Travelling with a 20 week old

Welcome to Sense by Meg Faure, the podcast that’s brought to you by Parent Sense, the app that takes guesswork out of parenting. If you are a new parent, then you are a good company. Your host, Meg Faure is a well-known OT infant specialist and the author of eight parenting books. Each week, we are going to spend time with new moms and dads, just like you to chat about the week’s wins, the challenges and the questions of the moment. Subscribe to the podcast, download the Parent Sense App and catch Meg here, every week to make the most of that first year of your little one’s life. And now meet your host.

Meg: Welcome back everybody, I’m Meg for your host. It is my delight to travel with you each week, as you raise and nurture your little ones and each week I’m joined by a mum and we kind of travel through her journey as she goes through each week with sleep and feeding and development stimulation. We look at the highs and lows of parenthood, and it’s a really, really exciting journey and keeps it real for me. It keeps me on top of what actually happens at every single age band. And very often we have Cassidy join us with her little Max and we’ve actually tracked Max all the way from birth. So if you guys have not heard Max’s birth story, you have got to go back to the first episode. I think it was podcast two, in fact, where Cass and I met and started to talk about Max’s journey. He’s 20 weeks old now. So that was 20 weeks ago.

It’s hard to imagine that he has, you know, that this little life that actually was hanging in on tender hooks and that really, we didn’t know whether or not he was going to be okay is this absolutely robust and thriving little boy. And if you followed our journey with Cass you’ll know that some weeks we’ve had challenges with how he’s feeding, we’ve had challenges with weight gain. We’ve had challenges with sleep deprivation. It’s all the classic baby stuff that every single one of us go through. And so this week we joined by Cass again, and she’s going to be talking about her journey with a 20 week old. So welcome back, Cass.

Cass: Thank you. It’s funny hearing you say, because I can imagine if you’ve never seen Max, you picture quite a frail little boy with that description, he is not.

Meg: Not at all.

Cass: He is robust looking.

Meg: He’s very robust and it’s incredible how you can go from being literally potentially a death store. And luckily it was very short lived. It was only a week before they got on top of what was going on. And he is, as you say, he’s absolutely thriving and a gorgeous boy.

Cass: No he is. But yeah, I think we mentioned last week, the cliff hanger for last week was the fact that we were going away. So we are currently in England. It’s the first time Max has been out of…Well, he’s gone between our house and my parents’ house. So he has had more than one bedroom in his life, but this is the first time he’s been away. So we’ve traveled on a ferry. We’ve been out to a pub for dinner at night, which he’s never done before.

Meg: And how did that go? I mean, he’s had a fairly good bedtime bath-time routine literally from day one. And so taking him to pub, how did that work out for you?

Cass: So, well, I’ll actually start for the fact, because there were two nights in a row. So the first day we were getting the ferry over and the original plan we were getting the long ferry, which basically means we would’ve got on the ferry after he’d had a bed and bath routine at home and then we put him in a cot and it’s overnight. So he would’ve basically not really have noticed that he was missing bed and bath routine and all of that, but they unfortunately canceled our ferry 24 hours before. And we were put onto a different ferry, which meant we were on the ferry during bed and bath routine. And it’s a four hour journey, and oh initially I actually felt quite anxious. I thought, oh my God, this isn’t the plan. This is not working out or no, but you know, there’s nothing you can do about it. So you just say, okay, we’ll do what we can. He was the model baby on the ferry.

Meg: That’s amazing.

Cass: I think other people were looking at us thinking, wow, that baby. Even, I was looking at Max thinking, keep this up, buddy, you look great.

Meg: That’s amazing.

Cass: He cooed looking out the window, loved it. And he woke up as we were boarding. So he fell asleep on the way to the ferry and woke up as we were boarding, looked around out the window, then we fed him. He fed really well. Then while we were burping him he was flirting with the guy in the seat behind laughing and joking. And then he started getting to sleep time, and I said to Alex, okay, you know, let’s put him in the pram and try and get him to sleep. He was laughing, smiling. Alex said, there’s no way he’s going to sleep. So he put him in the pram and he sat there laughing and smiling for a while and then suddenly movement stopped and he put himself sleep and slept for the whole journey.

