GROWTH & DEVELOPMENT: NEWBORN

BREASTFEEDING

Research in recent decades has shown that there are numerous and decisive advantages of breastfeeding over artificial formula, and not just for the baby. First of all, it is known that breast milk is the absolute best for feeding the newborn and making them develop physically in the most harmonious way.

For example, the breastfed baby, even if well fed, gains less weight than the bottle-fed baby, thus running a lower risk of later being overweight or obese.

It is also shown that human milk, through its content of antibodies and “immunocompetent” cells, protects against certain infections, such as gastroenteritis, bronchitis, otitis, meningitis and other less common diseases. Some also believe that even the danger of white death, or the development of certain allergies, or diabetes is lower in breast-fed infants, although in these cases the evidence is somewhat weaker. Evidence of the claimed ability of breast milk to even promote the development of intelligence is also uncertain.

On the other hand, there are advantages of breastfeeding also for the mother. For example, immediately after delivery, the baby’s sucking stimulates the release of oxytocin, a hormone that stimulates the contraction of the uterus, making bleeding during the puerperium less likely. It also promotes faster recalcification of demineralised bones during pregnancy, reducing the risk of osteoporosis and hip fractures in old age. A nursing mother is also less likely to get certain types of cancer, such as ovarian and early breast cancer. Finally, breastfeeding delays ovulation, thus acting, at least in part, as a natural contraceptive.

There are very few exceptions where breast milk is contraindicated for medical reasons:

  1. A rare metabolic disease called galactosemia, in which lactose, the sugar found in all types of animal milk, causes severe damage to the body.
  2. If the mother has tuberculosis or AIDS
  3. If the mother uses drugs

Almost all medicines can be taken by the nursing mother without major risk to the newborn. For example, antibiotics are usually allowed, as are antidepressants, which many mothers take for some time after giving birth. Breastfeeding must be stopped, however, if the mother is to be treated with radioactive isotopes, chemotherapy, or thyroid medication.

However, in case of doubt about the toxicity of a medicine to the infant, it is always advisable to consult the lactation consultant for guidance. Ultimately it is important to keep in mind that, although artificial breast milk substitutes are nowadays adequate and safe, there are more than enough reasons why they are considered a fallback and adopted only when it is really impossible to breastfeed.

FORMULA MILK

When the mother is not breastfeeding, she can now count on a range of artificial “formulas” which, from a nutritional point of view, adequately replace a mother’s milk. These products are usually cow’s milk derivatives, modified to simulate the composition of a woman’s milk.

Why untreated cow’s milk cannot replace human milk

Cow’s milk as it is, in fact, is not suitable for human babies. First of all, it contains proteins and mineral salts in excessive quantities compared to the ability of a baby’s kidney to eliminate waste. And the risk would be that these substances are excessively concentrated in the baby’s blood, upsetting his hydro-saline balance.

Furthermore, cow’s milk is rich in “saturated” fatty acids, which are not ideal for the health and growth of the baby. Its proteins, casein, lactalbumin and lactoglobulin, are large molecules and difficult to digest compared to those of breast milk. Among other things, these proteins do not contain some amino acids, such as taurine, which are apparently essential for the health of the newborn. Finally, in some children, cow’s milk causes tiny lesions of the intestinal mucosa, from which microhemorrhages occur and which, in the long run, lead to iron deficiency anemia.

The formulas

The formulas, although starting from cow’s milk as a basic component, undergo a series of changes that bring them closer to the composition of breast milk. In fact, proteins are brought to the concentration present in breast milk and are enriched with amino acids absent in cow’s milk and essential for the newborn. The saturated fats of cow’s milk, then, are replaced by polyunsaturated fats coming from light oils and more suitable for the human body. Finally, the formulas are enriched with vitamins and minerals, in order to satisfy every nutritional need of the infant.

