Brailling supplies and baby checkup (or: how Stella is going to poison Amy by feeding her milk)

[pne]

This morning, I went to the Hamburg Blind and Vision Impaired Association to buy a slate and stylus and some brailling paper.

Their office was currently being renovated; I'm glad I found their current temporary location, around the corner.

The lady who assisted me was blind, which was fitting, I suppose, though I was caught off-guard at first. There was a young lady with her, perhaps a trainee, who could see, and she filled out the receipt for me.

Next, I went back to Harburg where I met Stella outside the pædiatrician's practice for Amy's fourth routing check-up. We got asked into the examination room (?) fairly quickly and an assistant weighed and measured Amy (5500 g/12 lb 2 oz; 60 cm/23½ in). After that, we had to wait quite a while—over half an hour. When the doctor finally came in, she apologised and said she had had to handle a rather complicated case which took longer than she had anticipated.

I imagine that Amy's little patience had come to an end after that wait, though since she started crying during the checkup and refused to be comforted even when Stella held her in her arm against her chest—so the doctor had to do the examination over Amy's crying (listening to her chest, holding her from various extremities, moving the legs, feeling the lower abdomen are the things I remember). She proclaimed her normal, though she said we should look to see whether she starts to lift her head when lying on her stomach, something she doesn't often do just yet, and to see whether she rolls over from her back onto her side, something which she's only done once (about two weeks ago).

What she said next, though, miffed us a little: she said that starting at about 4½ months, we should start feeding her some carrots at lunch for a week and see how her skin reacts to that, then if she handles it well, slowly add fruit and potatoes during the afternoon and evening (each new item of food on its own for a week to see how she reacts to it before introducing a new one).

Stella told her that she had planned on nursing her exclusively for at least six months, especially after the allergic reaction she had had to the birds and/or the dust at my parents-in-law's house, and that she wasn't too keen on adding solid food before that. However, the doctor implied that at that point, Amy would be drinking so much milk that the levels of harmful substances (environmental poisons, pesticides, whatever, that Stella takes in through food) would no longer be negligible, and that she would not be able to supply all the necessary nutrients purely through nursing. The doctor also implied that conservative opinion stated that one should start adding solid food at four months and that she was being enlightened by putting the time at four-and-a-half to five months.

When Stella said that she still wasn't too happy about the suggestion, the doctor said that it was our child and that she could not force us, but that what she had told us reflected the current state of medical knowledge and was really for the best. (Stella did not appear too convinced by that, and said she'd think about it.)

I don't know. From what I've read, nursing exclusively for six months is just fine; we had even considered nursing for eight months as we had heard that doing so (i.e. postponing introducing other food for a little longer) can be good for children who are especially susceptible to allergies, as appears to be the case for Amy given my own allergies and her reactions to the visit to Kiel. AFAIK, nursing exclusively indefinitely is indeed not good and that there is indeed a time when babies want to explore solid food and also need not only the training that comes from chewing but also the nutrients, that time is not at 4½ months—that sounds a bit like the practices which the nursing books I had read called outdated.

Stella says she's glad that she'll be going to the "nursing mothers' café" held twice a month at the hospital where she gave birth in the not so distant future, where she'll be able to talk to the nurses working for the hospital, some of whom are trained nursing and lactation consultants.

jpallan?

Comments

[karen2205]

I'm not Jess, but I'd say you and Stella are right - mkbreastfeeding would be a good place to repost this for some more advice.

FWIW, I do think the doctor has a point about introducing new foods slowly enough so that you can see if she does react to them badly, and I agree that when she shows an interest in food is a good time to start introducing it - which might be sooner than you expect.

[pne.livejournal.com]

FWIW, I do think the doctor has a point about introducing new foods slowly enough so that you can see if she does react to them badly,

Oh, I'm fine with that bit; I had read that advice previously, and it makes sense to me.

and I agree that when she shows an interest in food is a good time to start introducing it - which might be sooner than you expect.

I think I'll cross that bridge when we come to it… but for now I'm inclined not to feed her solid food before six months even if she would like some.

[jpallan.livejournal.com]

Your initial thoughts were correct - nursing exclusively to 6 months is beneficial, and the ONLY substantial risk is of anemia, and ONLY in children exclusively breastfed past 7 months (exclusively meaning without any food, not without bottles -- there's no reason to give her infant formula).

