The Rouge Test

Here's something kind of fun you can do with your kiddo...a little experiment that doesn't involve wearing a hat to measure brain waves! In developmental psychology its been called "The Rouge Test".

Step 1. Put some bright red lipstick on the end of your baby's nose. Blush, pudding...anything that's safe for baby skin and colorful will work.
Step 2. Distract your baby so that she forgets that you did anything.
Step 3. Put your baby safely in front of a mirror so that he can see himself.
Step 4. Watch to see what your baby does. Does she try to interact with the other baby? Ignore the mirror? Try to touch his own nose?

If your baby is around 15 months or over, watch to see if he touches his nose or gives some other clear indication that he realizes the lipstick is there. Its about this time that toddlers develop self-recognition. They begin to understand not only that they are their own person (which starts to happen around 6 months) but that their self has specific characteristics...like a name and a certain look. Touching the lipstick on the end of their noses is a sign that says "Hey, that's me, and that's not supposed to be there!"

Before this time, they'll see a baby and might be interested, but won't have a sense of who that baby actually is. If your baby doesn't seem to exhibit self-recognition yet, just try it again in another month or so...they'll probably get it by 18 months.

Self-recognition is an important step in development...but be prepared. Once they realize they have a "self", the next step is trying to figure out how much control they have over their environments, and this is the stage parents often refer to as the Terrible Twos. When you hit it, take heart. Your sweet baby isn't trying to be "terrible", they're being smart. They're trying to figure out how the world works and exactly how it works for them.

TV for Toddlers: Do We Really All Do It?

If you’re not aware, the current guideline by the American Academy of Pediatrics says, “No TV for kids under 2 years old.” Many parents don’t know this – especially since there are movies, TV shows…even whole channels of programming aimed specifically at kiddos 2 and younger. Some parents I’ve talked to thought it was okay as long as it was “educational” TV. These parents tended to mean shows like Disney’s Baby Einstein, whose videos by the way, have been recalled because of the research findings on infants and screen time. Other parents have said they thought it was okay since their kids seemed to enjoy it so much. This explains the research findings that despite the “guidelines,” the majority of 1 years olds watch at least 1 hour of TV each day.

I know all about this research, which is why I very deliberately didn’t register or buy any “kid” DVDs when Ian was born. Somewhere in one of my many Target trips during that first year, though, I ran across a Wiggles DVD on sale. I’m a big fan of The Wiggles for young kids, so I bought it with the intention of saving it. Then Ian turned a year old and one day, out of curiosity (and probably a bit out of fatigue) I popped it in the DVD player to see what his reaction would be. He loved it. He seemed mesmerized and sat still for longer than I’d ever seen him. It was glorious in so many ways. My mind quickly wandered to all that I could accomplish in 30 minutes of time…dinner, dishes, catching up on emails or grading, and dare I admit – Facebook? Then better judgment came in and I put the DVD up, vowing to not take it out again until after 2.

But eventually stress hit and so I suggested…yep, The Wiggles. As a researcher, I know the data. As a therapist who works with families, I know that if the “rules” are causing stress to the family, its often time to be flexible. I was very comfortable knowing that for this brief time, Ian was joining the rest of America’s babies with his hour of TV a day. The problem was, the major stress passed and the DVD still stayed out. By this time, my husband and I knew all the songs and motions ourselves…we would tease each other when one of us would break out into one of them accidentally in a store. But as I watched Ian gazing at the screen one evening while I was making dinner, I reminded myself of the reasons why the guideline is what it is. I took the DVD out and put it in the top of a closet so that it wasn’t just so darn easy to grab and begin playing.

Here are some of the reasons why the guideline is there:

• That locked in look you see where your toddler is staring at the screen? That’s his brain shifting to auto-pilot in a sense, and for a brain developing as rapidly as a toddler’s is, that’s just never a good thing.
• There’s evidence that the level of stimulation kiddos get from programming that actually holds their attention gets them used to that level of stimulation all the time – which has been associated later in childhood with diagnoses of ADHD.
• Toddlers learn through interaction, which they don’t really get from a TV. While older children can learn from TV, there’s very little evidence that says toddlers do the same, but there’s quite a bit that says TV exposure may actually lower things like their vocabularies and later school performance. (This is the big reason for the Baby Einstein recall).
• Any time a toddler is watching TV they’re not doing something else – and we want them doing other things like looking at books and moving.

