Nate's First Six Months

I thought I would reflect a little on the first six month's of Nate's life.

I didn't write for the first month of Nate's life. Most of the first month we were struggling with getting Nate home, dealing with the constant feedings, and the wonderful change to our lives. Nate started small, but he was a very good eater (after some initial difficulties). That first month is still quite a blur.

Breastfeeding - I'm still glad that we choose to breastfeed Nate. I never realized that mom and baby had to work so hard to get breastfeeding to go smoothly. It was a struggle at first. I can see where people may give up or move to formula at least part-time. Nate has been a very healthy and happy baby. I believe that breastfeeding helped on the health and growth side. It also meant that Nate and mom got to spend a lot of quality time close together. While we have started Nate on some solid foods, at six months Nate is still getting the majority of his nutrition through breast milk. Another great benefit to breastfeeding, his poop has very low odor which makes changing diapers much more pleasant.

Diapers - Wow, a baby goes through a lot of diapers. I went from basically never changed a diaper to where I can almost change a diaper in my sleep. We decided to use cloth diapers and while they can be a hassle I still believe it is a good decision. Also never realized how much poop can come out of such a small kid. As Nate has started to eat solid foods his poop has started to change. I'm afraid the days of very low odor poop are almost over. Poop has started to change as solid foods have been introduced. It is interesting to see how different foods go through Nate. For example, I never realized out fibrous bananas are.

Hiccups - Interesting how much Nate hiccups. His hiccups have decreased over time, but he still has them quite often. For the first couple months the hiccups didn't seem to bother Nate at all, but now the hiccups seem to be a little annoying.

Sleep - This is still one of the areas that we struggle. Nate sleeps reasonably well, but he still wakes up at night more than we would like. This means that we are still not getting the sleep we would like. The regular sleep deprivation is something we are looking forward to getting over at some point. While Nate has proven he can sleep over 8 hours at a time, that is more the exception not the rule. And even when he does sleep long periods it is on his schedule (not necessarily ours).

Teething - At six months, Nate has one tooth and another will come through any day now. Nate has cried a lot when as these teeth have come in over the last month. He also produced amazing amounts of drool. We believe that teething may be behind some of the recent sleep issues and certainly makes Nate fussy at times.

Gas - We were lucky that Nate did not have colic, but he did have a lot of gas. He now handles the gas with no problem, but there was time where he didn't sleep well and was rather uncomfortable because of gas. We spent a lot of time in first couple months trying to figure out how to prevent and relieve gas pains. In the end, time seemed to be the best cure.

Food - We started Nate on some solid foods at about five months. We've fed him rice, oatmeal, banana, avocado, squash, and apples so far. Nate eats pretty well and hasn't turned down any type of food, but the plain rice and oatmeal are certainly not his favorites. Of late, Nate seems to be spitting up less, but we still have cloths/rags scattered everywhere around the house to always be prepared for when Nate spits up next. I will say that the wood floors in the house have been great as it makes cleaning up really easy.

After six months Nate has gone from rather small (6lb 2oz, 19") to a healthy, growing (17lb 15oz, 26"), and smiling baby.

Nate at Birth	Nate at Six Months

Nate has been a blessing. We never expected Nate to be easy and his first six months have certainly had its ups and downs. The positives certainly outweigh the negatives. His smile and laugh make the difficult times melt away. Seeing those firsts (smile, laugh, turn over, sit up, etc) have all been exciting. Then there are the firsts to come (crawling, words, walking, etc) that we are looking forward to experiencing. The next six months should be exciting.

When are infants ready for solid food?

So our pediatrician gave us the go ahead to start giving Nate solid foods. I wanted to understand what was behind that recommendation. The main things that doctor was looking for was the following:

• Loss of tongue-thrust reflex
• Able to turn away (saying he is full)
• Hold head up unassisted (and sit up)

I trust our pediatrician, but when major organizations (AAP/CDC/WHO) keep recommending nothing but breast milk (or formula) until 6 months I have wonder at least a little.

Doing some research it seems as if it is difficult to really tell if a four month old has enough gastrointestinal maturity to handle solid food or not. At four months many infants still have what is considered an open gut. With an open gut an infants intestines could allow things into bloodstream that would stay in intestine with mature gut.

So while I don't believe we could do much harm by experimenting with some simple foods we'll certainly make breast milk his primary source of nutrition. We are in no hurry and we'll probably wait til fifth month to try some solid foods. At some point we'll probably experiment with some foods like rice, oats, bananas, or avocado. Those are some of the common first foods for infants.

Kellymom had a good list on introducing foods at six months and 12 months.

