Monday, April 22, 2013

Switching from breastfeeding to bottle feeding

  Bottle feeding – Switching from breastfeeding to bottle feeding

My baby is 4 months old and I have to go back to work in
6 weeks time. I have decided that I would rather give my baby formula than try to express milk for the feeds that I will miss. Please can you help me to make the process as easy as possible for baby?
You have done well to make the decision in advance so that you have plenty of time to start supplementing feeds in an easy and unstressed manner. In general the optimum time to start offering a supplementary feed is when baby is around six weeks old. At this age the breastfeeding is well established but not to the extent that baby will reject the bottle. Remember this is a very broad generalisation and that every baby is an individual! For this reason it may be necessary to enlist help, so that the introductory formula feeds are not given by you.
Make sure that your helper ensures that the experience is a loving and positive one for the baby, with lots of cuddling and chatting. If it’s not possible to have help in this situation then try to wear heavy clothing between you and the baby and try gentle distraction. When introducing the first formula feed, both you and the hungry baby should be in a positive frame of mind. Once you have successfully introduced one feed per day, stick with that one feed for a week or ten days before introducing another feed. This helps baby to get used to the new situation and will reduce your levels of discomfort, as the milk will initially build up in expectation of the missed feed.
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Sunday, March 24, 2013

Potty training

Most parents eagerly anticipate potty training as a milestone in their child's development, if for no other reason than that it means an end to nappy changing. But few moms and dads are prepared for how long potty training can take.
Sure, some children master it within a few days, but others can take several months. In general, the younger your child is when you start to toilet-train, the longer it takes. You and your child have a better chance of success if you understand the elements of training and approach the process in a clear fashion. Here are the basic steps:

A. Assess your child's potty training readiness — and your own

When your child is about a year old, she'll be able to begin to recognize that she has a full rectum or bladder. Some children are ready to start potty training as early as 18 months, while others aren't interested in the process until after the age of 3. Many parents begin potty training when their children are about 2 and a half.
Try not to put on the pressure – rushing her when she's not ready will be counterproductive.
And don't expect this child to have the same timeline as your older child. Boys tend to train a bit more slowly than girls, while second (and subsequent) children may learn more quickly than firstborns.

B. Buy the right equipment

First and foremost, invest in a child-size potty chair or a special adapter seat that attaches to your regular toilet. This eases the anxiety some children feel about the grown-up toilet – some fear falling into it, others dislike the loud noise of the flush.
Figure out what equipment is best for your toddler before you go shopping, then ask your child to help you pick a potty chair out. Once you get the special chair home, write his name on it and encourage him to play with it.

If you're buying a potty chair for your son, look for one without a urine guard or with a removable one. You may have to wipe up a little more stray pee, but the guards tend to bump into and scrape a boy's penis when he sits on the potty, which can discourage him from training.

If you're using an adapter seat, make sure it's comfy and secure, and buy a stool to go with it. Your toddler will need the stool in order to get up and down from the toilet quickly and easily, as well as to brace his feet while sitting, which helps him push when he's having a bowel movement.

C. Create a routine

Set your toddler on the potty seat, fully clothed, once a day – after breakfast, before her bath, or whenever else she's likely to have a bowel movement. This will help her get used to the potty and accept it as part of her routine. If there's not an easily accessible bathroom around, bring your child's portable potty outside, to the playroom, or wherever she may be.
Once she's fine with this routine, have her sit on the potty bare-bottomed. Again, let her get used to how this feels. At this point, let her know that this is what Mommy and Daddy (and any older siblings) do every day – that taking off your pants before you use the bathroom is a grown-up thing to do.
If sitting on the potty with or without clothes is upsetting to your toddler, don't push it. Never restrain her or physically force her to sit there, especially if she seems scared. It's better to put the potty aside for a few weeks before trying again. Then, if she's willing to sit there, you know she's comfortable enough to proceed.

D. Demonstrate for your child

Children learn by imitation, and watching you use the bathroom is a natural way to understand what using the toilet is all about. If you have a son, it's simpler to teach him to pee sitting down at this young age. Later, when he's mastered that, he can watch his dad, older brother, or friend pee standing up – he's bound to pick it up quickly with just a little encouragement.
When you demonstrate for your toddler, it's helpful to talk about how you know it's time to go to the bathroom, then explain what's going on as you're using the toilet and let him see afterward what you "made." Then show him how you wipe with toilet paper, pull up your underwear, flush the toilet, and wash your hands.
Even though you'll be helping your toddler with these activities for some time, especially wiping after a bowel movement, seeing you do it and hearing you talk through it will help him get used to the whole process. (If your toddler is a girl, when you wipe her be sure to go from front to back, especially after a bowel movement, to minimize the risk of urinary tract infections.)
If your toddler has older siblings or friends who are potty-trained, consider having them demonstrate, too. It can be helpful for your child to see others close to his age exhibiting the skills he's trying to learn.

