Sometimes the baby swing turned all the way up will buy me 15 minutes. That is just enough time to get Eva her evening bath and into her crib. Then she starts her one hour of intermittent fussing and yelling while she fights sleep. So I run from one end of the apartment to the other, ssshhhing this kid, patting that one. It’s both frustrating and exhausting.
I have a new, deeper, respect for families with a fussy infant. What gets me through is a couple of things. Firstly, I know that this is temporary and it’s not because of anything I’ve done or not done. Secondly, I take help wherever I can get it. I try very hard to have a 2nd pair of hands at my house in the evening. I make sure that everyone has watched the Happiest Baby on The Block video and that they all understand that if they start to feel angry or frustrated, they need to put Zoe down and walk away. The only way colic is going to hurt a baby is if she is shaken or otherwise roughly handled out of frustration. Our new motto is: no one ever died from crying.
By the way, set your TIVO for March 11, Rachael Ray (should be on your local ABC affiliate). Yours truly will be making her daytime major network debut.
Dr. Lara Zibners, Mar 04, 2010
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