Maria Betsworth - CFC Breastfeeding specialist Archives | Annabel Karmel

Paced bottle feeding

Lara Karmel — Wed, 18 Sep 2019 14:23:22 +0000

What is Paced Bottle Feeding? Whether you are fully bottle feeding formula milk or breastmilk, it is always important to know how to do it in a baby-friendly manner so your baby can learn how to gain control over the feed as well as avoiding overfeeding.

Here are my useful tips:

Paced bottle feeding is an important method to practice when offering the bottle. Not only does it avoid overfeeding it also helps the baby digest the milk and signals when the baby is full. Much like on the breast, it makes it a bit harder for babies to drink. So you are really pacing the amount baby will get which makes this very breastfeeding friendly.
The mechanisms on the baby’s mouth are different when bottle feeding and breastfeeding, so making sure to take it steady to feed the bottle in a more upright position. It will help the baby not to get lazy on the breast after.
Start off by nursing baby in an upright position, offering a bottle that has a slow flow teat – you do not need to buy different flowing teats for growing babies. This is more a marketing campaign than anything. The flow of your milk from the breast is always the same so the rest should also stay as a slow flow option.
If you pick up certain signs, for example, nose crinkles, hands splay or get tense, eyes widen or the swallowing motions change, offer a little pause during the feed.
Just simply lean baby forwards a little with the bottle in the mouth and allow a little time for the milk to go down and for baby to relax again. Restart the feed slowly again.
You could also remove the bottle gently and let the baby indicate if more is needed.
Taking a little break gives time for signals in the stomach to tell the brain if it is truly full, just like when you eat a meal. Taking breaks is natural for the baby much like feeding on the breast. And like this, you are really feeding to baby’s appetite and won’t be overfeeding.

Visit @milkmakingmama for more advice and support.

Also read this interesting article on Responsive Bottle Feeding.

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Responsive Bottle Feeding

Lara Karmel — Mon, 09 Sep 2019 10:00:27 +0000

Whether the bottle you are giving your baby contains formula milk or breastmilk, bottle feeding is still a big opportunity to bond with your baby. And that’s why responsive feeding is very important.

This includes giving baby the chance to take breaks, to see if baby might be finished with a feed. It’s about reading subtle cues like spraying of the fingers and hands, sucking becoming less rhythmical, slowing down in the suck frequency, more movement and baby generally getting wrigglier.

Reading such cues will help pace a feed (see my info on paced bottle feeding and how it is done). Paced feeding is crucial when it comes to the amounts that baby is taking in. It is most certainly possible to overfeed a bottle-fed baby so making sure you offer the bottle in a paced style (more angled down) to make it harder for baby on the bottle and for baby to naturally indicate breaks is key.

Responsive bottle feeding also includes the emotional aspect of feeding a child. Regardless of how a baby is fed, it’s a time to bond, to cuddle, to be close. It’s a special time, so make it count; sit in that favourite nursing chair or comfy spot on the couch, or sing a lullaby for the time you bottle feed.

Really watch baby. Get to know gentle feeding cues and when it’s time to have a break and let baby indicate if more is needed. Find your own routine and groove with baby.

Visit @milkmakingmama for more advice and support.

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Breastmilk storage

Lara Karmel — Mon, 09 Sep 2019 09:58:06 +0000

Here is the most important information on storing pumped breastmilk correctly.

Use sterilised equipment whilst pumping and to store your milk in. I would recommend milk storage bags as they are space-saving and you can label them and use them right away.

Milk at room temperature lasts 6 hrs.

Milk in a cooler bag (-150 – 40) will last 24hrs.

Milk stored in the refrigerator (40) will last 3-6 days.

Milk stored in the freezer compartment (-150) lasts 2 weeks. Milk stored in the deep freezer (-200) lasts 6 months.

Make sure you label the date and even time to store correctly.

When you want to reheat the milk, thaw frozen milk in a warm water bath first and then reheat in a bottle in a bottle warmer.

When out and about I used to take milk from the fridge and carry it in my diaper bag. By the time I wanted to offer it, it had warmed up a little and was available to offer, I also pumped ahead of my baby’s feeds so most of the time I took a bottle I had pumped before she would drink, so she would have warm and fresh milk whilst out and about.

As with all foods, I would recommend getting used to smelling the milk and even trying a little to see if it tastes “off”.

Visit @milkmakingmama for more advice and support.

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Pumping

Lara Karmel — Mon, 09 Sep 2019 09:57:34 +0000

A lot of mamas start pumping for many reasons, sometimes even just to see how much they would produce and are in shock when there is not much coming out. Here are a few facts to ease your mind:

If you’re exclusively breastfeeding and are pumping for the first time, don’t expect there to be an ocean of milk flooding your bottle. The mechanism of a pump is slightly different than a suckling baby, therefore it might take a bit of time to build up a pump supply. If you are pumping in the very early days after baby is born, use hand-expression techniques as the thick colostrum will only be wasted in the parts of your pump, catching it on a spoon or in a little sterilised cup is easier.

