Natural Solution for Clogged Tearducts in Infants

 When Thing 1 and Thing 2 were infants they had clogged tear ducts. They almost constantly produced these really thick tears that would dry and leave their eyes crusted together. I squeezed their tear ducts with a q-tip, just like my pediatrician showed me, but it didn't seem to help much. It finally resolved itself when they were each around 6 months old.
 When I took Cindy Lou Who in for her first checkup, she was starting to develop the same problem. Now keep in mind, my pediatrician is very conservative in his practice. (A different pediatrician since we moved a couple years ago.) I know this from my experience with my kids and from working with him at the hospital. He's not one to throw around alternative therapies and often gets frustrated when his patients put so much faith in them. So when he told me the following I figured it was worth a shot. "Ok, I know this sounds crazy and when I worked in Detroit I never imagined that I would ever suggest this to a patient, but it works. If you squirt a little breast milk in their eye it takes care of the clogged tear duct. If that's too weird for you, here's a prescription for antibiotic drops."
 And I'll admit it sounded a little weird. I know that breast milk has antibiotic properties, but would you really squirt dinner in your eye and expect it to clear up and infection? Generally not. However, when the thick tears and eye crustiness started getting worse I gave it a try. After a feeding I just squirt a bit of breast milk in each eye. It was pretty freaky looking to see her eyes coated with milk. But it didn't seem to bother her at all and she had no more issues with goopy eye secretions or crustiness after that point. I'm not going to guarantee that it will work for everyone, but it's a pretty harmless intervention and worked really well for my baby.

Breast Feeding vs. Infant Formula

  Whether you choose to breast-feed your infant or not, is a very personal decision. When I first started working on a Postpartum unit the lactation specialist gave me a list of 101 reasons why women should breast-feed. Most of them were completely ridiculous and several of them were listed two or three times. You have to choose what will work for you, your baby and your situation. I don't believe that you should let anyone try to convince you to do anything that you're not comfortable with or won't work for you and your infant. I'm not writing this post with the intent to make anyone feel guilty about their decision, but to go over some the facts about each side of the issue.

 The Case for Breast Feeding

• Breast milk is perfectly designed for your infant at each stage of his/her development.
• Breast milk is much cheaper than the alternative. (I won't say that it's free, because it requires way to much work to qualify as such.)
• Breast feeding helps the mother's body to heal. It makes her uterus reach its pre-pregnancy condition more quickly.
• Breast feeding decreases a woman's risk of breast, cervical and ovarian cancer. I mention this one because I've heard it numerous times and I feel that this fact is very misleading. Research shows that if a woman breast-feeds for 14 years of her life, it decreases her risk of cancer by 20%. So if iI have 7 kids and breast-feed them for 2 years each I will decrease my risk of cancer of my reproductive organs by 20%?! That doesn't seem like really good motivation for me.
• Breast feeding burns calories! During pregnancy our bodies are designed to store fat, so that we can feed a baby. What better way to get rid of those extra pounds?
• Breast feeding promotes bonding between mother and infant.
• Breast feeding provides infants with immunity against illnesses. It provides immunity against diseases that the infant is too young to be safely vaccinated for and for other diseases that the mother has immunity against where there are no vaccines available.
• Breast-feeding is environmentally friendly. Little or no packaging or containers required.
• Breast-feeding decreases a child's risk for allergies and auto-immune diseases.
• Breast-feeding makes for overall healthier children. I breast-fed Thing 1 & Thing 2 and the first time that I had to take either of them to a doctor for anything beyond a well-child check was when Thing 2 needed stitches at age 2.
• Infant formula just does not taste or smell that good. Yes, I have tasted it. I make it a point of tasting anything I force my patients to take (within reason).
• Breast-milk has antibiotic properties.
• Breast-feeding means fewer bottles to wash. (Unless you work and pump. Then you have to wash your bottles and your pump parts. :S)

 The Case for Infant Formula

• Infant formula has improved dramatically since it was first developed.
• It is very physically demanding to breast-feed an infant.
• It is sometimes inconvenient to breast-feed an infant. 
• Breast-fed infants are often resistant to taking a bottle when mother is unavailable.
• Breast-feeding is very time-consuming.
• Society (and sometimes family and friends) are unsupportive of breast-feeding moms. They are often intolerant of breast-feeding in public, yet most establishments do not provide a clean place to breast-feed in private.
• Some women for physical reasons can not breast-feed.
• Some women can't breast feed for a multitude of other reasons.
• No one is ever offended if you bottle-feed your infant in public.
• Some infants don't take well to breast milk.
• It's easier to wean infants off of formula versus breast milk. (Or so I hear.)
• Formula fed infants are less likely to come down with jaundice.
• Mothers of formula-fed infants have no additional dietary restrictions.

