Caring For a Baby
Instalment Two: Feeding the Baby

The Main Contents

Part One
Breast Feeding the Baby

The book What to Expect the First Year says it can be best to start breast-feeding as soon as possible after the baby's born if mother and baby aren't too exhausted, because feeding a baby with a bottle in the early days can mean it isn't so keen to feed at the breast, because it takes more effort to suck milk from the breast than it does from a bottle. I don't know how many problems that really causes. But it says it can be best to ask before the baby's born if it can be brought to the mother for breast-feeding rather than being fed or pacified with a bottle. It says in the first days after birth, it's best to feed the baby a lot so the breasts start producing more milk. Also, feeding the baby a lot will stop the breasts producing quite a bit of milk only to get far too full and hurt. It used to be recommended that mothers only feed their babies every four hours, but that could make the problem worse.

Oh yes, I was speaking to someone who said that when she gave birth to all her kids, the people at the hospital said she mustn't feed them any more often than four hours. She obeyed, but she found it frustrating because they all cried in between times and she knew feeding them would quieten them down. She said it's a contrast to nowadays where people can do what they like more. My sister feeds her baby whenever she seems to want food, and she's a happy baby.

The book What to Expect the First Year even recommends we wake the baby up to feed them in the first few days, because they'll want to sleep most of the time, but feeding them will stimulate our breasts to produce more milk and the baby will appreciate that later.

Signs a Baby's Hungry

The baby will likely give signs it's hungry before it cries, so if we notice them, we can start feeding it before it does, since it'll be more difficult to get a crying baby, especially one frantic with crying, to settle down and start feeding. Some signs a baby's hungry can be individual to that baby, and we'll probably get to recognise them as time goes on; but some are common to all babies. Signs a baby's hungry can include:

• Movements of the mouth: An early sign of hunger can be various mouth movements, such as lip smacking, the tongue going in and out, sucking motions, and opening and closing the mouth repeatedly.
• Sucking on things can be another sign: The baby might suck on its hands or fingers, its lips, or on things like its blanket. It won't necessarily be a sign of hunger, because especially as it grows older, a baby will suck on things like blankets just because it enjoys it or for comfort.
• Another sign of hunger is if the baby makes rapid head movements when it comes into contact with something, as if it's searching for something to suck on, or it opens its mouth when its lips, chin or cheek are gently touched.
• Excited movements of the arms and legs at a time when the baby's probably getting hungry might well mean they are.
• If the baby hasn't been fed for some time they can get panicky. Frantic movements of the head and arms can mean they're worried they've been forgotten about and they're not going to get their next meal.

Crying can be a late sign of hunger. If a baby's crying, especially frantically, it can be a lot easier to attach it to the breast if we calm it down before feeding it. We could rock it gently and talk to it soothingly, or let it suck one of our fingers till it calms down.

It can be best to feed the baby when we notice its signs of hunger rather than waiting till it cries if we can, because then we won't have the hassle of trying to attach it to the breast while it cries or calming it down first.

Problems Breast-Feeding

A lot of women have trouble breast-feeding. This can be because their milk supply's a bit limited or because they have difficulty at first positioning the baby so it can attach itself to the nipple in a way that'll make it easiest to get milk.

Care will need to be taken by everyone at first that the baby's latched on to the nipple properly. Breast feeding isn't instinctive; a lot of new mothers have to practice quite a bit before they know how to get the baby in the right position. It can be frustrating for mother and baby before they get the hang of it; but it can be nice when it's finally achieved.

The poor milk supply problem can often be related to the problem of not being able to get the baby's mouth in a good position to feed, since when the baby latches on to the nipple well and begins to suckle, the body usually starts producing more milk.

In the first few days after a baby's born, the body produces something called colostrum, which is quite a bit thicker than milk. It's a nutritious thing. But it takes a lot more effort to suck it out, because it's like trying to suck honey through a pin hole. Smaller babies can have difficulty. But if babies are put on the breast a lot at first, they can suck it out and then the milk can come through freely.

They won't have to suck much out at any one time. Since the stomachs of newborns are very small, they'll only need a little bit at any one time. So we don't have to worry if we're not producing much at first.

We can use the time the baby's at the breast as practice for positioning it on the nipple properly. It can take a bit of practice. Even women who've breast-fed before can find their new baby does things a bit differently. If the delivery was difficult so mother and baby might be stressed and exhausted, it's probably best to wait and sleep a bit before both try to get the hang of breast-feeding. That's especially if the mother had an anaesthetic. If we're drowsy, it's best to wait till we feel more up to it before practising breast-feeding.

Sometimes, the milk supply can increase slowly, so giving the baby milk from a bottle as well as from the breast for a little while can keep the baby well-fed till the body starts producing more milk. And pumping breast milk when the baby's asleep can help sometimes, especially since it can be put in a bottle for someone else to give the baby if the mother's busy when it cries. Leaving it around for too long isn't good though, since breast milk changes as a baby grows, in line with its needs.

If more serious problems develop such as feeling sick or feverish, and having pains or swelling in the breasts after the first few days when it's normal, getting medical advice is the best idea.

Making Sure the Baby's Managing to Attach Itself to the Nipple Well

If the baby's mouth isn't positioned on the nipple well, getting milk will be more difficult for the baby, and the mother's likely to get sore nipples. A little bit of soreness in the first few days is normal, but if it gets worse instead of better, it might well mean the baby isn't positioned well. If the nipple feels as if it's being pinched when the baby's feeding, the baby isn't on the nipple fully.

The baby will be able to latch on to the nipple better if its mouth is wide open and it takes the whole nipple in its mouth rather than just the bit at the end. One way of trying to encourage a baby to open its mouth wide is if a mother gently strokes the baby's lips with the nipple until the baby opens its mouth wide like a yawn. When it does open its mouth wide, the mother can gently put the nipple in. If the baby doesn't open its mouth, the mother can squeeze a bit of milk, or colostrum in the first days after it's born, onto its lips, to entice it to want more and open its mouth.

The baby needs to take the whole nipple in its mouth rather than pinching the end with its lips. A baby's suck's powerful, so if the baby were to just grab the bit at the end of the nipple between its lips, the nipple would get sore. Looking in a mirror might help us work out whether the baby's mouth is on properly. The baby needs to not only have the nipple in its mouth but the darker bit around the nipple. The bit just under that is where the milk glands are, and they're stimulated to let the milk flow by the skin around them being sucked. If only the nipple is sucked, that won't happen.

It's best to raise the baby up to the breast rather than leaning down to the baby. It would be uncomfortable to lean down for the length of time the baby will take to feed, and shifting position to get more comfortable might well mean the baby hasn't got so much of the nipple in its mouth so its powerful suck's pinching the end, and that can end up hurting us. So it's best if we can sit comfortably with our back fairly straight. Putting a big pillow on the lap and then putting the baby on that can help raise the baby up to the breast in a way that'll be comfortable for the mother, because it'll be less of a strain on the arms than it would be to hold the baby with no support all that time. Holding the baby for some time in one position might give us arm cramps.

Putting the baby on a pillow can also be best for women who've had Caesareans, because the pillow can protect the scar from the baby leaning on it. If it'll help us feel more comfortable, the pillow can be raised up even further by us putting our feet on a footstool. And if it's more comfortable, we can put pillows under our arms, so there isn't so much strain on them holding the baby for half an hour or so. Or we can sit in an armchair with our arms on the arms of it.

Or sometimes, we could feed the baby lying down. That'll be nicest when we want some rest, especially at night. We can lie on our side with the baby lying on its side too so we're stomach to stomach, with the baby's mouth in line with our nipple. Then we can gently squeeze it so we can fit it better into the baby's mouth as we would if we were sitting up, remembering it isn't just the nipple that needs to go in the mouth but also the darker bit around it. The baby's gums need to compress that bit and the bit just below it where the milk glands are to stimulate them to start the flow of milk.

It's best if we experiment with different positions to find out which ones we can hold for a long time without getting stiff or bits of us beginning to ache.

One position is where we hold the baby's head with our hand which is on the opposite side from the breast we're feeding the baby with, supporting its body with the arm attached to that hand, so the hand on the same side as the breast we're feeding with is free. That'll mean that with our free hand, we can cup the breast we're feeding with, and make it easier for the baby to feed from it. We can do that by putting our thumb about an inch above the nipple and a finger an inch below it, and gently squeezing it so it's a more elongated shape, more the shape the baby's mouth is.

There are quite a few different positions we could breast-feed in. But it's important that the baby's head is frontways on to the nipple rather than it having to turn its head to the side to grasp onto it, since it's more difficult to swallow when the head's turned sideways.

Oh yes, I've just turned my own head to the side and swallowed and it was more difficult.

If the baby turns its head away when we begin to feed it, we can encourage it to turn back if we stroke its cheek, the one nearest to us. Then a reflex will make it turn towards our breast. It's not a good idea to press both of its cheeks to encourage it to open its mouth, since that can confuse it. The books say once it gets used to feeding from us, the feel of our breast, and sometimes just the smell of milk, will cause the baby to turn towards our breast.

It's best to do things gently. Once the baby's mouth is open wide, we can pull the baby closer. It's better to do that than to lean forward into an awkward position to try and get our nipple into its mouth. And we need to be careful not to push our breast into its face or its face into our breast, or to try to stuff the nipple into its mouth if it isn't that eager. We can let the baby take the nipple at its own pace.

It might take a few attempts before we get the baby latched on to the nipple firmly. It might not open its mouth widely enough at first. But when it's suckling well and has a firm grasp, we can let go of our breast. We'll be able to tell if it's taking in milk rather than just sucking a bit of the breast it won't get milk from because if it's swallowing quite a bit, we'll be able to see a rhythmic motion around its jaw, cheek and ear.

Another way we can tell if the baby's on the breast properly is if it makes low gulping sounds when it swallows, so we know it's taking in quite a bit at once. If it smacks its lips a lot, it'll mean it isn't on properly. We can take it off several times and try to reposition it if we realise it's not on very well. But we'll need to stop it sucking first, because the suck's powerful, so if we just try to take it off the breast while it's sucking, it'll pull the nipple so it'll hurt. We can stop the baby sucking if we put a finger gently into the corner of its mouth.

It's best if we keep checking whether the baby's on the nipple properly. Sometimes, they can be so keen to suck that they start sucking other bits of the breast entirely even though they're getting no milk, and that can end up hurting and we can get a bruise.

The baby's lips ought to be pouting outwards when it sucks rather than tucked in, so it can take in more of the nipple. Also, the baby can start sucking on its lower lip or tongue instead of the nipple. So we'll have to keep checking to make sure it's taking in milk.

That reminds me. Someone once said he had new twin boys, and the mother tried to feed them both together, and one kept trying to latch on to the other one's nose to suck that.

The baby's tongue ought to be underneath the nipple rather than on top of it. Sucking on anything is more comfortable if the tongue's underneath. We can tell that if we try sucking something with our tongue on top of it. If the baby's tongue's on top, it might start sucking it instead of the nipple. If we notice it doesn't seem to be taking milk in, it might be sucking something it shouldn't, so we can put a finger gently into the corner of its mouth or push our finger gently between our breast and its mouth to stop it sucking, and then take it off the breast and put it back on, checking that the baby's tongue is low down in its mouth. If it's sucking on its own bottom lip, just gently pulling the lip downwards/outwards should stop that.