To build up a good pumping milk supply, the key is to regularly pump every 2-3 hours (even in the night if you can) and pump until your breast feel soft and “empty” (remember they are not empty).

If no milk is flowing, don’t be distressed. It might take a little tricking your body to give away the glorious milk. Have baby, a photo or a video of baby, next to you to look at, so hormones help your milk release. Oxytocin is released when baby is suckling and simply looking at your child. Once oxytocin is flowing milk will flow too and cause the letdown effect.

Hand expression before you pump might also help to get things going.

Just like breastfeeding, pumping takes practice. Your body has to adjust to the silicone parts trying to imitate what your baby normally does.

To boost your milk supply, throw in some power pump sessions every now and then: pump for 10 minutes both sides – 10 minutes break – repeat.

Remember breastfeeding is very different from pumping as it involves cluster-feeding, comfort suckling, etc, this builds up a milk supply greatly. Having baby near you for a cuddle whilst pumping will help.

If you are pumping at work, do start before you are returning to work to get the hang of it first, so you are not stressed out at work if your milk might seem less. Additionally, you can start building up a good freezer supply for emergencies.

Get yourself some delicious lactation-inducing products to boost your milk supply further.

Give yourself some credit, pumping takes a lot more than breastfeeding and involves a completely different mind frame.

Take a breath and try and relax. What milk will flow, will flow. You can build up a good supply with a lot of different tricks so just breathe, mama. You can do this!

Visit @milkmakingmama for more advice and support.

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Newborn feeding patterns

Lara Karmel — Mon, 09 Sep 2019 09:57:10 +0000

Let’s face it, newborn feeding patterns are madness. Records on how long a baby can feed are broken on a daily basis and a day may seem like an eternity of nursing.

This stage doesn’t last forever, and to help you rationalise why you are constantly feeding, here are a few facts:

The size of a newborn stomach starts off being rather tiny, therefore a newborn needs to feed frequently.

Newborns also love to comfort feed. Some barely leave the breast for the first weeks of their life. Whilst that is extremely exhausting, it is recommended to soldier through this phase with as much nipple cream and distractions or simply baby-watching as you can.

These frequent feedings do NOT indicate anything wrong with your milk, your milk supply or baby not getting enough. Newborns love the closeness to their mama and they know how to suckle, and that they do!

If baby is gaining weight at a steady rate, has wet and dirty nappies, your milk supply is perfectly adequate.

Frequent feeding is great to stimulate the breast into transitioning from colostrum to mature milk. It also establishes milk supply and simply helps baby to practice breastfeeding and strengthens the muscles needed to do so.

The hormones flowing between you whilst feeding are essential for bonding and to produce milk.

Get comfortable mamas! Lay back and let baby have as many feeds as needed. Let the world stand still. If you have two or more kids around, ask somebody to take them out for a little play, so you can focus on your newborn.

It will get better from here onwards and feedings may space out more and moreover the coming weeks and months.

Other times in which baby might have had a routine and seems to go back to endless nursing sessions, it can indicate growth spurts or developmental changes, this is also a temporary phase in which your baby might need you more to overcome it.

Breastfeeding on baby’s cues is the best you can do! You are not spoiling your child this is normal breastfed baby behaviour.

Visit @milkmakingmama for more advice and support.

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Breastfeeding friendly bottle feeding

Lara Karmel — Mon, 09 Sep 2019 09:56:20 +0000

There may be occasions where you need to bottle feed your breastfed baby. So here are a few tips on how to make the experience as stress-free as possible for you and your baby:

Buy a bottle that has similar shape to your nipple. Try different ones if baby seems to reject but do try at least for a day with the same one.

Try and avoid orthodontic nipples, even though they claim to help teeth development they are the furthest away from a human nipple and could make breastfeeding difficult as the suckling effect on these is different for baby.

Choose a slow-flowing or newborn bottle. There is no need to get different flows for a growing child – our breasts release the milk always the same, therefore if baby gets older baby does not need a more rapid flow. As muscles in the mouth and jaw develop, baby will drink effectively with a slow-flow bottle and it is much more similar to a breastfeeding experience.

Offer feeds on gentle feeding cues, not extreme hunger.

Give the bottle in a more upright position as it helps to adjust to the flow of the bottle and is easier for baby to digest.

Switch sides like you are breastfeeding to avoid a certain side preference if baby is still breastfeeding and to stimulate equal facial and visual development.

Give baby the chance to indicate when feeding is done – this does not need to be when the bottle is empty but when baby is showing signs of wanting to stop like a change of swallowing motions, pushing the bottle away or moving the head to the side.

Regardless if you are formula feeding, bottle feeding expressed breastmilk or substituting some feeds to a breastfed baby, it helps to create similarities to the breastfeeding experience.

Visit @milkmakingmama for more advice and support.