Is occasional TV going to completely ruin your child? No. If you resort to popping in a video on your long road trip to hold your toddler out for the last leg of the journey, you’re not a bad parent. But its just not a good idea on a regular basis, especially if you’re using it more like an electronic pacifier. If you can’t get rid of the screen time, limit it to 15 minutes at once (which is about the maximum time you’ll have before getting that glazed look) and interact with your child while you watch the program with them.

If you’re looking for replacement activities that will get you a few minutes of downtime, try CDs with music, books, or craft supplies instead. Especially if they’re “special” items that only get taken out when you need these moments, they’ll entertain a toddler for quite some time. I managed to find a great CD and giant flip chart combo that has songs with the lyrics written out on the pages of the flip chart. Add some of your own dance moves as you’re folding laundry or drying your hair and you’re sure to be more entertaining than someone on the TV screen dancing around!

Milk Share

For all you breastfeeding moms...do you have an abundance of milk - maybe even some left in your freezer that's still good? Consider checking into Milk Share. Each of you knows the benefits of providing breastmilk for your babies, but there are some moms who are unable to nurse for various reasons...and that's where Milk Share comes in. Milk Share isn't a milk bank. Instead, it acts as the "middle woman" (so to speak) between moms who are wanting to provide breastmilk for their babies and moms who have some to give. We encourage you to check it out and help out another momma!

Idea for Future Posts?

So sorry we have been derelict in posting anything new! The end of the semester definitely took its toll.

As we're brainstorming for ideas for posts, do you have any suggestions? Maybe there's something you're curious about or need help with? Let us know! Its always easier to write when you have something to write about!

Lack of Breastfeeding Support in Hospitals

While breastfeeding is almost universally recommended, I’m sure I don’t have to tell you that in the US breastfeeding is not well supported. A 2009 Center for Disease Control Report gave the US a grade of 74 for supporting breastfeeding. Oklahoma only got a 66, but was higher than Ohio (59), Arkansas (62) and Louisiana (lowest at 49).

This is distressing as since 1991, the World Health Organization has promoted 10 simple steps that hospitals and health care providers can take to support breastfeeding. This Baby Friendly Hospital Initiative has been shown to increase both the number of women who begin breastfeeding and the duration of breastfeeding. The Initiative has accredited over 15,000 hospitals and birthing centers world-wide. However, in the US, there are only 89 centers that are accredited! (See list).

Even if a hospital cannot implement all 10 of the “baby friendly” steps, there are four important ones that can make a big difference. The first two encourage the hospital to have a policy outlining how they will support breastfeeding and require that all staff who interact with breastfeeding moms are aware of the benefits of breastfeeding. This gets everyone on the same page, assures that it is not just the lactation consultant who knows how to support new moms, and makes sure that even the maintenance workers know the benefits of breastfeeding. My research group did a small survey a few years ago and found that many hospitals in Oklahoma did not have a written policy or provide comprehensive training.

Next, it is very important that a baby be allowed to nurse in the first hour after birth. A survey of maternity nurses in Oklahoma found that just over half of nurses knew that the best time for an infant to start breastfeeding was in the first hour after birth.

Finally, community support is very helpful in maintaining breastfeeding. Oklahoma has only 1.6 lactation consultants per 1000 births, while Alaska, which has the highest breastfeeding score, has 9.3! Stillwater is lucky enough to have a La Leche group, however. If you are not familiar with La Leche, it is a group of women who get together to support each other while breastfeeding. The national organization supports a wonderful hotline which answers any and all breastfeeding questions: 1-877-452-5324.

So what can you do to make a difference? Ask your Ob/Gyns about their support for a hospital policy for breastfeeding. When you take a tour of the maternity ward, ask to see a copy of the hospital’s breastfeeding policy. Check out La Leche – it is a great way to get the word out about the importance of breastfeeding!

Study: Lack of breastfeeding costs lives, billions of dollars

We saw this on CNN.com and thought you might be interested...

You can go here to read the original article

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Miriam Falco, CNN Medical News Managing Editor

April 5, 2010 10:06 a.m. EDT

(CNN) -- If most new moms would breastfeed their babies for the first six months of life, it would save nearly 1,000 lives and billions of dollars each year, according to a new study published Monday in the journal Pediatrics.

"The United States incurs $13 billion in excess costs annually and suffers 911 preventable deaths per year because our breastfeeding rates fall far below medical recommendations," the report said.

The World Health Organization says infants should be exclusively breastfed for the first six months of life "to achieve optimal growth, development and health." The WHO is not alone in its recommendations.

