Most babies will spit-up (also called reflux) in their first months.  But when does it become a problem?  When does it go away?  Is there any way to lessen your laundry burden?  Let's look at the latest information about a common issue.

​How is GER different from GERD?
GER is gastroesophageal reflux, which is a completely normal pattern of spitting up that causes no harm to a baby.  The valve that closes the top of the stomach just isn't mature yet, and there may even be some benefit to this washing backwards of the stomach contents. 

Less common is gastroesophogeal reflux disease, or GERD.  This is actually a disease where the stomach acid starts damaging the esophagus.  This may be suspected when baby has growth and/or breathing problems.  It can only be diagnosed by putting a tube down baby's throat and looking, and may require additional tests.  The reason it matters is because studies show that when a doctor labels a child as having a disease it makes the parents more likely to give medications, even when it's explained that the drugs aren't likely to help.  In the past, medications were overprescribed.  So physicians have been advised to be very careful about which babies they label as having GERD, since most will actually have normal GER.

​How common is GER?
About 2/3 of infants will spit up occasionally, and sometimes it will even be quite often.  This is an extremely common concearn for new parents.  It happens most often around 4 months old, and then only 10% will still do it by 1 year old.  It's understandable, since as adults we only vomit when sick.  How in the world can you tell whena baby is sick if they spit up all the time?

What are some lifestyle changes that can help with reflux?
​There are a few things parents can do right away when they think their baby has a reflux issue.  This can help their doctor determine if medications are actually needed, and better yet, help baby feel better. 

• Try eliminating dairy, soy, and eggs from a breastfeeding mother's diet.  These are the most common allergens for babies.  If baby is on formula, they should try a special hydrolysate formula.
• Feed baby more often with smaller meals.  If you're breastfeeding, make sure you aren't pumping too much and creating an oversupply.  If your letdown is strong, try taking baby off when you feel a tingle and let it drip into a cloth.  Latch back on when it slows down.  If bottle feeding, try paced bottle feeding.
• Give baby probiotic drops.  Studies have shown it reduces symptoms of reflux.
• Sit baby up after meals.

​What about medicine to stop baby's reflux?
Although medications are available for true GERD, the pros and cons of each one should be discussed with your doctor, since they all have side effects.  Some of the medications that are relatively benign in adults can be more dangerous for infants.

We live in a time when guilt is looked on as a negative emotion.  Is it really?  The actual definition of guilt is when you know you've done wrong.  That feeling you get when your conscience pricks you about your actions.  In that respect, guilt isn't a negative at all.  It's a wonderful mental tool that keeps us from being psychopaths, quite frankly. 

​I contend that we often use the wrong word when we say "guilt".  What we really mean is that we feel annoyed, we think the other person is wrong, or we feel regret.  That's so different from thinking we're doing something wrong.  

I hear: "She made me feel guilty for bottle-feeding."  "That made me feel guilty for not co-sleeping."  "I was made to feel guilty at my appointment."    

​First of all, no one can make you feel guilty.  They really don't have the power unless you give it to them.  You can choose to feel bad over something someone said, but you don't have to.  There is a huge difference between someone giving you information and someone saying something rude.  Information is just meant to help you balance pros and cons, but you still have to make the best decision for your family, which is different than every other one.

​If you find yourself "feeling guilty", then ask this one question, "Am I doing something wrong?"  If the answer is no, then move on with your life and realize that we're never going to all agree on everything.  Don't waste one more second on feeling bad for making a rational decision. 

​If yes, then stop doing that thing.

​For example, I've heard some women who had a true low milk supply because of metabolic issues say they felt guilty for giving their baby formula.  What would the other option be?  Letting your baby starve?  There's no guilt when you make an informed, rational decision. 

​If the issue is something in the past that we can't change, then that's regret, not guilt.  I regret many things, because most parents do.  (Mr. and Mrs. Perfect Parent are actually just hiding it.)  It's Ok to make the best decision you could at the time and then realize later with more information that you would have made a different one.  But even here, we shouldn't wallow in our regret, since we can't change the past. When we know better we do better. 

Let's all stop using the word guilt and get on with helping each other do the best we can.  Let's all move forward.