If you found this article helpful, you may be interested in reading:

Introduction to breastfeeding
Breastfeeding Tips & Advice

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Comfort feeding

Lara Karmel — Mon, 09 Sep 2019 09:55:36 +0000

“Baby is only suckling for comfort”, “that’s not good”, “take baby off so you are not the only one to sooth baby”, “you are a human pacifier”, “you will be stuck with this forever, “it is a terrible habit’: “use a dummy for that’:…

Haven’t we all heard things like this about comfort feeding from others?! And it probably made us question whether or not we are doing it right. Actually, allowing your baby to comfort suckle is very good and the best thing you can do! Here are reasons why:

Babies go to the breast for many reasons. They’re hungry or thirsty, they’re tired, they’re scared or hurt, they’re feeling overwhelmed. All of these are equally valid reasons for a baby to nurse.

If we are putting arbitrary limits on breastfeeding it is made much more difficult. It is already hard for a new mama to learn about breastfeeding, what is normal and what is not. Don’t listen to advice like this, your baby needs you for all the reasons above and that is natural.

Comments like this are based on old schedules about feeding and are not valid.

It is important to nurse frequently for all these reasons and mostly to establish good milk supply in the early days.

Overfeeding your baby like this is a myth, breastfed babies are in control of how much milk they take in, so not every time they nurse will be a full feed.

You are not spoiling your baby! By responding to baby’s needs quickly, consistently and with love, we teach them that their world is a safe place.

When baby grows up, nursing will become less frequent so enjoy this closeness while it lasts. It has so many benefits for you and baby.

Find your own routine and what works for you and your baby. Don’t let yourself be influenced by others. I know this is hard to do. I often question what others have told me but then I do my own personal research and try and find my own routine, I am being rewarded for it when it works out for me.

Families and friends can be so valuable and important when becoming a new mum but this is also your OWN journey, so stand up for yourself and do what is right for you.

Visit @milkmakingmama for more advice and support.

If you found this article helpful, you may be interested in reading:

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Finding a pumping routine

Lara Karmel — Mon, 09 Sep 2019 09:54:51 +0000

First and foremost, you don’t have to pump if you are exclusively breastfeeding your baby on demand. Pumping can be a great tool to build a stash and to boost supply. Here are some helpful tips:

Basic rule – milk supply works on a demand-and-supply system, the more milk is needed the more milk is made.

If you are adding a pump to your routine you are not “emptying” baby’s usual meal but you are telling your body to make more milk.

Your breasts are never empty, whilst you are pumping or breastfeeding you are already making milk, because the more milk is being removed, the more milk is needed.

If you add one pump session a day to your usual feeding routine you will make more milk, the more pumps you add the more milk is made.

It does take a bit of tricking your body to get used to a pump. Many mothers confuse the lack of output during a pumping session as the lack of milk they are producing and they get scared seeing only a small pump amount. If you are just starting to pump whilst breastfeeding you might see small amounts of milk flowing at first. This is completely normal. The pumping output does not represent the overall amount of milk you produce.

If you are starting to pump once a day to build up a stash, I would recommend pumping in the morning before baby’s first feed. Many mamas say their milk production is at the highest in the morning. But finding a time that works for your routine is the key.

After you have pumped you can breastfeed straight away, this might also be better because you will see more milk flowing during your pump session and baby will also get all the milk needed.

It can be daunting introducing pumping to your routine, take your time, massage before and during a pumping session and do NOT panic about the amount you are pumping, a pumping supply needs to build up steady.

Baby will, whilst breastfeeding, get all the milk needed and your body will adjust perfectly to what is needed.

You are making enough milk!

Visit @milkmakingmama for more advice and support.

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Breastfeeding cues

Lara Karmel — Mon, 09 Sep 2019 09:54:08 +0000

Breastfeeding a baby whenever they are ready for some milk makes for great milk supply and a happy baby. Here are the most important feeding cues to look out for:

Subtle feeding cues: eye movement, eyelids fluttering (if baby is sleeping), hand coming to face and mouth opening.

The more obvious ones: rooting towards your chest, squeaking and whimpering – now is a great time to offer as baby should take the breast easily and comfortably.

If hunger builds up further, most babies will get tense and start to cry – a crying baby is hard to latch on and needs to be consoled first to establish a good attachment and effective feed.

Breastfeeding becomes easier if you are answering a gentle request. Or any time you like, even without any cues, rather than to a demanding and very hungry baby.

Try not to wait until your breasts feel overfull as this could make it harder for very young babies to latch on and it slows down milk production.

You can offer a feed when you feel like it, even when baby is not signalling any cues. Watch and learn from your baby and don’t restrict nursing sessions or implement a routine.

Visit @milkmakingmama for more advice and support.

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Are endless breastfeeding sessions normal

Lara Karmel — Mon, 09 Sep 2019 09:53:02 +0000

When my second daughter was born, she crawled to my breast and didn’t leave it for approximately three months straight. My husband sometimes only got to see the back of her head. She broke all records on how long a baby can stay on the breast.

These endless nursing sessions left me questioning if this is “normal”.

