Tag Archive | Babies and Toddlers

When is Baby Ready for Solid Foods?

When Shlomo was a baby, we decided to give him solid food only at 6 months.  Not 5 months and 2 weeks, but six months, to the day, or perhaps plus a day or two.  After all, nursing babies don’t need solid food before then; the range of 4-6 months is because, until recently, formula-fed babies were thought to need solids from 4 months, regardless of whether their digestive system was completely ready for it.  (Recently, the guidelines have changed, and the new guidelines say to start solids only at six months, regardless of whether the baby is breastfed or formula fed.)  And so six months it would be.

Honestly, four to six months is an estimate.  Just like not every baby smiles at six weeks exactly, not every baby is born on their due date, and not every baby crawls at the same time – so, too, not every baby’s digestive system is ready for solids at exactly the same time, either.  The 4-6 months for starting solids is a general guideline; even though, as a general rule, you won’t hurt your baby by giving them solids at five months and one week, it doesn’t mean that that’s what’s absolutely best for your specific baby.

If so, how will you know when to give your baby solids?

When Shlomo was five months old, we went to visit my family, in Canada.  When he fussed after a feeding, my mother, always wanting to get to the fun stuff, give advice, and catch a “first” before we went back home, told us that he needed solids.  He was five months and a few days, and we said no.  He might want it – in fact, he definitely wanted it – but he didn’t need it.

When Shlomo was five months and one week, my family went to visit a lakeside cottage; we had been invited to go with, but the technical details did not work out, and so we stayed behind, with my grandmother, cousins, and Esther, who also couldn’t go for technical reasons.  During the week that followed, Shlomo suddenly stopped sleeping as well as usual, stopped pooping during the day, and when he woke up at night and pooped, it was this weird poop (Yitzchak says it was “foamy”) that leaked all over.  After a few days of this, Yitzchak picked up the phone and called his mother (ahem, ahem).  She listened to the description and said, “Sounds like he’s ready for solids.  Try giving him banana first and then oatmeal; those are two foods that practically nobody reacts to.”

I was peeved.  I had wanted to wait until six months.  Helloo, the baby’s gut takes about six months to fully close.  But I told myself that evidently Shlomo’s gut was showing signs of readiness two weeks early, and five months, two weeks, was still pretty good.  We went out, bought some bananas, opened one partially, took a spoon, scraped some banana onto the spoon, and fed it to Shlomo (how I miss the banana-scraping days; oh, wait, we’ll soon be back there).

Abracadabra – that night, he went back to sleeping normally, pooping normally, and all was well.  My mother had her wish (kind of; I don’t think she was wishing that this would happen while she was away vacationing), and my best-mother complex had taken a slight, but not too serious, hit.  We took bananas with us on the plane home, and fed them to our five-months-two-and-a-half-week-old.  Shlomo’s first solid foods had been eaten not at home, but at his great-grandmother’s house.  (And he loved it, by the way.)

This, then, is the answer: Your baby’s gut is ready for solid food when they don’t poop on their regular schedule, their poop is weird foam, and they’re not sleeping well.

Lately, Tova has been pooping later and later in the day, and making only one or two poops, as opposed to her usual three or four.  They are also very liquidy, instead of the regular seedy.  Is this her version of foam?  Or should we wait?  For the moment, we are waiting.  We have time; there’s no rush.

Plus, there are three very nice advantages to breastmilk-only poop: 1. You don’t have to take her out of a synagogue, or stop praying, just because she made a poop.  2. Most (95%) of the poop that gets on her clothes doesn’t leave any kind of mark, even without stain treatment.  Of the remaining 5%, if I put stain remover onto it once, it comes out 99% of the time.  Which means that between two breastfed kids, I have maybe two or three garments that were stained, truly stained, by breastmilk poop. 3. Ditto for breastmilk spit-up – I don’t think I’ve had to use stain remover at all.

In other words, I really like the convenience of my baby’s bodily fluids not staining anything.  And I will miss that when we add solids.  On the other hand, after they start solids, the poop becomes more solidified and they spit up less.  So it kind of (but not quite) evens out . . . right?

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Formula: Sometimes, Medically Necessary

When?

Well, once upon a time, the gene for not being able to produce breastmilk was pretty rare.  If a woman couldn’t produce enough milk, she needed a wet nurse.  Wet nurses were expensive, though.  So if she didn’t have the money, and didn’t have the milk – well, let’s just say the gene wasn’t passed on to the next generation.  Survival of the fittest, did we say?  Perhaps of the richest, who often used a wet nurse even when it wasn’t necessary, to spare Mom the “burden” of breastfeeding.

Over the centuries, many tried and failed to find a substitute for human milk.  The formula we have today is the grandchild of the earliest experiments at alternative feeding; usually these alternative methods resulted in infant mortality within the first year; some from the food itself and some from bad hygiene.  In other words, it is the grandchild of the first non-toxic formula.  Obviously, back then, no one gave formula unless the baby didn’t have a mother, or the mother had not a drop of milk and no one to nurse her baby.

Since the age of barely non-toxic formulas, we’ve come a long way.  We’ve come so far, in fact, that unless you know a person’s medical history, it’s hard to guess which kids were formula fed and which were breastfed.

In other words, formula does a pretty good job of enabling these babies to grow, develop normally, and have a great chance at a good life.

That doesn’t mean, though, that formula is for everybody.  Formula isn’t human milk, and because of that, it wasn’t made for human babies.  However terrific a job it does at compensating for the lack of breastmilk, it still isn’t the ideal baby food.  Formula is like medicine.  In many ways, it IS medicine.  It was made for certain situations, and in those situations, it literally saves thousands, if not millions, of lives.  But just like you don’t give your child penicillin if he doesn’t have an infection, you shouldn’t give your child formula if he doesn’t absolutely need it.  Giving either of them too frequently, and without just cause, can have unwanted results. But, that’s not the topic of this post.

With the advent of good infant formula, a lot of babies survive who wouldn’t have had a chance previously.  With the advent of successful fertility treatments, and good prenatal monitoring, a lot of babies are born who wouldn’t have had a chance to be otherwise.  Combine these factors together, including the fact that if a couple’s infertility is female-factor, the same hormones that made pregnancy difficult may make lactation impossible – and there you have it, growing numbers of mothers and babies who are simply unable to breastfeed.