E. Explain the process

Show your toddler the connection between pooping and the toilet. The next time she poops in her diaper, take her to the potty, sit her down, and empty the diaper beneath her into the bowl. Afterward, let her flush if she wants to (but don't force her if she's scared) so she can watch her feces disappear.
You also may want to pick up a few potty-training picture books or videos for your toddler, which can assist her in taking in all this new information. Everyone Poops, by Taro Gomi, is a perennial favorite, as well as Where's the Poop? and Once Upon a Potty, which even comes in a version with a doll and miniature potty.
Keeping a book like this in the bathroom, or a poster or flipbook that illustrates the steps in using the potty, can help your toddler get familiar with the process and relate it to what she does in the bathroom.

F. Foster the habit

Encourage your toddler to sit on the potty whenever he feels the urge to go. If he needs help getting there and taking off his diaper, make sure he knows it's okay to ask you for help any time.
If you can, let him run around bare-bottomed sometimes with the potty nearby. The more time he spends out of diapers, the faster he's likely to learn, although you'll have to steel yourself to clean up a few more puddles. Tell him he can use the potty whenever he wants to, and remind him occasionally that it's there if he needs it.
Sometimes toddlers won't sit on the potty long enough to relax and let anything come out. Calmly encourage him to sit there for at least a minute or so. You'll have the best luck getting him to stay put if you keep him company and talk to him or read him a book.
When your toddler uses the potty successfully, shower him with praise. This will help to give him positive reinforcement as he masters potty training. Chances are that he'll continue to have accidents, but he'll start to grasp that getting something in the potty is an accomplishment.
Still, try not to make a big deal out of every trip to the potty or your toddler may start to feel nervous and self-conscious under the glare of all that attention.

G. Grab some training pants

Once training is under way, consider adding training pants – extra-thick cloth or disposables that pull on like underwear – to your routine. They'll allow your toddler to undress for the potty on her own, which is a critical step toward becoming completely potty-trained.
While cloth training pants are less convenient than disposable pull-ups, many parents say they work better because your toddler can really feel when she pees or poops in them. Whichever option you choose, introduce them gradually – probably for a few hours at a time – and stick with diapers at night for the time being.
When your child consistently seeks out the potty whenever she has to go, it's time to move on to "big-kid" underwear. Many moms and dads have found that undies with a favorite character on them give kids a dandy incentive to stay dry.

H. Handle setbacks gracefully

Toilet training can be difficult for parents and children. Keep in mind that temporary setbacks are completely normal and virtually every child will have several accidents before being able to stay dry all day long.
An accident doesn't mean that you've failed. When it happens, don't get angry or punish your child. After all, it's only recently that his muscle development has allowed him to hold his bladder and rectum closed at all, and he's still learning why it's important to use the potty. Mastering the process will take time.
What can you do? Reduce the chance of accidents by dressing your toddler in clothes that are easy to remove quickly. When he has an accident anyway, be positive and loving and calmly clean it up. Suggest sweetly that next time he try using his potty instead.

I. Introduce night training

Don't give away that stash of diapers just yet. Even when your child is consistently clean and dry all day, it may take several more months, or even years, for her to stay dry all night. At this age, her body is still too immature to wake her up in the middle of the night reliably just to go to the bathroom. In fact, it's perfectly normal for a child to continue wetting the bed occasionally until she's in her early school years.
When you're ready to embark on night training, your toddler should continue to wear a diaper or pull-up to bed, but encourage her to use the potty if she has to pee or poop during the night. Tell her that if she wakes up in the middle of the night needing to go, she can call you for help. You can also try putting her potty near her bed so she can use it right there.
If she manages to stay dry consistently at night, it might be a good time to start nighttime training. Put a plastic sheet under the cloth one to protect the mattress. Put your toddler in underwear (or nothing) and have her use the toilet before you tuck her in. Then see how it goes. When she wakes up, get her in the habit of using the bathroom before she begins her day.
But remember that many children aren't ready to stay dry at night until they're school-age. There's also not much you can do to help things along, short of limiting liquids before bedtime, so if your toddler doesn't seem to get the hang of it, put her back in nighttime diapers and try again in a few months when she's a little older.

J. Jump for joy — you're done!

Believe it or not, when your child is mentally and physically ready to learn this new skill, he will. And if you wait until he's really ready to start, the process shouldn't be too painful for either of you.
When it's over, reinforce his pride in his achievement by letting him give away leftover diapers to a family with younger kids or help you pack up the cloth diapers and send them away with the diaper delivery service one last time.
And don't forget to pat yourself on the back. Now you won't have to think about diapers ever again – at least, not until the next baby.
Ref The ABCs of potty training article on

Monday, January 14, 2013

Toddler sunburn

If your baby gets a sunburn and he's younger than 12 months old, call the doctor, even if the sunburn appears mild. Sunburn in a child under age 1 can be more serious than it appears. The doctor will ask about your baby's symptoms and possibly ask you to bring your baby in for an examination, to make sure he doesn't need emergency treatment.
If your child is age 1 or older and his skin is just a little pink and tender, you probably don't need to call the doctor. (See more details under "When to call the doctor," below.) Just try to keep him as comfortable as possible until the burn heals, and follow these tips.