Powder and liquid formulas

The formulas on the market today are practically interchangeable as they are distinguished by small differences in flavor or other marginal characteristics. Almost all products are both in powder to be diluted and in liquid form. Liquid formulas have the advantage of being usable directly, eliminating tedious preparation work. They also give the security of a constant composition, as the dilution is done with exact technical criteria. However, and here is the only problem with liquid formulas, once the bottle is opened, the contents cannot be stored like that of a box of powder. Instead, it must be consumed within twenty-four hours. Therefore, it is not advisable to use a ready-made milk if only sporadic additions are needed during breastfeeding.

The continuation formulas (II)

After the first four to five months, the baby’s kidney becomes capable of eliminating the greater quantities of salts and waste of a more concentrated milk. Thus, slightly more concentrated formulas were created than those used from birth, the percentage composition of which, I repeat, is copied from breast milk. These are the formulas marked with the number II, unlike the number I assigned to the formulas for the first months.

Formulas II, among other things, are enriched with iron, also to prevent the problem of cow’s milk anemia I mentioned.

Preparation of the formula

The safest (and most convenient) way to dilute powdered milk is to mix up the amount you are supposed to use in 24 hours all at once. It is not true that this could lead to deterioration of the product or its contamination. Indeed, the risk of introducing bacteria is more likely if you prepare one bottle at a time.

It is therefore advisable to put the number of measuring spoons of powder corresponding to the volume of milk throughout the day in a graduated jug. For example, since almost all formulas must be diluted in the proportion of one measuring cup every 30 cc. of water, to prepare half a liter of milk there are 16 measuring spoons of powder. Then the mixture is divided into five or six bottles that are kept in the refrigerator and heated in a microwave oven or in a bottle warmer at the time of use.

How much milk do we give them?

Even with infant formula, a newborn is able to regulate spontaneously and, in particular, to set limits and to eat only when and as much as necessary. The sense of satiety is in fact linked to the quantity of nutrients that the baby finds in milk, no matter whether maternal or artificial.

Among other things, we have said that formulas have a composition similar to that of breast milk. Why then, if the baby knows how to regulate himself with the breast, would he not know how to do the same with the bottle?

In short, whenever the baby seems hungry, he should be offered a bottle that contains a small excess of milk compared to what he usually takes so that he can always fully satiate. On the other hand, never insist, not even for a second, for the baby to finish that last bit of milk in the bottle and we will soon see why.

Throw away the remaining milk?

But if there is some milk left in the bottle, should it be thrown away as it is always written on the packaging, insinuating that it can easily spoil and cause infections or poisoning? This insinuation is absolutely false and is used by infant formula manufacturers for obvious commercial reasons. In truth, infant formula, whether it is a reconstituted powdered formula or an already liquid one, behaves like any other milk. That is, any residue may very well be kept in the refrigerator and heated for subsequent feedings, even twenty-four hours after the original feed. It is not true that heating it more than once causes its deterioration.

On the other hand, it is true that a formula could be contaminated with pathogenic germs (such as the infamous salmonella) if the person preparing it does not take the necessary precautions. It should be kept in mind that each of us can inadvertently touch objects, surfaces on which a wearer may have left microscopic traces of feces, for example by not washing his hands well after being in the bathroom.

The first hygienic rule to avoid infections in our baby, therefore, is to scrupulously wash your hands before touching any container that is used for the preparation of his milk. It is perfectly useless to sterilize baby bottles if this principle is not obeyed. I will tell you more. The sterilization of the containers could also be avoided, if this procedure is strictly respected.

Sterilization

But how should sterilization be done and until when? Both kettles and cold sterilization solutions are effective and harmless. Therefore the choice between the two methods must be made on the basis of convenience criteria, also using both alternatively depending on the circumstances. The substantial difference between them lies in the fact that hot sterilization is more complicated but faster, while cold sterilization is simpler but slow.

In my opinion, it is still sufficient to continue sterilization until the third month of life at the latest. After that, the cleanliness of the containers and the respect for the hygiene of the person preparing the milk are adequate for the protection of the baby against contamination by pathogenic bacteria.