And – that’s fine.  In fact, it’s great.  It is absolutely terrific that these mothers are able to have babies, and that these babies are able to survive.  It’s a modern-day miracle, and one that we all have to be thankful for.

Again, the problem isn’t formula.  The problem is the abuse of formula. Let’s take a look at some possible contraindications to breastfeeding:

– As usual, mother has no milk.  By no milk I mean that she tried supplements, she tried dietary adjustments, she went to lactation consultants, she nursed and pumped around the clock to raise supply – and no luck.  Nothing doing.  The mother who suffers from this often feels inferior, because she feels betrayed by her body and unable to give her baby its most basic necessity – food.

– The baby who cannot form a vacuum.  This is usually fixable by some surgical procedure (yes, even clipping a tongue is technically a surgical procedure, even more so fixing a cleft palate), and until then, the mother has to stick it out by pumping and/or nursing.  Many mothers, too many, give up prematurely.  (There, but for my research, go I.)

– The mother who is taking a medication that is incompatible with breastfeeding, and there is no breastfeeding-compatible medicine available for her.

– The baby who is lactose intolerant, including lactose from human milk.  Sometimes this is fixable by a change in the mother’s diet.  Sometimes, no matter what the mother eats or doesn’t eat, the baby reacts.

– The baby whose mother got pregnant only a few months postpartum.  While this doesn’t mean that you have to stop nursing, if the baby is less than nine months old, chances are high that supplements will be needed.  Sometimes, the baby will start eating more solids.  Sometimes, if the baby isn’t old enough for solids or refuses, formula will be necessary.  Here I want to add that for the first two or three months of pregnancy, the milk stays suitable for the older baby.  Around week 16-20, it begins to turn into colostrum, and possible supply will decrease.  Again, any breastfeeding is better than none, and even if supplements are necessary for a few months, when the baby is born, the mother can dump the supplements in the trash and nurse tandem.

– The baby whose mother chose a method of birth control that is incompatible with breastfeeding.

– The mother who is hospitalized without being given an opportunity to pump.

– The mother who was given bad advice by medical or lactation “professionals”.

– The baby who has no mother.

There are probably more, but these are the main, basic, categories that come to mind right now.

Let me ask a question: Why aren’t there more banks for human milk?  At the moment, at least in Israel, there is a government-supervised bank, but the milk goes mostly to preemies, gastro-intestinally compromised babies, or babies without a mother.  Why can’t a “normal” baby get donor milk?

Some of you will say that it’s gross.  Well, I have news: Birth is gross.  Changing diapers is gross.  For goodness’ sake, any bodily fluid is gross.  Well, except breastmilk, in my mind; it tastes okay and it’s good for you (I tried a drop of my milk so that I’d know the difference between good milk and sour milk).  What grosses most people out, I think, is the idea of sharing the breastmilk.  But think of it this way: When you need a blood transfusion, do you say, “Ewww, gross, that blood was in someone else’s body?”  Of course not.  So, why is it gross to use donor milk?  As long as the donor is healthy – and if she is willing to feed the milk to her own kid, I think that she can pretty much be trusted – there’s no reason why not.  The only difference between donor milk and the wet nurses of old is that donor milk can be fed to the baby by its parents, while a wet nurse took all the responsibility on herself.

So, now there are Facebook groups and community milk banks.  But they aren’t widely enough spread, they don’t have enough donors, and not enough recipients are aware of them, or willing to use them.  But if formula, in the mind of someone who tried to breastfeed and couldn’t, is a sign of failure, why is donor milk worse?  It’s better – no, you couldn’t breastfeed yourself, but you still made sure that your child got breastmilk.

I think society needs a change of mindset.

Formula is a legitimate choice for those mothers who cannot breastfeed, or whose babies are unable to breastfeed.  Formula is a very, very, good thing, as long as it is not abused.  Those mothers who use it without medical necessity ruin how society views formula for those who have a legitimate need to use it.

Those who need formula should not have to pay the inflated price formula companies ask.  It is not fair, it is not just, to force someone who has no other option to pay an outrageous fee, for that many containers a year.  Formula that is medically necessary should be hugely subsidized.  Formula that is not medically necessary should be off the shelves.

Breastmilk, even donated breastmilk, is better than formula.  Feeding someone else’s breastmilk to your baby is not a sign of failure but a sign of courage and dedication.

Breastfed babies are the norm, not the exception.  Breastfeeding needs to be accepted and encouraged, not something shameful and disgusting.  I am not for a woman exposing her entire front and side on a park bench.  I am for women being able to sit and nurse, modestly and decently (I don’t use a blanket, but between the blouse and the t-shirt underneath, no one sees anything), in public places.  Without worrying if they will be yelled at, without feeling that the whole world is staring at them, without worrying about a smoker coming to sit down next to them (and then they are either stuck second-hand smoking for half an hour, or they have to get up and move in the middle), and without having to walk ten minutes, with a screaming, hungry, baby, to find a place to nurse.

Pumping should be legitimate and supported, especially for working mothers.  It should not be easier for a mother to switch to formula when she goes back to work, especially since, in the long run, it costs us all money.

Society needs a change.  But it won’t happen if we play Ostrich.

 

 

Why Do Mothers Choose to Formula-Feed?

During my maternity leave, I went back to an old hobby of mine – reading about baby feeding, health, and development.  Probably, all of you know on which side of the breastfeeding – formula feeding divide I very firmly stand.  That said, it irks me a lot when people say, “The most important thing is a happy mother; if breastfeeding is too hard for you, it’s better to just give your baby formula and quit nursing, as long as you’re not stressed out.”  Which, by the way, is bunk.  Then there are those who say that mothers who choose, from the outset, to add formula, care just as much about their babies, and do not do it for convenience but for the baby’s sake.

I’ll let Alpha Parent say it; here’s a quote from her post comparing past and present in baby feeding:

Self-interest is still quoted as the prime reason for not breastfeeding. From the UK Department of Health Infant Feeding survey (which involves around 8000 mothers and is done every 5 years): “The most common reason for choosing to breastfeed was that breastfeeding was best for the baby’s health, followed by convenience. The most common reason for choosing to bottle-feed was that it allowed others to feed the baby, followed by a dislike of the “idea” of breastfeeding.”

