I'm Back.

I would like to apologize to all my readers for my long absence. After my family moved to Utah we experienced quite a few changes. There have been some pretty tough times over the last two years, and when push came to shove I had to let go of my blog for a while. I am thankful to all of the emails and letters of support I have received over the last couple years, and I do apologize for how few I was able to respond to. I have recently moved back to the city of San Francisco, and have resumed my career in child care.

As a quick announcement, I have recently contracted with Day One in San Francisco to teach my Infant Acupressure techniques in their San Francisco location. The first class will be held on January 26th 2012. For more information, or to register, please visit their site.

Thank you all for your continued support and interest. As before, I am interested in any feedback or questions you may have for me. Happy parenting!

- Naomi

5 tips for safe and effective bottle feeding.

Breast is best. However for a lot of mothers this isn't the way things worked out. No matter the reason, many parents find themselves faced with the task of using a bottle to feed their baby. Though there are some benefits, there are also many drawbacks to using the bottle. Whether you are using breast milk or formula in the bottle there are a few simple things you can do to make it a lot easier on yourself and your baby.

1. Be sure you are using the right speed nipple flow.
All bottles initially come with a stage 1 nipple. This slow-flow nipple is usually good for a couple of months. However, the age suggestions for increasing the speed of nipple flows are general at best. Every baby is unique, often even identical twins will not advance at exactly the same time to a higher flow. Some of the ways you can tell if your baby is ready for the next stage of nipple are: if your baby is losing suction pretty often while eating, becoming frustrated after eating for just a few minutes, eating a lot less but becoming hungry much more often, a sudden increase in the amount and intensity of gas, and a lot of chewing on the nipple during meal times. If you see any of these signs, or a combination of them it is time to get a faster flow bottle nipple.

2. Choose a non-toxic bottle.
BPA's and PVC's have been shown (to my satisfaction) to be dangerous as containers for baby's milk, unfortunately most bottles on the market still contain these chemicals. Also, plastic containers that advertise as BPA and PVC free have often replaced these unsafe chemicals with chemicals which have little or no research available on them. The best materials for containing your baby's milk are glass and stainless steel. Kleen Kanteen makes a wonderful stainless steel baby bottle, which is not only safe for your baby's milk, but easy on the environment. I have not personally used this bottle, so I cannot attest to how effective it is at reducing gas, but purely from a green and chemical-free perspective, it is the best choice. As far as glass baby bottles, you have many options, however my personal favorite is Dr. Brown's glass baby bottles. In my opinion, Dr. Browns is hands-down the best baby bottle for reducing gas. There were many times when I used this brand of bottle that the baby I was feeding would not only not have a burp, but also sleep peacefully without any of the usual discomfort that can result from not burping after a meal. The only drawback to the glass Dr. Brown's is that the production of glass is very hard on the environment. However, some families may not be able to afford to buy only the most non-toxic and environmentally safe bottles. For these families, the best ways to reduce the leaching of chemicals from your baby's bottles into milk and formula are: choose bottles that are colored, and not see-through; and do not warm your baby's milk or formula, but serve it at room temperature. Babies usually are not particular about the temperature of their meals (especially if they have never been breastfed), and there are no reasons why the milk or formula should be served at any particular temperature besides your baby's willingness to drink it. Chemicals do not leach into milk and formula as much from cool bottles or from plastics that are an opaque color.

3. Try to keep air out of the nipple during feeds.
As your little honey-suckle downs a big bottle of creamy goodness, try to keep the bottle at such an angle that air does not get into the nipple. If your baby takes in a big mouthful of air during a feed, the easiest thing for her to do with it is to swallow it and continue eating. This is very bad for gas. If that bubble is swallowed near the beginning of a meal, it could be forced through the stomach and into the intestines by the time your baby is finished eating. A large bubble of air going through your baby's intestinal tract is very uncomfortable for her, and though it will eventually be expelled at the diapered end, sleep may be difficult in the meantime. If your baby does swallow some air during a feed, try to get the burp up right away. If it does not come up, I recommend giving your baby a "bicycle legs" massage or regular clockwise stomach massage about 30-40 minutes after eating.