Do's and don'ts for treating and soothing sunburn

  • Offer plenty of fluids: breast milk or formula if your child is a baby, water and other liquids if he's older. This helps the skin heal and replaces fluids lost by being out in the sun.
  • Soak a clean, soft washcloth in cool water, wring it out, and gently place it on the sunburned area for ten to 15 minutes a few times a day, making sure your child doesn't get chilled.
  • Try a cool bath. To make it more soothing, add baking soda or an oatmeal-based bath treatment (found in drugstores). Pat your child's skin dry – don't rub!
  • Apply a water-based (alcohol-free) moisturizing lotion or an aloe vera gel to relieve itching. Itching can get worse if the burn starts to peel.
  • If your child's hurting, you can probably give him the correct dose of children's acetaminophen or ibuprofen to ease the pain. If you have a baby younger than 12 months, ask the doctor when you call whether it's okay to offer a pain reliever. (Ibuprofen is recommended for children 6 months and up.) Never give your child aspirin. It can put him at risk for a sometimes fatal condition called Reye's syndrome.
  • Dress your child in loose clothing that won't irritate burned skin.
  • Keep your child out of the sun until the burn has completely healed. It's very easy for a child who's already sunburned to get a second burn.
  • Don't put petroleum-based products like petroleum jelly on your child's skin. These prevent heat and sweat from escaping and can make a burn worse. The same goes for butter and oils.
  • Don't use first-aid sprays or ointments that contain benzocaine. Benzocaine can irritate skin or cause an allergic reaction.
  • Don't pop any blisters. Blisters form to protect your child's underlying skin, and breaking them open can lead to infection. If they do break, apply an antibiotic ointment and a nonstick wound dressing. Don't trim off the dead skin.
 When to call the doctor
Call the doctor right away if your baby has a sunburn.
If a child age 1 or older has a mild sunburn and his skin is just a little pink and tender, you don't need to call the doctor.
Note: You may not notice a sunburn right after you bring your child indoors. The redness and pain of a mild first-degree burn can take several hours to appear.
Call the doctor if your child:
  • starts to blister in the first 24 hours
  • has swelling on his hands or face
  • has signs of infection (pus or red streaks)
  • is running a fever or has chills
  • has a headache
  • seems to be in extreme pain or just doesn't feel well
  • vomits, feels lightheaded, or faints
Why is a sunburn so serious?
A sunburn is literally burned skin. Your child's skin is very thin and very sensitive, so it can burn quickly.
A sunburn might be a first-degree burn, which causes redness, mild swelling, and pain. A second-degree burn is more serious. It's more painful, with more swelling, redness, and blisters.
A first-degree burn usually heals in two to five days. A second-degree burn can last for a couple of weeks.
If your child has spent too much time in the sun, he may also be at risk for heat stroke.
What if my child's skin starts peeling?
Don't be alarmed if the sunburned skin starts to peel. Peeling is a natural part of the healing process. It usually begins a few days after the sunburn happens.
Is skin damage from the sun worth worrying about?
Yes. A sunburn means that the skin has been damaged by ultraviolet (UV) radiation, and exposure to UV radiation from the sun is the number one cause of all types of skin cancers. Some studies suggest that severe sunburns during childhood cause melanoma – the deadliest form of skin cancer – later in life.
Because children's skin is more sensitive than adults' skin, children are more prone to sunburn and skin damage. Fair-haired, pale-skinned, freckled, and green- or blue-eyed children are most at risk for skin damage and cancer from sun exposure, but ultraviolet radiation is dangerous for everyone.
How can I keep my child from getting a sunburn?
It's not hard, but you have to be diligent. A child can get burned after only ten to 15 minutes of exposure, even on a cloudy or cool day.
Dress your child for outdoor activities in long sleeves, pants, and a hat, and apply sunscreen. Keep him in the shade as much as possible, although shade provides only partial protection against sunburn.
The sun is most dangerous between 10 a.m. and 4 p.m., but the skin is exposed to UV rays during all daylight hours, year round, even when it's cloudy.
Put sunscreen on any exposed areas of skin. Choose a sunscreen with an SPF (sun protection factor) of at least 15 and apply it liberally about 15 to 30 minutes before you head outdoors, to give it a chance to be absorbed. Reapply sunscreen every two hours, or more often if your child is sweating a lot or has been in the water.