If the baby's nose is poking into the breast so it can't breathe easily, we can press the bit its nose is poking into down a bit so it's got some breathing room. Or we can adjust its position so its nose isn't poking into it so much, perhaps by lifting it up slightly. But we'll have to be careful if we do that that the baby doesn't lose its hold on the nipple and the surrounding bit that it's supposed to be sucking. If it does, we can just take it off the breast and then try repositioning it again.

It's naturally best if the baby's nose doesn't get buried in the breast in the first place. When we put the baby on the breast, it can be good if we aim to touch our breast with its chin and bottom lip first, rather than touching it to the breast nose first, aiming to get the baby's chin as far below the nipple as the baby can reach and still get the whole nipple and surrounding bit in its mouth. That might make more certain the baby's tongue is below the nipple when it starts sucking; and also, if it puts more pressure on the bit below the nipple than above it, it'll be better, because that's where the milk glands are and they produce more milk in response to pressure. Also, it'll be best if the baby has room to breathe. We can look to see if the baby's in a good position while it's feeding. It'll be more likely to be if its head's tipped back a bit with its chin touching the breast and its nose free.

If our nipples start to hurt while the baby's feeding, it might mean the baby isn't on the nipple properly; so we can try taking it off the breast and putting it back on. It's best to do that, or the pain could get worse.

If the baby's positioned on the breast well, it might well take a few short sucks and then several long ones. It might pause for a little while sometimes and then start sucking again. If it sucks a few times and then falls asleep, chances are it isn't positioned on the breast well so it isn't getting much milk. Or if it wriggles around rather than relaxing and getting down to feeding, it might well mean it isn't positioned well so it isn't getting much milk.

It might take practice to get the baby positioned on the breast well at first; but after a while, attaching it will probably become second nature.

When we take the baby off the breast, putting a finger in the corner of its mouth or between its mouth and our breast to stop it sucking, it's best to gently push our finger between its gums till we actually feel it stop.

Some babies are more excitable than others, and often lose their grasp on the breast and then scream and cry in frustration to be put back. They tend to get the hang of it after a while though. Till then, it's best to calm them down before trying to re-attach them.

Different babies have different styles of breast-feeding. Some like to suck especially hard and gulp the milk down as quickly as they can, while others like to take a much more leisurely approach, playing with the nipple and savouring each mouthful of milk before swallowing. And some like to have naps in the middle of feeding, and get grumpy if woken up.

The best way to end a feed will often be to wait till the baby takes its mouth off the nipple itself. If it doesn't, maybe because it falls asleep while feeding, as babies often do, we'll be able to tell it's lost interest in feeding. If its suck-swallow rhythm has changed so it's only doing about one swallow per four sucks, it'll mean it doesn't really want to feed anymore.

Hospitals often provide someone who can advise new mothers on the best way of breast-feeding, watching our technique and advising on things we can do to improve it. If the service isn't offered, it can be best if new mothers ask if a lactation consultant or someone else who can advise them can come and see them. If no one's available in the hospital so new mothers leave before they've been given advice, it can be best if a professional person like the baby's doctor or a midwife gives advice within days. There might be other places to get help, such as help-lines we can ring. We can look for some reputable-seeming organisations with help-lines on the Internet. But someone who can come and visit and look at what we're trying can be best, or if we can visit them. It's best to get the problems sorted out early before the milk begins to dry up.

Creating a Nice Environment Around Us While Feeding the Baby Where Possible

It's best if we're relaxed when we feed the baby. Sometimes the milk doesn't come out while the mother's feeling tense and anxious; it starts flowing again when the mother relaxes. If we're feeling self-conscious because others are in the room, it's probably best to ask them to leave or if we go somewhere private. And we can do relaxation exercises such as leaning back, letting any parts of our body we notice are tense go limp and taking a few steady slow breaths, since people tend to breathe too fast when they're stressed and it can make the anxious feelings worse. Or just listening to soft calming music for a few minutes can help, or reading a magazine we find interesting.

The baby might be helped by listening to calming music or being rocked a bit before a feed if they're agitated. It'll be easier for us to feed them if they're calm.

In time, breast-feeding will become second-nature to us, so we'll be able to put the baby on the breast without concentrating that much. But at first, we'll have to really pay attention to what we're doing. It can be best if we go somewhere where we'll have peace and quiet, where there isn't much going on to distract us from what we're doing.

Mothers with older children to keep entertained at the same time could perhaps organise some colouring for them to do or something.

When we're more used to breast-feeding, we might be able to flip through a book or magazine at the same time to occupy us. But it'll be good to stop and talk to the baby from time to time, not just because it'll be nice, but because it'll be good for the baby to hear the sounds words make even from an early age. Even babies can appreciate the companionship, and the more familiar they become with the sounds words make, the more readily they can pick them up and start repeating them later. To have us talking to them will be better than if they're left to try to pick words up from the television, because we can repeat them slowly, and they can concentrate on the words more if we're talking directly to them and if they haven't got the distraction of all kinds of things on screen attracting their attention. So the more we talk to them, the more familiar they'll become with the sounds that'll help them learn to talk later.

Talking on the phone might be too distracting for us in the first few weeks we're breast-feeding, so it can be best to turn the ringer down so the phone doesn't make us jump when it rings, and let the answerphone pick up the calls. It might also be best to avoid watching television till we're good at breast feeding, since earlier it might be too distracting.

It can be nice if we have a cup of juice or milk or water by us so we can quench our own thirst while we're breast-feeding, making up for the fluids we're losing. But we shouldn't have a hot drink near us, in case we accidentally spill it and we or the baby get scalded. If we don't want something cold, a lukewarm drink might be nice enough. And a healthy snack can be nice, especially if it's been a while since our last meal so we might get hungry while in the process of feeding the baby. The more healthily we feed ourselves, the more healthily the baby will be fed.

If the Breasts Become Swollen and Painful in the First Few Days After Birth

Sometimes, when the breasts start producing milk, they become very swollen and painful, and hard because they're full of milk. Not only milk though. Blood rushes to the breasts to help fuel the milk-supplying operation. But the breasts can be so painful that it's difficult to bear having a baby sucking on them, and it would be difficult for the baby to get a grip on them anyway, because the nipples seem flatter because the breast around them has swollen up. Thankfully, the problem doesn't last that long, often a day or two. Then the body often gets the hang of producing milk without a hitch. For first-time mothers the pain can often be worse and last longer. There are ways to reduce the discomfort though:

• Heat or warmth can soothe the breasts. One thing that can be done is that just before trying to feed the baby, a warm flannel can be put around the nipple and the surrounding area, and the warmth might help soften it and make it easier for the milk to start flowing. The flannel can be warmed by being dipped in warm water. Or a person can lean their breasts into a bowl of warm water. Warm water's better than hot water. Too much heat can actually increase swelling. Milk flow can also be stimulated if a mother gently massages the breast the baby's feeding from.
• Something frozen used after feeding can help reduce the pain and reduce the swelling. I remember I sprained my ankle once, and someone recommended to me that I rest it on a bag of frozen peas to help the swelling go down and soothe it. The book What to Expect the First Year says that though it might look and seem a little odd, chilled cabbage leaves fitted over the breasts can be surprisingly soothing, perhaps with holes torn in them for the nipples to poke through. It's best to use the large outer leaves, rinsed and patted dry.
• It's best to wear loose clothing that doesn't rub against the breasts.
• Feeding the baby often can relieve the swelling, even though it might hurt for a while. The more the baby's fed, the sooner the swelling will go down and the pain will ease. It might get worse if no milk's being taken from the breasts. If the baby hasn't got a good appetite, some more milk can be expressed with a breast pump. Not too much though, or the body will start producing more milk than the baby needs because there will seem to be more demand for it than there really is, so the swelling will get worse because of the milk in it that isn't being used.
• The nipples can be squeezed a bit gently by hand before feeding, to get a bit of milk out and stimulate the flow, and to soften them up a bit to make it easier for the baby to feed from them.
• The feeding position can be changed from one feed to the next. For instance, one can be done lying down, then the next reclining on pillows with the baby held up to the breast with a pillow underneath it to help raise it up enough. Feeding in different positions can make sure all the milk ducts are being emptied so it might help relieve the swelling from the engorgement.
• A mild painkiller can be taken for severe pain, but it should be one prescribed by the doctor who can make sure it's one safe for the child if it's taken by a breast-feeding mother. And it's best to take it after a feed rather than a little while before when most of it will be in the system when the baby feeds.

Some women worry that if their breasts get less swollen after giving birth than they did when they had their first child, it means they won't produce so much milk. But they will. The fact the breasts often swell up less than they did with the first child might mean they're used to producing milk now; or it might be because the mothers are more practised at nursing so they can help their babies take the milk more efficiently so they take more of it. Very rarely, a lack of swelling does mean there's a problem with the milk supply, but only with first-time mothers, and the problem can usually be solved.

If the Breasts Produce Too Much Milk

Sometimes, at first, too much milk comes out, and the baby chokes and gasps and splutters because more is coming out than it can cope with. And there can be so much it can leak out and spray sometimes when it isn't even being sucked out, and that can be embarrassing, especially if it happens in public. It can either mean the breasts are producing too much milk or it's being let down too quickly. But it won't last that long. The body will gradually adjust over the next weeks till the supply and its speed and the demand for milk match up much better. Till it does, keeping a towel handy to dry mother and baby can be a good idea. Also, there are things that can be tried to slow the flow:

• Since the milk might come out really fast at first and then start coming out more slowly, if we put the baby on the breast and notice it's gasping and frantically gulping down milk trying to keep up with the rate it's flowing, we can take the baby off the breast for a little while and see if the flow will slow, and then put the baby back.
• We can feed the baby from only one breast per feed. That way, at least the baby will have to put up with the first fast flow of milk only once per feed, rather than twice.
• Gently putting pressure on the part of the breast around the nipple while the baby's feeding can stop the milk flowing so fast.
• We can reposition the baby so he/she's more upright, in a position that'll allow him/her to let some of the milk trickle out of the mouth. Some babies do that.
• We could try feeding the baby against gravity by leaning back on pillows or cushions or just in a chair where we can do that, or lying on the back with the baby on the chest. That position might be a bit awkward, so we might not want to feed the baby like that all the time, but we can sometimes.
• We can pump a bit of milk out before the baby starts feeding, so the flow has slowed down a bit when it starts.

It won't be worth us decreasing the amount of fluids we take in, because drinking less doesn't make the body produce less milk, and drinking more doesn't encourage it to produce more. If we drink less, we'll just risk getting dehydrated.

Some women's milk flow doesn't slow down; but if ours doesn't, at least as the baby grows, it'll be able to take in more milk at one time and get better at coping.

When the Breast Lets Milk Down

A lot of women find their breasts leak drips of milk a lot. It can even happen when they just think about the baby. Sometimes it happens when the mother isn't thinking about the baby at all though, but perhaps out in public trying to look clean and efficient. So it can sometimes be embarrassing for mothers, and also uncomfortable because of the constant wetness. There are things that can be done to reduce the problem though:

• There are little things called nursing pads we can buy. A nursing mother can put one in each bra cup to absorb leaking milk. We could carry some around with us in a bag and change them as often as we leak. One of the books advises we don't use ones with a plastic or waterproof lining, saying it traps moisture rather than absorbs it and that can cause nipple irritation. It advises we try several brands till we find one we really like, saying some women prefer disposable ones while others prefer washable cotton ones.
• If we find we're leaking quite a bit in bed at night, we could put a towel under us or wear a bra with one or more nursing pads in each cup. It'll be better than changing the sheets every day, or even eventually having to get a new mattress. I don't know how many people actually do this or have problems that bad.
• We can wear dark-coloured clothes to camouflage milk stains.
• It isn't a good idea to try stopping leakage by pumping some milk out with a breast pump, because the more milk is taken out, the more the body will produce. If there seems to be more demand for it than before, the body will produce more, so the breasts will leak more.
• When the milk supply has been coming through for a while and has settled down, we can try stopping leaks by pressing our nipples when we feel a leak starting. Or we could fold our arms tightly across our breasts. It's best not to do that in the first few weeks though, because it can stop the body releasing milk so easily and could cause a clogged milk duct.