4. Sterilize your baby bottles and nipples regularly.
It is true that as soon as you touch a baby's bottle or nipple it is no longer sterile, however, regular sterilization cuts down the risk of getting thrush or a bacterial infection drastically. The only time when it is shown to be consistently safe to go without regular sterilization is if you are only using fresh breast milk in the bottles. Fresh breast milk has antibacterial properties that render it very resistant to thrush and the risk of infection (thank you @katrinayellow from twitter for reminding me to include this information). For the first two months you should sterilize the bottles every day, for months 3-6 twice a week is sufficient, from 6 months to 1 year, I recommend trying to do it at least once a month, and after 1 year it is usually fine to completely discontinue sterilization. The reason I recommend continuing with the occasional sterilization at this pace is based on the general ability of babies to fight off infection. If your baby is more prone to bacterial infection, or would be more adversely affected by an infection than most other babies, I would continue with at least bi-weekly sterilization for as long as your baby is using the bottle. Also remember to wash and sterilize pumping equipment after each use. To sterilize your baby's bottles, you can use a Medela microwave bag, which is handy and easy, you can boil them, or run them through the dishwashers heating cycle. Washing the bottles and nipples with soap and water is important as well, this should always be done before using the bottle and nipple again for another feeding.

5. Make sure your baby's milk and/or formula is fresh.
Fresh pumped breast milk can stay out in a bottle at room temperature for about 10-12 hours before it begins to have a risk of growing bacteria. Fresh mixed formula can only be out for about 1-2 hours before it begins to develop a bacterial risk. Fresh pumped breast milk can be refrigerated for up to a week (though sometimes as little as 2 or 3 days. A sterile container helps retain freshness in refrigerated breast milk.) with no significant bacterial growth risk, and fresh mixed formula can be refrigerated for up to 2 days. Breast milk can be frozen for 3 months in a soft-freeze, 6 months in a hard freeze and 1 year in a deep freeze. Thawed breast milk (and sometimes even refrigerated breast milk) is nearly as susceptible to bacteria as fresh mixed formula is, and should be held to a minimum of the same standards. If you pre-mix a large amount of formula, refrigerate the bulk of it for up to 2 days. If you have thawed breast milk, it should be served within 48 hours as well. For night feedings, you can pre-mix or thaw your formula or milk and keep prepared bottles in the refrigerator. Leave out the first bottle for up to an hour before it is used for the first feeding, then take out a bottle for the next feeding to warm over 2-3 hours. By the time it reaches room temperature, it will probably be within an hour of your baby's next feeding time. If you prefer to mix your baby's formula by the bottle rather than all at once, keep sterile bottles of pre-measured water with pre-measured formula to mix just before each feeding (the only drawback to this is the bubbles that are caused by shaking formula can cause severe gas in some babies). It is very important to keep in mind that once your baby's mouth has touched the bottles nipple, that formula or breast milk will only be safe for 1 hour, TOPS. I know it is hard to throw out breast milk, and formula can be expensive, but if your baby only eats half a bottle and refuses to finish it, throw the rest away. Also, it is a good idea to familiarize yourself with the smell of fresh formula and breast milk, as well as the smell of breast milk and formula that has "turned", because if you are in a pinch and need to offer your baby some milk that you are unsure of, you will be able to use your nose to warn you of bacteria growth.

Feeding a baby is both a joy and a chore, but with these 5 tips you can be more confident that your baby is getting the best from each feeding (for more information on how to make good choices for your baby's things read this). I hope that these tips have been helpful. If you know any new or expecting parents, please don't hesitate to forward them my site address. I also love questions and comments. If you have a topic that you'd like some tips on, feel free to ask, and I will credit you when I write them. Happy parenting!

5 tips for soothing a colicky baby.

Colic. The dreaded, the mythical, the bane of parental existence... colic. It's such a cute little word when you look at it, yet the meaning it carries is ugly indeed. Crying. Your baby crying and there seems to be nothing you can do to help. The definition of colic is basically a baby who cries at predictable times during the day for around three hours at a time. There is no known cause or cure. Helpful huh? Of course colic has existed since babies have, and mothers over the years have learned a few things to try that might help you and your little screamer through the rough patches. Also, my 5 tips for gas and reflux can also be tried to help remedy colic.