One of the toughest things for a new mom is trying to figure out to get anything done while caring for a little one.  They love to be held and close to you, and that's perfectly normal.  At some point the laundry, dishes, and a thousand other tasks need to get done, too.  Since I'm nursing a baby as I write this, maybe I can give you some ideas.

Revise Expectations
​The first thing to understand about getting things done is that you're not going to get as much done.  Maybe it's not what you want to hear, but it's important that you have realistic expectations.  Please let go of the expectation that your house will be spotless and you'll go back to work at 6 weeks doing exactly what you did before.  Newborns take a lot of time to feed and keep clean and happy.  You're also recovering from birth and adjusting to a new family member.  All of this is enough!  But at some point you'll need to get back to accomplishing tasks, although you won't be back to pre-birth productivity while caring for your baby (and that's ok!)

​Plan it out
You may not have been organized before having a baby, but afterwards a loose schedule can really help.  Without it, time tends to fly by.  If you're finding there are tasks you're consistently not getting to, try planning out the time you'll do them.  After the first few weeks your baby will have some semblance of a rough schedule, and you can plan the best times for different activities.  Many babies have a fussy period in the evenings, so that might be time for a bath with baby or sit-down work while constantly feeding. 

Wear Them
​One of the best ways to keep a baby happy so you can do things is to wear them in a baby carrier.  Babies who are worn more are shown to cry less and have better social skills since they are constantly around an adult learning more than you think.  Baby won't know you're throwing a load of clothes in the dryer or packing a suitcase; all they know is you're holding them and they like it.  It's also great for chasing around toddlers without worrying about leaving the baby.  If you wait until baby is able to be put down to do anything you might be waiting awhile!  There are many, many types and brands of carriers, and different ones will work best for different babies and different ages.  My babies love their sling when newborn and an Ergo when older. 

Make a "Nest"
​Especially for the first months when babies seem to be eating constantly (babies should eat at least 8 times a day), consider making a "nest".  In the most comfortable place in your house gather everything you'll need for feeding, changing, keeping baby happy, and some things to work on.  Don't forget some snacks and drinks for you!  It saves a lot of time and frustration to have everything right there when you need it.  Perhaps that book you've been wanting to read for times when baby will only sleep in your arms.  This nesting strategy can work well for older children when they're sick and need extra attention, too.

In the Wee Hours
​One given about parenting is that you'll be up at night at least some of the time.  Are there things you could do while you're awake anyway?  One word of caution: The fastest way to discourage long night waking is to keep the lights and noise low, so they realize night is different than daytime.  But you might listen to a podcast or lecture, do a little picking up with one hand, or do a little work on the computer while holding your awake sweetie.  Sleep deprivation is a very real thing during the postpartum time, so I'm not advocating staying up if everyone else is sleeping.  Work in the middle of the night is only for when baby is awake.  If you're up at night I highly recommend a daytime nap with baby.  A 20-minute nap can be a real life-saver!

​Enjoy it!
​At the risk of sounding cliché, you'll never get this time back.  I doubt any 90-year-old woman wished she had spent the first months of her baby's life doing other things.  Often we stress ourselves out by filling our plates with things we really don't want to be doing anyway, just because we think we have to.  Try to drop the things you don't enjoy so you can have more time to spend on the things that are really important to you.  Then make the drudgery more fun.  Maybe throw on some music while you sweep and get some exercise in a beautiful place outdoors. 

Spend a few more moments smelling that sweet head, taking pictures, or holding hands with your husband as you stare at the peacefully sleeping face.  Those are the things life is all about, anyway. 

It's easy to find lists of the benefits of breastfeeding, and studies are coming out all the time that show how beneficial it is, but mostly focusing on the baby.  What about the one who has to do all the work-MOM!  Let's face it, even when breastfeeding goes well she has to deal with waking up at night, wet shirts, and time breastfeeding that she could be spending doing something else.  If your nursing experience has problems it may (and for many women is) very hard and artificial milk seems tempting.  But let me tell you about some reasons breastfeeding is really beneficial for the woman doing it.  It may just give her the motivation to get past some of the uncomfortable days.