Rest assured, endless nursing sessions – as time consuming and exhausting as it may be – are pure milk supply gold! During the early days some babies barely ever leave the breast which helps to stimulate your breast and leads to your milk coming in.

The urge to suckle is very strong in babies. Not only is it the ultimate comfort but it also really gets the right hormones flowing for a great milk supply. There is nothing wrong with letting your baby suckle for comfort. On the contrary, it will build up a great and steady milk supply.

These endless sessions are time-consuming. I found that distractions and finding practical solutions whilst having a toddler around, the key to not feeling overwhelmed.

Here are some of my top tips:

Nursing in a sling: to start this off try and master laid back nursing at first so baby gets used to latching on in such position. Baby will then take to nursing in a sling easier. Walk around in the carrier or sling, it will empower you to still go to places whilst giving baby the opportunity to nurse for as long as needed.

At home I had a nursing station with everything I needed. Snacks, water bottle, phone, TV or a book and other distractions.

For my toddler, I had a little box of toys she could play with whilst I sat down nursing. Try and focus on non-messy toys. We had a doctor’s case or a wooden puzzle that we could play with together. And “the virtual nanny” aka TV was helpful as well when we hit the witching hour where my baby would need a lot more attention.

I know these nursing sessions can leave you questioning why baby doesn’t come off the breast at all. You may feel like it is a lack of milk but trust me and repeat after me: “If you are nursing around the clock on baby’s feeding cues with a correct latch, you are making the perfect amount of milk for your baby’s needs. Long feeding sessions do NOT indicate anything wrong with your supply but are the way baby likes to feed at this point in time. And it will get better! Hang in there and get comfy.

Visit @milkmakingmama for more advice and support.

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How to sterilise bottles

Lara Karmel — Mon, 09 Sep 2019 09:39:29 +0000

There are several ways in which you can sterilise your baby’s feeding equipment, such as:

Using a cold-water sterilising solution.
Steam sterilising.
Sterilising by boiling.

The following instructions apply to all feeding equipment you use for your baby – whether you are using expressed breast milk or infant formula. Remember to first wash your hands well with soap and water and clean the work surfaces with hot soapy water.

Before sterilising, always clean and rinse. Clean the feeding bottle and teat in hot, soapy water as soon as possible after a feed, using a clean bottle brush. Then rinse all your equipment in clean, cold running water before sterilising.

Remember…

All feeding items must be thoroughly washed and rinsed before they are sterilised. Dishwashers will clean bottle feeding equipment but will not sterilise it. This is because temperatures reached in a dishwasher are not high enough for sterilisation, so you need to both clean and sterilise the bottles.

Cold-water sterilising solution

Follow the manufacturer’s instructions.
Change the sterilising solution every 24 hours.
Leave feeding equipment in the sterilising solution for at least 30 minutes.
Make sure that there is no air trapped in the bottles or teats when putting them in the sterilising solution.
Keep all the equipment under the solution with a floating cover.

Steam sterilising (electric steriliser or microwave)

As there are different types of steriliser it is important to follow the manufacturer’s instructions.
Make sure the openings of the bottles and teats are facing down in the steriliser.
Manufacturers will give a guide as to how long you can leave equipment that you are not using straight after sterilising before it needs to be re-sterilised.

Sterilising by boiling

When you use this method, you must take care to ensure safety and prevent scalds or burns. Never leave hot pans and liquids unattended, especially if children are present.
Make sure that whatever you sterilise in this way is safe to boil.
Boil the feeding equipment in water for at least 10 minutes, making sure that all items stay under the surface of the water.
Remember that teats tend to get damaged faster with this method.
Wash hands thoroughly. Clean and disinfect the surface where you will put together the bottle and teat.
It is best to remove the bottles just before they are used.
If you are not using the bottles immediately, put them together fully with the teat and lid in place to prevent the inside of the sterilised bottle and the inside and outside of the teat from being contaminated.

Visit @littlepeachlondon for more advice and support.

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Myths about breastfeeding and breast milk busted

Lara Karmel — Thu, 27 Sep 2018 08:32:18 +0000

Let’s address the most common breastfeeding myths and set the record straight. After all, there’s so much conflicting information and advice out there, and parenting is complicated enough without the added challenges of incorrect advice.

“Baby is feeding all the time and I don’t feel like I don’t have enough milk”

The most important indications that things are flowing well are steady weight gain in combination with regular wet and poopy nappies. If they are meeting their developmental and physical milestones then you have nothing to worry about.

The following are NOT indicators of low milk supply:

Baby is constantly on the breast
Baby cluster-feeds all evening and night
Baby seems fussy on the breast
Your breasts feel soft and not full anymore
You don’t feel or never have felt a let-down sensation
Baby suckles endlessly
Baby changes sleeping patterns and wakes up more frequently

Babies go to the breast for lots of different reasons and any of the above behaviours are not indications of a lack of milk.

"Breastmilk does not keep your baby full enough to sleep through the night"

Wrong! Breastmilk covers babies’ nutritional needs perfectly. Sleeping through the night is a developmental milestone that every baby reaches in their own time. Filling baby up does not mean a full night sleep.