And here’s some more, for those who claim that breastfeeding doesn’t allow you to sleep at night:

Breastfeeding mothers get more sleep and their sleep is of higher quality. A breastfed baby can eat as soon as he is hungry. If co sleeping, that means before the baby even starts to cry. A formula-fed baby has to wait for formula to be prepared and warmed, in the meantime getting more and more distressed and agitated as well as waking others in the household. When breastfeeding, even the mother does not need to wake up fully to nurse her baby. Furthermore, the hormones produced during nursing have a relaxing effect, and the mother is likely to sleep even better when she nurses her baby. Studies have shown that parents of infants who were breastfed in the evening and/or at night slept an average of 40-45 minutes more than parents of infants given formula (Doan et al). Parents of infants given formula at night had more sleep disturbance than parents of infants who were exclusively breast-fed at night.

And for those who think that Dad can feed the baby at night if you formula feed:

I’m sorry to burst SMA’s bubble but as Gabrielle Palmer (The Politics of Breastfeeding, 2009) has pointed out, “The reality is that few fathers actually do take the whole responsibility of infant care and most artificial feeding is still done by mothers”. Pauline Lim, author of the very useful book Teach Yourself Successful Breastfeeding, concurs that:

“In reality few partners actually share the night feeds, so don’t be tempted to stop breastfeeding for this reason. There might be an odd occasion when this happens but the novelty wears off very quickly, leaving you firmly back in charge of the night-feed. This is particularly true when your partner has to get up for work.”

Remember when we were dealing with tongue-tie?  I pumped and went to sleep, and Yitzchak fed her the pumped milk.  Or, sometimes, I just pumped while he fed Tova the previously pumped bottle.  However, this was for a very limited time, until Tova finally learned how to nurse while lying beside me in bed, and Yitzchak did it not because he ideologically believed it was better for him to share the nighttime burden (because there is no question that nursing is better than getting a bottle of pumped milk, no matter how fresh), but because I was so weak, out of it, and barely functioning that he basically had no choice.  It wasn’t easy for Yitzchak and I don’t think we would have been able to keep it up long-term.  Especially since I would wake up when Tova cried and then have to fall back asleep. During those early weeks, however, it was a lifesaver (and you know something is wrong when it’s easier to pump than it is to nurse).

Here’s a study that compares the health of formula fed, or mixed formula and breastmilk fed, babies with those exclusively breastfed for the first six months.  Obviously, any breastfeeding is better than none, but that does not mean that supplementing a breastfed baby with formula does not have any undesirable side effects.  Another thing that should be mentioned is that breastfed babies are not healthier than formula fed babies; rather, formula fed babies are sicker than breastfed babies.

Don’t worry, give me a few days and we will get back to the elections.  We are still waiting on the final 1% of votes to come in, and until they do, nothing is official and the only thing we can do is speculate.

 

Poopy-Training and Tzuk Eitan

Remember how, during Tzuk Eitan (Operation Protective Edge), we were potty-training Shlomo and a siren went off while he was on the potty?

Well, 6 months later, we are about back to where we were then.  How we did it, I don’t know.  I think by just making a direct reward, a direct consequence, and letting it be.  In other words, the direct reward and direct consequence are the only things that we associate with pooping.  It was just getting to be too much, and we felt like everything in his life, and ours, was connected to poopng . . . something we didn’t feel was healthy or beneficial.

Direct reward: He gets his pacifier from the moment he’s off the potty until he leaves for gan the next morning.  There is no connection between the pacifier and the potty, you say?  You’re right.  Except that the pacifier was the only thing he really seemed to care about on a long term basis.

No potty, no cookie?  No problem, I don’t need a cookie anyways.

Potty and half an hour of uninterrupted playtime with one of us, even on a busy day?  Well, that’s nice, but I get it enough anyways, and when I really want it I’ll poop in the potty.

No potty, no pasta (because pasta is constipating and he eats too many carbs)?  Who cares, I like vegetables and as long as I’m not hungry it doesn’t make that much of a difference.

No potty, no tablet? Meh, who cares.

Poop in pants and pick it up with a wipe?  Who cares?

Poop in pants and pick it up with my hands?  Ewwwwww.  But it’s not so bad, it gets a reaction, and the solution is simple: Don’t poop.

No potty, no pacifier?  But I waa-aa-aaa-annn-ttt.

Originally, I suggested trying poop-f0r-pacifier for a single week to see if it would work.  The idea was that at the end of the week, something would have changed.  Either he would give up the pacifier, he would poop in the potty, or possibly both.

In the end, what happened was none of the above; and all of the above.

He is much less dependent on the pacifier, and can sleep well without it.  (If Tova wakes him up, we give him the pacifier whether or not he’s pooped.  Tova waking him up is not something that he can control, plus it means that he won’t become resentful of her waking him or us up.  Win-win.)

And when he wants the pacifier, which is nearly every day, he sits and poops on the potty.

If he poops in his pants, he helps clean it up.  Just like he would clean up after himself if he spilled oatmeal.  We clean up our poops, he can help clean up his.  Because he is a clean freak, this is a very awful punishment – which is why, when it was done by itself, he held in his poop for a whole week and became seriously constipated.

Shlomo isn’t pooping every day yet, but we’re averaging about three times a week, which is pretty good.  Sometimes he holds in his poop so long that he gets poop smear stains on his underwear – poop that tried to come out but got pulled back in.  When that happens, he has two choices: Put a big poop in the toilet, or touch the poop in the underwear.  It’s been about a month since the last poop outside the potty, and we’ve only had a few big smears and a few little ones.  Tfu tfu tfu, may it continue to get better.

Also, at some point more than a month ago, we switched from potty to toilet seat.  We took the stool and the toilet seat and sat him on the big toilet.  At the beginning he was afraid and held Yitzchak’s shoulders, until he realized he wouldn’t fall.  Then he had a choice: No toys and potty, or toys and big toilet.  Guess which one he chose – the big toilet.  He poops with his tablet in hand.  And if that means that he only poops 6 days a week and doesn’t poop on holidays, so be it.  The maximum is three days, and even that is only once a year, and not every year.

The toilet seat has this lid in the front meant for making sure that the pee won’t spray all over the place.  He complains that it hurts his peepee.  Solution?  Stick a wad of toilet paper between the plastic and the peepee.