​Reduced cancer
Many studies show that pregnancy and especially breastfeeding reduces your chances of breast cancer.  What may surprise many people is that our breast development does not end at puberty.  We see fatty tissue laid down in the breast during the teen years, but the actual maturity of the breast glands themselves does not happen until the breast goes through a pregnancy and lactates.  Breast cancer is a use-it-or-lose-it type of disease with women who have never been pregnant at greatest risk, and the effect cumulative.  This means that for every month you breastfeed your chance of breast cancer goes down.  This is not only true for breast cancer, but all reproductive cancers, like ovarian and uterine cancer, too.  (Breastfeeding also reduces breast cancer in your daughters, but remember we're just talking about moms here.)  On top of all that, if you do end up getting breast cancer breastfeeding is associated with living longer!

Delayed fertility
​Women who breastfeed in a biologically normal way will have a delay in their fertility that rivals birth control pills.  It's called the Lactation Amenorrhea Method, and is very effective for the first 6 months after having a baby.  Once the baby starts eating solid foods around 6 months breastfeeding is less effective, so another form of birth control can be used if desired, but often ovulation does not return until a year or more after birth.  This delay is more effective the more the baby is getting nourishment and meeting other needs at the breast.  For some women, this is so effective they will have to wean their babies in order to start cycling again if they wish to get pregnant.  This delay in fertility is a free and easy method that's free of side effects that are present with all hormonal forms of birth control.

Reduced diabetes
​As we get older the chance we'll develop diabetes goes up, but breastfeeding can help reduce that.  If you had diabetes before becoming pregnant breastfeeding will help your blood sugar levels so that you need less insulin.  Metformin, a common diabetes medication, has been shown to be safe for breastfeeding babies.  Especially after a gestational diabetes diagnosis women are advised to breastfeed so they will be less likely to develop type 2 diabetes.  They are especially at risk for this metabolic problem, but others can develop type II diabetes, and breastfeeding lowers the risk for everyone.  Since sometimes diabetes can be associated with difficulty breastfeeding, make sure you get help with breastfeeding if you need it. 

Less postpartum depression
Let's face it: mothering in the first weeks and months is really hard.  Sleep deprivation, a lack of support, and hormonal shifts can contribute greatly to postpartum mood disorders.  It might seem like an easy solution for mothers to try and lighten her load by switching to artificial milk, which someone else can feed to the baby in a bottle.  The problem is that the hormones released when a mother breastfeeds actually lessens her negative feelings and helps to calm her.  When a mother weans her baby, especially abruptly, the depression or anxiety can get worse because of the hormone changes and less connection to her baby. 
​
Ease of feeding
Sometimes the reason for giving artificial milks is that is seems easier than breastfeeding.  No doubt, in some situations breastfeeding is quite a struggle.  However, many breastfeeding difficulties can be overcome with some lactation support, education, and time.  In the long run, for most women, breastfeeding after the first few weeks becomes quite time-saving.  No mixing, washing bottles, remembering to put it in the diaper bag, or worries about contamination.  It's always the right temperature, immediately available, safe, and free!

More sleep
Studies have shown us something somewhat counterintuitive: that breastfeeding mothers actually get more sleep than their artificially-feeding peers, one study finding an average of 40 minutes more at three months.  One of the lines you hear from companies making artificial milks is how the partner can now wake up and give the baby a bottle while mom sleeps.  In real life however, our partners are often working and the brunt of childcare falls on mom, no matter how she's feeding the baby.  Yes, breastfeeding moms will be tired some days, but the thing to remember is that giving a bottle will not solve that.  One explanation for this is the ease of breastfeeding without having to fully wake to prepare a bottle, and the other is the hormones released in both mom and baby that makes them both sleepy afterwards. 

​There are many other ways in which breastfeeding benefits mothers, like reductions in heart disease, osteoporosis, lower cost, decreased postpartum bleeding, helps her lose weight, and helps boost self-confidence in parenting.  So you see, it's not only baby who needs breastmilk.  Mothers deserve to know how good it is for their own physical and mental health, too. 

