Weaning

Weaning (the process of transitioning from breastmilk or formula to adult/table food) is, like many other things in parenting, something that each diad or triad has to figure out for themselves.  There's no "right" answer or way to do it.  So if you're reading this looking for advice, please don't feel like this is a prescription for what to do.  Just a description of how we did it, in case that's helpful for you and your family.

Miss O was fully breast fed or nursed until I went back to work at 3 months.  We did occasional bottles during that time, to get her used to someone else feeding her (see this post for an explanation).  But MOST of the food was with me.  At 3 months, I started pumping full time at work, which meant hiding out in my office 2-3 times per day with the double pump, so that O could have enough breast milk to last her during the day while she was at day care.  We continued on that pattern until 4ish months.

Between 4-5 months, we started giving O "tastes" of foods.  she'd lick a carrot (yes, raw) or we'd put a spoon full of something in her mouth for the flavor, knowing she'd push it back out with her tongue.  We did this just as she was beginning to sit up supported, such as in a bumbo chair or well supported in one of our laps.

At 5 months, the daycare provider told us "Olivia cries when other babies eat food and she doesn't have any!"  I know that her crying was about wanting to be part of the experience, not about hunger.  But it made me feel guilty anyway. :-)  Thus, even though we never really planned on doing purees at home (which reminds me I need to write a post about baby led weaning), I started sending 1-2 little containers of pureed veggies, fruits, or meats into day care for them to play with.  During this process, she still was getting all her required nutrition from breast milk.

Between 6 and 9 months, we started offering solid table foods.  This phase of the game took a LOT longer than I expected.  I thought my curious daughter would start eating food and really pull back on the breast milk... but no, she didn't.  I got more efficient with my pumping, so that I only needed to pump twice daily.  But I still was S.O.L. if I couldn't pump the 10-12 ounces she needed during the day.  That's why all of you who know me in real life started noticing how much weight I lost around 9 months!  I couldn't keep the girl satisfied with enough breast milk!

All of that leads me to the decision process on weaning.  By 12-13 months, several things had happened.  A, I was SO SICK of pumping at work. B, I'd increased from 20-32 hours, meaning that I'd have to pump even MORE than I used to.  C, Olivia had transitioned from day care 3 days a week to being home with our awesome summer nanny 4 days a week.  D, she was REALLY doing well with eating solid foods.  I could tell that she was doing more than playing with the food, actually eating it.  Our grocery bill was going up.  Table food was successful.  Thus, I decided the time was right to slow down on the breast milk and really increase the solid food intake to meet O's needs.  I felt like I needed to do one thing at a time-- night weaning or pump weaning.  And since I hated the pump so much... it was what I got rid of first.

The process of weaning from the pump was stressful to me.  I didn't know how much to pump, how frequently to pump.  I was worried about engorgement.  But it all worked out.  At 13 months, I started pumping less, but still twice a day.  A couple weeks later, I transitioned to pumping once a day but still on both sides.  And finally, I started pumping once a day, but only one side (alternating days).  At 14 months, I had a couple of really busy days at work, forgot to pump all together, and realized I survived!  Thus, I brought the pump home, sterilized it, and sold the darn thing!

Simultaneously, I weaned Olivia off bottles.  She went from 3 a day to 2 a day at around 12 months.  Then from 2 a day to 2 smaller ones per day around 13 months.  Then down to 1 a day at 13.5 months. By 14 months, she was getting a little 2 ounce bottle of breast milk, mostly just because she liked it and not for the calories.  Then, of course, I'd stopped pumping.  But I had this frozen stash of breastmilk that I'd been managing all along since storing up during my maternity leave.  So I decided we should continue with the little "snack bottles" until it was all gone.  I started defrosting 2 ounces at a time, and MOST days, O would drink one.  Though some times either the nanny or daddy would forget.  At this point (we're nearing 16 months), we have one week left with summer time nanny and then O goes back to daycare.  The timing is going to work out perfectly, because I have about 8 ounces of breast milk left in the freezer!  I can't believe how many transitions are happening this fall.  But at the end of next week, no more bottles, no more breast milk in the freezer will be one of them!  Crazy, right?