 I think that more or less covers it. Can anyone think of any points that I left out? And you don't have to be strictly one or the other. You can breast feed sometimes and bottle feed at others. It's up to you. I choose to breast-feed because it makes my children healthier. There is something so adorable about watching my babies breast-feed. I love it. I love to snuggle with them every few hours and listen to their satisfied eating noises. And it saves me a lot of money. I breast-feed exclusively because I have not been able to convince any of my babies to take formula on any occasion after my milk came in. Ever. (The first day that I went back to work after having Thing 2, it took him 11&1/2 hours before he was desperate enough to even drink pumped breast milk from a bottle, let alone formula. He always was a stubborn child.) Breast-feeding Cindy Lou-Who, with all of my diet restrictions is one of the most difficult things I have ever done, I have a hard time coping without food  but I do it because I love her and I feel breast milk is best for her. But after this experience I have new empathy for mothers who throw in the towel and switch to a bottle. I feel that breast is best, but there are plenty of good reasons not to breast-feed.

Postpartum Depression

 Postpartum blues effects up to 85% of women in the period after they have given birth. Postpartum depression is a more severe condition that effects up to 25% of women. "Symptoms include sadness, fatigue, changes in sleeping and eating patterns, reduced libido, crying episodes, anxiety, and irritability." No kidding. Suddenly you have a bundle of joy who needs constant care and attention, doesn't let you sleep, siphons off your energy, doubles your load of housework and reduces the time that you have to do it. Not to mention it's a pretty big change for your body. Giving birth/having surgery and recovering from it is very physically demanding, and then there's the hormone imbalances too. And if you're like me there's a pretty big change in routine. I went from working full-time to spending my days sitting on the couch breast-feeding. Instead of seeing friends, coworkers and other people on a regular basis you stay inside because you don't want your baby to get sick and you feel like you are constantly breast-feeding. And you can kiss your personal time goodbye. No wonder women get depressed after having babies. This motherhood business is a challenging undertaking.
 I share my story in the hopes that it will help someone else. The first couple weeks after I had my baby I was feeling pretty good. I was so excited not to be pregnant anymore. No more sciatic pain, no more gallbladder issues, my back injury resolved, my varicose veins were improved, and no more of all those other pregnancy inconveniences. Not to mention my baby is so sweet and beautiful and I am so excited to have her here. At about two weeks things became more difficult. My baby stopped sleeping through the night, my three year old was turning from mischievous to terror. I was dropping weight fast because while trying to meet the demands of three small children I just didn't have the time time to make myself three balanced meals a day. People were complimentary, and I would be polite, but think 'Are you crazy? It's not healthy to drop 26 pounds in two weeks.'   I was discouraged with my inability to keep my house clean, and take care of the needs of my family. I thought 'What is wrong with me that I can't do this? Many of my friends have more kids, and they can still maintain a clean house.' I adore my children, but was struggling to cope with them. I craved peace, quiet and enough time to sit down and eat. At work at least there are federal laws that demand that I get a lunch break. One day I calculated I had about 700 calories in the entire day. (And normally I eat a lot more than that. In high school my husband nicknamed me "The Vortex" because I could eat him under the table at a time when he had regular swim practices.) That same day someone called to check on me and gave me some unrealistic advice. Not very helpful. It just made me feel frustrated and that people didn't understand what I was going through and had higher expectations of what I should be doing than I could possibly achieve right now. I started having thoughts of killing or hurting myself on a regular basis. I wasn't prepared to take any such actions, I just felt unstable. I thought about calling my doctor, but decided against it because I work with him on a fairly regular basis and I'd rather he didn't think that I was crazy. Besides that I was pretty certain that my problem could be better fixed by methods other than taking medication.
 I talked to my husband and let him know that I had a problem. I told him I needed more help with the kids and the house and that I just needed to eat better. He made a point of helping me out more and regardless of the chaos going on made sure that we had a regular date night. I found that as long as I could get three healthy and satisfying meals a day and few good snacks, I was happy and doing ok, with or without sleep. I made some energy bars and some meals with leftovers that could be reheated quickly (and also supplemented my diet with a daily dose of ice cream). When my baby was almost four weeks old, I started taking my kids to a weekly play group again. (With work, it had been over a year since I had had time for that.) It felt so good to talk to other adults again. I discovered that my neighbor who I have always thought of as one of those "supermoms", had struggled with postpartum depression too.
 Just when I thought I had this business under control my baby developed reflux. She was vomiting quite a bit and irritable. There's something about being covered in vomit on a daily basis that's just depressing. And there's something so frustrating about having your baby cry all the time and not being able to fix it. So I cut out all of the "naughty items" from my diet. There are more things that I can't eat, than items that I can. (This included my energy bars, because those had cranberries, peanut butter and chocolate chips.)  Once I made these adjustments she was a significantly happier baby, throwing up less and sleeping more, but I felt like I was starving. I looked at my very well-stocked pantry and felt discouraged because I could eat almost nothing in it. The few things I can eat are pretty bland and tasteless. Once I woke up to feed her in the middle of the night and cried myself to sleep afterwards thinking about the mint brownie ice cream in the freezer that I couldn't eat. Sometimes I would think about slashing my wrists or hurting myself in other ways, but would step back and realize "I don't really want to do this. I'm just losing my mind because I'm hungry." Not to mention that would just be an extra mess to clean up.
 Last week I had my six week check-up and mentioned that I was having struggles with postpartum depression. My doctor made a few jokes and asked if I wanted a prescription. I don't need drugs. I need FOOD and CHOCOLATE. Can you write me a prescription for a chef and a maid? Do you think you could clear that one with my insurance? (Not that there is anything wrong with taking medication if that is what you need, but I'm pretty sure that I need calories, not pills.) Oh well, too bad for me. My baby is seven weeks old and my diet is still a huge stumbling block. It's hard to have energy and feel happy when getting balanced nutrition is so difficult, but I am pulling through. Now that we have her reflux under control I am able to eat a few more things. I'm coming to terms with the fact that food is more about the nutrition it provides than actually having any taste. I don't feel like hurting myself anymore and  I know that I can get through this.