Sometimes, the feeling a mother gets when the breast lets milk down is a bit like pins and needles, sometimes quite bad ones, or a feeling of warmth and fullness. It can be a more intense feeling in the early months of breast-feeding, and when it happens at the beginning of a feed. The body might let milk down without it being sucked during a feed, perhaps from the breast the baby's not feeding at; but the feeling probably won't be as strong as it was at the beginning.

There are things that can cause a few temporary problems with the breasts' ability to let milk down, including anxiety or tension, fatigue, large amounts of alcohol, illness, and being distracted from the job of feeding. So if the milk often only starts to flow slowly, it can help to do something for relaxation before feeding, to feed in a place where we won't be disturbed much, and to only have the occasional alcoholic drink. Stroking the breast gently before feeding can also stimulate the flow of milk.

We don't have to worry about the flow of milk starting much though, because it's very rare to have serious problems.

Things That Can Relieve Nipple Soreness

Some mothers experience shooting pains just after feeding. That will often just mean the breast's filling up with milk again. They usually don't last beyond the first few weeks.

Nipple soreness during feeding can often be caused by the baby not being positioned on the breast very well. But some babies do have a much more powerful suck than others, so that can make the nipples sore. Also, it's usual for nipples to be sore at first until they toughen up a bit, which doesn't take long.

There are things that can be done to reduce the pain of sore nipples:

• When the milk supply first gets going and the breasts swell up because blood as well as milk flows into them to get the process going, as well as making the breasts painful, it can be difficult for the baby to get a grip on a nipple. It can be made easier if a bit of milk is taken out by hand first so the nipple isn't so hard and swollen. We need to be sure the baby's mouth's firmly positioned on the nipple, with not only the nipple in its mouth but the part of the breast around it, since that's where the glands are that produce the milk in response to pressure, like the pressure of sucking. If just the nipple's in the baby's mouth, the baby won't get much milk, and our nipples will get sore.
• It can help if we expose sore or cracked nipples to the air for a few moments after feeding. Also, it's best if they're dry before we put clothes over them. We could even dry them with a hairdryer on a warm, rather than a hot setting, if we hold it a safe distance away.
• It's best to make sure we aren't wearing clothes that'll rub against the breasts, and that we change nursing pads regularly if our breasts leak milk so we're not wearing something against the breasts that's going to keep them wet. The ones with plastic linings aren't so good because they trap moisture rather than absorbing it, according to one of the books, although I'd have thought they have an absorbent bit that keeps moisture in. On the other hand, if the skin on our breasts feels too dry, we could use some kind of moisturiser, though it'll be best to ask the doctor for one safe to use when breast-feeding, as well as asking what painkillers are safe to take while breast-feeding if the soreness is bad.
• Relaxing for about 15 minutes before feeding can help, since it helps the body release the milk more easily, so the baby won't have to suck so hard to get it.
• It's important not to wear a bra that's too tight, because that can make the pain worse because of the pressure, and could even lead to a blocked milk duct.
• If we've got cracked nipples, it's best to watch out for signs of infection, since germs can get in through the cracks.

I know someone who said his wife got sore nipples when she first started feeding her new baby, and he went to a shop to try to find something that might help. He got some very thin rubber things she could put over her breasts and the baby could suck the milk out through them so the nipples were protected to some extent.

If a stinging or burning pain is felt during feeding, that can mean a thrush infection has been passed from the baby's mouth to the nipples. The baby might have caught it in the first place when it was travelling down the birth canal. The book What to Expect the First Year says it's caused by a fungus that naturally lives in places like the mouth and vagina and usually doesn't flourish enough to be a problem because other kinds of organisms living alongside it stop it. But sometimes illness, antibiotics or hormone changes such as women get in pregnancy make it easier for it to spread. Then it can cause infection. It can be passed to the baby's mouth and then to the mother's nipples.

It can look like raised white patches on the inside of a baby's cheeks and elsewhere in their mouth that can look like cottage cheese. It can bleed if a mother mistakes it for left-over food and tries to wipe it away. On the breasts, it can cause the nipples to become itchy and flaky and to feel a burning sensation. It's best to speak to a doctor about it. Anti-fungal agents can be given that can clear up the infection in both the mother and baby.

More Serious Breast Problems

One of the books says that sometimes, a little lump develops in a breast that's red and tender. This is most often a clogged milk duct. It can happen when the milk's being made faster than it's being removed from the breast so some of it gets forced out into the surrounding breast tissue where it shouldn't be so it causes swelling and pain, and the swollen tissue presses on the duct. It isn't a serious problem in itself, but it can lead to infection if nothing's done about it. The milk duct can usually be unclogged if the milk is stimulated to get flowing out of the breast more. A mother can try this by putting the baby on that breast first at each feeding, and leaving it there to see if it'll drain all the milk out. If there still seems to be a bit of milk in the breast afterwards, more than a few drops, expressing it by hand or with a breast pump can help. Varying the position we feed the baby in with each feed can make more certain it gets latched onto the breast well at least with some feeds, so it'll be more effective at sucking milk out.

It's best to make sure our bras or other clothes aren't too tight, because that can contribute to a milk duct becoming clogged.

If we place the baby on the breast so its chin is gently rubbing against the place where the clogged milk duct is, it can help clear it. Gently massaging our breasts ourselves can help soothe them, as can warm baths and putting warm or cold flannels over them for a while.

A clogged milk duct will usually clear within a day or so. Sometimes the problem will get more serious. But mostly, if we can feed the baby as often as we can, it'll help clear it. Feeding it might hurt because of the pressure on the swollen part. If it hurts too much to tolerate, expressing the milk with a breast pump might hurt less. And we can ask about painkillers that are safe to take while breast-feeding.

Putting something warm over the breasts and gently massaging them before feeding can soothe them in milder cases, but with severe cases of swelling, it's better to put something cold over them to ease the pain, since heat doesn't help.

The breast can become infected by bacteria, either if it gets in through cracks or sores or infects a blocked milk duct. If the swelling and redness on the breast get worse and other symptoms develop like flu-like symptoms and a high temperature, there might be a bacterial infection. If so, the doctor can prescribe an antibiotic it's possible to take while breast-feeding and the infection will probably clear quickly.

According to the book The Baby Whisperer, it's still safe to feed the baby from a breast while it's infected, since if it swallows any bacteria, it'll be killed by the acid in the baby's stomach, and the infection might well have been passed to us by the baby anyway; but if the baby isn't happy, it might mean the taste of the milk has changed a bit and it doesn't like it; so it can be fed from the other breast and we can express the milk from the infected breast with a pump or by hand and throw it away, to stop the breast getting clogged with milk and swelling and becoming more painful.

I think I'd personally be a bit cautious about feeding a baby from a breast I knew was infected!

It'll be important that we drink enough fluids ourselves so we don't get dehydrated at all.

In rare cases, a breast can develop an abscess, where the pain will be very bad, along with a high temperature, and swelling and hardness in the affected breast. In that case, nursing from it should be stopped, and pus can be drained from it under local anaesthetic, along with the taking of antibiotics. Milk could still be taken from it to keep the flow going, but it shouldn't be fed to the baby.

Breast-Feeding While Ill

It's possible to breast-feed while ill with quite a few conditions; many infections won't be passed on through the breast milk and it might even strengthen the baby's immunity to the infection. But the infection could be passed on in other ways, so it's important to take precautions such as washing hands before feeding or handling the baby or its belongings or anything the baby might touch, especially things it might put in its mouth. That's especially after we go to the toilet or blow the nose and so on, of course.

Drinking extra fluids can help us recover if we get a cold or flu or several other illnesses. It's especially important if we're losing fluids through diarrhoea or vomiting; they'll need replacing. Healthy drinks like fruit juices can be best. And eating a balanced diet can help. It's best not to take any medication without a doctor's approval, since some shouldn't be taken while breast-feeding.

Breast-Feeding While Having a Period

Some women don't get their periods back till they stop or reduce breast-feeding, but some do. If so, it's possible the milk supply won't be so plentiful for a few days during it because of hormonal changes, and it's possible the hormonal changes will make the milk taste slightly different, which might make the baby less enthusiastic about feeding. Things should return to normal a few days later.

Another way the Breasts can be affected is they can feel a bit tender/sore the day before the period starts or when ovulation happens.

If the Baby Loses Interest in Feeding at a Few Months Old But Seems Otherwise Healthy

When the baby starts to take more of an interest in the world around them, for instance things just within reach that they can grab hold of and play with, fun things to look at and so on, feeding might begin to seem boring to them compared with all the new things they might be able to play with. So they might lose interest in feeding for a while. They just want to be up and about exploring the exciting new world. We might keep them interested for longer if we feed them in a quiet place where there isn't much going on.

One of the books says we could tuck the baby's arm in between the baby and us so the baby can't reach for things to play with. We could wrap them in a blanket to stop them squirming if they're very lively. If we've got anything like a brightly-coloured piece of cloth with decorations on it, something the baby will enjoy looking at and that will catch their attention easily, we can put it over our shoulder where the baby will see it as it feeds. If we've got more than one thing it might enjoy looking at, we can swap them around often so the baby doesn't get bored with just one thing.

Sometimes though, the baby will be so interested in playing and exploring that a parent will just have to wait till they're hungry and want to start taking proper feeds again. It probably won't take that many days, although the baby might not be as interested as they used to be in feeding again.

They might well begin to slim down when they're about six months old and lose their baby fat. It's natural they'll do that as they become more active. As long as they seem healthy, it isn't a cause for concern.

But as they're introduced to solid food, they won't need breast-feeding or bottle feeding so much anyway, and they might enjoy the new flavours and novelty of eating solid food.

Other Advice About Breast Feeding

The book The Baby Whisperer says there are charts that are supposed to show how much milk a baby should be taking in at any one time, but they're not worth taking too seriously, because they're designed for average babies, and it's perfectly allright if babies a bit smaller or bigger eat different amounts, as long as they seem healthy. And babies will simply be hungrier some days than others. The charts can be useful as rough guides, but there's no point getting anxious because the baby's not taking in quite the amount they say babies will.

Also, it's best if we let them suck at one breast for some time before starting on the other one, because the most filling, creamier milk comes out from each breast later; the first milk to come out is really a thirst quencher, and not as nutritious as the milk that comes out later, so babies can want to feed from the more nutritious milk less if they take the thirst-quenching milk in from both sides first so they're full. Babies can miss out on some nutrients if the mother swaps sides only minutes into a feed.