Meg: That’s incredible. But you know it’s interesting. And I think I once said it to you right at the beginning, when we were talking about bedtime routines, he was very, very little and you were talking about, you know, when do we start a bedtime bath-time routine? And I said to you, you need to start it as soon as possible. And one of the things with early parenting is that things can be very frustrating because you are kind of bound by times with these babies. Like every night, the whole bath time routine has to happen between 5:30 and 7 or whatever it is. And you can’t do anything out, you can’t get out, you can’t do anything. But actually the things that hold you hostage are the things that set you free. And I’ve always said that to moms, like the things that you, you know, if you get routines in place, if you get them to just understand that that’s the way something happens then for that one night that they’re out of sync, they’re actually kind of just take turn and it’s absolutely fun. So he’s proof of that.

Cass: Yeah. And we did, I mean I made sure we paid very close attention to awake times that day. I made sure he had one long sleep. So he took him out in the pram. So he’d had a good rest in the day. We had his dodo blanket with him, so we gave that to him which he only has when he goes to sleep. So we gave that to him and we put him in the pram, you know, there were certain things that we tried to keep, are those associations, and so that really helped. We then had to, poor little sausage, had to wake him up to put him back in the car to drive to the hotel that we were staying at overnight. And I don’t know if you’ve ever been in the bar, it was sort of car area of a ferry, but it is noisy, it’s bright, you know, when he’s deep in his thinks nighttime sleep.

So he got a bit antsy on the way to the hotel or, and I say a bit because it, considering that interruption and everything, he could have screamed the hallway to the hotel. And we went upstairs and again, we didn’t bath him, but we then did everything after bath bedtime routine. So we dressed him, put a sleeping bag on, gave him a feed. So it was very much okay, this is what happens at bedtime usually. And I have to say, I did look at him thinking you’re not going to sleep because he was wide awake again, laughing, cooing. And I thought you are seeing this as potentially, we should be giving you your two hour awake window, you sort of woken up from a nap. So I was a bit worried.

Anyway, we put him in his cot again, sleeping bag, dodo blanket, white noise, and by the time we’d finished brushing our teeth and got into bed, he was asleep.

Meg: That’s incredible.

Cass: Yeah, it just really highlighted to me the importance of as exactly as you say, all of those associations and routines that we’d done for the last 18 weeks because I think we started about two weeks now means that even in the most alien of environments, he’s going, okay, I know what I’m supposed to do. So yeah, that was a dream. He did wake in the morning in the hotel at about 5:00 AM, absolutely screaming.

Meg: Yeah, where am I? Where am I?

Cass: Yeah, but I’ll forgive him because he had been an absolute dream.

Meg: Absolutely. And it’s quite interesting you bring up something and I know that isn’t directly pertinent to what you’re talking about, but I’d like to talk about travel and time zones because it’s one of the questions that parents actually often asked me. Like how do we switch time zones and how do we do travel? And there were a couple of principles in what you said that really do highlight the right way to travel with little ones. So first of all, the day before, so, in your departure city and then in your arrival city, you fastidiously stick to awake times. And so, that’s important and that is regardless of if you’ve transferred time zones. So if, for instance you’ve transferred and you’ve ended up arriving somewhere that should be kind of three o’clock in the afternoon for your child, but it’s actually seven o’clock in the morning just switching to awake times for the day hours.

And so that is important, which is exactly what you did, a really good, solid sleep watching awake times, very carefully in departure city. And in the following day, wherever you’ve landed up, you just go straight back into awake-times and that will help parents to actually transfer time zones. And in fact, when my second was only a little one, we actually took a sabbatical and traveled around the world for three months. And that’s literally how we changed our time zones. We just kept our awake-times when we got into the new city for the daylight. That’s the first principle which you’ve highlighted. The second one is that it is really great if you can travel over sleep time because in general, most forms of travel, whether it is car, ferry, or a plane is white noise, there’s so much noise and hum, and vibration from the vehicle that you’re traveling on, that you actually can get them to sleep. But you’ve got to watch that you don’t get them over tired and you know, I’m sure all of us have sat on an airplane with a mom who’s or dad, who’s got a screaming child who’s kind of screaming through the night and usually it’s because they’re overtired. And if you’re missing those awake times, you’ve got them overtired. They just then become completely wired and it becomes a whole lot worse. So the very important thing that you also did was actually then stick to what would be a kind of a bedtime routine, obviously without the bathroom, without everything else. And if you’ve been doing it consistently, since they’re very little, they actually will fall asleep, whether it’s on a plane or whether it’s, you know, on a ferry or whatever, but you do need to make sure they don’t get overtired. So yeah, excellent principles.

