When and how to stop breastfeeding

Intro

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 in 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 am Meg Faure, an occupational therapist, and I have an absolute passion for working with moms of little babies. And in this podcast series, each week we meet different moms. Usually, actually Cassidy who’s on with us today, and we follow them with their journey as they go through life with their little ones. And this week we’ve got little Max who is 17 weeks old. Cass, I cannot believe it. The dreaded 17 week sleep progression, which actually happened a little earlier, but that landmark has arrived. So tell us how the week has been.

Cass: Wow, of course, we left you on a cliff hanger last week because he was going for his weighting in and he had actually lost weight.  So previously, his weight gain had slowed down, but he was still gaining. But this time when we went, he’d actually lost 50 grams. So we’ve been referred to the pediatric team here to see what is going on there, but I have decided to stop breastfeeding. I’m expressing and bottle feeding so that I can monitor exactly what he’s having.

Meg: What’s going on exactly.

Cass: Yeah, exactly. So that’s been a bit sad because obviously my last feed, I didn’t realize was my last feed, but it actually was not a very good feed. He didn’t feed very well at all. It was the one just before we were going to the doctors and he was really fussy and he hadn’t really fed and I thought, oh, I wish he’d done a good feed, because   he might weighted more, if had a full tummy. And I did mention that to her. You know, I said, if he’d have done a big feed, would he have maybe a bit better? Or she said, you know, no, the fact is he’s not putting on the weight like he should. And so we have moved to bottle feeding. We haven’t been doing it for very long. It’s only been a couple of days, but he is definitely feeding better. And I think the main thing is when he is acting almost like he’s bored and moving his head away, the bottle can go with him. So, he’s fine with that. I think the issue was when he pulled off the boob, there’s only so many angles I can get my boob to. So if he didn’t want to face into my chest, he just, he didn’t feed. And I think that this doing bottles might be a bit of the game changer. It also, as I said, means I know how much is going in him, and so that worry or unknown has gone. And I know that if he doesn’t do a very big feed, it’s only a few answers,  then I’ll feed him again later and I might try and give him a bit of a bigger feed or I can just monitor things. So it’s sad, but positive.

Meg: So, are you offering expressed breast milk or are you looking at formula at the moment? Express milk

Cass: Express breast milk apart from at night where he’s on formula. So he has formula just before he goes to bed. And then in the middle of the night, at the moment we’re on around midnight, he has his first feed, because I don’t know if we’ve managed to get rid of that 10 O’clock great wake. He’s still waking before midnight, but we just give him the dummy and he goes straight back to sleep.

Meg: Which is perfect.

Cass: Like instantaneously, and then he’ll wake in about midnight and then he may wake again for the dummy in between, but we will feed him at three o’clock or four o’clock. So, those will be formula just because we’re being a bit lazy at the moment until we get to grips with there’s bottle feeding, but you can buy the ready-made bottles of formula that you just pour into the bottle and off we go. So, when he’s crying in the night for his feed, I’m not sort of wasting time while I get to grips with how formula works for the first time. But the plan is to move on to formula at night and then that first feed in the morning I pump and give that to him or it’ll be one from the freezer or something that we’ll defrost.

Meg: Yeah. That’s excellent, I mean, I think what you spoke today, is that he is a social butterfly. He was very gregarious; when we first met Max, we really felt like he was a settled baby because he was fairly laid back. But actually in a sensory personalities, they often do end up moving towards big social butterflies, particularly if they’ve got very engaged parents and very engaged family that, you know, kind of are very animated, they start to learn that actually this whole world could be a whole lot more interesting. And I think it is like that for Max, that his world is interesting, and so he’s seeking information. What often happens is that they show quite early signs of actually needing, wanting to start solids. Has he been very interested in your, in when you are eating, is he showing you those signs?

Cass: He has, and actually we now set him in front of us when we are eating. I mentioned it to the GP when he went for his way and that I was really keen to start him and she felt it was too early. So she said to speak to the pediatric team about that. So when we go there we’ll have that conversation, but we have this weekend, we did go in and ordered the high chair, just so that, so that we [inaudible 05:50] forced him ahead when we get the go ahead. But yeah, I mean he definitely, I think is showing signs of social butterfly.