It was making all the rounds on social media via CNN this week.  A study has now shown that "cry-it-out" is perfectly safe.  Well, that was the headline anyway.  The truth is far from it, but how many parents will really read the entire story much less delve into the details of the study?  I'm always suspicious when an article about a study doesn't link to the actual study.  I want to look at exactly how and what the scientists were measuring, but all we can get is the author's interpretation of the results.

Assumptions

The basis of all "sleep methods" is the assumption that babies are supposed to sleep all night without waking.  This is a fundamental misunderstanding of sleep in general and infant sleep in particular.  Do you ever wake up at night?  Many studies have shown that infants and young children normally wake at night, and this message is being lost in our education of new parents.  Those who have babies who sleep without crying all night are eager to tell everyone about it, probably because it has come to be a sign of good parenting.  This leads to other parents who have babies that wake up (the majority) to feel they are doing something wrong and that their child has a "sleep problem."  But waking up at night is not only normal, it's protective!  Deep sleep is part of SIDS, where a baby just stops breathing and doesn't wake up.

​Another assumption is that a baby who wakes at night will cause the parents to sleep less.  But research into co-sleeping showed the opposite.  The parents who sleep in the same bed with their babies got the most sleep and breastfed longer (formula feeding is a big risk factor for SIDS, also).  That goes against sleeping advice from the AAP (American Academy of Pediatrics), but it leaves parents sleep deprived with the only option then of leaving a baby to cry.  (By the way, putting a baby alone in a room is also against the AAP advice!)  The Academy of Breastfeeding Medicine has advice for parents who need sleep but don't want to leave a baby alone. 

​As a Certified Breastfeeding Specialist, I also couldn't help wondering about the assumption that these babies were not hungry and that preserving both the mother's milk supply and her delay of fertility was unimportant.  I realize that not everything can be studied at once, but were any of these babies breastfed and was their growth being monitored during these periods of crying and lack of milk?

Problems with this study

​First of all, this is an extremely small study.  Should 43 Australian babies guide "normal" and "safe" for all other babies?  These 43 babies were split into 3 groups, so each group was less than 15 children!  Can this even be considered a legitimate study with such a small sample size?  And why did the media run to pick it up and report it?  Probably because they know thousands of tired parents will click on any story claiming to have an answer on how to get their baby to sleep all night.

​Also, the age of the babies was 6-16 months old, so these results are not applicable to babies younger than 6 months for sure.  Many parents start sleep training at very young ages, which likely is more harmful for several reasons than it would be for an older infant or toddler.

​Then there's the explanation of what the parents actually did (assuming they followed the instructions of the researchers).  The headline calls it "cry-it-out", yet the actual interventions being studied were graduated extinction and bedtime fading, which are both extremely different from putting your child in a room, closing the door, and not getting them until morning.  "Cry-it-out" means different things to different people.  In this study, no child was ever left to cry for more than 35 minutes at a time.  So they really weren't left to "cry-it-out" at all!  Bedtime fading was a technique that actually made me laugh out loud, because it's what I've always done without even knowing I was "sleep training"!  They just pushed back the bedtime until the baby was actually sleepy.  Which begs the question, why were these parents trying to put a baby to bed who wasn't even tired?  Maybe because society tells us our babies should be tired at a certain time or we're comparing our baby to someone else's. 

​Most obnoxious of the results of this study to me was the result of the babies left to cry for half an hour at a time ended up sleeping SO much better!  Really?  They went to sleep, on average, after several nights of crying for almost 15 minutes before the babies who were held and comforted by their parents.  It just doesn't seem like much benefit in relation to the stress of listening to a baby cry.  And a year later, babies were sleeping the same.  So it's not as if parent have to do some type of sleep training or their children will always have issues with sleep, as they're often told.

What about the definition of "sleep problems"?  These were just parents who self-reported that their child had a problem.  Did they really, or were they normal children who had parents that had bad information or expectations?  Were the parents overworked and stressed and blamed normal child waking as the "problem"?  No doubt some children need some help calming down for bed, but I just wonder how many children in this study got better at sleeping longer just because the parents calmed down about it or because they got older. 