Here are some things I recommend trying if you are having struggles with postpartum depression:

• Talk to someone, your spouse, a friend, your doctor, someone. Talking helps. (If you have no one else, shoot me an email. I'll listen.)
• Get some sleep. Let your house go a little. It's ok. When your baby is sleeping, squeeze in a nap. Your physical and mental well-being are more important that the state of your house. (This one is hard for me. I have a hard time relaxing when my house is a mess.)
• Eat a balanced diet with plenty of water. If you are breast-feeding, you should continue to take your prenatal vitamin, drink two liters of water and eat an extra 300 calories per day.
• Don't try to be perfect. No one is. Supermoms are a fairy tale.
• Get out of the house. I highly recommend joining a playgroup. In talking to other moms you will discover one of three things: 1. The other moms are going or have gone through the same thing. 2 Other children are more difficult than your own, consider yourself blessed. 3. Your children are more difficult than your average child, consider yourself strong. 
• Exercise. I know this is hard to find time for this and I personally don't do enough of it, but if even if you can put your baby in the stroller and go on a walk, it helps. (Although don't overdo it, you just had a baby.)
• Try to do something for yourself on a weekly basis. I would say daily, but if you're like me that just ain't happenin'. Take a long bath, paint your toes, read a book, have a bowl of ice cream.
• Remember that this condition is temporary. If it doesn't go away, get some professional help. There is no shame in getting help so you can take care of yourself and your family.