“If Baby keeps waking up offer formula”

A full baby doesn’t mean a sleeping baby! Formula fed babies can wake up just as many times as breastfed babies. It is absolutely normal for babies to wake up many times during the night to top up on food or even for comfort during the first year of life and far beyond that

"Breastmilk declines in quality over time"

Breastmilk is an ever changing always adapting nutrients super food that covers all of your babies needs and far beyond that. It will cover age appropriate needs and offers antibodies to protect baby and help build a strong immune system. Breastmilk never loses its nutritional value.

“Being a human pacifier or nursing baby to sleep is bad”

There is absolutely nothing wrong with letting baby comfort feed as it builds up a great milk supply, helps baby lowering the heart beat and create a calm and content sleep environment and sleep association for baby. And never forget a pacifier is to replace YOU the comfort and closeness YOU offer. It is natural and normal to be close.

“Nipple confusion doesn't exist”

Actually, some baby’s find it difficult to master the skill of a good latch introduced to a bottle too early in their breastfeeding journey. It is recommended to establish breastfeeding first before introducing a bottle as the suckling mechanism of breast and bottle varies greatly and perhaps leads to nipple confusion.

“You should not be a human pacifier”

Offering the breast on demand also offers baby the chance to suckle for comfort, not only is this practice important to establish a great milk supply it also helps oral development, and provides ultimate comfort for all different moods your baby could be in like being frightened, in pain, feeling lonely, sad, anxious etc. Plus it is a temporary phase that many breastfeeding babies will outgrow so you won’t be doing this forever.

“Stress, tiredness and lack of food or drink cause a bad milk supply”

The main causes for bad milk supply are an insufficient latch, difficulties draining the breast completely and poor positioning. The body will provide the best nutrition to the child regardless of the state the mother is in, whilst she might be suffering from malnutrition or tiredness her baby will still receive all the benefits from breastmilk. Milk supply is mostly inflicted by frequent feeding as good positioning and attachment.

“You should space out feedings to let your breast fill up”

The most important principle is to feed on demand and practice responsive feeding whereby you look out for baby’s feeding cues and offer the breast. Letting the breast fill up will lead to slowing down milk production as well as forcing a schedule onto a baby. Which can severely impact your overall milk supply.

“My boobs are empty”

Boobs of a breastfeeding mother can never be empty. Babies drink on average 70-80% of your breastmilk. And whilst feeding you are already making more. Clever hey!

Your breasts are not passive storage contains of milk but milk factories that continue to produce as milk is being removed. Breasts that feel soft do not indicate a lack of milk in them.

“You need to feed 10 minutes on each side”

It’s is much better to let baby decided to feed for as long and as often as it may want.

“You only have milk when your milk comes in 2-3 days after labour”

From the moment and even before baby is born you produce milk. In the early days it is called colostrum and is a much thicker milk which is perfectly adequate for baby’s little tummy. Milk only changes when they call it your milk “comes in” – but really due to stimulating the breast with babies suckling motion your milk will change and become more milk like which is a transition not a switching or coming in process. It is best to refer to it as milk transitioning to avoid pressures and misconceptions about milk.

“Baby needs to have a feeding schedule”

Babies need to feed on demand. When you pick up feeding cues of baby being hungry you should offer your boobs this helps to get a great milk supply.

“You must offer both breast each feeding time”

It is perfectly fine to give one breast and next feeding session the other side. If baby is latching of naturally and does not seem interest in the other side you do not need to offer it. It is more important to let baby finish naturally then take baby off.

“You can't tell if your baby is getting enough milk whilst breastfeeding”

Having plenty of wet or dirt nappies in combination with regular weight gain as well as reaching milestones and outgrowing clothing and diapers are definitely indicators that your baby is doing fine breastfeeding

“If you have small breasts you can't make enough milk”

This couldn’t be further from the trust, the size of the breasts do not matter at all when it comes to breastfeeding. Milk production is down to picking up on babies feeding cues and regular feedings.

Visit @milkmakingmama for more advice and support.

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The different infant formula milks

Lara Karmel — Tue, 25 Sep 2018 10:56:51 +0000

We know that breastfeeding exclusively for the first six months of life is the best way you can feed your baby, however not all mothers can breastfeed, and some choose not to. When this is the case infant formulas are available, but it can be a minefield trying to understand which one is best for your baby.

This article aims to help you make an informed decision on choosing the right formula for your baby by interpreting the science behind infant formula. Despite over 100 years of research scientists have still not been able to identify all the components found in breast milk, therefore, infant formula companies cannot replicate breast milk exactly. There is not one infant formula that is closest to breast milk than any of the others, as well as breast milk being uniquely nutritionally matched to the baby it contains beneficial immune system defences called antibodies that are harmonised between the mother and her child.