We are still working on peeing while sitting on the potty.  At present he insists on standing up to pee and then sitting back down to try pooping.  Eventually, I think he will get it.  In the meantime, he has peed on himself a few times when we told him to push down his peepee and pee into the toilet while sitting.

I write the bathroom-appropriate details because I assume that some of my readers are parents who are potty-training boys, and I assume it will be helpful.  If Shlomo reads my blog when he is older and protests my explicit instructions meant for potty-training parents, I will let him reword it.  Otherwise, I will save it for him and his wife when his son decides to pull the same stunts.

I take comfort in the fact that Tova, unlike Shlomo, does not like sitting in dirty diapers.  She will cry until you change her diaper, even if it only has pee in it.  Shlomo did not care if his diaper was wet or dirty, unless it got his clothes wet or dirty.  The biggest obstacle to his potty training was that he simply did not care.  For all that he is a neat freak, having a gross bottom was someone else’s issue and not worth the break from playing.  Hopefully, since Tova seems to dislike being wet or dirty, she will be happy to learn how to keep herself dry and clean by going to the potty.  She is also a girl, and supposedly girls train faster – but this we will see in due time.

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Update from after Shabbat, Feb. 28: Apparently, I need to stop posting poop-training updates.  Shortly after this was published we found poop in his underwear – or rather, slime in his underwear.  It was much more than just a little stain.  Then he pooped in the toilet.  The next day, we found another stain in his underwear.  And the day after that.  Sigh.  Today I told Shlomo that my contract includes washing poopy underwear for maximum eight months, and that it applies to one-, two-, and three-year olds, but not to four-year-olds.  Then I got a brilliant idea: My contract doesn’t include washing a 4-year-old’s poopy underwear, right?  And the extra loads are a waste of water and electricity; if I don’t do the extra loads I suffer from the stink and have to make sure nothing touches it.  Solution: He can hand wash his own poopy underwear.  Fair enough, no?  It takes the task of my hands, and saves electricity and water . . . and teaches him some responsibility.  We’ll see what happens now.

A Tongue-Tie Survival Story

Survival?  Well, I don’t know.  But it does sound catchy, and we did make it through with not a single drop of formula.

When the hospital’s pediatrician checked Tova he told Yitzchak, “Just so that you don’t sue me, she has tongue tie.  It shouldn’t cause a problem for nursing and in 90% of cases it doesn’t.”

When Yitzchak brought Tova back to me (note: in Hadassah Ein Karem they don’t separate you for a minute; in Soroka it took two and a half hours before she was brought back to me, during which time Yitzchak was with her for all except five minutes) he told me what the doctor had said.  Angry as I was at how the birth had gone, the birthing-factory treatment (they have 20 delivery rooms and no competing hospitals) and how I was being treated like an idiot (thanks, Soroka), I rolled my eyes, thought, “Oh, great; a nursing mother’s nightmare,” and asked why they hadn’t clipped it.  Yitzchak told me it shouldn’t be a problem, and I hoped that he was right, while reminding myself that he was the sane one at the moment (and I was the exhausted, hormonal one).

After a few days, we brought Tova to the pediatrician because we were concerned about her jaundice.  The jaundice, thank G-d, turned out to be fine, but the pediatrician asked to weigh her (fine by me, since I hadn’t taken her to the well-baby clinic to check her weight yet) and discovered that her weight was not fine; I think she had gained 50g.  We were to come back in three days.

Three days later she had gained only another 30g.

Three days after that, we came back again.  This time, she was already over a week and a half old and hadn’t yet regained her birth weight – and at the rate she was going, we weren’t sure when she would.

At two weeks, she still hadn’t.  I don’t remember when it was, but there was a week in there that Tova gained only 70g – slightly less than half of what she should have gained.

I remember that during this time my mother called and asked how we were doing.  I said we were fine and thank G-d everything was going pretty good.  And as I said it, I thought of how ironic it was.  Shlomo had bronchiolitis (or bronchitis, not sure which) and was on antibiotics.  Tova wasn’t gaining weight and the pediatrician, Dr. R.,  had sent us for a pee test and told me to pump, see how much I got, and then feed her the bottle to see how much she took, and had given us a referral for the ER just in case she did XYZ (don’t remember what).  I was sore, overwhelmed, and dealing with excruciating pain every time I nursed.  Yitzchak and I were barely sleeping, despite being blessed with a baby who, if left to her own devices, will give us a decent night’s sleep.  And with all this, I told my mother I was fine.

Then we did a nursing test.  I brought Tova in, she was weighed, Dr. R. put me in a private room to nurse, and then 40 minutes into the nursing session Tova was weighed again.  To our credit, she had gained 85g.  Not all would stay, obviously, but it meant that she had eaten quite a bit.  Don’t tell the pediatrician, but a good portion of it was squirted into her mouth, since she wasn’t nursing well.  Not that it mattered, of course: the point was to see how much she was getting, and it didn’t really matter which of us was doing the work, as long as it did the job.  To my dismay, the previous day’s “cheating” backfired: I had sent her to be weighed just after a meal, so that the scale would show more.  It wasn’t enough, obviously, and when she was weighed, hungry, the next day it looked like she had “lost” weight.  I didn’t tell Dr. R. why she had “lost” weight; it was enough that to see that she obviously could get enough and officially rule out milk supply as the issue (it wasn’t the issue and I knew that, but we had to prove it).

Several times along the way we were suggested formula – starting in the hospital.  Because even a single bottle of the stuff can do permanent damage to a baby’s gut, Yitzchak and I have started calling formula “medicine”.  It is lifesaving when medically necessary and potentially damaging in any other case. What parent gives their kid medicine when it’s not medically necessary?  And what parent will expose their kid to something even potentially damaging, if there is another option?  Thankfully, our pediatrician was as reluctant as we were to add formula and gave us other options.

The “other options” weren’t fun, though.  The next step was to see if she would gain weight if enough food was forced down.  So, Dr. R. told us to nurse every two hours, maximum every three at night, and come back in two days.  If she hadn’t gained at least 50g – well, let’s not think about that.

We did it.  And thank G-d, she gained 70g in those two days.  In other words, problem found, and it was a simple, easy-to-fix problem.  Tova wasn’t eating enough, and therefore wasn’t gaining enough.  Thank G-d, a million times over, that that was the problem.