There are many reasons that 6 months of age is the "magical" age for introducing solids, here are a few

* Baby's intestines should be fully "closed"
* Babies are less likely to aspirate foods
* Baby is better able to recognize that she is full and regulate how much she needs to eat
* Baby is able to indicate she is full by turning away from food
* Baby should be have fully developed head control and be able to sit up with minimal assistance
* Baby has had breast milk or formula during the crucial first 6 months of life; giving him the healthiest start with optimal nutrients

There are many reasons that 12 months of age is the "magical" age for introducing "forbidden" solids; here are a few:

* Baby's system is less likely to think that foreign proteins, like the egg protein, need to be considered invaders and fought off. Creating an allergy is considerably reduced in older infants
* Baby has been sensitized to a variety of foods and allergies are less likely to be induced
* Baby's development is such that some forbidden foods, cow's milk for example, will not adversely affect health
* Baby's gastrointestinal system is better able to process pathogens, such as botulism spores in honey.

source: http://www.kellymom.com/nutrition/solids/delay-solids.html

How long does breastmilk last

It seems there are a lot of differences in how long people recommend storing breastmilk. Sure, it is going to differ depending on how you store the milk. I've pulled some recommendations from multiple sources to show the variety of opinions. It is interesting as most of these recommendations are based upon different studies. I haven't had the time to dig in and understand the methods and details behind each of the recommendations.

From Kelly Mom -

HUMAN MILK STORAGE
	Temperature	Storage Time
Freshly expressed milk
Warm room	79°F / 25°C	4-6 hours
Room temperature	66-72°F / 19-22°C	10 hours
Insulated cooler /icepacks	60°F / 15°C	24 hours
Refrigerated Milk (Store at back, away from door)
Refrigerator (fresh milk)	32-39°F / 0-4°C	8 days
Refrigerator (thawed milk)	32-39°F / 0-4°C	24 hours
Frozen Milk (Do not refreeze! Store at back, away from door/sides)
Freezer compartment inside refrigerator (older-style)	Varies	2 weeks
Self-contained freezer unit of a refrigerator/freezer	Varies	3-6 months
Separate deep freeze	0°F / 19°C	6-12 months

Source: Kelly Mom - http://kellymom.com/bf/pumping/milkstorage.html

From CDC -

Location	Temperature	Duration	Comments
Countertop, table	Room temperature (up to 77°F or 25°C)	6–8 hours	Containers should be covered and kept as cool as possible; covering the container with a cool towel may keep milk cooler.
Insulated cooler bag	5-39°F or -15-4°C	24 hours	Keep ice packs in contact with milk containers at all times, limit opening cooler bag.
Refrigerator	39°F or 4°C	5 days	Store milk in the back of the main body of the refrigerator.
Freezer			Store milk toward the back of the freezer, where temperature is most constant.  Milk stored for longer durations in the ranges listed is safe, but some of the lipids in the milk undergo degradation resulting in lower quality.
Freezer compartment of a refrigerator	5°F or -15°C	2 weeks
Freezer compartment of refrigerator with separate doors	0°F or -18°C	3–6 months
Chest or upright deep freezer	-4°F or -20°C	6–12 months
Reference: Academy of Breastfeeding Medicine. (2004) Clinical Protocol Number #8: Human Milk Storage Information for Home Use for Healthy Full Term Infants.

Source: http://www.cdc.gov/breastfeeding/recommendations/handling_breastmilk.htm

From La Leche League -

Preferably, human milk should be refrigerated or chilled right after it is expressed. Acceptable guidelines for storing human milk are as follows. Store milk:
Room temperature (66-78°F, 19-26°C)	4 hours (ideal), up to 6 hours (acceptable) (Some sources use 8 hours)
Refrigerator (<39°F, <4°C)	72 hours (ideal); up to 8 days (acceptable)
Freezer (-0.4 to -4°F, -18 to -20°C)	6 months (ideal) up to 12 months (acceptable)

Source: http://www.llli.org/FAQ/milkstorage.html

From Abbott Nutrition (makers of Similac) -

Refrigerator	Use within 24 hours if possible. Discard after 72 hours.
Freezer	Up to one month in freezer compartment of refrigerator. Do not store in door of freezer.
Deep Freezer	3 - 6 months (0 F or less); store at back of freezer. Best if used within 3 months.

Source: http://abbottnutrition.com/resources/en-US/home/breastfeeding/BreastMilk%20Storage.pdf

So from these and other sources it seems that there is a range of acceptable storage times. It is interesting that a major manufacturer of formula bases their numbers on a study with some of the shortest storage times. One other good thing I've picked up is milk is probably not bad unless it smells bad or tastes sour.

Baby Don't Stink

Before Nate came Sherri was all worried about having a diaper genie or similar device to keep the diapers from smelling up the place. I figured how hard is it to take the diapers out everyday? Well someone did give us a Diaper Champ as a gift.