The American College of Obstetricians and Gynecologists, the American Academy of Pediatrics, the American Academy of Family Physicians and the Centers for Disease Control and Prevention all agree that breast milk alone is sufficient for newborns and infants until they are 6 months old.

However, a 2009 breastfeeding report card from the CDC found that only 74 percent of women start breastfeeding, only 33 percent were still exclusively breastfeeding at three months and only 14 percent were still exclusively breastfeeding at six months.

Dr. Melissa Bartick, one of the new study's co-authors, says the vast majority of extra costs incurred each year could be saved "if 80 to 90 percent of women exclusively breastfed for as little as four months and if 90 percent of women would breastfeed some times until six months." Bartick is a hospitalist -- a doctor who specializes in the care of hospitalized patients -- at Cambridge Health Alliance, an instructor in medicine at Harvard Medical School and a mother of two.

Bartick and her co-author Arnold Reinhold found that most of the excess costs are due to premature deaths. Nearly all, 95 percent of these deaths, are attributed to three causes: sudden infant death syndrome (SIDS); necrotizing enterocolitis, seen primarily in preterm babies and in which the lining of the intestinal wall dies; and lower respiratory infections such as pneumonia.

Breastfeeding has been shown to reduce the risk of all of these and seven other illnesses studied by the study authors.

Bartick calculates $10.56 million for each of the estimated 911 children's deaths. Researchers also included the direct costs of health care and parent's time missed from work. They did not include the cost of formula, which is another added cost for moms who don't breastfeed.

There are a lot of factors contributing to low breastfeeding rates in the United States, and Bartick says moms shouldn't be blamed, because they receive mixed messages and often lack support from the moment their babies are born.

She says the biggest priority should be to improve maternity care practices. Bartick refers to a 2007 CDC survey of hospitals and birthing centers, which scored each facility to determine how well it complied with recommendations meant to encourage women to breastfeed.

According to that survey, Bartick says, "U.S. hospitals scored a 63 - that's a D."

Bartick says many hospitals delay immediate urgent skin-to-skin contact between mom and baby, which can make things harder for the newborn to act on its natural instincts to suckle.

Moms also need to be better educated about the importance of breastfeeding and they need adequate support after they leave the hospital in case they run into problems because the newborn isn't properly latching on and therefore not getting enough food.

Dr. Alan Fleischman, medical director for the March of Dimes, was not surprised by the findings of the report. Fleischman, who did not work on this study, says if a new mom is struggling with breastfeeding, she may end up in a situation where "grandmother suggests to stop the silliness and give formula instead."

He believes the mothers and grandmothers of new moms also need to be educated about the benefits of breastfeeding because for their generations, feeding their babies formula was the norm.

Super-sized Portions

Can you remember when the BIG MAC was the “worst” burger a person could get? To provide more and more value, fast food chains and restaurants are offering larger and larger portions of all kinds of food. And it’s not just fast food - I recently saw a recipe for a 44 oz home-made smoothie with 10 cups of fruits and vegetables!

My Mom used to say “Be careful how much you take...don’t let your eyes be bigger than your stomach”. But the trend to value-size meals has taught all of us just that. Because we get large portions outside of the home, we think that we need large portions at home. And we end up eating more.

One research group invited a group of nutritionists to an ice cream social and gave each person a bowl and an ice cream scoop. Some bowls were small and some of them were large and some of the ice cream scoops were small and others were large. The researchers then kept track of what everyone ate. What do you think happened?
If you guessed those who got big bowls and big scoops ate more, you’re right! People who had big bowls ate over 50% more than those who had the small bowls and scoops.

You eat more from large packages even when you aren’t hungry. A study looked at a group who had just eaten lunch and then went directly to a movie. At the movie, half the group was given a medium popcorn and the rest a large. Although the group wasn’t hungry, those who got the large popcorn ate 50% more!

It seems our ability to estimate calories becomes less accurate the larger the portion size becomes.
So what can a family do to combat this trend to portion distortion? It may be easier to change your environment than you're thinking.

First, try to eliminate large packages from your pantry. If you need to buy big bags at a warehouse store, keep the large size package out of sight in a cabinet or break the package up into smaller “portions” for storage. Even if you buy a bag of chips or cookies for snacks, repackage the bag into smaller snack sized plastic bags.

You might want to take a look at your glasses and plates and buy something smaller. There is a natural tendency to “fill-up” a glass, though when you think of it no one needs 20 oz of juice or milk or pop at one time. It may take a trip to the thrift store to find smaller glasses but you can end up saving calories and money by using glasses that hold only 6 to 8 oz. The same goes for plates, instead of 12 inch plates look for those that are 8 inches across. There is no rule that says seconds aren’t allowed if someone is still hungry, but smaller portions at the start will help prevent overeating and waste.