Meg: So let’s, yeah, exactly. So let’s just talk about solids though, because of course now you we’ve brought up something that is highly controversial. And as you know, from my books and the app we do talk about 17 weeks as between 17 weeks and six months is at right time to start. Your GP potentially does not believe in that, actually potentially believes in six months. And when you go to the pediatric team, you can hear a totally different story or one or the other stories. And I think a couple of things kind of come to mind that I think we should just touch on. The first is, you know, there’re kind of two guidelines that I use. The one is the age; based on research that are safe for solids. And the other one is the individual baby, because those are two completely different factors you have to factor in.

So let’s start with, with when can babies have solids? And I think the history to this is that allergies were on their increase. And, well, there were two reasons why the World Health Organization recommended you wait until six months, the one was there allergies and potential health reasons why they felt later introduction of solids was better. And that information has been refuted in a number of studies. So we now know that there’s no increased chance of allergies in little ones who are starting solids at 17 weeks at all. And in fact there is an in increased chance of allergies for babies who have late introduction of solids. So that’s kind of after seven or eight months. So it does mean that you do want to have solids and introduced at least by the time they’re eight months old. So that’s the first thing is if we know that there isn’t an increased chance of allergies and in actual fact babies who are like have very slow exposure to allergens like peanuts and fish and eggs are more likely to have allergies.

And that’s why in the Weaning Sense book and in the Parent Sense App, we have fairly rapid introduction of new challenges in terms of allergen foods, because it is protective and we’ve now got enough evidence to know that that is a hundred percent right. But the second reason why the World Health Organization recommended that babies don’t have solids till six months is that they recommended exclusive breastfeeding. It wasn’t that they were anti the solids, it was that they were anti-anything but breast milk. And the reason for that is that the World Health Organization advises mothers in developing countries where even giving your baby formula presents a risk because water isn’t necessarily pure and people are poor. So they are not actually using the correct quantities of formula powder with the water, and so little ones end up having malnutrition. And the best way to protect against that is to have exclusive breastfeeding until six months. So that’s a little bit of the history why the World Health Organization says that. That information, of course, comes down into government organizations, which is your health visitors and your pediatric teams. And so that’s what they generally stick with. And you’re going to probably, I will put money on it, we can chat later next week, I’ll put money on the fact that they’re going to say, wait until six months old. But in actual fact, the science and the literature does not indicate that. And the pediatric dietician who has written all my books with me and is advisors on the App is actually one of the, is on the board of…One of the advisors at EFSAGAN, which is the Infant Feeding Association in Europe, so we know that we can stand behind that information.

Cass: You know, I think from all of the stuff that I’ve seen that you’ve done. And also the fact that these night wakings have been coming into play; he’s a bigger baby. I was weaned at three months because I was huge. You know? And so I have…One of the reasons I’ve actually ordered the high chair as well, because I’ve sort of decided when that highchair arrives, I want to start.

Meg: Just wait a little bit.

Cass: Yeah. So it’s reassuring to hear.

Interlude

This episode is brought to us by Parent Sense, the all in one baby and parenting app that help you make the most of your baby’s first year. Don’t you wish someone would just tell you everything you need to know about caring for your baby; when to feed them, how to wean them, and why they won’t sleep? Parent Sense App is like having a baby expert on your phone, guiding you to parent with confidence, get a flexible routine, daily tips, and advice personalized for you and your little one. Download Parent Sense App now from your app store, and take the guesswork out of parenting.

Meg: Having said that, you have to look at the baby themselves as well. So that becomes really important. And that means that some moms who listening with 17-week-old their babies are nowhere near being ready, and whereas other babies at 17- weeks-old are actually ready. And there are a couple of very clear kinds of signals if we look out for them; one is that they should be able to sit quite robustly upright on our lap while being supported just around their lower waist and hip area. And so they’re not shopping all over the place and falling over and their neck is kind of, their neck is not able to hold off their head. That would be an indication that they’re not ready for solids. So, you know, for anywhere between four and six months, he will actually be able to sit upright, supported on your lap, and that’s one of the indications.