So at least for the next couple months I have figured out that we really don't need our Diaper Champ. While it is pretty cool with the handle to drop the diaper inside. I also like the fact that you can use any bag and not specially designed bags for the product. Below is a picture of the Diaper Champ.

Here is what we are using at the moment for most of the diapers. We are recycling grocery/retail bags. Because the odor is so faint we don't even have to take them out very often. I've heard others describe the smell of breastfed babies as something resembling the smell of buttermilk. My understanding is formula fed babies are a whole different ballgame of smells. We have a week old bag of diapers in our bedroom from when we change Nate at night and we don't even notice it. Below is all we really need for first six months.

So I'm sure we'll be glad we have the diaper champ once he starts eating solid food. But as long as he is a breastfed only baby the diaper champ is overkill. Just another advantage of breastfeeding.

Another reason not to take babies to movies

Babies tend to cry quite often. I certainly don't enjoy hearing the crying and I especially don't enjoy hearing my own son cry. This worry of is there something wrong, is he hurting, etc. goes on in your mind. But I've learned that females tend to have another reflex around crying. Breastfeeding mothers will experience letdown reflex (sometimes called milk ejection reflex) with they hear a baby cry. It seems reasonable that the female body makes milk ready when baby cries, which is most common reason for infants crying.

So my wife went to the movies yesterday. I stayed home and took care of Nate for a couple hours. There were a couple babies at the movie and they were crying. So not only was it a possible interruption to all the rest of the people trying to watch the movie, but the letdown reflex caused a significant buildup of milk in my wife's breasts. This pressure caused her to run home directly after the movie to pump (or feed) to reduce the pressure which was becoming rather painful. So she didn't get to accomplish a couple other errands and the end of movie was not as pleasant due to excess pressure in her breasts.

Not that we were planning on taking Nate to the movies, but I have another reason why babies should not go to the movies.

Why Breastfeeding

One of the things that Sherri and I decided on early was that she would breastfeed. It just seems to make sense. Not only is it the perfect food for babies, breastfeeding has positives for moms as well. Breastfeeding gives time for mom and baby to bond. Breast milk is easier to digest than formula and has hormones, antioxidants, and antibodies that help babies grow and protect them from infections. Breastfed babies also have lower incidences of SIDS, asthma, obesity, and diabetes. Then add the benefits to mothers, breastfeeding helps get rid of pregnancy weight and studies show that breastfeeding helps reduce certain types of breast and ovarian cancers as well as diabetes.

So based upon this why doesn't every mother breastfeed? Seeing Sherri struggle getting Nate to breastfeed gives me one clear indication. Sometimes is just isn't easy. The formula makers have made it easy. With the bottle there is no latching issues, no bruising, cutting, or soreness of nipples from baby. Plus anyone can easily feed the baby, and there are no problems later with work interfering or breastfeeding in public. 2007 data from the CDC states that 73.8% of mothers in the US initially breastfed. That number dropped significantly by the time babies reached three months and was even lower at six months. UNICEF goes even farther with estimating that 1.5 million infant deaths could be prevented worldwide if every mother exclusively breastfed for six months.

I have gotten quite a bit of satisfaction being able to feed Nate with breastmilk that Sherri has pumped. Makes me feel closer and hopefully that is some good early bonding between dad and son. I'm hopeful between breastfeeding and pumping breastmilk we can keep Nate 100% mom fed for six months.

I will say that without the lactation consultants and Le Leche League meetings and resources Sherri would have had a much more difficult time breastfeeding. I can see why so many people give up. The first week or two was really rough and she'll probably have scars for a long time to come. I am VERY grateful to these resources and encourage all mothers to learn more through resources like these - you and your baby will benefit.

Nathaniel (Nate)was born June 30th 2009. He was earlier than we expected (about two weeks). He weighed a whole 6lb 2oz and was 19in long. We thought except for a name we were pretty much ready for his arrival. Or at least we thought. I want to be a pretty active Dad and I'm looking forward to experiencing him growing up.

Many people told me to be prepared for lack of sleep. But until you experience it, I didn't realize how much the lack of sleep would really affect me. At times I feel like a walking zombie. I'm looking forward to Nate sleeping a little more between feedings. Right now Nate is about 3 hours between feedings (start to start). Another hour or so between feedings would be nice. I think that extra hour will make a big difference.

One of the other things getting used to is changing so many diapers. I've changed a lot of diapers in the first couple weeks. I read about all the diaper changes, but until you change 10 diapers in a day I just didn't realize. I'll talk more about diapers and our choice to go with cloth. We (well Sherri) also chose to breastfeed. It really makes a difference as the doesn't smell.

Off to get a nap....