I’d love to hear some of your suggestions for “downsizing” portion expectations.

Tay

Object Permanence: Why Peek-a-Boo is Magic!

Does this sound familiar? Your baby sees your cell phone and wants it. You're not that interested in a saliva-covered screen (trust me...in great enough quantities, baby saliva can fry a phone) so slip it behind your back, maybe making some comment like "All Gone" to her. She seems to believe you and goes on to soak some other object with her spit. Small catastrophe averted.

But wait! The next time you try this sneaky maneuver, she looks at you, and then reaches behind your back. You have failed to fool her.

The difference is explained by the fascinating development of what is called object permanence. Originally described by psychologist Jean Piaget, object permanence refers to the basic ability to realize that things continue to exist even when you can't see them.

Here's how it works. During the first six months or so, infants don't seem to have object permanence, so putting your cell phone behind your back really does seem to make it disappear. At this age, this is why games like peek-a-boo are so much fun. Think about it, you cover your face with your hands - disappearing - and then move them with a shout of "Peek-a-boo!" all of sudden revealing your hidden face. The infant thinks something like "Wow! Mom's magic! How did you DO that cool trick?"

Then, around 6 months of age, infants go through some very big changes that are ushered in both by motor developments and brain changes and the appearance of object permanence is one of these. Now your baby will look for your phone when you hide it and they will laugh and smile at peek-a-boo because now its sort of like your inside joke with them - they get what you're really doing.

Funny Calvin & Hobbes Cartoon Strip

You can test this first stage of object permanence easily by hiding something your infant wants (like under a blanket) and watching to see if she looks for it. Just keep in mind that if she doesn't, it could simply mean she doesn't want it that bad rather than that she hasn't reached this development. For my son, Ian, if I really want to show off this skill (which I do regularly for students in the child development classes I teach), I break out something he finds really exciting - like keys or a remote.

Still, at this point in the game there are some limitations in what infants are capable of and they'll make what are called "A not B errors", so there's a second stage of object permanence that happens later. Between the time the first and second stages develop, if something disappears, the infant will look where she thinks the object should be, but if its not there...then it really must have disappeared!

To test this stage with your baby, try this:
Lay two burp cloths side-by-side on the ground in front of your baby. Get her interest in an object (like a rattle, remote, phone, etc.) and let her watch you then hide it underneath the burp cloth on the left so that its hidden. Here's where you have to be fast and sneaky...without her seeing the object, slip it out from under the cloth on the left and slide it under the other one and watch see what she does. Does she look for it where she saw you hide it? If so, we've got the first stage of object permanence. But when she sees its not there, does she give up or look someplace else, like under the cloth on the right? If she continues to look then she has the second stage of object permanence as well.

With the development of object permanence, your baby has entered a whole new world. Hide-and-seek games will now be fun, but other things, like separation anxiety, will also increase for awhile as she tries to figure out what's going on.

When you get to this point, congratulate her on her new skill and realize that you'll now have to find better hiding spots for your phone. But make sure you remember where you hid it!

Why Your Baby Won't Sleep

Let me begin by saying that this is not, I repeat - not, a post on how to get your baby to sleep. There is an abundance of books, blog posts, and magazine articles out there offering tips, suggestions, and how-tos on that subject. And I think I've read most of them. Probably three times. No, this post is on reasons why you might find yourself searching for answers each day on something you could be doing differently so that your baby will either sleep more or longer.

At our house, Ian was a great sleeper from the time he was born. Long stretches, late mornings, great naps...needless to say, we were spoiled (and proud of what good parents we were since we had obviously provided such a wonderful environment for our new baby). Then he turned 5 months old and it all went downhill. First it was teething, then an ear infection, then he was crawling and thought he should practice that new skill each night, then separation anxiety hit, followed by another ear infection, then RSV, then learning to walk...there was always something keeping him from sleeping. I read every book and did everything I was supposed to, but he still wasn't sleeping. We even tried the cry-it-out method for part of one night out of sheer desperation and exhaustion even though I knew better. The book that had suggested it failed to explain what to do when you have a baby that will cry so long that he begins bursting blood vessels in his eyes. All three of us ended up in tears and cuddled together that night.