But letting a baby drain a whole breast before feeding from the other one might mean a baby only wants the milk in one breast per feed sometimes. The other one can be offered afterwards, but naturally mums shouldn't try to make the baby drink from it if the baby's had enough. The book says that since it's of course best to feed the baby from both breasts, mothers can feed the baby from one breast during one feed and from the other the next, and so on, and remind themselves what side they last fed their baby on by putting something on that side to remind them, perhaps pinning a safety pin to their clothes on that side or wearing a bracelet on their wrist the side they last fed on. Or a clean tissue can be put in the side of the bra the full breast's on, which will be convenient because it'll likely leak milk while waiting to be drained.

Then again, when a baby's first born, it's probably best if the baby can feed from both breasts as often as possible, to get the milk flowing in each one and to relieve the pain that can be caused by the breasts becoming swollen partly with new milk ready for feeding.

We'll be able to tell if a breast's been fed from well because it'll be a lot softer than it was at the start when it was full of milk. It'll never truly be empty, or at least not for long, because milk's being made all the time. But when the baby's swallowed a lot of it, it'll be coming out of the breast at a trickle, and the baby will be swallowing less often.

It's good to feed a baby often at first to stimulate the body to produce more milk. But soon, settling down to a routine where they're fed less often can be good, since it'll mean we're not always having to hold them.

Small or premature babies can be fed often for longer, since they won't be able to take in so much in any one go, so the milk supply might reduce if the baby's sucking isn't stimulating it to produce more very often.

It's important to eat a good balanced diet so the nutrients get through to the baby and the body's strong enough to carry on producing good milk. Faddish diets like ones where you have to cut out carbohydrates or most fats or other things might hold the promise of allowing people to lose weight fast, but people need some of those things in their diet. Also, exercising intensively can put a strain on the body that can make it less efficient at producing milk.

If a baby has begun to cry for a feed every hour or so but only takes a small amount each time, and it's inconvenient for us, they could be pacified with a dummy for some of the time. Mothers can gradually give fewer and fewer feeds, while gradually substituting more of them with a dummy. It'll need to be done gradually so the baby gets used to it rather than suddenly feeling deprived. If they're not happy with a dummy, they can be fed, but just given less than usual, so they'll eat more at their next feed. Within a few days, they'll probably be feeding quite a bit less often but taking in quite a bit more each time.

Having said that, some babies who were feeding every three hours suddenly start wanting more, maybe crying for a feed once an hour and only staying on the breast for about twenty minutes. That needn't be worried about immediately. It might be inconvenient, and the baby can be coaxed to change if it carries on for some time; but at first, the baby might just be going through a growth spurt, and the more frequent feeding might help stimulate the breasts to produce more milk, as the baby wants. Growth spurts are common at about three and six weeks. Within a few days, the baby might revert back to its old pattern of feeding on its own, because the breasts might be producing more.

Feeds will take quite a long time if the baby's getting enough milk. Perhaps between 20 and 40 minutes. The baby might go to sleep during feeds, but if we can do something gentle to the baby or put them upright if we notice them getting sleepy to see if they wake up, we can see if they want more food. If they eat enough during the day so they're full when they go to bed at the end of it, they won't wake up so much to be fed at night.

The book What to Expect the First Year suggests a few ways we could try waking the baby up if it falls asleep during a feed, such as wetting its lips with milk to see if that gives it a fresh appetite for it, jiggling the breast or bottle around in its mouth a little bit or stroking its cheek, or rubbing its back as if to burp it, even though there's unlikely to be a burp there. It suggests we might do that several times if the baby keeps falling asleep. It says it doesn't matter if a baby falls asleep during feeds sometimes, but it'll turn into a hassle if it becomes a pattern and the baby wants to drink a bit and sleep a bit and then drink a bit more then sleep, and it goes on like that all day.

By the time the baby's a few months old, if it wakes up during the night, it won't hurt it if we don't feed it. Giving it a big feed last thing at night and first thing in the morning if it wants one should be sufficient. After that, if the baby wakes during the night, it'll often be best if we help it back to sleep without feeding it. If we feed it, it'll expect to be fed during the night so it's more likely to keep waking up. If it gets used to being expected to sleep through the night so it knows that's what it's supposed to do, it'll get used to the idea.

A baby's got more chance of sleeping through the night if it has a good feed before going to bed. That way, it'll have a full stomach, so it won't wake up so soon feeling hungry.

Combining Breast Feeding With Bottle Feeding

Sometimes women find it awkward to breast-feed all the time because they keep having breast infections or nipple soreness or because they have work commitments and so on. Breast-feeding can be done in combination with bottle-feeding, though it's best if the bottle's introduced gradually. It's best if when the baby's born, it gets used to the breast first, because it takes more effort to suck from that, so it might not want to if it gets used to the bottle first. Also, feeding from the breast first will help build up the milk supply.

Mothers don't need to feel too guilty about bottle feeding and giving up breast feeding, since milk formula does contain a lot of nutrients.

Then again, I've always been taught breast milk contains antibodies from the mother that help the baby's immune system that it wouldn't get from being fed with formula milk. I don't know how much difference it makes.

If we want to start bottle-feeding the baby, perhaps because we want to go to work so we want someone else to feed the baby while we're there, it'll be best if we start them on a bottle a while before we go, slowly introducing it so they get used to it, or they might refuse to feed from it when we're gone.

When beginning to bottle-feed, we might have to experiment with different-sized and shaped teats before we find out what type's best for the baby. If the baby's small, and seems to be choking, there's such a thing as a slow-release teat where the milk comes out in response to the baby's sucking rather than coming out by itself.

It's important for people to follow the instructions on the label of the milk formula. The book The Baby Whisperer says some mothers mix more formula in with the water than it says they should, hoping to fatten the baby up or give it extra nutrients. But that'll mean the baby gets less liquid, which will mean it's more likely to get dehydrated or constipated.

The bottle could be introduced a few weeks before a parent thinks they might want to start bottle feeding. But since the baby will be used to the breast, some think it'll be good to give it its first bottle feed around an hour after its last feed, so it's hungry but not desperate for a feed and thinking the only thing it wants right now is the thing it knows is going to give it food, the breast. That way, it might take to something new better. Not everyone agrees with that though; some think it's best to give it the bottle for the first time when it's ready for a feed, since otherwise, why will it be interested in taking it.

After that, it might be best to start by maybe giving the baby a bottle every few days, and build up gradually to giving it a few a day. If bottle feeding's increased only gradually, it'll reduce the risk of breast infections or clogged milk ducts that might be caused if there's a lot of milk in the breasts that isn't being used. The body will find it easier to adjust to producing less milk if the demands on the milk supply are reduced gradually rather than stopped abruptly.

At the same time, it's best to make sure the breast milk supply isn't reducing so much there won't be as much as we want there. It's still best to give several thorough breast feedings a day to keep an adequate supply of milk in the breasts for a newborn. Expressing milk with a breast pump occasionally can help too. Feeding too infrequently can mean the breast milk supply dries up altogether.

If it does begin to slow down and a mother wants it to increase, stimulating the breasts to produce more, by feeding more often and using a pump to drain the breasts more thoroughly, can help. While the supply's increasing, it might be best to still do some bottle-feeding, reducing the amount being fed to the baby with it gradually till there's enough in the breasts to keep the baby contented. It might take a while, and isn't always successful. It's best to keep a check on the baby's weight to make sure it isn't losing weight and is getting enough out of feeding. Getting the advice of a doctor might be a good thing as well.

When trying the baby on a bottle, it can be best to get bottles with teats shaped like nipples, ones with a slow flow that the baby will have to put fully into its mouth before comfortably sucking the milk, rather than ones with a fast flow, so being fed by bottle isn't so dissimilar from being fed by breast that the baby might reject one, perhaps because it likes the bottle best because it takes less effort to suck from it or it likes being breast-fed so doesn't like getting milk another way. In any case, it might take a bit of time to get the baby used to two methods of feeding, and some baby personalities will already be more unhappy about changes than others; but things will probably get better with a bit of perseverance, though some babies never learn to be contented.

But another reason it's a good thing to get bottle teats that release the milk fairly slowly is that then the baby's more certain to be able to keep up with the flow. Some drip into the mouth even when the baby isn't sucking, and some little babies find that a bit difficult to cope with and might even choke because the milk's flowing too fast for them. When they're older, they might prefer a teat that lets the milk out faster though and get frustrated with one that only lets it out slowly.

Introducing the Baby to a Bottle

The baby might not take to the bottle at first because a cold rubber teat's less inviting than a warm breast nipple. The baby might find it more inviting if warm water's run over it, so it's at least more like a mother's body temperature. It can be rubbed gently on the baby's bottom lip at first to stimulate the baby's sucking reflex, and then gently pushed into the baby's mouth. If the baby still isn't happy though, a parent shouldn't try to force the baby to accept it. If after five minutes they're still refusing, the parent should just take the bottle away and could try feeding the baby with it an hour later. Otherwise, the baby will come to dislike it. If the next hour the baby refuses to take it as well, the parent can try the next hour and the next, all day. And they can try the next day if they don't have any luck the first.

Some parents say they've been trying for weeks and weeks. The book The Baby Whisperer says it's likely they haven't been persistent, but tried for a day or so and then gave up till they felt it was really important, then tried again and gave up, and then tried again the next time they felt they needed to. Trying persistently's more likely to work. It says a baby can go for hours and hours without suffering ill effects, so a mother doesn't have to worry the baby will starve if a few feeds are missed so as to make the baby hungry enough to eventually take food from somewhere it's not used to taking it from.

I can't say the idea appeals to me personally; but some mothers might have to get the baby used to the bottle fairly early on.

But them, there might not be any need for anything that drastic. Making the bottle more appetising to the baby might help.

Some babies prefer the bottle if it's warm, and some prefer room temperature. It's also best to try to make sure the baby isn't feeling unwell, for instance with a throat infection that's putting it off all food because it's painful to eat. The baby also might be distracted by other things in the room, so feeding it somewhere peaceful might help. Also, if the baby's recently started solid foods, it might be feeling too full for milk.

Giving the baby the bottle to hold and play with first can make them feel more comfortable with it. It's a bit daunting to have something new and unexpected shoved in your mouth; but if the baby's allowed to explore it first, they might put it in their mouth themselves, as they do with most things. Then if they like what comes out, they'll want it there more often.

Sometimes if the baby refuses to take the bottle when it's got breast milk in it, it could be because it reminds them of the breast and the closeness of their mother, which they prefer. So it can sometimes be best to put a different fluid in it, such as diluted juice.

A lot of mothers feel guilty about putting their babies on a bottle. But it won't mean they can no longer have feelings of closeness with their baby, and formula milk is healthy enough, so mothers don't need to feel too bad.

The more the baby learns to feel happy drinking from a cup, the less it'll need the bottle anyway. So if a mother doesn't go back to work till the baby's eight months old or so, bottle feeding the baby might never be necessary.

It's not a good idea to leave a bottle in the baby's cot while the parents sleep. If left to feed unsupervised, the baby could choke.

The book The Baby Whisperer says It can be best if a child isn't given a bottle to carry around all day to drink from when they want, because it may be that the more they fill up on milk, the less food they'll want, though I can't really see one bottle lasting all day causing that much bother. Once a toddler starts enjoying solid food, they might well give up the bottle of their own free will. If they're holding onto it past two years old, it might be because the parents have used it as a pacifier to shut them up when they've been getting whiny or stroppy, so the child comes to rely on it. Parents can try coaxing them off it by bringing snacks out with them and giving them to the child from time to time, and making rules about the bottle, such as only having it at night or in the bedroom from then on. The rules don't have to be stated as if the child's going to be losing out. It can be put to them in an excited voice that now they're growing up, they can have proper food instead of the bottle, so the bottle can be kept for night time.