Milk at room temperature

If we want to spend a good part of the day away from home, the problem arises of how many hours the milk already mixed can resist at room temperature without spoiling. The answer is simple: assuming it has not been contaminated by someone with pathogenic germs, it can stay at room temperature for several hours, especially if the weather is not hot.

At worst it can turn sour and unpleasant, but it cannot cause infections. Quite often I have been called by terrified parents for inadvertently giving their baby sour milk, without any harm happening. In conclusion, I think it is perfectly safe to carry a bottle of milk ready, filled to the brim and well sealed, for several hours and in any season. In particularly adverse weather conditions, we could carry the powder and hot water separately with us, or carry the ready milk in a thermal bag.

WEANING

Weaning literally means the act of removing a habit, that is, the habit of sucking on the mother’s breast or bottle. That is, in a broader sense, it means getting used to milk, gradually replacing it with other foods.

Despite the apparent simplicity, weaning arouses a series of doubts and anxieties and therefore also tension between the mother and the child.

First of all, when introducing new foods, you have to pay attention to potential allergies. Then, the little one does not always easily accept what is offered, indeed very often stubbornly refuses even to taste it. Often the mother, worried about the possible consequences that these refusals can have on his/her health, tries to force or trick him/her to eat.

On the other hand, I believe it is essential that weaning take place in the utmost serenity for the child to acquire a good relationship with food and therefore I will try to do clear many prejudices and clichés on this topic. Let’s start with one of them right away.

You can wean late

Most people believe that solid foods contain essential nutrients, which milk alone cannot provide to the baby. Therefore they can’t wait to start weaning, in the belief that in this way the baby will finally have a more substantial diet. Instead, it must be remembered that milk is a complete food and does not necessarily have to be integrated with solid foods to ensure satisfactory nutrition. The reasons for starting weaning are different:

1) After the first four to five months, the baby no longer needs the large quantities of water that milk provides together with nutrients. In fact, his kidneys work better and he can afford to eat more concentrated foods. With these he also has the advantage of having less frequent and voluminous meals to obtain the same substances that milk offers him.

2) Furthermore, solid foods, precisely because they contain less water, are less perishable than milk and can be kept longer under normal ambient conditions.

3) The solids then, especially those of vegetable origin, contain non-digestible waste which, in perspective, are important for protecting the health of the intestine.

4) Finally, solid foods, with their different flavors, break the monotony of milk and introduce the baby to the diet that he will adopt for the rest of his life.

I think it is easy to understand why none of the reasons I have listed justify the discouragement which so many mothers feel if the child is slow to accept solid foods. These foods are certainly important in the long run, but it makes no sense to fear that the child may suffer from nutritional deficiencies if we do not absolutely impose them on him/her within certain time limits.

In short, it is not at all essential, contrary to what almost everyone thinks, that a baby begins to eat solid foods between four and six months. If they wish they can continue to take only milk even until the end of the first year, without endangering their health and growth.

No forcing

It follows that, in introducing new foods, it makes no sense to resort to forcing or tricks. Instead, the most appropriate attitude is to propose them positively, as a game. If the little one accepts them willingly, once we have ascertained that they do not cause him allergies, we can offer them in increasing quantities, letting us be guided by his reactions.

As soon as they show the first signs of satiety, turning and closing their mouth in front of the spoon, we should never give in to the temptation to make them empty their cup or even to make them swallow a single teaspoon more than they willingly do.

On the other hand, if they want to complete the meal with a bottle of milk, let’s indulge them without hesitation, even if they ask for it half an hour or an hour later. It is not true that this spoils their digestion or dilates their stomach. 

If they clench their mouth or seem disgusted by the first bites of a certain food, it is best to stop immediately and allow at least a week to pass before proposing it again. It is not at all good to add sugar or other sweeteners to encourage your little one to eat it anyway. No food is important enough to use these kinds of tricks which, among other things, encourage bad habits.