The other indication is a social indication, which is real interest in what you’re eating, which knowing Max, and the fact that he is a social butterfly means that he probably is already indicating that. And then there are a couple of other small ones like that he can hold onto things. He’s taking things to his mouth and he’s not, hasn’t got as much of a tongue thrust reflex. In other words, when he gets his something to the mouth, he’s not immediately pushing it out with his tongue. And when they start to indicate all of those and they’re between four and six months of age, then it can be time for solids.

Cass: And actually it’s interesting you say that because…So I’ve kind of gone through that checklist. He is sitting up. No problem. We actually went to a, it’s called the mum club here and it’s an event for mums to go to with their babies and to sort of have a bit of a social time. And he was, to me, he looked older than all of the other four month old babies there. They were kind of lying in their mum’s arms with the dummy and you know, still bright eye and alert. But Max was sitting on my lap looking around smiling. He was the social butterfly again. So there was that side, and he does watch, but the interesting thing that I started doing is I just touched…I was eating a Satsuma and he was staring at me and I just bit in house and I just touched the Satsuma to his lip to see if the tongue came out or it, what he did and his mouth was wide open and he was trying to get it. I was, oh no, actually, sorry, can’t have that. I was just here. He did the same; I touched a spoon with a little bit of puree to it, and he again was trying to get it in his mouth. So to me, he is hundred percent showing the signs that he’s ready.

Meg: Yeah, and one of the things that you mentioned just now, which is so, so, so true is that this age is actually only for experimentation. So, and that’s why  Kath Megaw and I do talk about starting a little earlier, than rather later, because it takes you a long time to ramp up to the right quantities of solids for it to make a difference to sleep or to meet their nutritional needs. And particularly iron needs, Cass, because is iron stores are going to be depleted at six months, which we know all babies are, they’re born with iron stores and then they’re deplete by six months. And if they’re an exclusive breast milk, there’s no way to fortify breast milk. You know, formula milk and cereals, infant cereals, for instance, are fortified with iron, which breast milk clearly isn’t. And so, in order to get up enough solids in quantity and in variety to kind of tick the nutritional boxes, it’s another reason to start earlier, but it does mean that you’re going to be very experimental. So you might find, and remember this with myself, is that I started James on solids and then it became an obsession that I could never miss a meal or a day. But in actual fact, because it’s just experimentation, it doesn’t matter. And it’s, you know, you can have two meals in this day and only one tomorrow, and that’s not a train smash. So it’s a nice slow introduction with, you know, very laid back and a focus on experimentation.

Cass: Yeah, I mean, I’ve been so excited. I think you and I went for a coffee about, well, pre-COVID, so two years ago or something. And I think I was talking about how excited I was about weaning then, and I wasn’t even married then.

Meg: So that’s true.

Cass: I am very excited about the whole process and seeing him explore new flavors and textures and things.

Meg: Well, one of the hazards that comes with having a social butterfly is that when you open up that weaning box, it’s like opening Pandora’s box because they are like, what? There’s all these wonderful delights that I can experiment with, and so they tend to like to go off milk quite quickly. And so you’ll have to watch that until six months old, milk is the absolute priority. And so when you do introduce solids, you must always give him the milk first, so that you take away the hunger with the milk, and then given the solids to experiment with, rather than taking away the hunger with the solids, and then he’ll drink less milk sure. As it stands you and I probably will be speaking in a couple of weeks’ time, and you’ll be saying, he’s kind of going off his milk a bit because when they realize that there’s a whole lot more exciting stuff, they do become a little bit more resistant to the milk bottles. So just make sure you’re always giving the milk before the solid so that he is actually drinking the milk.

Cass: Yeah, no, no. It’s very exciting. It’s very exciting. I’m looking forward to it.

Meg: Have you decided, or are you thinking, are you getting your head around which vegetable or fruit you’re going to introduce?

Cass: Yes, Broccoli.

Meg: Oh, okay, lovely.

Cass: I read somewhere…Well, first of all, when I was a baby, when I was weaning, I apparently loved broccoli, but absolutely, and particularly a very sort of well-cooked… I like the idea of the fact that you can do a combination where you could have a very well cooked little flora, to broccoli, to self, baby led, and then I could do the puree as well. But also I read somewhere that the bitter green vegetables are always going to be, if you introduce that first, then they might have a better chance of liking them down the line.