Nourishing Ourselves While Breast Feeding and Being a Bit Careful of What we Eat

Mothers might be keen to lose weight, but it's important that we eat at least enough to keep us healthy. The book The Baby Whisperer says what we eat doesn't directly affect the nutrients in our breast milk that much, but eating fairly healthily will help our bodies have enough good nutrients to nourish both ourselves and the baby.

The books say what we eat can sometimes affect the taste of breast milk. Someone who eats hot spices or garlic a lot might find their baby enjoys those things when they get older because they've been used to the flavours in their breast milk, whereas a baby whose mother's eaten a plain diet might not enjoy them so much. Occasionally a baby might not want to feed because of the flavour of the milk if the mother's been eating some kind of spicy food the baby isn't used to.

Sometimes, foods we eat might affect the baby's digestion. If we eat foods with a reputation for causing wind like Brussels sprouts, and we notice the baby's got more wind, it might be as well to cut down on that kind of food for a while. Or if we've been eating a lot of fruit and the baby gets a bit of diarrhoea but has no other symptoms of illness, we could change our diet a bit and see if that affects it. Colic in some babies has been linked to dairy products, beans, cabbage, onions or caffeine.

There's no need to give up lots of things at once. But if the baby seems to be suffering with it, we could try giving up milk products or other things for a week to see if the baby gets better. If it does, it might mean what we were eating was causing it, or it might just be coincidence. Babies will after all get better from a lot of things on their own eventually.

If we've given something up for a week, we can try gradually introducing it into our diet again to see if the baby starts to get worse again. If it does, we could try eliminating it from our diet again to see if it gets better again.

Some babies can actually be allergic to things that show up in the breast milk, such as cow's milk, wheat, citrus fruits and some nuts. It'll take a few hours for what we eat to affect the breast milk. If we notice there's a pattern of us eating a certain thing and then our baby getting more wind, spitting up more, getting miserable or rejecting the breast a few hours later, we could try eliminating it from our diet for a few days to see if the baby gets better.

Things It's Best to Avoid or Only Take in Moderation While Breast Feeding

A lot of the toxic substances in tobacco can get into breast milk. Smoking more than a pack a day can even decrease milk production and cause vomiting, diarrhoea, rapid heart rate and restlessness in babies. Smoking around babies can also give them breathing difficulties and other health problems. It can also increase the risk of cot death. Anyone finding it difficult to stop smoking should at least try to cut down, and not smoke just before breast feeding.

Alcohol should only be taken in moderation, no more than one drink a day. Not that much gets into the breast milk, but still, the amount a baby gets from a mother's heavy drinking session can make it sluggish, sleepy, unresponsive and unable to suck well. In very large doses, alcohol can interfere with a baby's breathing. Too many drinks can also make a mother less able to care for a baby well and protect it from risks.

Oh yes, most people probably know drinking too much could mean we put the baby at risk. I remember someone's wedding where one of the guests got very merry. She'd had too much to drink and she was doing lively dancing in high heels, kicking her legs up. Those around her had probably had too much to drink to warn her to stop in case she fell over. If they'd been sober, they probably would have recognised the risk straightaway. She did fall over, and broke her ankle. It took ages before she wasn't in pain anymore.

Anyway, one of the books says alcohol can also make mothers more susceptible to fatigue and depression, and to doing unwise things. It can also weaken the reflex that lets milk down.

It says anyone who does have an alcoholic drink is best taking it just after they've given the baby a feed rather than before, since hopefully by the next feed it'll be getting through the system.

One book says caffeine should only be ingested in small doses as well. It says one or two cups of caffeinated tea, coffee or cola a day should be allright, but too much can make mother and baby jittery and irritable and can make it more difficult to get to sleep. It can also cause reflux in some babies. A baby's system can't get rid of caffeine as easily as an adult's can. So drinking other things or non-caffeinated versions of drinks we like can help.

Anyone who has a family history of allergies is advised to discuss with their doctor whether there are foods worth avoiding in case the baby picks them up.

If we want to take any herbs or food supplements or drink herbal tea, it's best to consult with a doctor as to whether they'll be allright, since some herbs can actually have powerful effects, not always good ones. Some are known to be allright for nursing mothers, but reading the label to see if other ones have been added to a tea with those in is a good idea, and it's best to only drink them in moderation.

It's best to peel and scrub/wash vegetable and fruit skins well before eating them to reduce the amounts of pesticides on them. The amounts passed on during breast feeding will usually be too small to harm the baby though.

It's best not to eat too much fish, because although that can be healthy, some types like tuna can contain mercury. Apparently sardines are better.

If a Baby Has Digestive Problems

Some mothers get blocked milk ducts or they don't produce much milk, so their baby has a hard time feeding. But if the milk supply's allright but a baby cries when it's had some food, it might well have pain from wind, or maybe reflux, where a bit of the milk's coming up again along with a little stomach acid.

Babies' digestive systems sometimes aren't quite fully formed when they're born and it takes a while for them to develop the finishing touches. So for a while, digesting food can be more difficult. If they cry after feeds, they could have a problem with wind or reflux.

The book The Baby Whisperer says if the baby pulls its feet up to its chest after meals while it cries, it might well have wind. If it arches its back and goes rigid, it might be reflux, although it might be the baby's way of trying to shut out the world.

It says if burping the baby or lying the baby on its back and gently moving its legs in a bicycling motion stops the crying, the problem was probably trapped wind. If sitting baby upright, such as in a swing or car seat stops the crying, it may well have been reflux.

A newborn baby will be using its digestive system for the first time, since before it was born any nutrients went directly into its bloodstream. So it'll be a little while before the digestive system's used to processing food.

While jiggling the baby around might soothe it at other times, if it's got a digestive problem, bouncing it around might make it worse so it'll cry more and might do things like spitting up milk more. So it's best not to do that soon after a feed or if it's already spitting up a bit.

Babies get trapped wind after they swallow air during feeding. And some babies enjoy swallowing, so they sometimes gulp air in even when they're not eating. But it can be painful if it gets trapped in the digestive system, as it can be for an adult, because the body can't break it down. It has to come out of one end or the other.

There can be signs that a baby's crying because it's got wind, says the book. It might bring its legs up to its chest and scrunch its face up. The baby's cry will tend to have a definite pitch and tone. It'll be intermittent, and the baby will look as if it's panting, as if it's about to burp. It might also roll its eyes and look between cries almost as if it's smiling. That's why its first smile can be mistaken for wind.

What to Do if a Baby Has Trapped Wind

The baby's stomach can be rubbed upwards several times. Or the baby's back can be gently rubbed repeatedly. The baby might vomit up a little bit when it burps; that's normal. We could put a bib or towel under the baby's chin or on our shoulder to catch the drips.

There are a few different positions we could put the baby in to burp them. One is holding them against our chest with their chin resting on our shoulder. We can support the baby with one hand while rubbing and gently patting its back with the other. Sitting in a rocking chair and gently rocking while we're doing that can be good.

Another position is lying them across our lap on their stomach, supporting their head with one hand, making sure their head's raised above their chest, and gently patting their back with the other.

If the baby seems a bit unsettled during its feed, we could try burping it and then beginning the feed again. If it seems a bit gassy or spits up a lot, we could try burping it every five minutes or so. If it won't burp after a few moments of patting or rubbing, we could change its position and try patting it again to see if it wants to. After a feed, it's best to always burp babies.

After a feed during the first six months after a baby's born, it can be good to keep babies upright for about ten to fifteen minutes after a feed if we can to stop the milk coming back up. It doesn't matter if they spit up a bit though; it's usual, and it's probably more unpleasant for us than for them.

Sometimes, the baby will wake up because it needs a burp. Just burping it and putting it down to sleep again will be all we have to do.

As the baby gets older, it will stop burping after every feed and that doesn't need to bother us; it'll just mean it's got better at not swallowing air.

Baby Heartburn, or Reflux

When a baby's born, its digestive system isn't working as efficiently as an older child's. There's a one-way valve at the top of the stomach that allows it to open to let food fall in but it's supposed not to open from the other side so food doesn't come back again. At least, it's not usually supposed to. But it's often not quite fully formed in little babies, so bits of milk do come up again, along with a bit of stomach acid. It can be painful for a baby to have the acid coming up. Sitting the baby upright for several minutes after a feed can help, because gravity helps keep the food down. And keeping the baby still as far as possible for a while can help, or at least not moving it in a lively way. If the baby starts crying if it's laid down soon after a feed, it might have reflux. We can see if it's happier in a sitting-up position or held in an upright position.

Sometimes, the stomach valve won't open on time so food doesn't get into the stomach when it should. So a baby can bring it up and might choke a bit while feeding. Sometimes the baby might projectile-vomit a few minutes after feeding because the valve didn't close properly so the food came up again.

Sometimes a baby can still have heartburn even if they don't sick the food up. So crying after a feed could be pain from that. But the more the stomach valve's used, the stronger it gets, so after a few months as the baby begins to develop more, it might well stop.

If a baby's got reflux, it might not burp so easily; and things that can help babies with trapped wind like patting the back can make reflux worse because more acid can come up. The more the baby cries, the more will come up as well.

Taking the baby to the doctor can help, because the doctor can prescribe medication for the baby that stops the stomach producing so much acid. Things can be done at home. Some babies find car rides soothing if they're in an upright position rather than slumped over. And the top of their cot mattress can be raised with a couple of books or something underneath it so it's at an angle that'll allow the food to slide gently down the digestive system rather than slowing down, because the baby's head and chest will be higher than its stomach.

Propping a baby up and wrapping them up tight can help when they've got reflux.

If reflux is suspected, it's best not to pat the baby's back when trying to burp it, because it can irritate the digestive system when it's already a bit inflamed from the stomach acid, so it can make the baby vomit or cry which will make it worse. Rubbing the back gently in a circular motion's better. If the baby doesn't burp in a few minutes, it can be best to stop rubbing the back. Gently tipping the baby forward can sometimes help any air come out.

It's best to try to make sure we don't over-feed the baby or feed it too quickly. A baby's more likely to be fed too quickly on a bottle, where some teats let the milk out fast. We can look around for some shaped more like breast nipples that let the milk out more slowly. We might find slow-release ones.

If the baby gets whiny after a feed, giving them a dummy to calm them might be better than giving them more milk, which might only make their reflux problem worse.

The book The Baby Whisperer says it's best to be careful about giving solid foods early, because filling the tummy too much can make reflux worse. If it's too painful, the baby might stop eating altogether for a little while. Some doctors recommend starting solids early if a baby has reflux, the theory being that they're heavier so they'll stay in the stomach more easily. But it might be best to ask to consult with a gastroenterologist first and ask them if they can determine whether the baby's digestive system is mature enough for solids, since if it isn't, the baby might get constipated, so even if more of the food does stay in the stomach, the baby will be exchanging one painful problem for another.

Reflux gets better over the first months of a baby's life as they develop. Most babies will have outgrown it by the time they're a year old, most of them months earlier. With a minority, it does hang around longer. If so, it's best for parents to take the steps they can to relieve it and try to stay calm for the baby's sake.

When the Baby Has a Growth Spurt

Sometimes, a baby will start waking up in the night when it didn't before. If it's hungry enough to take a whole feed, and wakes up at different times each night, or isn't so keen to go down for a nap during the day as it used to be, it might be having a growth spurt. Feeding it more often during the day, just for a few days, might stop it waking up in the night so much, and also will stimulate the breasts to produce more milk so when we start feeding the baby at the usual times again, there will be more milk for it to feed on, to give it more energy and nourishment as it grows and begins to do more things.

