Coffee Catchup 10 Feb Tauranga with Dorothy Waide

OHbaby! Coffee Catchup - February 10th 2014. Feel free to ask questions and Dorothy will reply when she can.

Hi Dorothy. I would love to know your recommended daily routine for a baby just turned 6 months old. She is fully formula fed and has been having 2 lots of solids a day (lunch and dinner). We introduced breakfast today after your talk yesterday. She has 5 bottles of formula (Nurture gold) per day. She has never been a big drinker and takes approx 700 - 800ml formula per day. I tend to feed her 4 hourly during the day at 7, 11, 3, 7 and approx 1am. I have tried offering her more bottles during the day but she ends up drinking less each time. Thanks, Kate.

Hi Dorothy,
Thank you for all your advice on monday.
My baby is 11 weeks and exclusively breastfeed. I express every now and again and freeze it and was wondering when giving my baby girl a bottle how much should i be giving her? She feeds every 3 hours 9am, 12, 3, 6, 9pm then once again either 4.30am or 6am depending on when she wakes.
She only feeds off one side each feed and will not take the second side. When i express i usually get about 150mls off a side.
Thanks again
Fiona (friends with rochelle )

Hi the name of the drops is Dorothy Drops and they can be purchased from Quintessence online.
ALso please find attached notes on introducing solids which will give you the foods you are asking about to avoid for a reflux baby
Introducing_Solids_-_2014Febohbaby.pdf

Hi Melanie
I would suggest swapping her milk and solids around so that she has her solids first followed by milk and then has another milk feed before her naps. I have just posted two different types of routine that you can have a look at and see if that helps.

If she is eating 4 large tablespoons of baby rice at each meal she is eating well.   What is an average portion for a baby this age and size. It does depend on the baby, some of the smaller babies can actually put away a lot more food than others,   I would suggest vegetable wise (lunchtime) approx 120 to 150mls - some babies wil either eat slightly less or more but hopefully that will give you a guide. Cereal wise 4 tablespoons is fine (this is before mixing) though.   Babies this age will eat anywhere from 2 to 5 tablespoons - some slightly more

HI Maria
YOur son may just need to suck (comfort) himself back to sleep and ideally as he grows he will find something else to comfort himself.   In my experience if you can take the time to try and resettle before giving the dummy then he may learn to resettle without it.   To do this when he wakes, there are a couple of options. The first would be to get in quickly before he wakes and cup/pat/shush him back to sleep and after say 5 minutes if he is not settling then offer the dummy. The other option is to wait and see if he resettles and if he doesn't then go in and cup/pat and shush and again if he doesn't settle then offer the dummy. I wonder how heavy your baby is as I do believe that the weight of the baby along with the age of the baby is important when considering introducing solids.

When offering new foods at lunchtime i.e. vegetables I always offer the new vegetable at a small portion. So if I start a baby on lets say kumara and pumpkin and then go to introduce a new veggie I would perhaps do 2 tablespoons of kumara, 2 tablespoons of pumpkin and 1 teaspoon of broccoli.   The new food hopefully will be mild enough so he learns to like it. I tend to offer for 3 days and I find at the end of the 3 days they are beginning to like the new mixture.   If they don't then i go onto another veggie mix and wait a few days and reintroduce the veggie again. This time I would offer 1/2 teaspoon to the mix until I find the right mixture that he will like. ONce he likes it then over time I increase the amount so that it is in more portion to the other veggies in the mix. When offering solids, I tend to offer purees and finger food. The finger food is to teach them texture, taste and smell and ideally it is what is the puree. IF they don't like a food I will always reintroduce, until they get to like it.

Cereals that I offer babies are Millet, oatmeal, amaranth, wholemeal baby rice, baby rice, quinoa - although this is a low gluten food so it is my last choice on the cereal front. How long I keep a baby on cereal at night depends on the age of the baby and also how long it takes for me to get a good mix of veggies going at lunchtime. ONce I have a good mix of veggies at lunchtime, then I drop one veggie down to dinner time. For example I will start with pumpkin and cereal and then the same as lunchtime get a good array of veggies and cereal going at night time and then when i feel the baby is ready, I just drop the cereal and replace with a carb.

BURPING YOUR BABY
Burping is a technique that requires assertive pressure and focus. Some babies are more difficult to burp than others and you may need to choose a combination of burping techniques to release stubborn wind.

Throughout, make sure your baby’s back remains as straight as possible to help open out his digestive tract.
Over the knees tummy down
Place your baby over your knees, with his tummy facing down and his left side farthest from you. Reach across and, curving your hand slightly, slip it underneath the tummy area then begin rhythmically patting him up and down his tummy. Mothers are often surprised to hear a sloshing noise that disappears once the gas is released.
Over the knee facing upwards
In this position it is easy to massage your baby’s tummy.

Try the following techniques:

•     Using firm pressure, massage his tummy clockwise.

•     Place your palm just below the ribcage on his back, at the level of the waistband on his nappies, and in one fluid movement massage downwards over his nappy or bottom. Repeat two or three times.

•     With your outstretched hand spanning the entire width of his abdomen with your thumb and fingers on opposite sides. Gently squeeze together your thumb and fingers in a kneading motion and repeat several times.

Then turn baby over and put in sitting position so that you can check their tongue.
Tongue Position
His tongue needs to be at the base of the mouth to effectively bring up wind. Press on his lower jaw to open it and hopefully the tongue will flop down. If this doesn’t work, then try gently ‘popping’ his cheeks.
On the Shoulder
Place your baby on your shoulder, facing towards you so that his chin rests on the crest of your shoulder. Using both hands, slip your thumbs under your baby’s hips and tilt upwards in a backward rotation to help straighten out his body. This may mean you lift him slightly away from your body to achieve this.

Do not pull his legs to straighten them as this can dislocate the hips. Once positioned, using the same arm as the shoulder you’re using, cross your forearm firmly under his buttocks to support him.

Using your palm massage the entire back with circular, clockwise motions.

Firmly pat your baby ’s back a few times then, with your hand spanned across his back with your fingers on one side and thumb on the other, gently apply pressure with your fingertips and thumb, and rub up and down both sides of his back using equal pressure on both the upward and downward strokes.

Your hand should be large enough - and your baby small enough - that your fingers and thumbs can reach the sides of his body. Massaging these areas will access both the ascending and descending bowels and encourage intestinal gas release.

With practice, a combination of these techniques will take no longer than five minutes to release the gas from his tummy.
On the Change Table
Hold your baby ’s legs below the knees and gently push his legs up so the knees are placed onto his tummy. Release slightly still bent, then place them to the right side of the tummy release slight, and then back to the centre of their tummy, and then repeat movement on the left side. This movement will also help release any bowel gas.
Nappy Change
The act of changing a baby’s nappy actually often alleviates wind as the leg movement during changing, followed by popping your baby back over your shoulder, can be effective in bringing the bubbles to the top.