However, since she was such a weak nurser, and didn’t want to be nursing so often, each feeding took about an hour.  Every five minutes, we were waking her up.  At one point, I was pumping in the evening, refrigerating the bottle, and Yitzchak was feeding her one of the late-night feedings so that I could sleep a bit.  (After all, I was only three weeks postpartum.)  Other times, Yitzchak gave the bottle I’d pumped earlier, while I pumped a new one.

You know that there’s something wrong when it’s easier to pump than it is to nurse.

Thankfully, I had a hospital-grade pump from Yad Sarah and could easily get 80-90 ml in about 20 minutes (from one side).  Let’s hope that when I go back to work and have to pump, I still have an easy time pumping the amount that she needs.

For a week, I nursed every two hours during the day and every three at night.  Ten feedings a day.

We asked the pediatrician – maybe it’s the tongue tie?  We were told to go to the ENT; the place where he does it, and he himself, will not clip a tongue before the baby is 8-10 months old.

Then it was every two hours during the day and every four at night – for another week.  Nine feedings a day, she said.

Then we got permission to let her sleep – no more than five hours – at night, but we still had to do every two hours during the day. Eight feedings a day; don’t do any less.

Then I realized that the usual postpartum breastfeeding pains had gone away, but Tova was STILL hurting me every time she had nursed.  I managed to keep her from making my nipples bleed, but the dark lines on the tops hadn’t gone away, and my nipples would often continue to hurt for an hour after each feeding – which in those days, meant that the side I had nursed on hurt pretty much until the next feeding.

It suddenly occurred to me that maybe her gassiness, my sore nipples, her difficulty gaining weight, and the long nursings, all had a common cause: TONGUE TIE.  I went online, asked if I was on the right track, and asked for referrals.  I was given two names: Dr. C., a surgeon in Be’er Sheva, and Dr. K., a surgeon in Ashkelon.  Be’er Sheva is closer, so Be’er Sheva it was.  I asked for a referral and Yitzchak took her in.  Dr. C., and all of Soroka, will only clip the tongue when the baby is at least a year; we should wait and see if it interferes with her speech development.  Yeah, and what about the nursing?

[Then Tova got a cough and we borrowed a nebulizer from Yad Sarah, bought a mask and saline solution, and “masked” her three times a day for five days.  Dr. R. wanted to see her again just to make sure that she was able to breathe okay.  And we got another list of things to watch for and another just-in-case ER referral.  Thank G-d, these referrals were never necessary.]

Then Dr. R. told us to go the Tipat Chalav (well-baby clinic, where nurses check development and give vaccinations) and that she was officially dismissing us.  Thank G-d.

I made an appointment with the surgeon in Ashkelon.  He, I had heard, would clip the tongue in the clinic, on the spot.  He was on vacation for a few weeks, so I took an appointment the first day he was back.

We went back to the pediatrician to get another referral.  Dr. R. doesn’t like surgeons; she prefers ENTs.  So she went to ask the ENT herself, partially to make sure that it was really impossible and partially because maybe if she asked the answer would be different.  It wasn’t, and she gave us the referral.

In addition, for the past month or so, Tova’s poop had been forest green.  Dr. R. said it could be because she had a cough, but sent us for a stool culture.  Thank G-d, it came back negative and the doctor said we didn’t really need to do it after the color changed back, even if it wasn’t perfect.  But we did it anyways.

So, we went to Ashkelon.  And I took Tova on a bus, by myself, to Ashkelon.  We left at 1:30pm and came back at 7:45pm.  She was two and a half months old, and still taking an hour to nurse.  Both buses were late, so I arrived 40 minutes late.  Thankfully, Dr. K. still took us, and even forgave us after I explained what had happened.  He asked some questions, including one that surprised me – if milk spilled out the side of her mouth while she ate (it did).  Then he checked her tongue, expressing surprise at how far the frenulum was tied, “It’s tied practically to the end.”  (Dr. C. had said it was “borderline”.)

Then he took out a sterile kit with scissors, a long q-tip, and asked me to hold her chin.  Using the q-tip to hold the tongue up, he showed me what he was about to cut, took the scissors, reassured me that the crying was okay and I shouldn’t worry, and clipped.  It took about two minutes.  There was a bit of blood, but after another two minutes it had all but stopped bleeding.  Tova, the sensitive baby that she is, cried hysterically for long after the bleeding stopped.  Dr. K. said that she would calm down when I started nursing – and she did.  I took her to a corner of the waiting room and nursed.

She latched easily.  She sucked fast.  It took 40 minutes, but not 40 minutes like the previous 40 minute nursings had.  Previously, when I stopped after 40 minutes, I felt like she hadn’t finished but didn’t have the energy to argue.  This time, I was pretty sure she’d eaten enough.  And – what had been sore still hurt.  But as any nursing mother knows, previous sore spots and new sore spots feel different.  There were no new sore spots.  And she didn’t leak milk.

I went to the wheelchair bathroom (that’s what you do with a stroller; this one happened to have a change table, too) and changed her diaper, which had leaked.  It had been full before the doctor clipped her tongue, but for obvious reasons, I nursed before changing her.  Since Yitzchak had forgotten to pack me wipes, and I had decided not to ask because obviously he hadn’t forgotten, I had to clean Tova in the sink.

We went home; Tova pooped on the first bus; I nursed her on the second bus, stopped just before I had to get off, and finished nursing her fifteen minutes later when we arrived home.

When we got home, a few things happened:

1. YItzchak changed her diaper – and her poop, which had been green when I changed her diaper in Ashkelon, had suddenly turned mustard yellow again.

2. She went back to nursing for an hour.  Luckily, this was temporary.  Now she nurses for twenty or thirty minutes; more than that happens, but not often.  She can eat every two and a half or three hours.  I am starting to trust Tova to tell me when she’s hungry. But I still want to weigh her again, just to make sure I’m not making a mistake by trusting her.  She still spills milk sometimes, but after she finishes nursing, not while she’s still attached.

3. Nursing didn’t hurt anymore.  After two and a half months of torture – it didn’t hurt anymore!  I’m still in shock, a few weeks later.

I have a life again.  When I was nursing an hour out of every two, this is how my day looked:

Nurse.

Pee and drink OR eat OR shower

Nurse

Sort laundry

Nurse

Poop and eat a bit

Nurse

Shower and get dressed

Nurse

Put in a load of laundry

Nurse

Get the point?