And then the other thing that I love about what you said is that you kind of reenacted almost identically, hopefully as close to possible what his sleep zone was like at home. So yeah, that was really, really perfect. And how has it been now that you’ve actually arrived at the in-laws?

Cass: Yes, so, well , I mean I am one of these people where, so I suppose I’m a slow to warm up in many ways in terms, because if I’ve got a plan or, you know, a routine, if someone then says, oh, we’re going to go and do this and that change, I need about five minutes to work through that in my head

Meg: I’m just the same, Cass.

Cass: Initially, I’m going; “Oh my God.” And so, we arrived and my father-in-law said…So we’ve book a table at the pub for 5:30 this evening dinner. And in my mind, I thought, sorry, what pub? But you know, I then thought, no, I’m one of the reasons we have never done a sort of really strict time routines. And you know, I know they’re routines out there where you wake your baby, if they’re still asleep and you stop them feeding, whatever it might be. One of the reasons we haven’t done that is so that we do have a bit of flexibility in life. So I thought, okay, I don’t want to be held hostage. And there are parents all around the world that take their babies to, you know, it was early evening. So I just worked it through in my head and I thought, okay, and I did a very quick maths on awake-times of when we’d need to get him to sleep, to try and make this work and sort bedtime out. Anyway, we got the pub, as we walked in, there was this mother with a younger baby than Max in the doorway, sort of shushing and jumping up and down and sort of, and I heard her saying it’s very noisy in there and  there’s a lot of lights and it’s really, she’s not doing okay. And I thought, oh no, this could be us and half an hour. Anyway, he honestly sat in his pram, just watching, cuddling his bunny and just sat there until it got too feeding time when I pulled him out of the pram and we fed him, then he did some smiling and we brought him back home and I thought, hmm. And so we got home at about eight o’clock. So late for his bed-time, and he is way over shot is awake time by about half an hour, he’s over shot his awake time. He had a power nap in the car on the way back.

Meg: Good, another great strategy, Cass.

Cass: So that helped. And then we did, because it was only eight o’clock and he hadn’t had a bath the night before we did bed and bath routine, but a very quick bath. And he went down a dream again. And I thought, my God, we’re very, very lucky. And he slept till 3:00 AM, did a feed and then slept till six, not waking at all.

Meg: What a good boy.

Cass: However…,

Meg: I had a feeling there was a however coming. It all felt too good for the moment there.

Cass: I know. So then yesterday I had to drive to visit my sister in Oxford, which was an hour and 40 minutes in the car there. Then I had a very quick brunch because I was again looking at awake-times, but again, he overshot his awake time by about half an hour, but he slept all the way there. He slept all the way back. And then we got back here, I gave him one short nap, which we had to wake him from in the afternoon. And then we went to do bed and bath routine at the now normal time for the first time he has to have two nights of not being in the normal routine and did bath, was lovely, he absolutely loved it. Then there’s a puppy, a very cute little puppy here, but he saw the puppy on the way from bath to bedroom, he is started laughing. I thought that was great. So now we are probably slightly more wired than we usually would be after calming bath.