Why a gradual introduction

At whatever age weaning begins, it must be done gradually. That is, at least twenty-four hours must pass between the introduction of one food and that of another, always starting with small doses. But why? First of all, an attempt is made in this way to precisely identify the cause of any allergic reactions. Reactions that can be recognized, already after the first administration of a certain food, because they manifest themselves with vomiting, diarrhea and skin rashes extended to a large part of the body.

Secondly, the gradualness serves to give the baby ease to understand and accept the new flavors without unnecessary forcing.

Finally, the child needs time to learn how to swallow the first creamy baby food and later to manage bigger and bigger pieces of food.

When do we start

According to nutritionists, it is advisable to start introducing solid foods no earlier than five or six months, first because it is not necessary to do so and then to avoid any allergic reactions as much as possible.

But which foods to introduce first?

Between five and six months it is traditional to offer fruit first. Usually, we start with this not because it is less risky or more digestible than other foods, but because, being sweeter than other foods, it is usually more willingly accepted by the majority of children. And, when introducing the various types of fruit, there is no precise order to respect.

In particular, it is not true that the apple should be the first because it is lighter and that the banana is “heavy”. From any fruit you start, you can continue with all the others available, without exception. We can therefore also offer the child peach, figs and pineapple, or even papaya or mango, provided they are ripe, clean and … affordable.

But do not expect fruit to replace a milk meal, since it does not contain proteins or fats that can satisfy the nutritional needs of the little one. The fruit smoothie is only a supplement to the meal, to be offered between feedings, to provide some vitamins, minerals and fructose.

MILESTONES

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VACCINATIONS

Why it’s important to vaccinate your children

The main goal we parents have is to make our children feel good, help them survive.  We feed them, we dress them, we protect them.

If children today were exposed to all the diseases they were exposed to 50 years ago, without the protection of vaccines, they would end up in the same situation as the children of that time.

For example, diphtheria outbreaks caused many deaths, as did whooping cough. Today people in the developed world don’t know what diphtheria is, there are few people with whooping cough. We no longer see this phenomenon because two generations have already been vaccinated and therefore these organisms are no longer circulating in the environment.

A short time ago, meningitis caused by meningococcal, pneumococcal, Hemophilus, measles or mumps caused many deaths.

Rubella killed, and also resulted in many children with severe deformations if the mother contracted rubella during pregnancy. Today this no longer happens because mothers were vaccinated against rubella when they were young girls, 20-30 years ago.

The bacterium of tetanus is present on the ground, or on rusty nails. If it gets inside a wound of a person not vaccinated against tetanus, the individual will have terrible neurological symptoms and die a very excruciating death. When I was a child, you could hear of so many children dying of tetanus.

Polio used to deform many children, and in Italy alone one thousand children died of measles each year.

 

Vaccines are the reason for the survival of millions of children around the world who would have died of these terrible diseases. 

 

Vaccine table

The table below (you can download it) is the recommended vaccination schedule.

Vaccines are done  as soon as possible to reduce the risks.

Until a child has been vaccinated, he or she risks contracting the actual disease.

The only reason to delay vaccination is  if  the child  is very ill with very high fever fever, if he has an important ongoing disease (not a cold or other trivial disease).

 

Download Vaccination Shedule

 

To know more about this topic please click HERE

THE BABY THAT DOESN'T SLEEP

Reflux almost always causes this problem.

The child who never falls asleep easily and who wakes up many times during the night, getting little rest and making the whole family rest badly, creates a very noticeable discomfort for himself and others.

Recent searches

Recent research has shown that, in most cases, the child who has this problem suffers from a physical disorder, almost always gastroesophageal reflux.

Read what I wrote about the topic in the “Gastroesophageal Reflux” section and check whether your child may suffer from it. 

Sometimes the child does not sleep because he has suffered bad conditioning, in other words he has been “spoiled” because the right rhythm has not been imposed on him at the right time.

I believe that in these cases the use of sedative medicines is counterproductive and I believe that the solution must be to “recondition” the child in the appropriate way.

If you have any kind of difficulty with your little one’s sleep I believe I can give you more effective help than you have received so far.