How much should my baby be eating?

[Excerpt from Simply Baby: An invaluable quick reference to infants] Each baby has his or her own nutritional needs. Unless the pediatrician specifies a change, a parent should not alter feeding habitss for a child that is eating regularly and gaining weight. The table below displays typical feeding habits for infants as they age.

Are all infant clothing sizes the same?

No.

[Chart from Simply Baby: An invaluable quick reference to infants]

Baby Gas Troubles?

[Excerpt from Simply Baby: An invaluable quick reference to infants] Most infants, especially newborns under 13 weeks of age, have gas because of their immature digestive system. Infants tend to swallw excess air when feeding or screaming which causes extreme discomfort. Gas discomfort will decrease with age as Baby gets better at eating and thier digestive system develops.

Things that minimize gas:

• Breast feeding with proper seal around nipple
• Feeding in an upright position (at least 45 degree incline)
• Smaller feedings
• Proper bottle nipple size (if too big, baby will eat too fast and if too small, baby will gulp air)
• Not over stimulating baby (by causing stress)

Symptoms of gas and the need to be burped:

• Stops in the middle of feeding and cries - refuses to drink remainder
• Arched back
• Squirm or grimace when laid down

Things crucial to expelling gas while burping:

• Holding baby upright
• Putting slight pressure on tummy
• Gently patting or rubbing back

How & when to introduce a cup

[Excerpt from Simply Baby: An invaluable quick reference to infants]

• At 6-7 months of age, parents can introduce a “sippy” cup. Some infants do not take well to the cup, but try and try again. Parents can try using a regular cup, taking the valve out, or using a straw.
• Around 10-12 months of age, start eliminating bottles progressively during feedings, substituting with a cup. Trying to eliminate bottles past that age can be done but it is more difficult.
• Parents can start with removing one bottle every few days or one every week, leaving the night bottle for last.
• Since they may not drink very much at a sitting (only an ounce or two), a cup must be offered at least 2-3 times more frequently than the bottle.
• Bottles should be eliminated by 15 months of age because toddlers grow very attached, refusing cups and demanding bottles. Tantrums and screaming are likely past 16 months of age.
• At around 14-15 months of age, toddlers become very attached to bottles and “sippy” cups. They will try to take them everywhere.
• Starting at an early age, drinking allowed with certain boundaries - such as only while sitting or only on hard floors - will avoid messes and unnecessary attachments.

 

My baby hit his head. Do I take to ER?

[Excerpt from Simply Baby: An invaluable quick reference to infants] Many babies fall, hit their head, and do not require medical attention. But, if any of the following symptoms are present within 15 minutes, call 911:

• Severe head or facial bleeding
• Seizures
• Bleeding from the nose or ears
• Change in level of consciousness for more than a few seconds
• Vomiting  
• Bruising below eyes or behind ears
• Loss of balance
• Weakness or an inability to use an arm or leg
• Unequal pupil size
• Slurred speech, or difference in babbling

If Baby does show any of the signs above, while waiting for medical attention do the following:

1. Keep Baby as still as possible in a dark room with shoulders/head elevated. Avoid moving Baby, especially the neck area, if at all possible.
2. Put pressure on any bleeding to slow, but avoid if the skull may be fractured.
3. If Baby shows no signs of movement, coughing, or breathing, start CPR.

If none of the above symptoms are seen within 15 minutes, there should be no cause for real concern.

Does my baby have a food intolerance?

[Excerpt from Simply Baby: An invaluable quick reference to infants] Some infants can have sensitivity, intolerance, or an allergy to certain food(s). Anyone can have an intolerance or allergy to anything, however, the seven most common food intolerances (making up approximately 90% of all) are: dairy, wheat, soy, tree nuts, peanuts, shellfish, and egg whites. These are listed in the nutritional information section of food labels. The most common food intolerance for infants is dairy (or cow's milk protein) and most will outgrow by 5-18 months of age.

Diagnosing is sometimes difficult because:

1. Babies cry for other reasons
2. Food in mother's diet takes 4-8 hours to be transferred to breast milk
3. Food in mother's diet can linger in breast milk production for up to 2 weeks
4. Symptoms can show up minutes or hours after eating the food (or affected breast milk)

Common symptoms of food intolerance are:

• Crying or inconsolability 5 minutes to 2 hours after eating
• Vomiting
• Diarrhea (with or without mucus)
• Hives
• Blood in stools
• Difficulty breathing or wheezing
• Stomach cramping
• Swelling or itching (especially of lips, tongue, or mouth)
• Dry, scaly, or red skin patches

Some facts on food intolerance:

• Varies in severity
• Dose related (small portions may be acceptable)
• Symptoms can change with age
• Should not interfere with child's growth
• If allergic to a particular food, could also be allergic to other foods in that group
• Cow's milk intolerance can cause green stools

If food intolerance is suspected in breast fed infants, try:

• A maternal food record (with items eaten, time, and infant symptoms)
• Mother starts an elimination diet

Because proper nutrition is crucial to an infant's development, consult the pediatrician if food intolerance is suspected.

Is my baby's poop okay?

[Excerpt from Simply Baby: An invaluable quick reference to infants] Newborns and infants have an array of colors, consistencies, and frequencies in bowel movements. Routinely use diaper cream during the first few months of age while bowel movements are frequent to prevent diaper rash.

When to call the pediatrician:

• Blood or mucus present in stool (especially if darker read in color)
• Bowel has a white color
• Black and tar looking (not including very first bowel movement)
• If exclusively breast feeding, no bowel movement in 7 days
• If exclusively formula feeding, no bowel movement in 2 days
• Consistency thicker than peanut butter if still on liquid only diet
• Green stool along with yellowish skin and/or eyes, if baby hasn't already been diagnosed with jaundice

*If there is a questionable bowel movement, save and bring the diaper to the pediatrician for testing.
COLORS
Any colors ranging from yellow to yellow green are normal when exclusively breast feeding or formula feeding. Breast fed infant stools should be mustard colored, seedy and runny. Formula fed infant stools should be yellow to green and soft. Different colors and what they could mean are below:
Green:

• Some infant formulas containing iron make stools change
• Foremilk/Hindmilk imbalance: Too much of the foremilk (less fatty) and not enough hind milk; sometimes caused by nursing too frequently or from only one breast
• Jaundice (liver not functioning correctly)
• Dairy Sensitivity, or cow's milk intolerance

Black:

• Iron Supplements
• Intestinal bleeding, if stools are also tarry call doctor immediately

Dark Red or Raspberry:

• Red food, if on solid foods (gelatin, juice, berries, etc.)
• Small tears at anal opening from constipation
• Extreme diaper rash

The first few days of an infant's bowel movements change from black, tarry to brown to yellowish. After the first week, the diaper usuage remains fairly consistent for 3-4 weeks. At one month, the number of bowel movements, especially in breast fed infants, rapidly decreases.
Once solid foods are introduced, the bowel movements become more solid and change colors depending on the food given. Most often, certain foods cannot be digested (corn, pea hulls, etc.) and are found in the stools later.

Is your baby refusing a bottle?

Some breast fed infants will refuse a bottle. Some things to try:

• Larger, smaller, and different types of bottle nipples
• Different temperatures
• Someone other than mother to give bottle, if possible
• Try bottle feeding for 15-20 minutes before nursing until successful
• If trying with only formula in the bottle, try expressed breast milk first. After successful on breast milk, start a mixture of prepared infant formula and breast milk until ratio of prepared formula is 100% of mixture.

Note: Once a bottle has been accepted, a bottle should be given at least every 7 days thereafter to eliminate future refusal.