So many new parents rely on pacifiers to soothe their babies, but there is some controversy over whether to use them at all and how to use them. Just like so many things related to parenting, the very ambiguous answer is IT DEPENDS.

If you are a parent who has been relying on pacifiers and things are going well for you, great! In many cases, they can be used without any apparent negative consequences. On the other hand, some parents find that pacifiers can interfere with breastfeeding, or have issues later with getting their kids to quit the habit. Some parents regret using them at all when they’re struggling with the consequences.

We usually hear about the parenting wins, but don’t always hear about the regrets. This makes sense, if you really think about it. For most people, when they recognize they’ve made a mistake, broadcasting that mistake doesn’t sound fun. Most people don’t want to go around telling people about all the mistakes they’ve made and how they wish they had done things differently. Remember this for ALL things parenting related, so you can turn the volume down on all the loud voices telling you about how the way they are doing things is THE BEST WAY. You’re likely only hearing about the successes and not the failures.

How about breastfeeding and pacifiers?

From the perspective of breastfeeding professionals, pacifiers can definitely be a problem when not used properly. If you want to breastfeed exclusively, the recommendation is to wait to use a pacifier until breastfeeding is well-established.

To secure a good milk supply from the beginning, you want to feed your baby from the breast as often as possible. The more the breast is stimulated, the more your body understands the need to make milk. So, even if the baby is just suckling for comfort, that is actually helping to establish a good milk supply. If you introduce a pacifier early on, it could sometimes replace having the baby at the breast which can delay your milk production. If your baby seems fussy and you offer a pacifier, it might be that the baby is starting to feel hungry and the pacifier soothes them temporarily. That delays the feeding and can interfere with the milk-making.

In a recent policy statement, The American Academy of Pediatrics states that, “Implementation of breastfeeding-supportive hospital practices, including breastfeeding in the first hour after birth, exclusive breastfeeding, rooming-in, breastfeeding on demand, avoidance of pacifiers, and information on breastfeeding support after discharge, enabled women to be more successful at meeting their prenatal desire for exclusive breastfeeding.”

But once breastfeeding is well-established, a pacifier might be a good option for your baby and your family.

Benefits of pacifiers

Not all parents want to use pacifiers. Not all babies accept a pacifier. But when you are trying to decide about bringing a pacifier into the picture, know that there are some well-documented benefits to using them.

• When babies are allowed to suck on a pacifier for medical procedures, they show fewer signs of distress and pain.
• Pacifiers can be comforting, especially to babies 10 months of age and younger because they have strong sucking reflexes.
• Because of a baby’s natural desire to suck, a pacifier can be handy for busy or tired parents. Although the human nipple has been the most obvious choice for ages, sometimes a little technology can come in handy.
• There is also some evidence showing that the risk of SIDS can be reduced when babies use a pacifier for falling asleep. There is also a lower risk of SIDS with nighttime breastfeeding.

Risks of pacifier use

There can also be some downsides to using pacifiers, and those are increased with increased use. So, that means using them occasionally or very moderately might not be a problem, but the more a baby uses it, the riskier it gets. Some of the downsides include:

Dependence: A baby might get very dependent on the pacifier. Any pacifier-using parent understands the horror of a lost pacifier! A baby might be inconsolable and not be able to sleep, soothe, or cope without it. It also might be difficult to break the baby of the pacifier habit when you’re ready and can cause significant stress to the child and family.
Ear infections: Depending on how much the baby uses it and for how long, higher rates of otitis media (ear infections) can be associated with pacifier use.
Dental problems: There are many dental issues that pacifiers might get blamed for. Some of them are only likely with incorrect, excessive, or long term use (4+ years). Others such as changes in the dental arch or the baby’s bite are associated even with more moderate use of pacifiers.