Claims About the Advantages of Breast Milk Over Formula Milk

The book What to Expect the First Year talks about the pros and cons of breast-feeding and bottle feeding.

It says there are several benefits of breast milk over alternatives. Here are some of the things it claims:

• Breast milk is much easier for a baby to digest than cow's milk, which means the baby isn't so likely to be troubled by wind, constipation and being sick.
• It's got a lot of nutrients in it that formula milks don't have.
• Breast milk is almost always tolerated well by babies, whereas a fair number of babies are allergic to cow's milk formula.
• The results of some studies suggest that breast-fed babies are less likely to get asthma and eczema. It doesn't say how reliable the studies are.
• It helps prevent babies getting infections, because it contains the mother's antibodies which help boost its immune system.
• Breast feeding means the baby's less likely to put on too much weight, because it'll stop drinking when it's had enough, rather than being encouraged to finish a whole bottle.
• Breast milk could be said to be a convenience food. It can be easier for the parents, because it's always in stock, ready to use and at the right temperature. No formula to risk running out of, to buy, to remember to take with you when you go out, to carry around and prepare. There's no risk of it spoiling in hot weather. No bottles to sterilise and warm. The baby can be fed instantly any time, anywhere. And if mother and baby have to be apart for several hours or a day or two, she can use a pump to get some breast milk out and put it in the fridge or even the freezer, so someone else can feed it to the baby in a bottle.
• It's free, unlike bottle-feeding, with all the expense of buying formula milk, bottles, equipment for warming the milk and so on.
• It can help nursing mothers lose a little weight, since some of the fat gained during pregnancy is meant for being used in the production of milk.
• Breast-feeding reduces the chance of another pregnancy soon after birth, because periods can be slower to come back. It doesn't do that for everyone though, and it still is possible to get pregnant.
• Breast-feeding means resting, taking time off from busily doing things; and rest is what the body needs to recover after a birth. So it can make people relax when they might not have done otherwise.
• It can make night-time easier, because instead of having to go to all the trouble of preparing a bottle after being awoken from sleep, all a mother has to do is put the baby on the breast. Mum won't even have to move from the bed if Dad gets the baby.

If we can't get the baby to feed at the breast despite following all the advice, it'll be best if we contact a midwife or doctor or someone like that, who can help us.

Teaching the Baby to Drink From a Cup

When the baby's about six months old, it can be good to start teaching them to drink from a cup. It's best to start with a trainer cup, because that's got a spout to control the flow and the baby can hold it themselves.

It's very important not to give a glass to a baby or little child, because they might bite or try to chew it or break it some other way, and then injure themselves. The author of the book The Baby Whisperer says she's seen far too many little children who've been rushed to hospital with bits of glass in their lips and tongue.

A baby will take a while to get used to drinking from a cup, maybe three weeks to a month, longer if they're not given it every day to practice with. Trainer cups come in different shapes. Some have straws rather than spouts. Some babies prefer some more than others. But the book The Baby Whisperer says it's best to persevere with one at first for a while rather than trying a new one if the baby doesn't take to one well at first, otherwise the baby will have to start learning something new again.

My sister told me her baby was used to drinking from a cup with a spout, but then one day she gave her one with a different kind, and the baby tipped it up a bit as usual and it spilled all over her. She was quite surprised.

The book The Baby Whisperer says some parents put their baby in a high chair for the first time when they first try them with a trainer cup and just expect them to know what to do. But babies need to be taught step by step. A good way is for a parent to sit them on their lap facing forwards, to guide the baby's hands on to the handles of the cup, and help the baby lift the cup to its mouth. It should all be done gently, and when the baby's in a good mood. It's best not to fill the cup up very full, because otherwise it'll be too heavy for the baby. The baby can always be given several little cupfuls of fluid a day.

The book says it's best not to start giving up breast-feeding or bottle-feeding till we can be sure the baby's good enough at drinking from the trainer cup to manage to take in as much fluid from doing that as they need.

When the baby first starts drinking from a trainer cup, some mothers think their baby will be bored by drinking milk or water from it so they give them something tastier like juice, thinking they'll be more likely to stick with the effort of drinking from the cup if there's something interesting in it. The book The Baby Whisperer says the trouble is that if they want to give them milk from it later on, the baby might think it's a strange flavour to be in the cup and not drink it. Also, it's best not to give the baby that many sugary things, for the sake of its teeth and weight.

If the baby's already drinking juice well from a trainer cup but doesn't want to drink milk from it, they might get more of an appetite for it if the parent entices them gradually. During the first few meals, they could give the baby two drinks at once, one just a little bit of juice and one with some milk. The baby can be encouraged to drink both. Perhaps the baby can be sat on the lap and cuddled every now and then. And the parent can make the milk sound yummy by what they say and their tone of voice when they give it to the baby. If some kind of game can be made of it, all the better. Babies are more likely to learn some things if they have fun while they're learning. If the baby doesn't want any milk the first time, it doesn't matter; it can be tried again later.

If the mother feels a bit of regret when the baby starts using a cup because the baby's growing more independent, that's normal. It's best to encourage the baby to do that though so they get used to feeding on their own though, so they don't start feeling awkward about eating on their own. Mother and baby can still have lots of cuddles.

It's important not to forget to give them fluid in a cup as we reduce the amount we give them by breast or bottle. They won't need as much fluid as we use to give them though after they start taking many of their nutrients from solid food. But in summer when they might get more thirsty because of the heat, we could see if they want more than in the winter.

Part Two
Feeding the Baby Solid Foods

When to Start Feeding the Baby Solid Food

The book The Baby Whisperer says it can often be best to wait till a baby's six months old before beginning to feed them solid foods, since sometimes their digestive systems won't be mature enough to cope with solid foods that well before then. Also, digestion will be more difficult before they've learned to sit upright, because the food travels downwards more easily when a person's upright because of gravity. It would be easier for anyone to eat sitting upright. Babies can't usually sit up by themselves till they're about six months old. Also, babies are more likely to develop food allergies if they're started on solids early when they wouldn't have become allergic to something if it was introduced into their diet later.

But then, it says sometimes there are signs that a baby's ready for solids earlier than six months. Babies are born with a reflex that makes them stick their tongue out when something goes in their mouth, to protect them. It disappears when they're between four and six months old. When it does, it's possible for them to eat thick mushy stuff like pureed fruit and vegetables, though it's best if they start off eating sloppy runny foods. A parent can find out if their tongue-sticking-out reflex has disappeared by gently putting a teaspoon in their mouth and seeing what happens. If the reflex is still there, the baby will probably push the spoon out with its tongue. Even if it's disappeared, the baby will take a while to get used to eating from a spoon. At first, it might try to suck it like it would a nipple.

The book says some people believe a meal of solid food helps a baby sleep, but actually, having a stomach full of milk helps a baby sleep just as well.

Some big active babies get hungrier than smaller ones who aren't so energetic yet. If a big baby seems hungry a bit earlier than six months and milk doesn't seem to fill them up, they're quite possibly ready for solid foods. With a particularly big baby who seems to be developing quickly, that could happen as early as four months.

If a baby wakes up hungry in the night and takes a full feed, firstly, adjustments should be made to its daily routine that might mean it doesn't get hungry at night but sleeps through it; but if a baby's eating several full feeds during the day and yet is still hungry, then solids can be tried.

Some babies look enviously or longingly at what the rest of the family are having, obviously wanting some. If they seem hungry even after being given milk, wanting other people's food could well be a sign that it's worth trying them on mushy solid food, which will give them more energy than just milk.

It's best if the baby can sit up on their own before being fed solid food, having quite good control of their neck and back muscles so their head doesn't flop around.

If a child is put on solids before six months, they'll still need as much breast or bottle milk as they had before; it won't be a substitute for it as it can gradually get to be after six months. And it's important that a baby put on solids early gets fed finely pureed foods, not lumpy food.

Encouraging a Baby to Stick With Solid Food Once They Start Eating it

It's best to carry on breast-feeding after putting the baby on solid foods at least till they're used to eating and drinking more like an adult. So maybe they could still have a breast-feed in the morning and at night and between meals for a while. It's best not to reduce breast feeding that quickly, because if the baby starts to miss it, perhaps particularly at a time when they're not feeling well or teething, they might start refusing solid food when they tolerated it before, as if in protest. Changing things too fast could make them feel deprived.

If they've already started refusing solids and a parent thinks that might be the reason, they can carry on trying to encourage their child to eat solids while feeding them more from the breast as they did before if they can. If they don't make a big fuss about it, the baby's refusal to eat solid food probably won't turn into a big power struggle, but the baby may well be eating it as they were before in around a week. After all, they'll get hungry after a while, and they'll usually eventually want to eat if they are. A parent shouldn't try to force them to eat solid food. They can feel content to try to gently coax them and try to make it seem fun.

Once a baby's started on solid foods, it's best to feed them solid foods at every meal every day, or so says the book The Baby Whisperer, which says it's the best way to get the baby used to them. It says if a baby's fed solid food for every meal one day but for only one the next and two the day after, for instance, then the baby won't know what's coming on any given day, then if their uncertainty makes them feel a bit insecure, and especially since it'll seem easier and more comforting at first, the baby might start demanding the breast and not wanting to eat solids. They can still have a breast-feed at other times after they've been started on solids, and as well as them at meals before they've started eating enough to fill them up.

It's Best to Wait for Longer Before Putting Premature Babies on Solid Foods

A premature baby will be doing the last bit of development they would have done in the womb outside it. That means that if they were two months premature, when they're two months old, they'll be at the same stage of development as a newborn would be at full term. So when a full-term baby's six months old, a baby born at the same time as they were but two months too early, while being thought of as six months old, will have only developed to the stage where a four-month-old full-term baby would have done. So it's best to wait a month or two longer before putting them on solid food. So perhaps they could start when they're about eight months old. Any parent who started before that but found their baby wasn't happy could stop and start again later.

Babies With Different Temperaments Can Take to Eating Solid Foods at Different Rates

Most babies will prefer it if solid food is introduced gradually, bit by bit. Some babies are especially sensitive to new experiences or lights that are a bit brighter or loud noises and so on, so a new experience that seems out of the ordinary will make them anxious. So if a baby seems to be like that, it's best to introduce solid foods more gradually than usual.

But some babies are boisterous and eager to try new things. More eager to throw things around as well, so it's best to watch out for that. All babies might do that to some extent though.

It might take about three months for any baby to entirely get used to eating solid foods, and most babies will probably think they're strange at first. After all, it's no wonder if a baby who's been fed exclusively on milk for six months wonders what's going on when they're suddenly given a dollop of sloppy substance that tastes and feels like nothing they've ever had before. So we may as well expect it to take a while before they're used to it and try to be patient and relaxed and enjoy the journey.

If the Baby Chokes on the Food

There are a few reasons why the baby might choke. One is if we put the spoon too far back in its mouth and it goes too near its throat. Another is if we put too much food on the spoon so the baby can't cope with it all. Another is if we try to give the baby mouthfuls too quickly so we're trying to shovel in one before it's finished the last one, so it's under pressure to eat more quickly than it can cope with. Another is if we give it the wrong kinds of foods. We shouldn't give the baby hard foods or foods with dry crumbs in for a while.