1. The Superman hold.

Hold your baby tummy down, feet pointing at you, with one hand under her belly button and one hand supporting her head. Stand with your legs spread apart and swing your baby through your legs backward and forward, supporting the majority of her weight with the hand on her belly button. You can continue to hold her this way while seated, suspending her between your knees, bouncing a bit. The reason i think that this sometimes works is partly because it helps expel gas, partly because it provides a bit of warmth from your hand that may soothe your baby's abdominal muscles if they are sore and partly because the motion of swinging or bouncing can help a baby focus on her internal equilibrium which takes the focus off of whatever is causing the colic.

2. Examine your diet.

One possible explanation for colic is that it is actually your baby expressing discomfort because of food allergies. If your baby is bottle fed there are many other types of formula you can try, your pediatrician will be able to recommend one that is right for you and your baby. However, if you are breastfeeding, there are a thousand things it could be. Many mothers try to eliminate suspicious foods from their diet one at a time, which can take forever, and is still not guaranteed to help. I recommend a bland your diet for 2 days, then adding foods back in over a couple weeks. Try oatmeal (no milk or sugar) and an apple for breakfast, a baked potato with olive oil (no dairy) and roasted turkey breast for lunch and brown rice, carrots and grilled chicken (no onions) for dinner. As you'll notice the things cut out of this meal plan are dairy, wheat, legumes and most fruits and veggies. The fruits and veggies that are most often the culprit seem to be things like broccoli, onions, beans, acidic fruits, If you are on this diet for a couple of days and see no changes in your babies temperament then chances are it is not something you are eating, and you can either switch out the bland foods for other bland foods to rule out the few things that you were eating, or just go back to your normal eating habits. If your baby suddenly calms though, try reintroducing a few foods a day until your baby begins to be colicky again. Then slowly scale back to pin point which food was the issue. In rare instances there can be more than one allergen causing your baby discomfort, and quite often the cause is not rooted in your diet at all, but eliminating your diet as a cause will save you a lot of guilt and worry.

3. Try sleep-in-motion.

I am not a big fan of using sleep in motion (swings, cars, strollers), because of potential sleep problems that can develop as a result of over using it. However, there are times when helping your baby get some sleep (no matter how) outweighs everything else. First try the baby swing, since that will be the most convenient, then the stroller, and only as a last resort try the car. Though the car can often be the most effective, it is also the most work and the hardest on the environment. If you have a bicycle, and a baby-safe trailer, it is also a good method to try depending on the weather. After your baby is asleep, if you can stop the motion and they stay asleep I highly recommend it. Their sleep will be deeper and more restorative with less outside stimulation to contend with.

4. Use a hair dryer.
The most strange secret weapon against colic is sound. Though no one is certain why, the sound of a hair dryer, vacuum, car engine or fan can get your colicky baby's attention and calm their stress like nothing else. Though I'm sure there is a rational explanation for why this so often works, right now it seems a little like magic. Because leaving electronic devices running for too long both wastes energy and can be a fire hazard using a prerecorded source for the noise is the best option. You can record it yourself or buy recordings here. Just remember that keeping the noise at a fairly high level also seems to help. I recommend starting with the sounds on lower, and slowly turning it up until your baby begins to react positively. Before investing time or money in this solution try the real sound so you can be sure it will work for your baby.

5. A vibrating back massager on the tummy.
When all else seems to be failing, a technique that has worked for me a few times is to get a vibrating back massage device, wrap it in a towel to mute the strength of the vibrations, and apply it gently to your baby's belly. Be careful not to keep the massage device in any one place for too long (over 2 minutes), and try to keep the entire massage under 10 minutes. If you sometimes go as long as 15 it should be okay, but shoot for short sessions. If your baby responds well and falls asleep, stop the massage device and put it away.

Though colic is a difficult thing to go through with your baby, even if all the tips, tricks and hints in the world do not help you can at least take comfort in knowing that it does not last forever. Most colic resolves by 4 months, and %90 of cases resolve by 9 months. I know that it is a small comfort but sometimes even a distant hope is better than none at all. Always remember to keep an eye on your own stress and frustration levels. If you begin to be overwhelmed, laying your baby down in a safe crib and taking a short break, even while they are crying, to calm your nerves can make a huge difference to your ability to cope well with the stress of the situation.