All infant formula milk is made up of a balance of proteins, fats, carbohydrates, vitamins and minerals. There are strict regulations in place that must be followed by all formula manufacturers to ensure that the nutritional profile of infant milks are similar and meet certain standards. Almost all infant formula milks are based on cows milk protein, goats milk and soya protein are also occasionally used too.

First Stage & Second Stage Infant Formula

First stage infant formula and second stage infant formula are nutritionally the same. The difference between them is the type of protein that is used. First stage infant milk‘s are predominately whey protein and second stage infant milks – marketed for hungrier babies, contain more casein protein. Casein takes longer to digest because it forms a thicker curd in the stomach making babies feel fuller for longer. It won’t give a hungrier baby any more nutrition at all, and in fact, a baby who appears hungrier, demanding feeds more often or cluster feeds often needs more nutrients for her developmental stage. Whey based, first stage infant formula is the preferred alternative to breastmilk during the whole of your baby’s first year.

Goats Milk-Based Infant Formula

Goats milk based infant formula is increasing in popularity, however nutritionally it is no more superior to standard first stage infant milks based on cows milk. Some parents think that using a goats milk formula will reduce the incidence of milk allergy. However this is not the case, both cows milk and goats milk have the same allergenicity. Goats milk protein is not easier to digest either.

Anti-reflux or Anti-Regurgitation Formulas

Anti-reflux or anti-regurgitation formulas are also available. Parents often try these if their baby frequently posits after a feed or they suspect reflux. However, it is important to note that bringing up a small amount of milk after each feed is quite normal as it can take a few months for the ring of muscles at the bottom of your baby’s food pipe (called the lower oesophageal sphincter) to fully form. Sometimes just reducing the volume of feed and feeding little more often it’s all it takes to reduce positing.

These types of infant formula should be used with caution. Did you know that you make these milks up with cooler water rather than the hot water required for standard formula? This means that any harmful bacteria residing in the formula is not eradicated as it would be when making up standard infant formula. Babies are at greater risk of food poisoning bacteria. In addition, anti-reflux formula contain cereal-based thickeners yet cereals should be avoided until your baby is over six months of age. Seek advice from your health visitor or GP or ask for a referral to a Registered Dietitian if you are thinking about trying one of these.

If your baby is very uncomfortable after feeds, is crying and arching her back and generally experiencing discomfort, it’s important to go and see your GP. More often than not this isn’t reflux and other conditions should be explored. In my experience the anti-reflux or anti-regurgitation milks do not work in the majority of babies, true reflux needs medication in order to manage it.

Comfort Milk for Colicky Babies

Comfort milk is also available and is promoted for helping babies who are unsettled and colicky. Some manufacturers also say that comfort milks help with wind, colic or constipation. However, there is no research evidence to show that these milks reduce symptoms. Moreover, it is very common for babies to have colic during the first few weeks of life. Babies cry a lot (especially before 3 months of age) and need a lot of attention, cuddling and soothing, and quite often more so in the evenings! What does help is smaller, more frequent feeds with more frequent winding and burping during and after feeds to bring up trapped wind. Colic very often improves as your baby gets older, it’s best for your baby to continue on first stage infant formulas even if they do have these symptoms.

Soya Based Instant Formulas

Soya based infant formulas are also available however these are not suitable for babies under six months of age unless your baby has a rare inherited metabolic disorder called galactosaemia. This is because Soya is rich in Phyto-oestrogens which mimic sex hormones in the body. There is a theory that this may impact on the development of the sexual organs in boys, and until further research is available the recommendation is for soya to be avoided in very young babies. The carbohydrate in soya infant formula is glucose which is also damaging to emerging teeth.

Allergen Free Formula Milks

Another type of infant formula available are lactose-free milk’s. These should never be used unless under medical supervision. It is very rare for a baby to have true lactose intolerance, and still rare but slightly more common is cows milk protein allergy which is a very serious condition and a lactose-free formula will not successfully treat it. If your baby has symptoms of diarrhoea, vomiting, or signs of an allergic reaction such as eczema, a rash, red bumpy skin, facial swelling or breathing difficulties seek medical help for a proper diagnosis.

Diarrhoea can also be a sign of a tummy bug or infection. Sometimes babies develop transient lactose intolerance after a tummy bug. However, this is usually short-term and your GP or dietitian would advise you on when to re-introduce lactose. Lactose-free infant formula contains a different type of carbohydrate which is more damaging to your babies emerging teeth, therefore it’s really important that these formulas are used under supervision.

Cows Milk Allergy

Formula to treat cows milk protein allergy are also available however these are only available on prescription from your GP. If you suspect your baby has a cows milk protein allergy, see your doctor for a formal diagnosis. your doctor will refer you immediately to a Registered Dietitian in order to commence a ‘hydrolysed’ formula and advise you on a cows milk protein-free weaning diet. It is essential you do this with the support of a Dietitian as cutting out dairy can have a detrimental effect on your babies growth and development.

Protecting Your Baby from Eczema and Allergies

There are also formula milks on the market that suggest they may protect your baby from developing eczema and allergies should you have a family history. However, none of these has enough research evidence behind them to back up their claims. There is a lot of evidence that breastfeeding is the best way to protect your baby from developing an allergy.