At 15 months, I also started getting tired of night nursing.  We were still waking twice per night (midnight and 4ish) to nurse.  And though we have a "family bed" and a montessori bed next to it, O can come and go as she pleases, the lack of consecutive sleep had begun to wear on me big time.  So, Ben and I flip flopped places in bed and we started night weaning.  It's taken about a month to get it down consistently, but O is going from 7pm to 6 am more often than not without nursing.  She frequently wakes and cries at which point daddy will soothe her back to sleep with a pacifier, back rub, and some water from the straw cup if needed.  But night nursing is essentially done.  Even on nights when daddy isn't home, we can get the same pattern with me (though I am more likely to just nurse her if she wakes... I'm lazy when I'm woken out of REM sleep).

All in all, it's been successful and by 16 months, I think we'll be consistently only nursing about twice daily-- morning before day care and evening before bed.  I hope we'll continue that pattern and relationship through the rest of this year (up until O's 2nd birthday in April), but I think she'll tell me when she's ready to be done.

How did you and your family decide to wean?  Cold turkey? Night wean first then bottle wean? Other?  

Feeding Baby Green by Dr. Alan Greene

Today I finished Feeding Baby Green by Alan Greene, MD.  I REALLY enjoyed this book.  I checked it out from the library (yay!  Free is within my budget!) and I'll be honest, I only skimmed the last couple chapters, which are more about older toddlers and kids.  I figure I'll check it out again in the future if I want more advice at that point in time.

But the first few chapters are great for new moms!  You might even want to read it if your trying to conceive or still pregnant, as it's got whole sections dedicated to what you should eat when pregnant, decision making about breast feeding, etc.  Here are, in my own words, a few take away points that were most relevant to my life given my personal background knowledge...

1) When a baby is breast fed exclusively (or fed pumped bottles), they will have exposure to a wide variety of tastes and flavors, even before they're eating solids.  Thus, for breast fed babies, Dr. Greene recommends starting solid foods at 6 months.  However, with formula fed babies, who typically are only exposed to one flavor for the first several months (e.g., whatever brand of formula you choose), it is more reasonable to start small tastes/flavors of pureed solids earlier (as early as 4 months) so as not to miss out on the window of opportunity for exploring new flavors.  I guess I found this especially relevant because as a feeding therapist, I've worked with so many kids who are failure to thrive and we want them on solids ASAP (e.g., 4 months), but there's a decent argument for waiting until 6 months in this that I hadn't thought of.  (Note: for all you medical folks out there, there are millions of other decent arguments for waiting until 6 months that I know, but I'm just not going to address them all here.)

2) Just as toddlers reach a developmentally appropriate "stranger danger" stage where they don't want to go with new people (this is biologically an AWESOME safety method!), they reach the same phase (around the same time) with flavors... at that point, new flavors will be registered by their brain as unfamiliar, unsafe, essentially poison!  So while you can teach an older toddler or child (or adult) to eat new foods, life is a lot easier if the foods are exposed to the infant/toddler early... BEFORE the food-stranger-danger hits!  Brilliant!

3) Especially if you're starting flavor tasting/solid foods on the early side (but even if you're not), it's a good idea to focus on feeding baby flavors that you don't particularly like.  Think about it.  Throughout their infant, toddler, and childhood stages, they'll have TONS of experience watching you eat your favorite fruit, bananas.  But if you don't particularly like beets, if you don't go out of your way to expose kiddo to them early, then you'll miss them all together... (see #2 for what happens then)!

Finally, I really liked that Dr. Greene included a biodiversity checklist in the back to encourage you to provide varied-enough foods in the early stages. I'd never seen such a complete list. I really liked it, so I copied it here for you (and for my reference after I return the book to the library!):