In three words: It Was Awful.

But we did it.  Without a single drop of formula to ruin our baby’s gut.  If I hadn’t read up on the subject of formula, nursing difficulties, and tongue tie, I wouldn’t have made it.

If Yitzchak hadn’t been so helpful and supportive, I wouldn’t have made it.

And next time they tell me in the hospital that my baby has tongue tie, or I see that my baby has tongue tie, I will wait a week to see if the weight gain is normal.  And if it’s not, or the baby isn’t latching well, I will make an appointment with Dr. K. in Ashkelon and take the baby to get its tongue clipped at three weeks instead of at two and a half months.

I tell this story for a few reasons:

1. It is therapeutic for me to write it.  Very therapeutic.  This post has taken me about two hours to write, and I feel so, so, so much better now.

2. If this post helps anyone else, I will have done a lot.

3. I believe that it is important. Important to write about nursing difficulties, important to know that they can be overcome, and important to be educated.

I do not tell this story because I want everyone to know that I, Chana of Little Duckies, gave birth to a tongue-tied baby and am a radical anti-formula mother who insisted that her baby will have no medicine that is not medically necessary.

I would rather be able to choose who I tell my story to and who I do not tell my story to; this choice vanishes the moment I write the story on the internet.

But it is important, it can be done, and if any of you are in Maccabi in the south of Israel, use the “contact me” page and I will try to help you out.  After all, it was another mother online who helped me.

Geography Lessons

When Shlomo was a baby we would use a bulb to suck gunk out of his nose.  He hated it, of course.  We would also pick his nose; he hated that, too.

Since pulling snot out of a nose is also called ‘digging for gold’, we started saying that we have to pull gold out of his nose.  Then it became pulling gold out of his nose because we needed to donate it.  To whom would we donate it?  To the hungry children in Africa, so that they could buy food.

When he cried, we would say, “The hungry children in Africa need your donation.”

Then, a few months ago, Shlomo’s car (a Cozy Coupe) broke a rule (or perhaps Shlomo broke a rule while/by using the car), and Yitzchak took the car to China.  A few days later, I asked Shlomo if he wanted car to go back in China, or if he was going to listen.

Yitzchak got mad, “Don’t say things you can’t do.”

I said, “You did the same thing a few days ago.  It’s going to go to the same China you put it into.”

Yesterday, car needed to go to China.  But as Yitzchak pointed out, China is now filled with poopy clothes (one item is a pair of Shlomo’s poopy underwear; the rest is the baby’s (I’ll find her a name to use on the blog soon)).  So, car went in China Room, and is now blocking the door and access to the washer.

China, which was originally on top of our washing machine (we have a front loader, like most Israelis), has now expanded to include the tops of the fridge and bookshelves.

A toy that breaks the rules goes to China.  Shlomo, therefore, does not want things to go to China.  People, however, cannot go to China.  I guess it’s just too expensive a plane ticket . . .

Extremism Sometimes Pays Off

Yes, it does.  Because if you’re extreme about something, you usually know enough to argue your case when necessary.  And you usually are loath enough to agree to any alternative, that you stick to your decision and persevere.

[Sometimes it’s not a good thing to be an extremist.   But sometimes it is.]

Here’s a case in which Yitzchak and I were – are – both extremely glad that I am as extremist as I am.  (And my apologies for not posting for an entire month.  For most of the month, I was slightly out of it.)

I was in the hospital, trying to sleep, with a baby who wouldn’t stop crying every time she was put on her back.  From the leg movements, the reason was quite obvious: gas.  But what can you do when the only place to put the baby is a bassinet, you have no gas medicine, everything is closed, and even if it wasn’t you aren’t allowed to leave the ward?  Answer: Nothing.  You’re stuck holding the baby.

I was so exhausted (and this was nearly entirely the hospital’s fault) that I felt like I was about to drop her.  I’m not a person who cries easily, but I was crying then.  I just needed another pair of hands, and Yitzchak’s (even if he had been allowed to stay overnight, which he wasn’t, strange as it may be) weren’t available; he had to be close to home to pick Shlomo up from the neighbor’s in the morning.  And more than that, he needed to rest, because he had slept even less than me and had to take Shlomo to gan in the morning.

I refrained from calling Yitzchak, even though he had told me to call if I needed support, and just sent text after text, knowing that he would see them only in the morning.  One of the sentences I kept saying over and over [to myself, and to Yitzchak, before he went to sleep,] was, “Dang it/sheesh, I just need another pair of hands that I can trust won’t give her formula.  And I don’t know that I can trust the nurses.”

At about 3am, a nurse came in and we had the following conversation:

Nurse: Hi, is everything okay?

Me: Everything’s okay. (Except that she’s crying and I don’t know what to do, I can’t hold her for fear of dropping her or falling asleep over her; I need to sleep and there’s no one to hold her, and every time I put her down, she cries because she’s gassy.)

Nurse: She’s been crying a lot tonight.

Me: Yeah, she’s gassy. (Wow, thanks for stating the obvious.  Are you offering to hold her so that I can sleep?  Can I even trust you?)

Nurse: Maybe she’s hungry?

Me: No, she just ate.

Nurse: But she’s only nursing.

Me: Yes, but she’s not hungry, she just ate.

Nurse: She’s nursing, so she’s hungry.  Maybe you should give her a supplement?

Me: No, she’s not hungry.  (I knew I couldn’t trust you!  Thanks for telling me that I made the right choice in choosing not to ask for help.*)

Nurse: You sure you don’t want to give her a supplement?

Me: Yes, I’m sure.  She’s gassy, she’s not hungry. (And formula isn’t a solution to anything; it’s just bad.  Plus, she only needs 5cc at the moment, and she got it.)

The nurse left.  And I cried and texted Yitzchak, who, when he read the text at 5:30 in the morning, was furious at the nurse.

Yitzchak took Shlomo to gan, and then came with the carseat and a pair of hands to relieve me.  He was going to bring gas medicine (Simicol) but after speaking with Mom decided not to (because it isn’t really for babies under a week old.)

But seriously, if I wasn’t so dead-set that formula is a medicine to be used only when medically necessary (baby doesn’t have a mother, baby is lactose intolerant, mother doesn’t have milk or for some reason her milk is contaminated), and is permanently damaging in every other case, then I probably would have given in.