Meg: Interesting, very interesting.

Cass: Interesting.

Meg: So I usually say, go with the starchy vegetables, like the butternut, sweet potato, gem squash, zucchini, all of that sort of thing, but you know, it’s certainly nothing cast in stone. Those tend to be a little easier on the tummy. Your green and particularly your green leafy veggies can be a little bit of gas producing, but give it a go with the broccoli. The app is actually going to show you Butternut and Sweet potato for sure, that’ll be the first thing. So as you switch across to weaning, you’ll see that it’s actually going to be the butternut.

Cass: They’re definitely…I think he’s going to love those so much, I almost want to save them for so when he’s…

Meg: Had treat?

Cass: Yeah, because I feel like he’ll just think, “oh my goodness” when he has something like Sweet potatoes or butternuts, so yeah, we’ll see.

Meg: Interesting.

Cass: We’ll see.

Meg: Yeah. So what else happened this week?

Cass: Well, the other cliff hanger that we left you on last week was we were going to get rid of the sleepy head. So the sleepy head has gone officially. The morning we recorded the last podcast, I’d put it in the cupboard, and the last podcast absolutely solidified to me that it had to go, because he was starting to roll last week. And he’s kind of getting a bit more confident on his rolling. Anyway, we took the sleep head away that night, it was a terrible night.

Meg: Yeah, it would be.

Cass: It was the moment we put him down, it was every 45 minutes. The next night was still not great, but not bad. And I spoke to a friend of mine actually, who had made a really good recommendation, but we both agreed it was probably too late. But actually, to put a rolled up towel underneath the sheet and then moved that away a little bit more, a little bit more. But by that stage, I’d done two nights without the sleep head, and I thought, I don’t want to go backwards. We’ve got to plow on now. Anyway, by night four, we were fine. He now actually sleeps. He looks a bit like Jesus on the cross with his legs, he’s gone from needing to have his arms sort of close to him, to sleeping completely out. But he doesn’t jolt when his arms sort of…We watched him through the monitor and as his arms were going down towards the cot where the sleepy head would’ve stopped him and he sort of would jolt and that’s what was waking him up every time. But now that doesn’t seem to bother him. So yeah, it’s been a success so far.

Meg: That’s brilliant.

Interlude
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Meg: Look, I mean a couple of awesome tips there and love the idea rolling up the towel and putting it underneath for moms who are trying to get rid of the sleepy head or duck tote, and you cannot believe that how common this question is to me now. Like when I do I get rid of it? And I always say, whenever they’re about to roll and they say, oh, because it’s going to be painful. And of course it is a little bit. And so I love that piece of advice. And what’s also interesting and maybe something to you to look at, I don’t know if you know this, but the babies use posturing to regulate their body temperature and moving your arms away from midline into stretched, stark position is often an indication that little ones are very hot. So, it might be interesting for you to just have a look at what the room temperature is and how well covered he is.

Cass: That’s really interesting because, actually yesterday walked into his room and he was doing very much of his Jesus Christ superstar rendition. But I thought, oh my God, the room is freezing. So, that was really interesting, but…

Meg: Probably it isn’t that for him. It’s probably….And that’s the other thing, is that sleep positions are actually one of our self-soothing cues. So some little ones will actually take themselves in wedge themselves right up against the cot bumpers of their Cannel, the bars of the cut or, you know, some prefer to sleep on their side. It’s obviously just his preferred position, which actually is quite fascinating with Max because he never liked swaddling, which was so unusual in babies.

Cass: Yeah, he didn’t. And I think actually he just got used to the sleepy head, but I feel if we’d never introduced it, he would’ve been absolutely fine because he was sleeping like that, you know, with his arms up. So, yeah, it was tough, but if there are any mums doing it on your own, or in your first night or something like that there, it happened, it moves quickly. It seems to be the three night rule worked for us. You know, it went quite quickly, but it was tough while it was bad.

Meg: Yeah. And so just out of interest, what were you doing in those three nights? Did you just pet him back to sleep because you didn’t see him every 45 minutes, you just pet him?