Doctors really aren't trained in nutrition and parenting -- they're trained in pathologies. They're competent, wonderful people, but that doesn't mean that they know everything. ;) You can look it up in La Leche League materials, either in English or German. :)

[pleiades829.livejournal.com]

The World Health Organization agrees with you:

---

A recent review of evidence has shown that, on a population basis, exclusive breastfeeding for 6 months is the optimal way of feeding infants. Thereafter infants should receive complementary foods with continued breastfeeding up to 2 years of age or beyond.

---

http://www.who.int/child-adolescent-health/NUTRITION/infant_exclusive.htm

Gobs more information at Kellymom.com (http://www.kellymom.com/nutrition/solids/delay-solids.html). They have lots of off-site links to medical journals and the like, so you can a bit more confident that the info isn't biased.

[pne.livejournal.com]

Thanks. UNICEF also appears to offer similar advice.

(Random bit of trivia: their "baby-friendly hospital initiative" is called "breastfeeding-friendly hospital" in at least some German hospitals, possibly because other hospitals claimed that they, too, are baby-friendly... just, perhaps, not as breastfeeding-friendly as hospitals which comply with the terms of the Initiative are.)

[robnorth.livejournal.com]

Not a damn thing wrong with waiting on solid food for 6 months. A lot of it is up to the baby; most of my porkers would have screamed us out of house and home if we hadn't started solids earlier. But if Amy's cool with what she's getting, that's fine.

(Although I must confess, I feel fear and trepidation when I see a baby of that age is under 6 kg; I'm so used to huge babies. When a baby gets sick, it's so much more reassuring when they have a few extra pounds to spare. I know all babies are different, and that's probably just the way Amy is. I'm just nervous around tiny babies.)

As for the "harmful stuff in milk", there's good news and bad news. The bad news is, yes, even breast milk isn't safe, and your baby is going to get Unpleasant Things in there. The good news is, the breast milk isn't going to have any more of that stuff than anything else you feed her. And the health benefits of breast milk way outweigh the detriment of any nasties that make their way in there.

(Tons of studies up in northern Canada, where I lived for so long, reassured the Inuit and other locals that even though there are dioxins and Chernobyl leftovers on the lichen that get into the caribou that the moms eat that gets into the babies, the health risk from the quantities involved isn't anywhere near the risk from bailing out of breastfeeding too early. My wife actually participated in one of those studies with our second daughter, which included samples of mom's blood and umbilical cord blood.)

[pne.livejournal.com]

Although I must confess, I feel fear and trepidation when I see a baby of that age is under 6 kg

She is below average weight, but the assistant said that what is more important than being "average" is staying on her own curve (i.e. her curve of height-vs-age or weight-vs-height over time is shaped similarly to the average curve, even if it's shifted up or down a bit), and the doctor mentioned that while her weight was below average, it was closer to the average line than the last measurement (six weeks ago?). Her length, in comparison, is pretty nearly exactly on the average line in the little booklet we have (which has 3%, 50%, and 97% lines).

The bad news is, yes, even breast milk isn't safe, and your baby is going to get Unpleasant Things in there. The good news is, the breast milk isn't going to have any more of that stuff than anything else you feed her.

The argument the doctor used is that for baby food, producers try to go to greater lengths to reduce the level of contamination than for food for general consumption, and that hence baby food is safer than what Stella might eat. (For that reason, she also recommended buying little glasses of prepared baby food rather than, for example, puréeing carrots we bought ourselves.)

And the health benefits of breast milk way outweigh the detriment of any nasties that make their way in there.

That kind of matches what I had thought, too. (For a similar reason, I believe that in general, it's better for smoking mothers to breastfeed as again, the benefits outweight the disadvantages.)

[robnorth.livejournal.com]

For that reason, she also recommended buying little glasses of prepared baby food rather than, for example, puréeing carrots we bought ourselves.

Oh, the little glasses of prepared baby food that are chock full of sugar and salt?

Bullshit. 'Scuse my French. Yeah, I know, us Mormons aren't supposed to swear and all, but this one's peggin' my bullshit meter at 11. Any guess she's getting a kickback from Nestle or some such?

Take your own food. Buy one of those little hand-crank baby-food grinders. (Dunno about Deutschland, but here they're ubiquitous, esp. at garage sales; a good wash and little bleach and voila.) Take some of your food. Put it in grinder. Grind. Feed.