Try to work together with your spouse or partner or supportive friend to give each other support and comfort, assigning blame and picking at each other, though natural, will only add more stress to the situation. Keep your spirits up, lean on each other and try try again until that magical day when your little human cacophony stops crying for no reason and spends the majority of his time being cute. Happy parenting!

5 tips for helping relieve baby's gas pains.

With every baby comes the problem of gas, and gas-related pains. For some babies these pains come only once in a great while, for others they are a regular part of their eating and sleeping routine. Gas pains can be identified by a few basic signs like squirming while asleep, sudden crying out (for no apparent reason when you know they shouldn't be hungry yet, and their diaper is clean), pushing the legs straight and stiff, and grunts which end in cries.

Some parents have had success using homeopathic gas remedies, but I have found that their effect is very small if detectable at all and much too expensive to be feasible for daily use. Also, one should be careful with gas drops because they work by consolidating all of the small bubbles in your babies tummy which encourage the gas to be expelled in one big burp rather than traveling through the digestive system. This doesn't always work as planned, if your baby does not burp after a feeding despite gas drops being used the resulting gas pains will be a lot worse than they would have been without them. Gripe water is often a better assistant, but many babies do not respond to it either. These tips and tricks are a few quick easy things you can do to help relieve your baby's discomfort from gas pains.

1. Prop your babies feet up an inch or two while they are sleeping.
This position reduces pressure on the abdomen, and as a result your baby will strain less when pushing to expel gas or gas-causing solids. Many women during pregnancy find this position comfortable for the same reason. I would recommend using something solid like part of a side-sleep support rather than a blanket because there is less of a risk that the baby could find a way to pull it over their face, or wiggle under it.

2. Gently massage around your baby's belly button in a clockwise circular motion.
This is one of the most basic forms of infant massage designed to help move gas and solids through the large intestine, which is the area it most often will get lodged in, causing pain. Other basic infant massage strokes include stroking from the base of your baby's rib cage downward to their hips and walking your fingers from left to right across your baby's tummy over and over again slowly moving from beneath the ribs to the diaper fastenings. If it is warm out, you can massage your baby while in nothing but their diaper using a light water based moisturizer like Avalon Organics Baby Lotion.

3. Place a warm towel low on the belly.
Sometimes a baby can get cramps from straining to move gas and solids through their bowels that are comparable to most menstrual cramps. Placing a warmed towel low on their tummy provides the same kind of relief that a heating pad provides for a grown woman. A warm bath can also be soothing in the same way.

4. Give your baby some tummy-time.
A little pressure on the tummy can be just the thing to help your baby push the irritation out. While your baby is laying on their tummy gentle stroking of the back from shoulder blades down to the hips can also sooth and relax your baby enough that the gas can be naturally expelled with less straining. Tummy time can be uncomfortable just after feeding, so do try to wait at least 15-20 minutes before you try this tip.

5. Play "Toes-On-Your-Nose" with your baby.
This is a home-remedy that has been passed down for generations. While your baby is laying on a comfortably padded and safe surface (like your lap), take their feet in your hands and gently stretch them up toward your baby's face. It is fun to sing or recite a little rhyme while you do this, and you might even elicit a little giggle from an older infant. When your baby is nice and relaxed, they should be able to touch their toes to their nose with very little pressure from you. Do not ever force your baby into a position that they are resisting. Also, be sensitive to their signals, and if they cry and arch away from you the game could be pinching a gas bubble or increasing their discomfort in another way. However if your baby is enjoying the game it can not only relieve gas, but be a sweet bonding-time for the two of you.

Gas pains are inevitable for babies, but for some they can make you both down-right miserable. I've recently added a few more tips for parents to try that can be read here. These tips have given me a helping time and again over the years. I hope you find them useful, please feel free to leave comments and questions or suggestions about these or any of my tips. If you find these tips helpful please do share them with your friends and family, especially those who are expecting a new baby. Thank you for reading!