I became more sleep deprived than the college students I got up to teach each morning and I felt like I could model for one of those Dove commercials about how "Such and such percent of mothers admit to letting themselves go". One all too early morning, my irritable husband turned to me and asked, "You've got the training. What do we do?" I burst into tears. He was right. I have a good deal of training in child behavior modification and infant development, and yet I was resorting to Googling what to do. At this point, the helpful books were thrown across the room. Then I calmed down and changed my frame of reference.

I tell parents that I work with that if a child isn't following through on a behavior to reexamine the request in order to see if its an appropriate expectation. So that's what I did. The question I was asking shifted from "WHY ISN'T HE SLEEPING?!" to "Should I expect him to sleep?" I realized that no, this wasn't an appropriate expectation for my son. I do think some babies can do this - just not all, and maybe not even most. Being honest, this didn't automatically get us more sleep, but as parents, we definitely began handling it better and with a lot less guilt - which was a big relief to us all. And he did start sleeping better, in part because he got older and in part because we started listening more we closely to what he was trying to tell us.

Through my own research, here are 10 of the things I found out (a lot of which I already knew but was too tired to remember):

1. Most moms have more trouble with getting their infants to sleep than they like to admit. In our society, it's sort of a maternal status symbol to have your baby sleeping through the night. Remember that secret when you start comparing yourself and your baby to another mom who's bragging on how well her infant sleeps.

2. During the first year it is actually safer for babies to sleep more lightly and wake more frequently. Breastfeeding moms too sleep more lightly, so are likely to be woken more easily by their babies.

3. Babies don't have an "in sync" circadian rhythm until around 10 months, so will have more difficulty regulating their sleep cycles and be more easily disrupted in those same sleep cycles.

4. If babies become too distressed, like what can happen from prolonged crying, they will fall asleep because their little bodies basically shut down. This is not the sweet slumber we want them to get. Its a survival response that I don't suggest using.

5. Babies don't manipulate and they don't realize that their desires aren't needs. So if they start to cry because they "want" to be held in the middle of the night, they are really convinced that they need to be held, and so are programmed to let you know they have an unmet need until you respond. If you delay your response, you're trying to send the message "See, you don't really need that." Unfortunately the message they get until they're older is "My need isn't going to get met."

6. The U.S. is one of the only cultures that has an expectation for infants to sleep through the night. Most others don't even try to make it happen until 2 or 3 years.

7. Separation anxiety is real. Around 6 months babies realize that they are separate from their moms (it's called self-other differentiation). For the first time they begin to realize that this means that she might not be there when they need her. So you'll get the panicked crying of the 8 month old in the middle of the night who wakes and can't find his mother or even the babbling of the 9 month old who's talking just to see if mom is around to hear her.

8. Routines are good, but babies change so quickly (especially after 6 months) that often their changes blow your routines out of the water (I do recommend bedtime routines since dependability does help with infant anxiety).

9. Babies with more difficult (I prefer the word passionate) temperaments are more likely to have trouble sleeping. They take more to wind down, get wound up more easily, and tend to sleep more lightly.

10. Infants have different sleep cycles than adults do. All of us use part of our lighter sleep as a time to store information. Infants are learning a lot more than adults each day so spend more time in that light sleep - causing them to be woken more easily. Also, when adults dream, our bodies undergo a temporary paralysis. It's what keeps us from acting out our dreams at night. Infants and young children (along with some individuals with sleep disorders) have brains that haven't developed the ability to put their bodies to sleep and so are more likely to sleep walk and talk. Infants will do this too. For instance there were a few weeks where I regularly had to go in and lay Ian back down at night because I'd find him standing up in his crib completely asleep but crying.

In summary...don't assume your baby isn't sleeping because of something you're doing or not doing. She may not be sleeping because she simply isn't developmentally at a place where that is possible. I'm actually suspicious if part of the reason all the infant sleep books are able to claim their methods work is because the moms using the techniques just have babies that grow up and get to a point where they're ready to sleep!

This all being said, you still may be sleep deprived - just maybe more knowledgeable on why. Babies have been this way for a very long time, but our schedules just keep getting busier and we just keep trying to do it all ourselves. We used to live in closer communities or around family that actually expected to help out sleep-deprived parents. We can't expect our babies to adapt to our schedulest, so if possible, this is a time to call in reinforcements. Family, friends, neighbors...it really does take a village to raise a child, so don't feel as if you're less of mother if you ask for help.