And then there was the nurse that told me that babies don’t get gassy before the fourth day – to which the response was a prompt [huge] burp.

Well-meaning, yes.  But definitely not that helpful.

And if I didn’t know better, I KNOW that I would have given in.  I know, because the only thing holding me back was the knowledge of the potential dangers that even a single bottle of formula can pose.

Extreme?  Maybe.

But it worked.

And continued working despite the issues that cropped up afterwards.

Because ignorance is not always bliss, and sometimes what you don’t know can hurt you, or your kid.

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*I believe, as I always have, that rooming-in is the best option, and I still believe it.  I also think – or rather, know – that if the delivery room staff, and protocols, had been different, I would not have been nearly so exhausted.  In other words, despite the difficulty presented here, I do not believe that it is good for the baby to be in a nursery, separated from its mother, just after being born; in fact, I believe the exact opposite.

Potty-Training Attempt #3 – No Turning Back

This post was begun on January 30, 2014.

Success!  Well, sort of.

What happened was this:

Shlomo turned three in March.  Traditionally, when a boy turns three, you cut his hair for the first time (a ceremony called “upsherin/upshernish” by American Jews and called a “chalakah” by Israelis), and give him a kipa (religious head covering) and tzitzit. About a month before his birthday, his ganenet announced that there was NO WAY that he would have his chalakah in a diaper.  How can you put tzitzit on a kid with a poopy diaper?  I agreed with her, and said that I’m all for it, but as we both know, it’s not fully up to us.

She insisted that we go for it and try again.  It just had to work.  She’s been a ganenet for twenty years and never has a kid worn kipa and tzitzit with a diaper.  I agreed, not fully believing that it would work – after all, this is time three, right?  And the first two ended in failure because Shlomo was just too stubborn, and at the end of the day, no one can make you pee or poop in the toilet if you don’t want to.

So we went for it.  Diaper off in the morning, on only at bedtime.  Poop belongs in the potty.  And for some reason, which Yitzchak and I believe to be a desire to get us to leave him alone, it worked.  Sort of.  He held in his pee – usually.  Stayed dry, and peed in the toilet, just enough to satisfy us and get himself nominally out of diapers (which is what led to the title of this post – Shlomo was nominally trained, and therefore there was no turning back).  We think that he just figured that if he didn’t give in, we’d keep trying every so often until he did, so he might as well just give up, or at least pretend to.

After a while it became more frequent, with less accidents.  But still, poops were saved for the bedtime diaper.  We would put him in pajamas and a diaper, get ready to read him a book, and he would poop.  We were just happy that he wasn’t holding it in; a lot of kids do, and the ganenet, when she saw that he wasn’t pooping in gan, asked if he was pooping at home, because she was worried.

At some point, I’m not sure how, we got him to poop on the toilet.  Yitzchak says that it was the tablet that he received as a gift for his birthday, from Bubby (Yitzchak’s mother).  We also bribed him with cookies and make a big fuss over it.  After a while, when he was more comfortable pooping on the potty, we stopped making such a big deal of it, and on condition that one of us sit with him (usually Yitzchak because my nose is more sensitive than his) he agreed to poop prize-free.  When we started seeing him backslide, we at first returned the treats and then realized that he was abusing the privilege: He would put a small poop in the toilet, get the treat, and then make a big poop in diaper.  Haha, you silly parents.  You fell for it, again.  And again.  So we took away all treats until he made a successful poop in the potty with no poops in his underwear.  And that’s been our policy since.

We STILL backslide sometimes.  I’m not quite sure why.  This morning I was feeding him and something started to stink.  I couldn’t figure out what it was, until it hit me and I asked Yitzchak to check his diaper (Shlomo was still in pajamas).  Yep, poopy in the diaper.  But as mad as we were, we were also relieved – Shlomo hadn’t pooped in four days (and prior to that, had made a week’s worth of poops in his underwear).  This evening, Yitzchak brought the tablet, sat with him, and Shlomo pooped in the potty.  We praised him.  And he got his treats back.  Boy, was he proud of himself.  I just wish I knew how to keep the poop in the potty – and what motivates him to decide to go on potty-strike.

Yes, Yitzchak STILL sits with him.  Poops are in a potty.  Pees are standing up, peeing into the big toilet, like any guy on the street.  I think the poops go in the potty for three reasons: 1. He’s scared of sitting on the big toilet. 2. The toilet seat we have isn’t comfortable.  3. It’s easier to poop with your feet on the floor.  Plus, you get the lid of the real toilet as a table to drive cars on.

Shlomo is not potty trained at night yet, and honestly, I don’t expect him to be.  He stays dry when he naps during the day, even during long 4-5 hour naps (which we allow only when we are going to be up late and we need the quiet to prepare for a holiday).  But my siblings didn’t stay dry till age five or six, and even then, I remember walking them to the toilet in the middle of the night.  If I remember correctly, twice – once about an hour after they went to sleep, and once around ten or eleven at night.

And after talking to Yitzchak’s mother, I found that she had had a similar experience with her kids.  So with a combination of genes like that, and the knowledge the a lot of night training is physiological and not necessarily within the child’s control – we still buy diapers for the nighttime.  One Shabbat, we had forgotten.  Since we had been planning to experiment anyways, we let him sleep in underwear.  Suffice it to say, experiment failed.  When we see that the diaper is dry several mornings in a row, we will try again.

And with this, dear readers, I [hopefully] end our saga of potty training until next time – which will hopefully be only with the next kid.

The Big Box

Yitzchak’s mother sent us a big box of stuff.  Well, she didn’t want to send a box; she wanted to send stuff with someone who was traveling to Israel.  But El Al changed their suitcase allowance from two to one, and someone was already paying for said traveler to take a suitcase #2.  That is, he was paying the airline’s fee for a second suitcase, and possibly paying the traveler, as well.  And this person didn’t want to take suitcase #3.  Plus, it would have cost at least $150 in airline fees for the suitcase.  So, MIL sent a box.  It cost $100 for the box, and they said it would get here in ten days.

When the box didn’t show up after ten days, we figured that they had meant ten business days.  It took a month.  When we finally received the notice that we had a package, I went up to the post office (against Yitzchak’s direction, because it was heavy, and I already had Shlomo in tow), and asked for it.  Turns out, I couldn’t receive the box, because a) In my excited rush to leave, I had forgotten my identity card, and b) I had to pay 245 shekels in customs tax.  In my rush to leave, I had also forgotten my wallet.