So he fed and then for the first time in a long time, he cried when he was put down, and I mean really, but it was a shouting kind of, “I do not want to be put down right now. Where’s the pub. Where’s the…Where’s the…

Meg: The puppy…

Cass: Eventually he did go down. You know, now you can hear the difference of distressed cry and a bit of a sort of shouty this isn’t what I want. There were no tears, it was just shouting. So I left him a little bit longer and he put himself to sleep, but at 11 o’clock, Max woke up and screamed for an hour. And we could not get him to go down. I ended up having to hand him to Alex because I was feeling so stressed about the fact, even though my in-laws have said, you know, don’t worry about any crying, don’t worry if he wakes…I was feeling so stressed about the fact that…I knew they wouldn’t be able to be getting to sleep with this crying. So I had to hand him to Alex and I said, I’m not helping the situation because I’m feeling very stressed right now. And Alex took over and for the first time in a long time gave him the dummy and he fell asleep. I say a long time, about a week and knew he fell asleep and went through till 2:30, we fed him and then he had to be given the dummy again at about four. And then he woke at 6:30. So last night, even though that was the night in the routine was actually, I think when we realized the impact of the disturbance of travel and being out and things like that.

Interlude
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Meg: Yeah. It’s quite interesting. I mean, I think different babies respond differently to being out of sync or out of routine and you, for instance, your slow-to-warm up, which you and I are, but Max definitely isn’t. They noticed every little difference. And so right on night one, they wouldn’t have settled because things have to be exactly the same in order for them to fall asleep. So your slow-to-warm up and sensitive little ones tend to be really tricky when you travel. And I’ll never forget in my practice many years ago, having a mom who had a very, very sensitive little one that I used to treat and one day they went to on holiday for the first time when she was 18 months old and the mom came back and she just said to me that that just really wasn’t worth it. It was just awful. It wasn’t a holiday. It was five days of hell. And we trying to now resume our old routine kind of five days back, and it’s just been 10 days of hell altogether, you know.

And that’s what holidays can be like for slow-to-warm up and sensitive babies, and so in some ways, a holidays easier to just take it home than to actually go traveling with those babies. Your social butterfly, which is what Max is, are slightly different. They’re actually absolutely fine because they like the novelty. They like the stimulation. So as long as you had them in a good routine, which is what you’ve done and you wired his brain for being in a good routine, they’ll be quite easy. But the problem is, and you pointed it out so perfectly that a cute puppy after bath, a night in a pub, you know, a night on the fairy, lots of novelty. And then suddenly when things resume back to normal, it’s like, no, no, no, no, no, hold on, there’s a world happening out there when you are trying to con me into thinking that the world stops at 6:00 PM. I now know it doesn’t, I know. So, it’s going to take a couple of nights for you to kind of wire him again for thinking that the world stops at 6:00 PM.

My first born was also social butterfly and still is. And I had to have a very strict routine of him knowing that the whole world ended at 6:00 PM like bath time was for, in his mind as a little one was like this watershed moment where the whole world stopped and nothing happened thereafter because I knew that if James knew that there was something fun happening or possibility of some sort of party outside of his bedroom or cute puppy, there’s no chance he would go down. So the routines are very important. The bedtime routines are very important for social butterflies.

Cass: But with that, you know, it’s difficult because you do have to have times when…

Meg: When that happens.

Cass: Yeah. And so, I guess really my question is that you just have to go with that. I know that probably the next couple of nights are going to be a bit trickier.

Meg: Yeah. And I don’t think it’ll be too many nights in Max’s case. I think probably tonight he’ll settle in by the third night. He would’ve settled back down completely. So, and I think you and I have spoken about this so many times on this podcast, the flexibility of being a mom and kind of mental flexibility. And so the mental flexibility is very, very important, which is exactly what we’re talking about. So it certainly is a case of having mental flexibility and just knowing that actually things are not always going to be perfect and babies are going to throw you curve balls. And Max has shown us that. I can hear him in the background, Cass, as he come to visit? Oh precious boy.

Cass: Yes, he has come to visit. Say hello. ,

Meg: He doesn’t often make a feature appearance on his own podcast.

Cass: I know. So he’s going to listen to these in years and be like, mom, why did you talk about my poo?

Meg: Yeah. So talking about that, how are the nitty-gritties going? The feeding and the poo and how’s that all going?