If you do want a book recommendation, out of all of them I think The No Cry Sleep Solution by Elizabeth Pantley is highest on my list. I have since analyzed the stack of infant sleep books that all say different things and my conclusion is this: Most of them agree on one big point - that if you go pick up/nurse/soothe your infants when they cry at night, you will be teaching them that if they cry, you will respond. The point of disagreement is that one camp believes that such a lesson is a bad thing and the other that its a good thing. I for one have never met a parent with grown children who looks back to when those children were infants and says "I think I held them too much," but I have met several who wish they had held them more. I still tell myself that when Ian wakes at night and I'm sitting in his nursery shivering and exhausted. I smell his hair, touch his skin, and think about how as much as I would love to sleep, I really don't want to rush moments like these.

More on Baby Foods

Here are some follow-up questions that have come up from our earlier blog on December 4, "Frequently Asked Questions About Introducing Solids."

Q: Are generic brand foods as good as name brands?

A: Our advice is to buy prepared baby food that you are sure is from a major US company. In the US, there is a lot a production quality control that goes into making baby food. Do avoid foods that come from China in particular. Also avoid buying your own vitamins from China.


Q: Is there any advantage to making our own baby food?

A: Cost is the major benefit here. If you do decide to make your own food, it is best to buy local produce or frozen foods. The longer foods are in transport or storage, the more they lose their nutritive value (organic or not). Foods start to lose nutritional value as soon as they are picked or harvested, so locally grown, fresh foods are best. The second best option is to buy frozen or canned fruits and vegetables from a major company that harvests and produces its food close to the farm. American sourced foods are always safer since we have stronger environmental laws. If you do decide to make your own baby foods, there are books and online resources you can use for recipes, storage techniques, etc. Do keep in mind that once your baby has been introduced to a wide variety of foods, by about 8 months you can begin getting creative with your recipes, even adding some seasonings like cinnamon (still no salt or sugar).

For more suggestions: http://www.umext.maine.edu/onlinepubs/htmpubs/4309.htm


Q: Should I try to buy foods that are advertised to have additional vitamins or supplements in them like iron or DHA?

A: Most additives are window dressing, however there are a couple of specific concerns you should be aware of. In particular, after 6 months breast milk does not have sufficient levels of iron and zinc. Babies should be able to get enough iron from adding solid foods to their diet. Zinc, however, is difficult to get in sufficient amounts this way since it isn't absorbed by the body very easily from grains. The best way for your baby to get zinc in her diet is by eating red meat. Though it’s common practice to introduce meat as one of your baby's last foods, some researchers in the field of infant nutrition now suggest using meat as an early baby food. In fact Dr. Nancy Krebs suggests that meat would be a better choice for first foods than cereals because of the importance of iron and zinc to infant brain development. We suggest that you be sure to include low fat red meat (beef and lamb) in your baby's diet several times a week for iron and particularly zinc.

In addition, DHA is a potentially important nutrient for infants (though part of the excitement is because it’s trendy). You can make sure your baby is getting enough DHA by taking a daily supplement yourself and thereby "enriching" your breast milk. Do know that DHA may have the side effect of decreasing "stress," which all new moms can use. We recommend trying to buy a supplement made from bacteria and not fish oil. They are more expensive, but are less likely to be contaminated with ocean pollutants. Always feel free to ask the pharmacist for help in selecting vitamins for yourself.

Lastly, Vitamin D is potentially problematic, but most pediatricians will place babies on a daily vitamin that should take care of this. If your pediatrician hasn't done this by 6 months, talk to him or her about the idea at your next well-baby visit. Also, 15-20 minutes of a mostly naked sun bath is not a bad idea (no glass in the way of the sun) as another way for your baby to get vitamin D.

Post-Holiday Dieting

Now that the holidays are over and the New Year has started, lots of us begin to worry about our weight. While fad diets or crash diets are not a good idea, when you are breastfeeding (or any time at all, REALLY!) A slow weight loss of ½ lb a week or less is fine. This works out to two pounds a month and can be accomplished by cutting down slightly what you eat or exercising more. The trick is to eat slightly less and still feel satisfied, not hungry and grouchy.

Plan what you eat – particularly when you are nursing, you need regular meals and snacks. Make a list of daily snacks and post it on your fridge. That way when you are hungry and “looking” for something to eat you won’t be tempted to binge. Try to sit down and enjoy your meal, because you will be satisfied longer than eating while multi-tasking. Somehow, it doesn’t count as eating if you do it while watching TV or working in front of the computer – so later you want to eat again.