1. Mushrooms: crimini mushrooms, oyster mushrooms, portobello mushrooms, shiitake mushrooms
2. Amaranths: beet, buckwheat, quinoa, spinach, swiss chard
3. Umbrellifers: anise, arracha, caraway, carrot, celery, chervil, cilantro, coriander, cumin, dill, fennel, lovage, parsley, parsnip
4. Cruciferous vegetables: broccoli, cabbage, cauliflower, chinese cabbage, collard greens, cress, horseradish, mustard, mustard greens, radish, rapeseed, turnip, turnip greens, watercress
5. Bromeliad: pineapple
6. Composites: artichoke, chicory, edible flowers, jerusalem artichoke, lettuces, safflower, sunflower seeds, yacon
7. Bindweeds: sweet potato, water spinach
8. Gourds: cantaloupe, casaba, crenshaw, cucumber, honeydew, muskmelon, pumpkin, watermelon, zucchini
9. Heath: blueberry, cranberry, huckleberry
10. Legumes: azuki, beans, black beans, carob, chickpeas, dried peas, green peas, kidney beans, lentils, lupins, navy beans, peanuts, pinto beans, snap peas, snow peas, soybeans, tamarind
11. Lilies: asparagus, chive, garlic, leeks, onion, shallots
12. Woody: bananas, plantains
13. Sesames: benne, black sesame, gomashio, sesame oil, sesame potherb, sesame seeds, tahini
14. True grasses: barley, brown rice, corn, millet, oats, rye, spelt, wheat
15. Rosy plants: almond, apple, apricot, blackberry, cherry, loquat, medlar, peach, pear, plum, quince, raspberry, strawberry
16. Citrus: grapefruit, lemon, orange, kumquat, kim, mandarin orange, tangerine
17. Nightshades: chili powder, chipotle, fingerling potato, green bell pepper, jalapeno, paprika, red bell pepper, red potato, russet otato, tomatillo, tomatoes, uchuva, yellow bell pepper, yukon gold potato
18. Grapes: currants, grapes, raisins
19. Laurels: avocados, cinnamon, bay leaves, cassia, sassafras
20. Myrtles: allspice, cloves, guava, feijoa
21. Loosestifes: pomegranate

Engorgement

Holy Cow!  Engorgement is a nightmare!  Stop reading now if you know me personally and don't want to know intimate details of my breasts... seriously....

So when I was about mid-way through my pregnancy, a friend with a 3-4 month old child at the time gave me some great advice.  She told me that she'd focused so much on reading up about pregnancy, labor, and delivery that she sorta forgot to read about what happens afterwards -- child rearing and all of the pieces that entails like breastfeeding, sleeping, etc.  She recommended I not follow her footsteps and do a little reading about what was to come.

Did I follow that advice?  NAH.  Why?  I was so engrossed in my pre-motherhood life and my green principles and my goals for a natural pregnancy, labor, and delivery, I really just didn't recognize how important her advice was.

And while in the hospital on days 0, 1, and 2, the early parenting thing was so straight forward, I thought I had time before things would get hard.  I mean, nursing went well from the first moment (the lactation consultant called us "the best pair for nursing in the unit right now!"), Ben was a rock star diaper changer, we were getting a fair amount of sleep, eating well ourselves, fought off the crazy pediatrician... what could possibly go wrong in the first 24 hours home?

Oh... you mean day 3 and 4?  THOSE first 24 hours at home? The days where engorgement is likely to bite every mother in the *ss???  And who had done no reading about it and didn't know what to do?  ME!

So.  For those of you who aren't yet mothers or maybe didn't have to deal with engorgement during your first child's life or something, engorgement is when you're finished producing colostrum and your milk comes in.  For me, it happened on Friday night, 12 hours after getting home from the hospital (aka, the land where nursing was easy), and coincidentally, while Ben was at work.  His mom had come to stay with me for the first 24 hours so that he could work and I'd be taken care of.

So we were nursing right along and everything was fine... and then all of a sudden, my breasts were literally the size of watermelons.  I thought they might explode.  And I knew that there was something I was supposed to be able to do about it, but I couldn't figure out what.  So my post-partum emotions just made me cry... not necessarily helpful.  My right side (while huge) was not as bad as the left, so Olivia still latched on fine and could feed.  But she and I could not make the left side happen for the world.  It was too engorged, to firm, and she couldn't get latched.  And my crying didn't help because it just made her cry.

I'd read and listened to a lot of sources that said one should not pump early on, because you don't want to teach your body to make more milk than your child needs, or it can make things worse.  But I couldn't figure out what else to do.  And Ben's mom was really interested in me pumping.  Unfortunately, the pump wasn't cleaned/sanitized, so I couldn't do it until Ben got home... hours later... after much crying... and yelling at my poor mother-in-law (who took it in stride, I might say!).

I did end up pumping on the left and feeding on the right through the next 12-18 hours while I figured things out.  I knew it wasn't the "ideal" situation, but it was how I could survive through the night and I didn't know what else to do.

The next day, once calm enough to actually do a functional google search, I learned about Reverse Pressure Softening, which was really my saving grace through the rest of the weekend.  I made a call on Saturday to the lactation consultants at Mt Auburn who also supported my choice to use RPS and to stop pumping.  And by Monday, we didn't even need the RPS!  We'd made it through!  Later, my midwife asked me if I'd tried cabbage, which I hadn't.  But I guess it would be the next solution on my 'to-try' list if this ever happens again...

