Wednesday, March 31, 2010

Starting solids

Ever since Sam emerged from the "newborn" phase, people have been asking me when we were going to start feeding him solid food. As with other questions, I turned to books.  Your Baby's First Year Week by Week by Glade B. Curtis, M.D. and Judith Schuler, M.S. suggests starting at 4-5 months, and says that by 6 1/2 months (his age now) babies can enjoy a variety of solid foods. Child of Mine: Feeding with Love and Good Sense by Ellyn Satter recommends basing starting solids on what your child can do (such as sitting up on his own).  Family members suggested starting even earlier by putting cereal in his bottle.

We started offering cereal by spoon at around 5 months. "Cereal" refers to a mashed, cooked, single grain, such as rice, blended with breast milk or formula. We tried making our own, but found boxed baby cereal preferable as it's quick and there's less waste. Some days he seemed to really enjoy it, opening wide for the spoon; others, he just played with the food, or the spoon, or the whole bowl; still others, he cried to get out of his high chair.  It wasn't going great, but we decided to let him go at his own pace.

Then, just last night, Sam's first tooth emerged, peeking out of his bottom gum. I had this thought: wouldn't it make sense that babies are biologically ready for food beyond milk when they grow teeth rather than by some arbitrary time line or unrelated skill development?  I haven't found any research on this so far, but my mommy intuition tells me he'll be more ready for solid food soon.

Wednesday, March 10, 2010

Donating breast milk

One of the best side effects of being an overproducing mom is the ability to donate milk.  I have stashed in the deep-freeze at least 100 oz. of milk per month since September—some months up to 200 oz. or more, depending on Sam’s appetite.   Since I don’t plan to quit pumping, I decided to donate my extra.  

My freezer stash
In the US, there are two ways to do this.  The first time I donated, I connected with a mom of an adopted baby through  I shared some basic info about my diet and documents showing I was HIV/HEP negative.  She sent me everything I needed to ship the frozen milk—cooler, coolpacks, etc.—and I just packed it up and shipped it at her expense.  Her adopted baby enjoyed about 250 oz. of milk, probably a week or two’s supply.

The other way to donate is through a milk bank. Donor moms are tested for disease and are screened for other factors, such as medications.  The milk is then processed at a lab and dispensed by a doctor’s prescription.  According to the Human Milk Banking Association of North America, “Common reasons for prescribing donor milk include prematurity, allergies, feeding/formula intolerance, immunologic deficiencies, post-operative nutrition, infectious diseases, and inborn errors of metabolism.” According to the World Health Organization, "Breast milk is particularly important for pre-term infants and the small proportion of term infants with very low birth weight; they are at increased risk of infection, long-term ill-health, and death."

Last week I had my phone screening with the Mothers’ Milk Bank at Austin, Texas (the closest bank accepting out-of-state donors).  Next they will send me paperwork to fill out and an order to have blood drawn at a lab close to me.  Once my results are verified, they will send me packaging and instructions to ship the milk.  I’ll get some dry ice, package up the bags of milk, and send it off.  This may seem like a lot of effort, but compared against the option of NOT helping sick babies with milk I don’t need, it seems manageable. 

Donating milk to an adopted baby was an immensely rewarding experience, because he will have the benefits of human milk, even if just for a short while, and the milk (and all my efforts to pump it) did not go to waste.  Donating to a bank may be even more rewarding since the babies who will eventually receive it may have a better chance at health because of it. I consider myself fortunate to be able to help other human beings in a way that most people never could.

– Premature recipient’s mom

 8 oz. of frozen milk

Tuesday, March 2, 2010

Formula-feeding support

If two-thirds of new moms initiate breastfeeding, the other third feeds formula right from the start.  What’s more, only 7.2% exclusively breastfed for six or more months (CDC, 2008); the 2005 Infant Feeding Survey in Britain showed that only 1% of babies were exclusively breastfed for one year.  That means that the vast majority of babies eat some formula during their lives.

Given this, we would expect that formula-feeding moms would have plenty of information and support.  However, according to a 2009 survey of data on formula feeding, “Many mothers who bottle-feed their babies reported receiving little information on bottle-feeding and did not feel empowered to make decisions…some healthcare providers noted that the WHO/Unicef code discourages active dissemination about bottle feeding.”  (Lakshman, 2009.)

The result of moms being uninformed is that hygiene and safety guidelines in bottle-feeding aren’t always followed. This includes using warm tap water, heating prepared bottles in the microwave, and over or under concentrating feeds.  Some mothers also changed formulas frequently which is not recommended. (Lakshman, 2009.)

Anecdotally, when I left the hospital with my newborn, there was not one document on formula feeding in the reams of paper I received on all things baby, nor had anyone at the hospital discussed it with me.  I went by the instructions on the can, though I still don’t know what the risks are if I, say, over concentrate feeds by adding the water after the powder.

It would be a shame if part of the effort to encourage breastfeeding meant a failure to address the needs of bottle-feeding moms.  Withholding of information about alternatives isn’t usually the best way to encourage something.  I think we’d be better off if new moms knew at least a little about both feeding methods, because most of us will feed formula at some point, and we owe it to our kids to get it right.

1.     Lakshman, R; Ogilvie, D; Ong, K. K. “Mothers’ experiences of bottle-feeding: a systematic review of qualitative and quantitative studies.” Archives of Disease in Childhood, 12 May 2009. 
2.  Center for Disease Control. 2008 Pediatric Nutrition Surveillance, National Summary of Breastfeeding Indicators, Children Aged less than 5 years [Data file]. Retrieved from