Another reason is if our baby's unusually insecure about new sensations. Most babies will think eating solid food seems strange at first, but some babies get extra anxious about new or different things. So we might have to be especially patient if we've got a baby like that. They might want to take longer over their food than many babies, and if we try to hurry them, they might have problems.

But if the baby chokes, it might not necessarily be to do with anything we've done. It might just be that the baby's having a bit of trouble getting used to the idea of eating solid foods. If they seem to be having a problem with gagging or spitting food out all the time over several meals, or if they don't seem to be enjoying their first tastes of eating solid food, we could wait a few days before trying them on solids again.

Later the baby will be eating foods it can pick up with its fingers and suck on. The baby might choke on that sometimes, but the risks can be reduced if the baby's old enough to sit upright by itself so its head doesn't slump around, and that at first, the foods are smooth, not the type where dry crumbs could get caught in a baby's throat or be inhaled by a baby like toast, and not hard things that are difficult for a baby to chew up like nuts. Babies can sometimes not sit up without any help at all till they're about eight or nine months.

It's best to wait till then before giving them foods with thick enough textures that they can be picked up with the fingers also because it's best to introduce thicker textures only gradually, experimenting with more and more lumpy mush to see what the baby can cope with. It's best if they're given mushy solids for a month or two so they can get used to them before they're given foods with other textures. Because they can't chew properly, they have to squish things up by pushing them to the roof of their mouth and squashing them to mush with their tongue, or gumming them to mush. They need to learn the techniques before moving on to eating things it'll be harder to do that with.

Then again, my sister's baby used to love sucking on bits of cucumber. She couldn't chew them up, but she used to enjoy sucking the soft bit on the inside to mush and then abandoning the rest.

What and How Much to Feed the Baby At First

It takes a lot of patience to teach a baby to eat solid food properly. It might take a lot of clearing up after them when they've thrown food around.

The books say that at first, it's best to give them only pureed food, and in small quantities, starting them off gradually. For instance, for the first week, they could only be given a teaspoonful or two at breakfast. Then the next week a teaspoonful or two at breakfast and dinner for a week. Then one or two at all three meals. A new food could be tried every week, perhaps with foods the baby likes being given at dinner and tea and new foods tried at breakfast, though it's best if the baby's fully alert when they're tried. Some think it's best not to try new foods till the baby's used to ones it's already eating.

We might have to try giving a teaspoon with a little bit of food on it several times before the baby eats the food rather than spitting it down them. If we just expect that, it'll help us to be patient.

If the baby's frustrated at having to try something new, they can be given a bit of milk first to take the edge off their hunger. Not enough to fill them up, but just a bit. But once they're used to solid foods, they can be given those first so they get used to taking them without a drink first. As the baby gets the hang of eating a few more things and begins to be able to chew, foods with textures can be slowly added. We could cautiously try new slightly less mushy bits of food every couple of weeks to see how the baby does with them.

At first, pureed fruits like pears can be good to give the baby. It's probably best to start off with fairly bland foods, healthy things like mild-tasting fruit and vegetables. A variety of foods could be cooked till they're soft and then mashed to make it easier for the baby to swallow them. Some could be mashed in a blender.

I've heard there's actually something called a baby food grinder that's got very small holes that the food is pushed through to make sure it's mashed up small. But then, my sister said she just used a fork to mash food up for her baby when she first started her on solids, and she managed to quickly mash the food up well. She gave her baby things like mashed banana and carrots mashed after being cooked for about 20 minutes till they were soft. Nowadays her baby's over a year old and eats all kinds of things. She likes dried foods like rice cakes and bread sticks, but there's no way my sister would have given those to her at first because they'd have been a choking hazard.

The books say the kinds of foods that could be cooked till soft and mashed up like that could be carrots, pears, peaches, bananas, brown rice, porridge, and similar things. As the baby gets more used to eating, more foods can be introduced that can't be mashed so finely; but if anyone in the family has a food allergy, it's best not to give the baby the food the person's allergic to till they're over a year old just in case.

It's worth making the effort to give the baby healthy food, because it can help with the baby's development. Some think it can even help babies develop more brain power.

The books say food should be finely mashed at first till it's the consistency of thick cream. It can be put through a strainer or mixed with liquid to get it to a texture like that. They say food should be like that till the sixth or seventh month, when thicker foods can be slowly introduced. The foods the baby's given can gradually get thicker and thicker as time goes on. It might not take long.

I wonder if shop-bought baby foods would be easier. Still, it sounds as if it isn't too long till you don't have to take huge amounts of care over the food you give them.

The books say a baby might only take half a teaspoonful at first, but in a surprisingly short time they might be taking a couple of tablespoons. It might take a while for them to feed, so we'll need to set aside a decent amount of time for it. What's more important than the amount they take in at first is that they come to think of feeding as enjoyable so they'll be encouraged to carry on. That means not getting annoyed with them when they spit food out or are reluctant to eat it at first or throw bits on the floor and so on.

The book What to Expect says it isn't necessary to warm the baby food. It says it's best at room temperature or even a bit cold, or if we want to warm it up, we could put it in a small jar that contained shop-bought baby food and stand the jar in hot water for a few minutes, rather than microwaving it which might make some bits too hot while others are quite cool. That might mean that if we tasted a cool bit to make sure it was an acceptable temperature for the baby to eat, we might think it was when other bits were quite a bit hotter. The book recommends we always taste a bit of any food we've heated up for the baby to make sure it isn't too hot for them.

When a baby's first introduced to solid food, they might well just spit it straight out again because they're so unused to it it seems strange, or because they have a reflex to spit out anything that seems unusual, which will protect them against choking on things they shouldn't be putting in their mouth. But once they get used to it, they'll probably handle it better.

Finger foods can be added at about nine months, when the baby's got used to eating thicker and thicker foods, depending on how much it seems to be able to cope with. If it's beginning to enjoy little chunks of food, we could give it cubes of soft ripe fruit, such as melon.

It'll be a few months before they really get the hang of eating solid foods. They might enjoy sucking on things from plates of the family around them for a while, and then want to eat things from the family's plates properly. When they get used to eating more like an adult, it can be nice if they eat with the family at family meals, so they get used to mealtimes being family occasions.

By the time a baby's nine months old, the norm is for them to be eating solids for every meal. By the time they're a year old, they might well be eating what everyone else in the family eats.

Expecting Things Not to Go Too Smoothly When Teaching a Baby to Eat Solid Food

The book What to Expect the First Year recommends we set up a high chair a few days before we start the baby on solids so they get used to sitting in it, so they're not faced with too many unfamiliar things at first when they start eating solids, and more importantly, so we can make sure they're comfortable in it before we start feeding them. It'll be easier to feed them in the high chair than our laps where they might be wriggling around and spitting the food everywhere. If we put them in the high chair to practice sitting in it a few days before starting to feed them, we can sort problems out if they're uncomfortable. For instance, if the baby slides around or slumps, we can pad the chair with towels or a small blanket. If the seat allows for the baby to sit in a semi-reclining position so they're leaning slightly backwards so they won't slump forward, we can put it in that position.

It's important to fasten the straps around them so they can't fall out. If the baby can't sit up at all, the book What to Expect recommends we postpone feeding them solids for a while.

It says it's also worth being careful about what spoon we feed them with. Little plastic spoons can be easier on the baby's gums. If the baby wants to hold on to the spoon with us as we feed it, it'll usually be allright to let them, though it can be awkward and the food can be more likely to go everywhere. Or we could keep a few spoons handy and give them one or something else to play with as we feed them. Some mothers give the baby the one they grab as they're trying to feed them with it and have more handy to start feeding them with one by one till they grab those as well.

It's best if the baby's bib's big, comfortable, easily removable and can stand frequent washing.

We can get babies much more comfortable with eating if we let them take a bit of control rather than suddenly trying to put this thing in their mouth when they won't know what on earth is going on. They're bound to be a bit daunted by that. Before we try, we can get the baby used to solid food if we put a blob of it on the high chair tray or table and let the baby examine it, squish it, mash it, rub it, and put its fingers to its mouth and taste it. That way, when we do try to feed it with a spoon, it'll have more idea of what on earth we're trying to get it to put in its mouth.

Some people try feeding the baby solids at first in a bottle with a large hole in the teat. But one of the books says that can be a bad idea, since though it might be easier for the baby, they've got to learn sometime how to eat with a spoon so it may as well be when we start giving them solids; and also putting them in a bottle can mean we give them far more than they need and end up over-feeding them so they end up obese.

We can think of the first few feeds as just practice feeds rather than the real thing, just being done to get the baby used to the taste of solid food. We can at first just put a little bit on a teaspoon and gently put the tiniest bit between the baby's lips. Then we can wait to see what the baby does. If it likes the taste, it might open its mouth wider for another one. So we can put the food a little bit further back that time so it can swallow more easily, although not so far back it risks gagging because it's too near the throat, in the same way we would if we put a spoon of food further into our mouths than it's supposed to go. Even if the baby likes the food though, it might still spit it out on reflex. Little babies have a reflex to do that with strange things. After the first few tries, the baby might start taking in more than it spits out. If we try feeding it solids for a few meals and it keeps spitting the food out though, it might just not be ready for solid food, so we can wait a week or two and then try feeding it solids again.

Though it's best to start feeding them solids at six months, not later, because with all the growing and new lively things they're doing, they'll need extra nutrition so they'll need to get some from solid food, we don't have to worry about feeding them a certain number of times a day or making sure they have a certain amount of food each feed. If we did, it would probably cause quite a bit of anxiety as the baby spat quite a bit of food out and threw some on the floor and so on. But we can accept that they'll take a while to get used to solid food, and be content to watch them getting used to it slowly.

We can think of the first feeds as practice feeds and times that help them learn to enjoy solid food. If the baby eats the food well, that will be encouraging, but if they don't, there's always next time. They might build up to eating it well gradually, taking more in each time, apart from when they think it's fun to fling it around or something. They might have a big appetite one day and a small one the next. They'll only be aggravated if we try to force them to eat. Even if they've got a small appetite most days, they'll probably be taking in enough food to give them the nutrients they need.

If a baby isn't keen on a food, it'll sometimes push it to the sides of its mouth with its tongue so its cheeks get puffed out with all the food piling up. When there's quite a lot there they can gag. So if we see food puffing out the baby's cheeks, we can tell them to spit it out, and then wait a week or so before giving them that food again.

Feeding the Baby One Food at a Time

The book What to Expect the First Year says it's best to give the baby one new food at a time, so if it has a bad reaction, we can tell which food's causing it. If we gave the baby a few at once we wouldn't know which of them it was. We could give the baby each food separately, each for five days or so to see if they have a bad reaction to it in that time. Then again, there might be a coincidence when the baby feels ill just after we've fed it something the first time. So it's worth waiting several days or a week and trying it again if the reaction wasn't too bad, and if they have the bad reaction again, we could leave that food out of their diet for several months and then try it again.

The kinds of bad reactions a baby might have could include excessive wind, diarrhoea, mucus in its poo, vomiting, a rough rash around the mouth or anus, a runny nose and/or watery eyes or wheezing when they don't seem to have a cold, and unusual wakefulness in the night or grumpiness during the day.

If the baby turns out to have a bad reaction to several foods, or there's a family history of allergy, the book advises we wait a whole week between trying one food and trying another, so we can be more sure about whether they've got a sensitivity to it or not. If the baby seems allergic to every food we try, it'll be best if we see the doctor and ask their opinion on us just giving the baby breast or formula milk for the next few months and then trying to give it solid foods again.