My Foray into Home Made Baby Foods

The benefits of home made baby food are, in my mind, almost innumerable.  Just to state a few, we've got:

Enhanced flavor - have you ever tasted jarred baby food?  The stuff is intentionally made blander than adult food because supposedly that's easier on baby's growing taste buds.  Homemade baby food or blenderized adult foods, in contrast, have the same nutritional input as we get as adults and have quite strong tastes in a lot of cases.  Sure, there may be flavors your little one doesn't like... but you're teaching them about real food taste from day 1 of eating solids-- as a feeding therapist, I think that's great.

Caloric/Nutrient density -  How about looking at the nutrition information on the back side?  It is quite low in caloric density, meaning that your baby can eat and eat it, but it doesn't actually add much nutritional value for them.  Yes, when they're little, they should be getting "most" of their calories from their liquid intake (breast milk or formula) because it's complete nutrition.  But why does that mean we have to minimize what they're getting in their fruits and veggies

Cost - that's right, ladies and gents... it's frugal.  When you buy real foods and puree them (or dice, chop, steam, etc based on whether your kiddo is old enough to do a little mashing/chewing), you're paying real food prices.  You're not paying for extra packaging, shipping, etc.  You're also not paying for ingredients or procedures intended to extend their shelf life in little jars.  Which brings me to...

Quite simply, You know what's in it - I'm trying (though not always succeeding, I'll be honest) to eat foods that my grandmother would recognize as foods.  That means that foods shouldn't have a million ingredients.  And I should be able to pronounce and identify all of the ingredients.  I think this is going to be especially important in those early months when I'm learning what my little girl is or isn't allergic to and does or doesn't like to eat.

Thus, this week, I began my foray into home made baby foods.  Yes, I realize that I'm 8 months pregnant.  And yes, I realize that my child won't eat pureed baby foods until she's AT LEAST 4 months old and possibly older.  But I've got some veggies in my organic delivery box that I need to store before they go bad-- it's hard to eat all of these things when I'm not feeling like cooking and I've been cooking for 1 this month while Ben's been out of town.

Tonight's experiment was to roast, puree, and store some rutabega.  I use my oven, my blender, and my new So Easy Baby Fresh kit that my friend, K, got me for my baby shower and put myself to work!  The little ice cube trays for storing the food are excellent, in my opinion.  Once they're frozen, I'll pop them out and put many of them down in a ziplock or other storage container.  Each little cube is 1 ounce, which will make it easy for me to know how much the little one needs and is eating at each meal.  They're also a bit sturdier (and have a lid) than regular ice cube trays, so I'm hoping that means the frozen pureed rutabega will pop out a little more smoothly.

All in all, it was a great experience.  AND... in a bit of selfishness (or maybe just to see what happens), I can also borrow a couple of those cubes to mix into other foods for the adults in my house... popping a couple down in some mashed potatoes or a little bit of spaghetti sauce means that hubby is exposed to a few more vitamins than normal... always a goal of mine.  And in a small volume, he'll never taste the difference.  Shhh...

Any experienced moms out there have advice about home made baby foods for me?

Mother's Milk Bank

So unfortunately, I don't qualify to donate to this milk bank due to the fact that I've traveled to England for too long... but I really hope the rest of you young moms check this out.  If you've never heard of this, it's a GREAT way to give back to community without costing yourself anything other than a little time and energy.

Mother's Milk Bank of New England

BPA free? What else you got?

So sure... BPA is bad. We got that news a few years ago. But when my patients at work ask me, "what bottle system would YOU choose?" I always wish I had a better answer which was more earth friendly than the average. The next step up is glass. Not only is glass BPA free, but it's also free of any other toxins in plastic we don't yet know about. And using glass bottles fits with the face that Ben and I stopped using plastic Tupperware containers last year too. We just really feel we want to minimize the plastic in our lives.

But glass bottles have their downfalls too. In my recent search, I've come across a new possibility. What about stainless steel? I mean, it's the preferred material for adult bottles these days, why not kiddos too? Check these out:


stainless Steel bottles by Pura! They are unbreakable, toxin free, and adaptable to grow with our little Olive until he or she is a toddler and beyond!

Thoughts? We just might be crazy enough to break out of the box and try 'Em...