Vegetarian or Vegan Formula

If you are vegetarian or vegan there is a very limited choice in terms of infant formula. Many have essential fatty acid derived from fish oils and animal rennet added to their infant formula. Vitamin D is added to all formula but is sourced from sheep’s wool so there are no vegan infant formulas available at present.

The recommendation for those who want to bring up their baby vegan is for mothers to breastfeed for at least the first year of life then alternative plant-based milks can be introduced into the diet under the supervision of a Dietitian. Plant-based milks are extremely low in nutritional value so shouldn’t be used unless under dietetic supervision.

For more information click here to visit Sarah Almond Bushell’s website

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Introduction to breastfeeding

Lara Karmel — Thu, 04 Aug 2016 15:29:09 +0000

Breastfeeding is often referred to as the 4th trimester. And rightly so, it should receive at least the same amount of information and detail as any other developmental changes during your first three trimesters.

During this 4th trimester, big changes are happening. Your boobs are now making milk on an hourly basis, you and your baby are getting to know each other.

This brings a new postpartum identity of body changes, perhaps a funny soft unstable belly, swollen breasts, and soreness and also the emotional changes of being a mum and the responsibility this brings.

Your baby will also go through massive changes during this 4th trimester. If you are breastfeeding, these next three months will probably mean you are inseparable. Now you can hold your child actively and physically in your arms, and your boobs keep baby nourished endlessly.

The 4th trimester also brings a lot more physical challenges, from extreme tiredness to sleep deprivation, to physical exhaustion from endless feedings. Usually, after the first three months, things will rapidly change, your baby will space out feedings, routines will be established, and things will slowly return to their place and shape.

Considering breastfeeding during the first three months as part of the fourth pregnancy trimester might help you understand the time and effort involved in providing for your baby.

I hope my advice articles will empower and support you nourish your baby. Visit @milkmakingmama for more advice and support.

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Getting the perfect latch

Lara Karmel — Wed, 03 Aug 2016 15:33:30 +0000

Baby’s position will make all the difference to a good latch. Once you have mastered the skill of breastfeeding, and latching on becomes natural, you may experiment with lots of different positions to nurse in. But in the early days, it is helpful to follow a few simple tricks and rules to establish a good, deep and comfortable latch.

Firstly, it would probably be good to get yourself some comfortable nursing pillows in order to get nice and relaxed during the first days of long endless breastfeeding sessions. I would recommend a big one for yourself and a smaller one for baby to lay on.

Sit comfortably, perhaps lay the nursing pillow if you are using one, on your lap and place baby on it.

Baby’s mouth is wide open.

The entire nipple and most of the areola (surrounding area of the breast) are in baby’s mouth. You should see more dark skin above your baby’s top lip than below your baby’s bottom lip.

You may see baby’s lower lip is curled back – but sometimes baby is so close you will not see the lips at all.

Baby’s cheeks are round and full.

Baby’s jaw and ears are moving in a swallowing, gulping motion.

Keep baby’s body in a straight line with the whole body facing the nipple and breast Support the neck, shoulders, and back so that the baby can tilt his/her head back easily.

Make sure the baby’s lower lip and chin are in contact with the breast first. A gentle stroke with your nipple on baby’s lip should lead to baby opening mouth wide ready to latch on.

A semi-reclined position might be particularly comfortable to nurse in as you can rest and lay down a little and gravity helps you.

Practice makes perfect. If you feel any tension in your arms, neck or shoulders do get somebody to get you an additional pillow or readjust your position. Nursing through feeling uncomfortable leads to increased pain, it is fine to unlatch baby readjust the position and try again. It also helps baby to practice latching on. And a relaxed mama will have a better milk flow.

When and if you encounter problems it is normal to tense up which ultimately makes it much worse, being stressed about positioning and tensing up is counterproductive in establishing breastfeeding.

Once established try a variety of positions you or baby like to nurse in, it will give you confidence and it frees up your mind about tensely holding your child whilst feeding.

Visit @milkmakingmama for more advice and support.

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Choosing & preparing formula milk

Lara Karmel — Tue, 02 Aug 2016 09:53:12 +0000

There are circumstances where it is not possible to breastfeed and although not as subtle or bespoke in composition formula milk provides an alternative that can keep mum and baby happy.

Choosing a formula

Most formulas are based on modified cows milk. Special varieties are available for premature babies as their digestive systems would be too immature to break down standard formula milk.

Cow’s milk

Little Miss Muffet taught us that milk is made of two proteins; curds (the lumpy bit) and whey (the watery bit). The curds to whey ratio varies according to the type of formula but most first milks are predominantly whey while ‘hungry baby’ milks favour curds.

Your baby will get all the nutrients they need from the standard ‘first milk’. ‘Hungry baby milk’ is intended to keep tummies fuller for longer, which means longer between feeds, however it is harder to digest and not always suitable for small babies and there is no need to change from one to the other if you don’t want to.