The little tykes like the stuff in the little glass jars better, but the reason is obvious once you see the ingredients list.

Besides, it's way more expensive. The only time we ever used them was on road trips, when procuring and grinding cooked carrots in the middle of the Trans-Canada Highway would've been inconvenient.

We bought Pablum-style cereals, for sure. Started with rice, then added one thing at a time, saving corn and wheat for last. Veggies, started with carrots, then peas, then other things. Fruit, started with pear, then apple, etc. Try to be anal about spacing new things a week apart if you're worried about allergies; that way, it'll be crystal clear which one's the culprit if you get a reaction.

But for veggies and fruit, we just ground our own. Sheesh.

On the whole issue of environmental contaminants, most people are appallingly ignorant. On the one hand, so many people have no clue that these things are even out there. On the other hand, so many of the people who do have a clue exaggerate the crap out of it, and come off sounding like Chicken Little. Oy.

[fridoline.livejournal.com]

Nowadays it is actually possible to buy baby food without salt and sugar - just the plain vegetable or fruit. But one does have to look around a bit and study labels carefully. We found those little glasses quite convenient at the beginning, when the little ones often only eat a few spoonfuls. Once Emily started eating greater quantities we switched to self-prepared.

[ladyortyger.livejournal.com]

*shrug* I had heard that at least 6 months was the best.

Check out La Leche League International's website..

http://www.lalecheleague.org/

[pne.livejournal.com]

Ah, right -- http://www.lalecheleague.org/FAQ/solids.html seems to apply here, for starters. Thanks for reminding me of their site.

[pne.livejournal.com]

As does http://www.lalecheleague.org/FAQ/contaminants.html (to address another point the doctor made).

[ladyortyger.livejournal.com]

;) I like 3L. It's a great resource.

[entirelysonja.livejournal.com]

As everyone has said, your doctor is working from highly debatable information. Here, 6 months seems to be the standard advice for breastfed babies.

Though if Amy does show interest in food, I would think it's worth giving it a try -- like breastfeeding on demand, you're following the child's lead.

(I plan to wait until about 6 months, unless Erika seems very interested sooner.)

[fridoline.livejournal.com]

Of course nursing exclusively for six months or even longer is fine. The doctor's suggestions do seem rather outdated.

Talking about outdated - the latest "fad" is to start with something other than carrots. Apparently they may cause indigestion with sensitive babies, so some recommend feeding pumpkin, parsnips, or zucchini instead. There are even some people who are allergic to raw carrots, though they can handle them when cooked.

I definitely recommend waiting until Amy shows you clearly that she is ready for solid foods. For one thing her intestines will have had more time to "mature". And another thing to consider is that after the initial excitement of feeding with a spoon it becomes clear that it's quite a bit of extra work! Putting the baby to the breast is much easier than preparing and feeding vegetable puree - and later one or two other dishes every day.

I also recommend looking twice if you seem to see signs that Amy is getting ready for solids. Increased salivation can also result from teething. Putting everything into her mouth is a normal part of her development. Watching you eat with much interest could be mere curiosity.

In the end you just have to make a decision and trust that it will work out. There is no one right way, and there will always be reasons why another way would have been good too.

[pne.livejournal.com]

Putting everything into her mouth is a normal part of her development.

*nods* One site that I found said that one sign of getting ready is if the child grabs food and puts it into its mouth, then repeats that -- saying that if it happens once, it's probably just curiosity, while if they do it more than once, it's more likely to be "yum, food".

[angharad.livejournal.com]

Why'd you get Braille supplies?

[pne.livejournal.com]

Because I started to get interested in Braille a month or two ago, and started learning it.

This way I can write hard-copy Braille rather than merely on my computer.

Just for fun, since I like languages and scripts.

[angharad.livejournal.com]

Cool. If you're going to read it too, I'll be interested to know how difficult you do or don't find its tactile aspect. I figure that would be the hardest part for me, since I'm not very tactile in general.

[pne.livejournal.com]

Yes; I can imagine it'll be similar. Stella said that she doubted I have the necessary tactile discrimination to learn to read it with my hands.

I shall have to see. I'm not planning on practising too hard, but it would be kind of cool to be able to read Braille by touch and not only by sight.