The unsure definition of "sleep problem" is similar to the definition of "behavioral problem", which was really the main reason for the study.  Previous studies showed and many psychologists suggest that leaving a child to cry for extended period could cause distrust and problems with attachment even into adulthood.  In this study, there was just a question a year later asking if the parent felt the child had behavioral problems, and there was no difference between groups.  So there was no expert determining if the child had an actual sleep problem, had any behavioral problems a year later, and we still don't know if these children will have more relationship/behavioral problems as they get older.  These are things that aren't easy to determine anyway, much less as a self-report by the parents, who may not know what a "behavioral problem" is or isn't.   

What CAN parents do to help their little ones go to sleep?

​If you're looking for help in determining what is normal for infant sleep and what to do to help your baby or toddler sleep better, this list of studies is far more helpful and includes much bigger and well-designed studies.  Never base your parenting decisions on one study or article!  Go with your instincts that are well-informed by facts about how the human body and mind work.

This is a topic that's definitely one of my pet peeves, and I'll just admit that right now.  Maybe because of my passion for breastfeeding and my observation on how much easier things are if it's started in a certain way.

Yes, I'm biased in favor of leaving parents alone with their newborn for at least an hour (and two is even better!)  Research and mainstream medical opinion backs me up on this.    The first hour after birth is the golden hour that should not be interrupted unless completely necessary.  Cochrane Review looked at all the studies available and concluded: "babies exposed to skin-to-skin contact interacted more with their mothers and cried less than babies receiving usual hospital care. Mothers were more likely to breastfeed in the first one to four months, and tended to breastfeed longer, if they had early skin-to-skin contact with their babies."  An even more extensive article on immediate skin-to-skin contact between mother and baby explains that: "There is good evidence that normal, term newborns who are placed skin to skin with their mothers immediately after birth make the transition from fetal to newborn life with greater respiratory, temperature, and glucose stability and significantly less crying indicating decreased stress."  Wow!  Who wouldn't want to take advantage of that?!

Let me give you some pointers on how to make it happen for you, because this takes more intentional planning than you may think.  Obviously, if baby is not doing well there will need to be more observation by the medical team, but most assessment can be done right on mom's chest.  If baby is full term and healthy there is no reason to remove them from their parents.  If mom is not doing well the baby can be held by the father.

When I attend births in hospitals, and sometimes even in out-of-hospital births, I see little advantage taken of this golden hour.  There seems to be two reasons: interference from others and parents themselves not giving priority to this time. 

Interference from outsiders
​Very few things MUST be done within the first two hours.  Contrary to popular belief, it is not usual for a baby to start nursing right away.  They go through phases of being somewhat stunned to moving around more, to finding and mouthing the nipple, to finally suckling right around an hour after birth. 

​Pediatricians agree that newborns experience too much pain, as explained in a recent statement.  I have seen hospital staff assure parents that baby will be able to nurse during shots only to give the injections before baby had latched for the first time.  Now baby's experience at the beginning is pain instead of comfort.
​
Which procedures can wait?  American Academy of Pediatrics concludes in their Sample Hospital Policy that vitamin K injections, weighing, eye antibiotics, measuring, and getting blood for newborn screening are all things that can wait.  In fact, the earliest any of these needs to be done is 6 hours for the vitamin K injection.  Some of these "standard" procedures can be delayed with benefits and certainly no drawbacks.  Ask your health care provider how long you can safely wait for tests and medications.   

​Giving the golden hour priority
​I know you want to let everyone you know about the amazing miracle that just occurred; your baby is here!  But you will never get that time back.  Grandma can wait to hear the news.  Cousin Sam will hear all the details in a few hours.  Please, I beg you, put your phone away.  Stare at your baby.  Murmur love into your spouse's ear because you both did an amazing job.  Kiss.  Hug.  Take advantage of the birth hormones as much as you can.  If you want pictures, have someone else quietly take them. 

Right after birth the baby (unless he has narcotics in his system) will be alert and have his eyes open.  This gives him a chance to get his first meal and meet his parents.  Usually baby goes into a deep sleep around two hours after birth, and then would be a good time to contact the "outside world", take pictures, and sign paperwork.  I just don't want anyone to miss out on that golden hour that only happens once in your baby's life!