Goat’s milk

While this provides an alternative to cow’s milk based formulas it is not suitable for babies who are allergic to the protein in cow’s milk, because they are so similar that the reaction, potentially anaphylaxis, could be the same for both.

If your baby gets on well with goats milk formula, they can progress on to goat’s milk when they are a year. However, it is lower in nutrients than cow’s milk and not recommended as the primary drink. It is fine to use in recipes from six months when your baby has started solids.

Hydrolysed-protein

This is only available on prescription for babies who have an allergy or intolerance to cow’s milk. Allergy and intolerance are not the same; an allergy relates to the protein in the milk while intolerance relates to the lactose or sugar.

This milk has the same nutritional value as normal formula milk but are usually lactose free and the protein has been hydrolysed (broken down) so that it can be digested by babies with allergies. Talk to your doctor if you are concerned that your baby has an allergy.

Soya-based

As the name suggests, a soya bean based formula that has been supplemented with nutrients, vitamins and minerals. Speak to a medical professional if you would like to try this formula. They are not recommended for babies under six months, and if you do choose them for your growing baby, keep a close eye on their teeth because they are often sweetened.

Preparing formula

Preparation areas need to be clean and you will need to follow the guidelines on your chosen formula to ensure that you make it up in the correct ratio. If you use a knife to level the formula in a scoop the knife must be sterilized. You will also need to sterilize bottles and teats after each feed.

It is best to make formula as you need it using boiled water that has cooled to around 70c. This ensures that the water is still hot enough to kill off any potential bacteria that may be in the powder. Ready-made formula is more expensive but convenient and useful when you are on the go. However, the composition of ready-made formulas are slightly different to their powdered counterparts, so keep a watch on your baby to ensure that they are happy with it.

To feed your baby, hug them close into your body so that they are fairly upright and their head is well supported. Hold the bottle at a fairly horizontal position, ensuring that there is no air in the teat whilst your baby is feeding. Give your baby regular pauses for a few moments around every 30 seconds by lowering the bottle down (and therefore stopping the flow) or taking it out of their mouth. This will help them to pace their feed and have time to register when they are full. We all know how it feels to gobble down a huge meal too quickly!

As formula milk is harder for babies to digest than breast milk it stays in their stomachs longer so they do tend to go a little longer between feeds, but your baby still needs to be fed little and often. Your newborn is likely to drink about 50ml (1 to 2 fl oz) every couple of hours. By two or three weeks they may have settled in to a three-hour feeding pattern consuming closer to 100ml (3 ½ fl oz).

It is advisable to make up 30ml (1 fl oz) more than baby usually drinks, once they start to finish the bottle increase the amount of milk by a further 30ml (1 fl oz). Eventually your baby will take a full 8 fl oz bottle.

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Managing breast engorgement

Lara Karmel — Mon, 01 Aug 2016 10:20:37 +0000

Engorgement is caused by an oversupply of milk and fluid, making your breast very large, full and swollen. This leads to baby having a difficult time latching on.

Here are my tips for dealing with engorgement:

Nurse as often as possible and keep baby close so you can offer feeds more often.

Try reverse pressure softening, in which you press gently with your fingers around the nipple and compress, to then immediately offer for baby to latch on.

Try warm compresses or a warm shower before a feed. You can also hand express a little milk out first, so baby might find it easier to latch on.

A mini pumping session on a low-suction setting before each feed to relieve pressure could be helpful. You could save this milk or store it in the freezer for further use.

Moving and massaging your breast to move excessive lymph fluid around – whilst lying flat lets gravity help you.

Especially in the early days of establishing breastfeeding – with milk coming in and excessive fluids after birth – engorgement is common. If you feel swollen lymph nodes in your armpits during that time, that’s milk-making tissue that you never knew you had! Rest up and nurse well.

If you are suffering from any severe symptoms like fever, or else, check with your GP.

Engorgement will pass with frequent nursing and breast massage, take your time to work on your breasts and rest up mama.

Visit @milkmakingmama for more advice and support.

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You’ve got enough milk

Lara Karmel — Sun, 31 Jul 2016 10:23:00 +0000

If your baby is gaining weight and has plenty of wet nappies you DO have a great milk supply.

The following do NOT indicate a low milk supply:

Baby nurses frequently.
Baby is suddenly feeding more frequently, sometimes during evening times. Baby is fussy after evening nursing.
Baby wakes up frequently in the night to feed. Baby does not nurse as long as before.
Your breast feels softer.
Your breast leak less or not anymore.
You don’t feel a great let down or have not felt one before. All these reasons do NOT stem from low milk supply.
It is perfectly normal for an exclusively breastfed baby to feed often, have periods of the day to do so, or times during growth spurts to increase feeds. But that has nothing to do with a low milk supply.
The only indicator of a low milk supply is baby NOT gaining enough weight or not enough wet or poopy nappies. So keep calm and latch on!

Visit @milkmakingmama for more advice and support.

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