Cass: Yeah. Yeah.

Meg: You patted him back to sleep.

Cass: Yeah. He just…Oh he got the dummy because he does seem to, when he does wake, if we give him the dummy, he’s going back to sleep really quickly.

Meg: Okay, excellent, good. Great Cass, so let me know, was there anything else? Were there some interesting products that you used this week? I’m always interested to hear about what products you finding invaluable.

Cass: I went with a bit of a theme this week of the bath, because interestingly he has had baby eczema and so that took me onto thinking about the bath, the things that have solved his baby eczema. So in terms of toiletries, I’ve been putting Oilatum in the bath, and then just, we use Aveno Body Wash on him.

Meg: Brilliant.

Cass: And then we used Sarabi moisturizer, and that combination has completely cleared up his eczema. So that was one thing. But the other thing, you know, made a big difference for us; well, one was the rubber duck that has the temperature on it. Not just, of course you can check the temperature with your elbow, but one of the reasons that we found that really useful is it gave us an indication of when it was time to get him out of the bath, more so than when the bath was ready for him to go in. We could keep an eye on when it started dropping and we thought, okay, that’s gone down to 35.9, let’s get him out. It’s starting to get cold. So that was quite a…

Meg: And what are you putting him in at, 38, 39?

Cass: No, 37 is what I was told, but could he go sometimes, when it goes to 38, I start putting cold in. So 38 is okay?

Meg: Yeah, 38 is okay. 37 is our body temperature, and you know, I mean, at the end of the day you can actually just feel with your arm and see if 38 feels too hot for you, it’ll feel too hot for him as well. But yeah, you can go a little higher.

Cass: Okay, yeah. So, we’ve been keeping…So when it hits just above 36, we get him out of the bath, because we are like, oh, it’s gone down. And so that’s been really helpful. And then the other thing is the Angel Care Support Seat.

Meg: I love it.

Cass: In the bath, it just makes it so much easier. We did a couple where we were just holding him and it just really highlights to us how amazing that support seat is. He’s now strong enough that he pushes his legs on the bottom of the bath and his hips go up, and we are sort of thinking we’re going to have to get the next stage up because he’s, you know, it’s a hazard to have him on that seat.

Meg: Yeah. It will be at about this stage and it’s worth getting one of those lovely bath rings. He won’t be quite ready for it yet because he needs to be sitting a little bit more upright, but certainly as he gets closer to six months, the bar rings are amazing. You know, they kind of just lose support around him.

Cass: Yeah, exactly. But, I mean the last four months bathing him with that support seat, I would say that is just a must for, and I think it’s cheaper than getting a baby bath, one of the small baths and those don’t last very long, whereas this is in the bath and they can…You know, I mean he’s still in it now.

Meg: Yeah. I do. I mean I do love the snuggle bath. It’s a little, almost like a little bucket shape, but it’s shaped like a bucket, but with slightly elongated one side, so that it’s almost like a hybrid between a bath and a bucket and those tend to be quite nice as well. And you can kind of support them under their chin to keep their head above it, and they almost have this freedom of swimming. But like you say, and particularly with Max, who’s a big boy and they’re out of them so quickly that it would’ve been a waste of money. So I agree with you, those an Angel Cares a great brand for those baby inserts. So yeah, great advice Cass, well, thanks you so much, very, very eventful week. And you have left us again in a cliffhanger because I’m dying to know how his weight is looking and what happens with your visit to the pediatric team next week.

Cass: Well, I’m hoping it will be next week. I haven’t heard from them yet.

Meg: Oh, you haven’t heard?

Cass: Yeah.

Meg:  I’m sure that he’s thriving, you know, and I think again, kind of throw it back to check when we last spoke or the last podcast we had together, I do think there is probably more anxiety in us than is necessary, but you are spot on that when a baby’s weight actually drops, it’s a very different story to when the weight gain slows down, those are two very different things. And when weight gain drops, it’s an issue.

Cass: Yeah. So, well, we’ll keep you posted.

Meg: That’s brilliant. Thank you, lovely to chat.

Cass: Thanks Meg.

Outro

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