Tuesday, April 5, 2011

Pediatric Advice

Below are some notes I took from my daughter's pediatrician. Some is information she told me, some is from pamphlets that she gave me and the rest is from books, magazines and websites I came across as an expecting mommy.. I received so much information that I found it useful to take some notes for myself while preparing for my new arrival! Hope you can all benefit from them as well!

Pediatrician Book: Feeding Suggestions
Table of Contents
(1) Freshly Expressed Milk Storage
(2) Milk Thawing
(3) Water for Baby?
(4) Introducing Solids
(5) Signs of Food Allergies
(6) Foods & Feeding By Age
(7) Colic Symptoms & Solutions

Freshly Expressed Milk Storage
-4 hrs at room temperature
-24 hrs in cooler w/ 3 ice packs
-5 to 7 days in refrigerator
-3 to 6 months (6 if at 0 degrees)
-Thawed milk can be refrigerated for 24 hrs
-Don't store thawed breast milk
-Don't store milk kept in cooler longer than 8 hrs
- Never refreeze thawed milk

Milk Thawing
-Warm milk under cool then warm running water for a few minutes OR
-Put milk in container with heated water
-Don't ever heat milk directly on stove
-Don't ever microwave milk
-Thawed milk must be used within a 24 hour period if refrigerated & within 1-2 hours if left at room temperature
-Don't refreeze leftover thawed milk

Water for baby?
-Breastmilk & formula contain enough water but some parents offer water for taste & variety
-If you give her water, limit it to 2 oz a day until at least 4 months. Use only boiled tap water or bottled water with added flouride. You can also use weak chamomile tea as part of the 2oz per day for fussy babies

Introducing Solids
-Should not be introduced until at least 4-5 months.
-Introduce only 1 solid food at a time to determine if it agrees with her or causes an allergic reaction.
-Always give with a spoon, not a jar or bottle
-Babies with only 1/2 to 1 teaspoon & should not be force fed.
-Stay away from foods that are a choking hazard such as raisins, grapes, sliced hot dogs, peanut butter, nuts, chips, meats, any food that's hard to chew & any food about the size of the baby's trachea.

Common Signs of Food Allergies
-Difficulty breathing
-Constipation, diarrhea or vomiting
-Watery eyes, coughing or runny nose
-Excessive bloating or gassiness
-Unusual daytime crankiness

Suggested Foods & Feedings by Age
Babies 0-4 months
-BREASTMILK: 8-10 feeds day for total 16-32 oz
- No solids at all

Babies 4-5 months
-BREASTMILK: 5-6 feeds day for total 24-36 oz
-SOLIDS: Rice or single grain cereal up to 1-2 times a day
-No vegetables, fruits, juice or proteins

Babies 5-8 months
-BREASTMILK: 8-10 feeds day for total 24-32 oz
-SOLIDS: Single grain cereal, cereal & fruit mix, oven dry toast or teething biscuits up to 2-3 times a day
-JUICE: Infant 100% juice max 4oz a day
-VEGETABLES: Strained or mashed soft vegetables 1/4 to 1/2 cup a day up to 7 months
-Soft boiled vegetables after 7 months
-FRUITS: Strained or mashed w/out peels max 1/2 cup a day up to 7 months
-Some soft fruits after 7 months
-No proteins

Babies 8-10 months
-BREASTMILK: 2-4 feeds day for total 20-30 oz
-SOLIDS: All baby cereals 1/2 cup a day, toast, 1/2 plain bagel, crackers & bread up to 3 times a day
-JUICE: 100% infant juice max 6oz a day
-VEGETABLES: Cooked, chopped soft vegetables only
-Soft or canned packed only in water or fresh peeled, seeded & chopped fruits
-PROTEINS: Ground or finely chopped lean meats, egg yolks, few teaspoons of
plain yogurt & cheese

Babies 10-12 months
-BREASTMILK: 1-2 feeds day for total 16-24 oz
-SOLIDS: All baby or unsweetened cereals 1/2 cup a day, toast, 1/2 plain bagel, crackers, bread, mashed potatoes, rice or pasta up to 3 times a day
-JUICE: 100% infant juice max 8oz a day
-VEGETABLES: Cooked, chopped or in sticks for finger food only
-Soft or canned packed only in water or fresh peeled, seeded & chopped fruits
-PROTEINS: Ground, chopped or small tender pieces of lean meats, egg yolks,
cooked beans, plain yogurt & cheese

Common Colic Symptoms & Solutions
-Colic "Rule of 3" is crying that occurs for more than a total of 3 hours throughout the day, 3 days a week for 3 consecutive weeks.
-Crying that starts off quietly & escalates to an ear-piercing pitch.
-Arching her back when she cries.
-She can temporarily be soothed by burping, the pacifier or the swing.
-Sleeps or dozes off during feedings during feedings, not swallowing & digesting

-Babies with some of the above symptoms often have GER (Gastroesophageal Reflux) instead of colic. Zantac can help relieve discomfort during feedings & reduce the spitting up. All babies spit up to some degree but they shouldn't be spitting up large amounts (vomitting) at every feeding. Zantac will help reduce the burning babies experience in their throat and esophagus from stomach acid. To prevent baby from spitting up the dosage, use a slender syringe & squirt the medicine toward the back of her cheek so she swallows it.
-Keep baby upright or no more than semi-reclined for at least 20 minutes after each feeding.
-When possible, have mom or dad soothe the baby after feeding to improve bonding, comfort & psychological feeling of comfort in the baby from the baby instead of from other friends or family.
-Elevate the head of the crib by rolling a towel and placing it under the mattress
-Breastfeed for 10-15 minutes from one breast, burp, then do the same on the other breast. Start on the opposite breast at the next feeding.
-Sucking is calming so don't let baby fall asleep sucking at the breast since she isn't actively swallowing & digestings. Offer a pacifier if she's done
eating & has fed for an adequate amount of time.
-Pick a consistent bedtime & make it obvious its bedtime. Do this by creating a nightly routine by exaggerating the differences between day & night feedings. You could dim lights, rock her, play gentle music, swaddle her, read to her & put her to bed after feeding & burping.
-Downsize daytime naps. They shouldn't be any longer than 1 to 2 1/2 hours at the most, diminishing in time & quantity of naps throughout the day as they get older.

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