Cass: That’s all been absolutely fine. In fact, you know, it’s funny, you become so obsessed. You don’t often celebrate poo, but yesterday when I was about to set off on an hour and 45 minute journey on motorways, Alex said to me, he’s done a poo in the morning, and I was like, yes! That means we’ll have a big [inaudible 20:07]

Meg: That’s excellent.

Cass: That’s the feeding yesterday was probably a bit fussier he’d he’s been feeding really, really well. And actually, so we had a really bad bout of sickness where I was talking about being a bit sicky last week, but it got actually worse.

Meg: He was projectile vomiting, almost everything.

Cass: Yeah. It was really hard. So, but when I was sort of ordering things to my in-law’s house, things like his formula and things like that, we were on a sort of zipped up. So the brand we use has the basic, and then they have the, you know, pro version, which I’m a marketer’s dream. I’d bought the pro version. And so when I was researching and realizing the price difference, I thought, let me just see what the actual difference is here. So, I Googled it and there were loads of comments and reviews that came up saying that little ones had had an upset tummy on their formula. So I thought, okay, that’s pretty interesting. Because Max has been, not very…He was only having two of these formulas at night. He was on breast milk all the other time. But in the night he was having this formula.

And again, interestingly, at the end of the day, his feeds were a bit better. It was tended to be the mornings that he was particularly bad and his lunch time. So I thought, okay, I’m going to stop it and see, and within 24 hours, his sickness has almost stopped. He was a little bit sicky yesterday, but nothing abnormal, nothing to raise concerns. And what I found out was that, and I don’t know if this is absolutely true, but somewhere somebody had written that the pro had egg protein in it and the basic had vegetable protein and obviously egg would be…

Meg: I don’t know that would be true. I would very interested to know that because egg is an allergen that you wouldn’t give in a formula to babies. I mean you do introduce egg, but you would never put it in a formula because of the risk of allergies. So, I don’t think that’s probably true, but I will…I mean, you bring up something that’s so important and that is how to pick formulas. There’s lots of regulations across the world that prevent healthcare professionals from advocating certain brands, and the reason for that is because the World Health Organization wants us to promote breastfeeding. And so promoting any form of formula becomes something that really healthcare professionals don’t like to do. And so I certainly am not going to associate my name with any specific brand, but there are principles that are important. And the one is that often when parents go from breast milk onto the first formula type of formula milk, that their thoughts are I’ve got to prevent allergies because maybe…I don’t know why we think this, but maybe formulas can cause allergies. And so people often tend to go on to, try to be clever. And they go onto one of three things, which I know you didn’t do, but they go onto one of three things; either hyper-allergenic milk or a goat milk or a soy milk thinking that, okay, then we can avoid the whole cow’s milk story.

But in actual fact, what we do recommend is that unless your baby has a confirmed cosmo protein allergy, which you actually can establish when you breastfeeding. So in other words, if you had a breast fed baby who absolutely reacts every time you have cosmo protein, it’s highly rare, very, very unusual. Those babies then may have a cosmo protein allergy, but for all other babies, the very first formula they should go onto is the absolutely bulk standard, most basic, cow’s milk formula, that’s really where we should all start, not on the fancy anti-reflux or on the fancy you know, kind of amigo enriched or whatever it is. I mean, it’s, there’s so many of these very expensive, as you say, soup top formulas. My recommendation is always to default point always to start at the most basic. And then most babies, 90% of babies will thrive on that anyway, and then only move them something that’s either very fancy or actually especially prepared or non-allergenic if there’s an established issue.

And you know, on that, something like for instance, a lot of moms say, well, my child is lactose intolerant, so I’m going to have them on a goat milk-based; actually any animal milk, whether it’s human breast milk, or goat milk, or cow’s milk all have lactose cause that’s the sugar that is in mammal milk. So lactose-free formulas are not necessarily a good idea, hypoallergenic formulas, also not a good idea. And having said that if there are reactions, then my suggestion is never to formula hop, but first to actually seek the advice of a professional and they actually guide you through it because we can go into this trap, which I actually did mention last week of this formula hoping where we go and we start changing, changing, and we don’t know what’s working. And before we know it, we’ve got like one through 15 different formulas, which is not the idea. So I think the fact that you moved onto a very simple formula has clearly worked for Max and is probably the solution.