If we try the baby on one food and they're allright on it and then we try it on another they're allright on, it'll be allright to mix the two together for the baby's meals if we like. Then we can mix three they're comfortable with, and so on. In fact, we can put a new food with ones the baby already tolerates well, and if there's a bad reaction, we'll know it's probably the new food.

Some shop-bought baby foods can be sold as single foods, so we could maybe try those.

It's best if we write down what food we've given them, perhaps in a notebook or computer document. It sounds tedious, but it could help us quite a bit because after a few foods, we might not be able to remember what we've given them and what we haven't. If the baby has a bad reaction to something, we can write that down so we no not to give it to the baby again; and if the baby does allright on a food we give it, we can write that down, so we know it's safe to give the baby that again, and so we can remember we've already tried that with the baby so we don't forget whether we have or not and wonder whether we should try it on its own for a week.

When the baby's a year old, cow's milk can be introduced. We can start gradually, feeding it to them just once a day for the first week or two, and then twice. If they have a bad reaction, we can stop and wait for longer before giving it to them.

It might be best to introduce new foods in the morning, so if the baby has an allergic reaction to them, it might have subsided by the evening so they and we get a better sleep than we would if they were up half the night with a problem like diarrhoea.

Foods It Might be Best to Avoid The First Year

The book What to Expect the First Year says there are several foods people shouldn't be given during the first year of life: honey, cow's milk, peanuts, nuts in general, egg whites and chocolate.

Hmmm, I know peanuts could cause an allergy and honey could cause a disease in some babies and some things could be a choking risk, but I don't know why chocolate and egg whites are forbidden. Ah, the book says they can cause allergies. Well I never knew that before.

The book says there are also concerns about eating some other foods before a baby's a year old, though some doctors do allow it in the last few months: wheat, citrus juice and citrus fruits, strawberries and tomatoes.

Oh yes. My sister said when her baby eats strawberries or tomatoes, she gets a sore bottom, and in fact she ate about four cherry tomatoes once and her bottom was even bleeding the next day. I don't know why the tomatoes did that!! But these seem to be mainly foods with a lot of acid in them, sharp to the taste.

Actually, I've just read in a BBC article that one or two new studies have found it's allright to introduce foods like cow's milk and egg white and so on earlier after all. But maybe other studies will say it's best to be cautious. It's probably best to wait and see.

The book recommends we introduce foods known to cause allergies in some people after introducing ones that don't seem to, but are of a similar type. For instance, it's best to wait till we know grains like oats, barley and rice are well tolerated by our baby before introducing wheat. It might be best to wait till the eighth month before feeding them anything with wheat in it, though if we don't have a family history of wheat allergy it might be OK to introduce it earlier. It's best to introduce citrus fruits and juices like orange and orange juice after we're sure they're tolerating other kinds of fruits and fruit juices well. It's best to introduce seafood after meat and poultry.

Oh yes, I've heard shellfish can cause food poisoning. I haven't heard about other fish being risky, but maybe they are.

It says egg yolks can be given as early as about eight months, for instance in mashed-up scrambled or hard-boiled egg, but it's best to leave egg whites till the baby's a year old because they're much more likely to cause an allergy. It says it's best to leave chocolate and any kind of nuts till after the baby's a year old or even later. Nuts could be a choking hazard besides the possibility the baby will be allergic to them.

Feeding the Baby Finger Foods

When the baby gets used to eating solid food, there will come a time when they learn to pick things up with their fingers and start doing that with food. They also might do that with bits of dirt on the carpet and put those in their mouths, so it's worth cleaning it often.

When they start picking up food with their fingers, it might take them a while to find their mouths, so they might put some in their ears or hair, over their bib and on the floor. We'll need to be patient. It's best to let them experiment and learn, rather than taking over and putting it in their mouths for them, because they'll learn by trying. What we can do is eat some ourselves, picking it up with our fingers, so they see what we're doing and might imitate us. Children learn a lot by imitation. We can do that when we give them finger foods for the first time as well.

The first few times we give the baby them, just putting them on the high chair tray perhaps, the baby will probably not eat them, but may well squash and smash them all around the tray, making a big mess. It's best to let them, because it's the way they experiment, finding out what they're like. If we eat some ourselves and act as if we're enjoying them, the baby might more quickly get the idea of what they're supposed to do with them and try eating them.

If the baby doesn't eat the finger foods at first, we don't need to worry. We can give them to them before we feed them a bit of food with a spoon each time. If they don't eat them, we can feed them as normal. It might be that they take a little while to get used to picking up food with their fingers, but when they've learned, they might really take to it. The more we let them experiment and try feeding themselves, the sooner they'll learn to feed themselves.

As for what to feed them, if we're wondering about whether a food will be appropriate, we could sample it ourselves, imagining we were a baby who couldn't chew, seeing how easy it dissolves. We can see if we can mash it up by pushing it to the roof of our mouth with our tongue and squeezing and squashing it with our tongue to see if it breaks down into little lumps that are easy to swallow. They'll be easier to swallow if they're moist. The food shouldn't be something with grit, dry crumbs or grain in it that the baby could choke on.

Finger foods don't have to be what adults might think of as finger foods; we could give the baby little mouth-sized bits of thick porridge or cottage cheese, for instance, though they'll be messy! Little chunks of some ripe fruit can be a good finger food, such as slices of banana. Pasta shapes can be good as finger foods, though because they haven't got much nutrition or flavour in themselves, it can be best if they're coated in mashed vegetable, perhaps carrot.

If we're in a restaurant and the baby seems to want what we're having, as long as it's easily chewable, hasn't got crumbs or grit that could catch in the baby's throat and isn't something it's best not to feed a baby of that age in case they have a bad reaction to it like honey, then we could try feeding it to them. They might really enjoy it.

Yes, my sister said her baby was eating all kinds of exotic things when she wasn't much more than a year old, even hot spicy things, and she enjoyed them.

Feeding the Baby Healthy Foods

We don't have to worry if we don't think they're having a balanced diet every day. It's best if we try to give them healthy food, but we don't have to get stressed if one day they haven't eaten any vegetables or they haven't had any protein for a few days. We can introduce them to a wide variety of foods one by one, and then let them decide how much of each they want each day.

It can be best to feed the baby plain foods before we start them on sweet ones like bananas, just in case they like the taste of sweet foods so much they refuse ones that aren't sweet. And if we introduce healthy foods early on, hopefully they'll develop a taste for them before they learn that certain things like fresh vegetables are traditionally not liked by children, though how much that makes a difference is unclear, and children's tastes can change so they could go off things anyway.

For a while, most of the nutrients the baby needs will still be coming from breast or bottle milk, such as protein. As it's gradually reduced, the baby will be getting used to eating more solid food. Giving the baby foods we know contain protein and vitamins will be useful. Egg yolk contains protein, and it can easily be mashed. So when the baby's used to solid foods, we could try introducing that. If we can make eating times fun, the baby's more likely to develop a healthy appetite for healthy food.

We don't have to worry from meal to meal about whether the baby's taking in enough healthy food or eating the right kind of food; but If we notice the baby's looking overly-plump or too thin, then it might be worth being concerned. Some mothers don't give their babies much to eat because they're worried about them becoming obese. But that's not fair; a bit of baby fat's just natural, and they'll often slim down when they start moving around and being more energetic. If we really do think they're too fat, they might be getting foods that are too fatty, so we could try switching to healthier ones. If they're a bit too thin or growing slowly, we could try introducing foods with more calories.

It's actually important that the baby gets enough fat in their diet. While we're feeding them breast milk or bottle milk, they'll be getting fat from that. When we give them less of that and start giving them dairy products instead like cottage cheese, yoghurt and cow's milk, it's best not to give them the diet versions. Doctors recommend they're given the full fat versions for the first few years of life so they get enough. But the book What to Expect the First Year says fats in fried foods and a lot of processed foods are a lot worse for people. They can give a baby tummy troubles since they're hard to digest, and giving a baby too many of them can make them unhealthily fat and can mean they eat less healthy food because they're full from the fatty food so they don't get a healthy balanced diet. And if the baby enjoys them, they can get into bad eating habits that stay with them later on.

It's similar with salt. It's a bad idea to add salt to a baby's food. A baby's kidneys can't handle large amounts of it, and everyone gets as much as they need from salt that's already in food. Most foods contain it. There can be quite a bit in some dairy products, for example. Besides that, if a baby develops a taste for salty foods, it can be difficult to get out of later, and too much salt isn't healthy for anyone.

It's important that the baby gets enough iron in its diet. Egg yolk's a good source of iron. It's possible to buy baby cereal fortified with iron. Some meats can also be a good source. Whole-grain bread can be a source of iron, so can cooked peas and similar things. Iron from vegetable sources isn't so easily absorbed by the body as iron from meat, but what can help the body absorb it more easily is if a food with Vitamin C in it is eaten at the same time. So that could be melon or some other fruit, or a vegetable.

It's best not to give the baby any vitamin supplements without the recommendation of the doctor, since it might be easy to give more than the recommended daily amount of vitamins for babies, which is small.

It's best if we start researching healthy foods we might enjoy and make an effort to eat healthily, so when the baby starts eating what we eat, they're still eating healthily. It might seem quicker and more fun to buy junk food, but we'll be doing the baby a lot more good if we don't resort to that often but get healthier food.

Ending a Feed if the Baby Loses Interest

It's best not to aggravate a baby by trying to make it eat after it loses interest, even if we don't think it's had much. After all, it's hardly going to starve just because it doesn't eat much one meal, and it might still be drinking milk anyway. Signs it's losing interest could be turning its head away, whining, clamping its mouth shut tight, spitting food out or throwing it around.

If the baby rejects a food it liked before, we could taste the food to see if it's gone off or tastes funny. If it doesn't, then maybe the baby's not hungry. Or they might not be feeling that well, or perhaps their tastes could have changed. Babies and young children can go off foods sometimes.

We could see if they'd like some different food. If they don't want that either, it's best to leave feeding till next time.

It's best not to try to make them eat any particular food or try to bribe them to eat it. Some babies will refuse a particular food several times and then eat it and love it. Or a baby might suddenly seem to have had enough of a food it loved before and stop eating it. If we try to give it a variety of foods as it grows up, and not be too insistent if it doesn't want a particular food one day, since that might just cause a power struggle and turn them against it even more, then the child might grow up happy to try new things.

Sometimes if a baby isn't hungry it can be because they're full up with milk from when we've been breast-feeding it or because we've given it snacks between meals. The odd snack isn't a bad thing, and for smaller babies with little stomachs it doesn't take much to fill, eating little and often can be better than waiting till meals and trying to eat quite a lot then. But for many babies, it's best if they eat most of their food at proper mealtimes. So breast-feeding and snacks could be reduced if the baby doesn't have much appetite at mealtimes and we think that might be the problem.

The way to reduce them without causing the baby to have a big protest is to distract them at the times they usually get hungry for breast milk or snacks, for instance by taking them out for a pram ride or a play. Within a few days, they might well have forgotten they used to have a snack or feed at those times if we're consistent about not giving them snacks then, so we won't have to do it every day from then on. They're unlikely to really need the snacks; they're just enjoyable to have. They might well be hungry by the next meal though, so they'll eat more. We could have the meal a little bit earlier if they're really grumpy.

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The articles are written in such a way as to convey the impression that they are not written by an expert, so as to make it clear that the advice should not be followed without question.