If you are having problems with postpartum depression, let someone know. You need help and support (not to mention food and sleep). Being a mom is hard work. Being a mom to multiple small children is even harder.  Don't be discouraged if you can't do it all, because no one can. Find a friend, family member or neighbor who can listen, give you a break or even just do lunch with. It's amazing how therapeutic it is just to talk to someone else about the problem. For other resources go to www.depressionafterdelivery.com or www.postpartum.net

What I've been up to

 I swear I have a dozen blog posts bouncing around in my head, but not enough time to write them. That is, time where I'm in the 'writing zone' plus had enough sleep plus have 2 hands free. I've written a couple in a state of sleep deprivation and come back to proofread them and I'm not quite sure what I was trying to say, so we'll get back to those. So I'll just summarize what I've been doing in list form, because Heather is all about the lists. :)

1. Feeding the baby- She gained 3 pounds in 4 weeks. I spend a lot of time feeding the baby.
2. Chipotle Roasted Vegetable Quesadillas- I found this recipe on Skinny Bovine's Kitchen. I left out the corn, and added 2 tomatoes, 1& 1/2 medium carrots, one Hatch chile and doubled the chipotle (and left in the seeds cause I'm lazy). It was so yummy. Unfortunately baby couldn't handle the spiciness, and the two times I ate it as soon as I fed her she projectile vomited on me. But if you aren't breast-feeding I highly recommend it.
3. Started reading How to Cook Everything Vegetarian. In the introduction he says that he tries to run his pantry dry at least once a year. I thought, I need to do that. So I have been trying to plan all meals around what I have in my pantry. In addition to rotating things, it just makes it easier to organize when I give myself a little space. And in the next few months I know there will be many sales on non-perishable items and I need to make room.
4. In my efforts to clean out the pantry I made Peaches and Cream Oven French Toast, using canned peaches, evaporated milk and powdered eggs. It was pretty yummy and all members of my family or at least those with teeth ate some (Cue angelic chorus). However, I'm pretty sure that I could come up with a healthier version that is just as yummy.
5. Dealing with reflux- A new development in just the past week. I've determined that baby can't handle it when I eat anything remotely spicy, but it seemed like cutting that out wasn't enough. No, no- there is a huge list of things that I have to cut out. And since I have it has made a huge difference. She's happier and sleeps longer through the night. The problem is when I got out beans, dairy and many fruits and vegetables, it makes it hard to find anything to eat, let alone anything vegetarian. (And I had gone weeks without eating meat and was feeling fine!) I may need to go back to being a carnivore for baby's benefit for awhile.
6. Enjoying my oh-so-adorable children who are probably the only people whom I would tolerate such shenanigans from.

Tips on Newborn Diapers

Cindy Lou-Who modeling the W brand diaper

 Through personal experience and talking to other moms I have determined that when it comes small babies (7-10 pounds), Pampers Swaddlers size 1 (8-14lbs) are more effective than Huggies at preventing leaks. After that stage I generally use Huggies because there are more coupons and deals available, and there's not a big difference.
 Last Saturday night, we were staying with family and I realized we only had 3 diapers left. So I made a late night run to Walgreen's. They did not have Pampers Swaddlers in size 1 stocked. So I decided to give the store brand a whirl. The Walgreens newborn diapers are sized up to 10 lbs, so I tried those.  I found that I have been having even fewer leaks than I did with the Pampers, and they are significantly less expensive.

Here's the price comparison for the Walgreen's that I stopped at.
Pamper's Swaddlers size 1- 40 diapers- $11.99
Walgreen's Newborn- 42 diapers-$8.99

Currently there is a P&G (manufacturer's) coupon out for $1.50 off 2 packs of Pampers or one case, and if you ask at the make-up counter there is another coupon (store) for $2 off any package of Pamper's diapers. At Walgreen's you can use both a store & a manufacturer's coupon for the same product. (Ask for the Infant Care coupon brochure.) So if the Pampers were available my total would have been $18.48 plus tax.

Currently (through 9/24/11) there is a deal where when you buy one Walgreen's product you can get a second of the same for 50% off. And in the Infant Care coupon brochure there is also a coupon for $2 off any Walgreen's Brand diapers jumbo pack. (Because it is a store coupon the $4 is taken off before the 50% off discount.) So my total was $10.48 plus tax for 2 packages of diapers. And they are just as good if not better for the stage that my infant is at right now. And yes, you don't have the reward codes, but a discount of $4 per package of diapers is worth more than a reward code.