Cass: Well, it was, because when we were doing just the one bedtime feed, we were on the basic one and it was only when I switched to nighttime feeds for all formula, I thought, okay, we’re getting more formula now I’ll get him a better version of formula. And actually it was not long after that, that things started to go…And obviously he progressively got more and more…I don’t know what it was, but it was maybe too rich for him. I don’t know. But he just was having an upset tummy and that has really stopped him. He does still sometimes be a little bit, but he’s consistently doing five to seven ounces a feed. So that’s all we need him to do.

Meg: Okay, good. Yeah, that’s exactly, that’s his amount. That’s exactly perfect.

Cass: So yeah, it was a really interesting find by accident that that was the cause.

Interlude

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Meg: And actually, I mean it kind of raises another thing that, obviously breast milk is fabulous, but having said that, breast milk, even breast milk at six months old, doesn’t have all the iron that’s needed because in fact it doesn’t have iron. So, you know, formulas can be fortified, but breast milk clearly can’t be. But actually from about this age, now that he’s onto solids, your focus can be that milk ticks the basics box. It’s like an underlying platform, whether it’s a good car’s milk formula, whether it’s expressed breast milk is the base, but actually all the enriched stuff now needs to come through solids. And so, if you’re wanting that little bit of extra Amigos or those extra essential fatty acids, you add those into the meals. You make meals that are rich with that. And what you’ll see on the app as you go through it now on meal times is that we have fairly rapid introduction of quite nice varied things. You know, we kind of bring in peanut butter within the first three to four weeks of solids. So that’s got lovely essential fatty acids. It’s got super proteins in it. So you can actually start to use solids as the kind of spicing up of life and ticking all of the extra nutritional boxes and just keep your milk as your flat base that you build on.

Cass: Yeah. I wish I’d asked before we started doing formula because, if you don’t know, you do just look and marketing makes you think, oh my God, I’ve got to have the best for my baby, you know, and I think that’s risky.

Meg: It is. And you know, the principles are that almost all formulas that are created are created really, really well. I mean, as long as you’re going for a reputable brand, there’s an enormous amount of research that goes into it. It’s very stringent requirements for that formula. So most reputable brands, you are not going to go wrong with, but I do think that the marketing companies have a lot to answer for, because they make us feel that this particular formula has got more amino acids that is going to improve brain or, you know, and, and it doesn’t stop by the way, when you get to 12 months old, they’re going to give you all toddler formulas. And actually, I don’t believe in toddler formulas at all. I think little ones must go into normal cow’s milk as long as it’s organic with no hormones, straight off the shelf in the shops from 12 months old. There’s no reason for them to be on any formula, but these formula companies unfortunately make an absolute living fortune, and we’re so down a river in terms of the marketing story.

Cass: I don’t think it even stops as an adult. I mean, should I have Oat milk, Soy milk, Almond milk, I don’t know.

Meg: Exactly. Well, Cass, it’s been wonderful chatting. I hope that you have a wonderful holiday with your boy and that you get to do some fun things. I think, you know, holiday time is always important to know that you and Alex knowing the two of you are still working, but yeah, enjoy it any anywhere and enjoy connecting with the family.

Cass: Thank you very much. Yeah, we are moving location again on Thursday, so there might be more stories by next week.

Meg: Yes. Well, you know, I think flexibility you’re on holidays, so yeah, if you need to do another pub dinner, you know that he can cope with it. It’s definitely not going to change his trajectory in three months’ time at all. The only reason you’ll remember that this happened is because of the podcast.  Even the positing will be a blip in the radar.

Cass: Exactly. Exactly; any habits that happen while we’re here, we’ll just deal with when we get home.

Meg: Yeah. Well, Cass, lovely to chat again and we’ll chat again next week.

Cass: Thanks so much, Meg.

Meg: Thanks Cass.

Cass: Bye. Thank you.

Outro
Thanks to everyone who joined us, we will see you the same time next week. Until then, download Parent Sensor App, and take the guesswork out of parenting.