Choose snacks with strong flavors- Research has shown that foods with stronger flavors are more satisfying. For example dark chocolate is more satisfying than milk chocolate – so an evening snack of low fat milk and a dark chocolate square feels more satisfying for most than just milk by itself or hot chocolate. Baked chips with a spicier than usual salsa is another tip for punching up the flavor and salsa has fewer calories than melted cheese.

Slow down eating – It takes a while, almost 20 minutes, for your stomach to signal your brain that it is full. Drink a glass of water when you start preparing meals, this jump starts the 20 minute waiting period to communicate “fullness” from your stomach to your brain. Eat your meals out of smaller bowls and plates because it tricks eyes into thinking that you are eating more than you really are. The same size serving on a small plate looks bigger than one on a big plate. Use a salad fork to eat your meal because it requires you to take more bites and smaller bites. So this makes you eat slower and gives you time to feel full.

The other part of the weight loss equation is exercising more. You can incorporate your baby into your exercise routine. It is a great way to “play” with your baby and can also be a great bonding experience for you and your baby. Here are some exercise ideas for you and your baby:

· Do crunches with your baby face up on your belly, but be sure to support the baby’s head with your hands. You can make funny faces at your baby to make it fun for them too.

· Dance with your baby to different music that you and your baby enjoy.

· Lay your baby on the floor with their back on a towel or mat and get into push-up position. Do a push up and when you go down rub your baby’s nose or make a funny face.

· The “bouncing bridge” could be done by lying on your back, placing your baby on your stomach and lifting your buttocks into the air. This causes a bouncing effect for your baby.

· Lie on your back, and hold your baby in your hands above your head. You can lift your baby into the air, like an airplane and make an airplane noise. You could also do this by standing up. This will be a great work out for your arms.

· Take your baby for a walk in the stroller. You can go around the block at your house if the weather is nice or head to the mall and walk around with your baby. This is a great way for you to fit cardio into your day.

For more tips check out: Ten habits to healthy eating!

Holiday Stress

There's no place like home for holidays, but when you have an infant, thinking about either preparing for company or preparing for travel can be a bit of a stress. Now, ideally (and of course that hardly ever seems to match reality), when preparing for time with family, try to think ahead of how you can keep your baby on schedule and then stick to that plan. Also come up with ways before the big day hits of what to do if your baby is getting worn out from all the attention" (translation: passed around like a bag of potatoes and overwhelmed by the perfume your aunt has applied without understanding the concept that "less is more"). Keep a close eye on your baby and try to "steal" her back when you see her starting to get overwhelmed - then head off to a quiet room, or even the car if you can't find even a quiet corner in the house. Signs infants have had too much (outside of crying) are if they begin hiccupping or begin avoiding eye contact. That's basically their way of saying, "Maybe if I pretend you're not there you'll go away." If you're afraid relatives will criticize your escape, get them involved in the get-a-way. For instance, ask your sister-in-law whether she'd mind taking the baby into the bedroom and rocking her. Most people won't object to some quiet time for the baby if they are the one who gets to escape with them, and that's especially true if you throw in something else like "I think she'd really enjoy some one-on-one time with you away from all this distraction." Not many people will be able to criticize that. Some may actually begin signing up to help.

Another tip - if you expect a specific criticism to come up from your oh-so-loving family, head it off. Two trusty tools of defense include 1) mentioning your doctor and 2) talking about how the topic at hand actually affects your baby (meaning, do they throw up, have bad diapers, wake up at night?). For instance, maybe your mother-in-law lets her disapproval of what you feed your baby (or don't feed your baby) known. Rather than trying to argue with her that 6 month olds really don't need turkey and dressing or that sweet potato pie is actually not the same as sweet potato baby food, shortly after you arrive, drop a comment about the issue. For instance, try something like how you're "so glad you took your doctor's advice about what to feed your baby" or about how you "really have to watch what you feed your baby since the last time you tried breaking the rules from your doctor, the diapers were just a disaster!" If people understand how breaking the routine effects your baby, they simply don't complain so much. They still many not agree that the routine itself is the way they would do it, but they're at least not as likely to push the boundaries you've already set. You can also insert little positive reinforcement comments. Telling your mother-in-law how glad you are to have in laws that support you in how you're raising your children is likely to make her think twice about contradicting you.

Now keep in mind, keeping your baby on her routine does not mean that you can expect everyone else to conform to lunch at 11 o'clock and a quiet nap time at 2 o'clock. It may not even mean that they'll wait on you to nurse before starting lunch. And also, some babies can handle routine "fudging" better than others. You're the one who will be able to tell how much that's true for your infant. Try to decide ahead of time what you're willing to let go. You're less likely to cave to the pressure from your mother that "it won't hurt him to stay up a bit later" if you've already thought through whether that really is true.