I called Yitzchak and told him.  He arranged to come home a bit early, take the notice, go to the post office, pay the fee, and pick up the box.  So, he did.  He came home, went to the bank and the post office, and came back home carrying a BIG box.

In the box were some toys and a LOT of clothes.  There was also a coat, snow pants, boots, and gloves, the last of which Shlomo hates.

And now we have a big box on the floor, that I don’t want to get rid of, because it is such a good toy.  So the big box stays.  It takes up space in our small living room, because it is a great toy.

As they say, the packaging is more fun than the contents.

(This one from July 1, 2013.  Boxes are still a lot of fun, but Shlomo has learned that the stuff in the box is often worth a second glance.)

Rules in Our House

rule sheets, what you can do, what you can't do, rules, regulations

1) No playing with matches or touching them, unless you found it and are giving it immediately to an adult.

2) No playing with plugs, or sockets.

3) You may not go outside without permission.  (The flip side is, ‘You must lock the sliding thing at the top of the door every time someone goes out or in.’)

4) No banging your chair back so that it tilts on a diagonal.  (This used to be annoying and damaging to the chair.  Now it is also dangerous.)

5) No hitting or biting, either yourself or anyone else.

6) The parent who put you in time out is the parent who ends the time out.

7) Do not throw anything that is not soft.  (Ducks, pillows, and scarves are allowed to be thrown, and are often thrown as part of a game.  Balls are not included, either.)

8) If you throw your food or dump your bowl, you are officially done.

9) If you choose not to eat supper, you get nothing except water until 6:00am.  (This sounds awful, but it’s really not.  He either chooses to eat, or chooses to sleep.  This became a rule because he wanted to play instead of eating supper a few times, which lead to sleepless nights.  After two or three nights in a row, I understood that it was a game and a habit – that gained him more playtime, and attention in the middle of the night.  So, we made the rule.  It only had to be tested once, and now he makes his choice and accepts the consequences.  Yeah, it was awful.  Yeah, it was mean.  But oh, man, was it necessary.  And better now, when he can’t get out of bed, than later, when he’ll be able to.)

10) Only Mommy milk is instant.  Everything else takes at least a few minutes to prepare.  Since you chose not to drink Mommy milk anymore, you no longer have instant food.  And not always, at every second, can we give you attention.  The moment we can, we will.

11) Writing is only on paper.  Not on laundry baskets, floors, walls, or buckets.

12) You can take a big-person book off the shelf to read it.  You may not take it off the shelf to step on it or otherwise harm it.  Books that get torn will get you put in time-out (only since he started ripping books to see how we were going to react; before that, we took the book away and told him that we don’t rip books).

13) After you make a mess, you have to help clean up.  After you help clean up, you get lots of praise.

14) When someone is talking to you, listen.  (This is a rule for the parents, too.)

15) If you hurt someone, you have to apologize, give a hug, and do “gentle”.  Hitting in order to get attention, gets you none.  If you want something, ask nicely.

Rules for the parents:

a) Do not make a rule that you cannot or will not uphold.  It lowers your status considerably.  (I learned this from my own parents, the hard way.)

b) Choose your battles.  If it’s not dangerous, and he’ll grow out of the stage, let it be.  For instance, if he wants to wear a belt with an outfit that doesn’t need it, or if he wants to mismatch his clothes, let it be.  No kid does this after they’ve grown up.  Or, if he wants to take all his clothes out of his drawers, let it be.  It takes about ten minutes to put them away neatly, and five seconds to dump them in.  No kid does this when they grow up – unless they’re looking for something.  So, let it be.  Ditto for your clothes.  But not for Dad’s pants that must be folded a certain way; those you have to teach the kid not to touch.

c) Stick with your rules, and give appropriate punishments.  For instance, banging the furniture next to your playpen at 2:00am cannot be punished with time-out, because both parent and child need to go to sleep and are overtired.  So, the punishment is psychological:  Tell the kid that he had a choice of where to sleep, but now, since he made a bad choice, Mommy is going to decide where he sleeps.  Then put him back in the playpen (note: playpen has been out of use for months now), which was what you were going to do anyways.  Note that this is not really a punishment, but it sounds like one to the child, who doesn’t know whether or not you were going to let him decide.  Also note that the option of pushing punishment off until morning is kind of stupid when the child is less than two years old.

d) Don’t do something that you’ll regret later.  For instance, don’t go out when it’s almost naptime.  If you do decide to risk it, be prepared for either a very late nap and a later bedtime, or for a very cranky toddler.  Either way, you have only yourself to blame.

e) Anything that you do not want to see played with, needs to go high up.  Otherwise, you have only yourself to blame.

f) Items on the counter must be at least two inches from the edge.

g) Act mad, don’t be mad.  And even if it’s so funny that you can’t be mad, you’d better play the part, or the kid will never learn.

h) Save the real anger and yelling for the big stuff – like running into the street.  Ditto for slaps.

i) Something you don’t like – time-out.  Something moderately dangerous (picking up the cord to the fan or a box of matches) – gets a gentle slap on each hand and time out.  Something extremely dangerous (trying to plug the cord in, opening the box of matches, running into the street) gets a not-so-gentle slap on each hand, three slaps on the bottom that wear the parent out and barely hurt the kid – there’s a diaper, remember – and time out.

j) Messing around with documents like birth certificates, passports, and the like is categorized as “moderately dangerous”, earning a gentle slap on each hand and time-out.

l) When the child is playing or reading nicely, or helping out, give lots of specific praise.  (“Wow, you really listened quickly; I didn’t even finish the sentence!” or “This is going so fast.  There’s no way I’d be able to clean everything up this fast without your help.”  or “You knew just what I needed!  I didn’t even have to look for my shoes!”)

m) Admit when you are wrong, and apologize for it.

n) Kids are smart; treat them as such.  Teach them what they can touch and what they cannot.  Teach them to take responsibility for, and to accept the consequences, of their actions.

o) Take responsibility for your actions and accept the consequences of them.  Yeah, many adults have issues with this.  That’s a big problem, but it’s not one of mine, not one of Yitzchak’s, and won’t be a problem for any of our kids, G-d willing.

(This one is from November 2012.  See what happens when I go through five pages of drafts?)