Vitamin D during pregnancy could prevent RSV in infants

 This week a study was published online from the American Academy of Pediatrics that found that a deficiency of Vitamin D in cord blood is associated increased rate of RSV in infants. So it stands to reason that if an infant is not starting out Vitamin D deficient, they are decreasing their chances of catching RSV. The study suggested that if pregnant women increased their Vitamin D intake, it would decrease the rate of RSV by about 20%. That is AMAZING! And not only would it decrease the number of cases of RSV, it would decrease the severity, meaning fewer deaths, fewer tiny babies on CPAP and vents, and fewer infants being held down by nurses like me so they can have boogers sucked out through a tube in their noses. I may be jeopardizing my job security by proclaiming this information to the world, but I'm OK with that. But seriously RSV is a HUGE part of what I do and I would be glad to see fewer kids come down with it.
 The point is, if you are pregnant I recommend that you make sure that you are getting enough Vitamin D. Start today.  Not only does it reduce rates of RSV, your body needs it for cardiovascular health, a thriving immune system and strong bones. One may ask how much is enough Vitamin D and where do I get it?- The latest recommendations (as of November 2010)  for daily intake is the same for men and women under age 70, 600 international units, and 400 IU for children. Now there is debate that because of these new study findings, perhaps pregnant women should get more than that. It remains to be seen. The caveat with Vitamin D is that if you take too much it can lead to toxicity. (Vitamin D poisoning can lead to dehydration, vomiting, loss of appetite, constipation, muscle weakness, irritability, fatigue and kidney stones. Pregnant women have enough issues with those conditions without taking a vitamin supplement that would make them worse.) Vitamin D toxicity is actually pretty rare. It only happens when too much is taken over a period of time, usually months, and when an adult is taking 50,000 IU or more per day. Vitamin D from food has never resulted in an overdose.

  Of course you can get your Vitamin D from a prenatal vitamin or a Vit D supplement, but if you are looking for an answer that doesn't come in a pill form, here are a few good places:

• sunshine- not that the sun actually contains Vit D, but our skin has the power to turn ultraviolet light (UVB rays) into Vitamin D. (Aren't our bodies amazing?)
• fish- especially fatty varieties like catfish, salmon and tuna
• eggs
• fish liver oils- I suppose this proves that my grandma was right, or at least partly. Eating a tablespoon of cod liver oil a day can prevent illness. One tablespoon contains 1360 IU. That doesn't mean you can convince me to take it. It smells ghastly.
• mushrooms- I recently learned that a serving of button mushrooms contains 100% of the Vitamin D that you need for a day.
• In the United States milk is fortified with Vitamins A&D, because they help with the absorption of calcium. (Many people find it surprising that "Vitamin D milk" or whole milk has no more vitamins than skim or 2% milk. The only thing that it has more of is saturated fat.)
• Most cereals, butter and dairy products are also fortified with Vitamin D.

 Now I'm asking you to do me a favor. If know someone who is pregnant, share this information with them. Making sure that you're getting enough Vitamin D  while you're pregnant is a simple way to make a huge difference. If 20% fewer children in the United States came down with RSV each year, that's roughly a million children. And think how many families that would effect if there were that many children who weren't coming down with RSV. The thought makes me happy. So please, please, if you are reading this, spread the good news to your friends and family so they can keep their families happy and healthy.

Keeping Your Baby Safe

I think most of have heard of or know of a parent that has experienced the horrors of SIDS. For those of you who haven't, SIDS stands for Sudden Infant Death Syndrome, and it's just that, the sudden unexplained death of an infant under a year old. While the causes are characteristically unknown, there are several things you can do as a mother to lower your baby's risk.

• Always put your baby to sleep on its back.
• Eliminate excess bedding, clothing, soft sleep surfaces and stuffed animals. One sleeper, one onesie and one blanket should be enough.
• Breast feed. This one factor reduces the risk of SIDS by 50%.
• Keep room temperature in infants sleeping area cool.
• Eliminate exposure to tobacco smoke
• Use a fan to circulate air in the infant's room.
• Eliminate mold.
• Do not put an infant to sleep in your bed or in a bed with other siblings.

Other than the reverse of the above factors there are many things that increase the risk for SIDS. These include: prematurity, maternal drug, tobacco or alcohol use in pregnancy, inadequate prenatal care and nutrition, and the infant or mother being overweight.

Recently the FDA has warned consumers not to use infant sleep positioners. Many of these sleep positioners claim that they reduce the risk of SIDS, but this claim is unfounded and these positioners have in fact resulted in the suffocation of several infants. There are two basic positioner types: mat with side bolsters or wedge with side bolsters as shown below. If you have been using these I strongly recommend that you stop now.

Mat with side bolsters

Wedge with side bolsters