Remember that a lot of the stress your baby feels comes directly from what they're picking up from you, so regardless of what happens, focus on the positive things about the whole experience - like how great it is to see your father-in-law cuddled in the recliner with your son (you really can ignore the football game going on at the time). After all, those will be the Christmas memories you're likely to remember a few years from now anyway.

Merry Christmas!

Frequently Asked Questions about introducing solids such as When? What? and How? ("So Now You Actually WANT Me to Put Things In My Mouth?")

Each of you has done something wonderful for your baby by feeding them breast milk. Research has shown babies who are breastfed tend to be sick less often, have higher cognitive abilities as they grow up, lower rates of allergies, and a lower risk for obesity. As your baby nears the age of 6 months, new choices need to be made about introducing solid foods into your baby's diet - especially as there are so many choices available. To help, we have put together some answers to commonly asked questions about this new adventure for your baby. We always recommend you discuss specific questions related to your baby's health with your baby's pediatrician so that he or she can tailor the answer specifically for you.

Q: What should I expect when we start?

A: Keep in mind that this is a very new experience for your baby, especially right at first. We do recommend that even from the beginning you establish good eating habits for your baby, like sitting up and eating from a spoon instead of adding cereal to a bottle. Also try not to rush your baby as she eats. Let her explore and engage in the experience. Don't force her to eat anything and watch for her to signal that she doesn't want any more.

Introduce foods after your baby has breastfed or taken a bottle (remember that milk is still the primary food for your baby during her first year of life) and when she's not too tired or cranky. You can allow the baby to explore a first food off of your finger, too, since that might be a little less foreign than adding a spoon into the mix.

At first, start off with foods that are almost liquids. You can add breastmilk or formula to achieve the desired consistency. Your baby will likely push it around with her tongue when you first introduce her to foods, in part because she's playing with both the new taste and texture. As she masters swallowing, you can begin to thicken up whatever it is she's eating.

When you introduce a new food, always wait at least four days before introducing another one so that you can watch for any sign of an allergic reaction. Regarding allergies, high allergen or risk foods such as peanut butter, wheat, soy, eggs, fish, and dairy do need to be introduced MUCH later. Consult your pediatrician on when such things can be added to your baby's diet.

Q: When should I start my baby on solid foods?

A: Remember that if you're eating a healthy diet and taking your prenatal vitamins, your breast milk will contain everything your baby needs until 6 months of age, so solids aren't necessary until then. In fact, the American Pediatric Association still recommends that solid foods be held off until your baby is 6 months old. This is particularly true if there is a history of allergies that run in your family. What you're watching for in your baby is for him to develop the ability to maintain head control and lose his tongue thrust. When babies are younger, that tongue thrust helps prevent them from swallowing something accidentally and choking. Once its gone, your baby is showing he is mature enough to swallow on his own.

Q: What if my baby doesn't like a food?

A: Most researchers don't think babies develop either an immediate love or dislike for a food the first time they eat it, so if your baby rejects a certain food, move on and come back to it later. If your baby seems to choke or have problems either keeping food in his mouth or swallowing, consider waiting until he's a little older to try again or think about changing the consistency of the food. And also, some of your baby's preferences for tastes will be related to what you ate during your pregnancy and while breastfeeding since tastes and smells of your foods are transferred to the baby both ways. And breastfed babies are much less likely to be picky eaters!

Q: Any tips for older siblings?

A: Keep up those healthy eating habits! Take time to eat, sit at the table, and avoid introducing "food on the go" as long as possible. Limit the sugars, snacks, and sodas, especially those with caffeine, and encourage a healthy lifestyle by acting as an example yourself and by what you keep in the house to eat. You can even use family meals as a great teaching platform for things such as following directions (using a recipe), math skills (measuring ingredients or calculating serving sizes), creativity (making colorful food arrangements or faces on a pizza), chemistry (why baking powder is in a can or eggs are added to a recipe), along with basic skills like colors, counting, and the alphabet (Let's have a dinner where everything we eat starts with the letter A!). And don't forget the added benefit that young kids actually LIKE to wash dishes (just consider using something besides your nice China when you let them do so!) We highly recommend Ellyn Satter's "Division of Responsibility" for feeding babies, and older children too. Check out this story about first foods on her WEB site: https://ellynsatter.com/testimonials.jsp?category=success_stories