We can't keep thinking that the first 5 years of a child's life doesn't matter because they will learn what they need to know in school.  Evidence shows over and over that strong attachments with a few caregivers early in life has an effect on a child for the rest of their life.  This sad news a study on attachment behavior showed was that 40% of children do not have strong attachments to their parents.  This means they either avoid their parents or actively resist them when they're upset. 

In fact, strong attachments were a better predictor of success that IQ or test scores!  That's amazing news, because giving our children an attentive caregiver is something we can all do!  I think we all know people who are very smart, but ended up making terrible choices and being unhappy.  Could this early childrearing be the answer to situations like that?  It could also explain why homeschooled children do so much better on tests.  Perhaps the early childhood attention they got gave them the head start to enjoy learning for the rest of their lives. 

Even if you do not have the money to supply your child with everything you think they need in order to be smart, the good news is that you can create a "home-learning environment" no matter what your income level.  Just choose your child's activities and toys carefully.  More is not always better, sometimes it's just more.  Books, educational toys, and exposing your child to a large vocabulary is all it takes to benefit your child even more than money.  Spending time playing and reading with even young children has been shown to greatly increase their adult success.  It takes more time, but turning off the TV and devices and actually talking to your kids is what is really going to benefit them.

I'm so excited to announce a new resource!  Power in Birth will now be offering a Birth Boot Camp Sibling Preparation Course!  This class will be around 1 1/2 hours in the privacy of your own home and will include a workbook for each child.





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Your class will include:
-Information about baby's current home and development
-Simple instruction on the birth process
​-Appropriate birth video
-What to expect during labor
-A fun time with visuals and silly activities
-Ways children can help before, during, after birth
-What to expect after baby arrives

​This class is only $35 with $10 for each additional child.  ​So let me know what YOUR family needs to learn about birth and let me help you prepare YOUR children.  We all want birth to be a pleasant, exciting, amazing experience for the ENTIRE family!  Please contact me to set up a class.

My degree is in Animal Science, and we raise many kinds of baby animals here on my farm, so I often look to them to get an idea of what is and is not normal with our own babies.  I got it, humans aren't really animals because we have much more higher brain function and aren't operating nearly as much from instinct, but I still think there's a lot we can learn from looking at the animals around us.  Devoid of cultural expectations, peer pressure, and personal anxieties, we would listen to our instincts and find easy answers to raising children that are apparently baffling the "experts".

I love watching a mother hen walk around the yard with her clutch of new chicks.  They constantly make little "cheep cheep" noises softly as they wander after her pecking at random things on the ground.  It's an adorable sight, and I can always tell when the group is nearby from the sounds.  But sometimes a chick get separated from the mother.  The result is an immediate distress cry from the babies.  It's much louder and more urgent than their normal sound.  It makes the mother instantly turn around to go find her "crying" baby.

​It's the same thing with other animals-pigs, goats, cows.  When babies think they are in serious trouble they let out a loud and insistent distress cry.  This cry brings Mama running and heaven help you if she thinks you're hurting her baby!  We all understands why this happens.  It protects the baby from danger and alerts the mother to a situation where she's needed.  Her very presence will calm the baby down quickly. 

​Why do we think our babies don't need us?  Why do we consider the stress they feel when separated from us as less than any other kind of stress?  As Western society mothers we are told to ignore the distress cry from our babies because it doesn't mean anything.  Even the AAP recently came out with a statement that outlined how harmful pain and stress is for the development of newborns.  A bit of a "duh" moment for many of us mothers, but at least there is some scientific acknowledgement that babies are not immune to the well-documented effects of stress on both adults and animals.  

​I want to encourage mothers to listen to their own instincts.  When your baby is giving the distress cry they want you.  They're scared of being alone, maybe they're hurt, maybe they're not sure anyone will ever come get them.  Remember, batteries go out of baby monitors, babies get tangled up in blankets, their arms get stuck through the bars of a crib, they get sick, and many other things could be happening when you leave them alone to cry.  The claims that you'll "spoil" your baby by soothing them is nonsense that has no basis in either research or common sense.  If that were the case, every animal raised by its mother on the planet would be spoiled rotten!