How to use pacifiers

If you want to use a pacifier, and want to minimize the risks of using them, there are a few simple things to keep in mind:

• Wait until breastfeeding is well-established, especially if your goal is exclusive breastfeeding.
• To minimize pacifier use and potential for dependence, limit it for helping your baby fall asleep or in moments where you’re less able to comfort your baby in other ways.
• Try to wean your baby from the pacifier at around 10 months of age to minimize the risks for ear infections.
• Never sweeten a pacifier with sugar, corn syrup, or anything else. That can definitely contribute to dental problems, including cavities and gum disease.
• ONLY use good quality pacifiers that are designed for that purpose. Don’t try to make up your own pacifier or get low quality or used pacifiers. There have been cases of infant deaths caused by bad pacifiers.
• Use pacifiers made with safe materials to minimize the risks that can occur with certain plastics and chemicals.
  Inspect and change pacifiers often. Make sure there aren’t any cracks, breaks, or tears in the pacifier that might be pulled off and become a choking hazard.

References

https://publications.aap.org/pediatrics/article/150/1/e2022057988/188347/Policy-Statement-Breastfeeding-and-the-Use-of

https://www.aafp.org/pubs/afp/issues/2009/0415/p681.html#:~:text=The%20American%20Academy%20of%20Pediatrics,of%20sudden%20infant%20death%20syndrome.

https://pmc.ncbi.nlm.nih.gov/articles/PMC2791559/

I love the word primitive. It can have a negative connotation, but for me, it just describes things that have been around for a REALLY LONG TIME. We have primitive instincts and developmental patterns that have persisted since the beginning of human existence. I love to think about that. It means that I still have things in common with my most distant relatives!

One of the most obvious and amazing ways to see this is with newborn reflexes. A normal healthy newborn will do some very strange-seeming things that are actually designed with a purpose. Primitive reflexes show up in a newborn, and then go away once that baby achieves some developmental milestones and doesn’t need them anymore.

These reflexes are automatic and are controlled by the oldest part of the brain, the brainstem. This is the part of the brain that connects the big round complex thinking part of the brain to the spinal cord and cerebellum. Our involuntary vital functions like consciousness, breathing, blood pressure, heart rate, sleep, and instinctive behaviors, are controlled by the brainstem. Some people call the brainstem the reptilian brain. It’s the part that we share in common with other animals. It’s very basic, very old, and very critical for survival.

What are the primitive reflexes for?

The combined function of these reflexes is survival. Many of the primitive reflexes help a baby with feeding, and others offer protection from falling or injury. Human babies are born with big highly developed brains but underdeveloped bodies.

This is different from most other mammals. Their offspring are born with highly developed bodies, but their brains are not as highly developed as ours. A baby deer can be walking and feeding itself within an hour of birth. They can start running shortly after! Our babies don’t have bodies that are coordinated enough or strong enough to do these things, so they have primitive reflexes that make certain things happen automatically.

What are the primitive reflexes?

• The Sucking Reflex: This reflex is important for helping a baby coordinate breathing and swallowing. You can see it in action when you put something into a baby’s mouth a certain way. The baby will automatically clamp down and start sucking, even if it’s not going to get them any milk! Babies tend to be soothed by sucking.
• The Rooting Reflex: This reflex helps a baby feed. You can see it when you lightly touch the side of the baby’s face on the cheek. They will turn their open mouth in that direction. This helps a baby initiate feedings as often as possible which is really important in the early days of life. For new parents, this one can be confusing! Maybe you just fed your baby and then your partner takes the baby for some snuggle time. If they accidentally touch the side of the baby’s face with a finger or a shirt in just the right way, she might start rooting as if looking for a nipple! It doesn’t necessarily mean she’s hungry again, it could just be that the touch triggered the reflex.
• The Snout Reflex: This reflex is also related to feeding. When you touch the baby’s top lip, this reflex makes their lips pucker.
• The Palmomental or Grasping Reflex: This reflex may be helpful for feeding because the baby will often grab for a nipple. It may also help a baby hold on when being carried so they can avoid falls. You can see this reflex by stroking a baby’s palm. They will usually grip immediately and hold on tight!
• The Glabellar Tap Reflex: This reflex is most likely present to protect the baby’s eyes. They initiate the reflex by tapping the baby’s head between the eyebrows. This makes the baby blink. An older child or adult would stop blinking after a few times, but a newborn will continue to blink.
• The Asymmetric Tonic Neck Reflex: This reflex may be helpful for birth. When performing this reflex, the baby’s head turns to one side and that same arm automatically straightens out while the opposite arm bends up at the elbow. It’s thought that this can help a baby maneuver through the birth canal in a better position. You can see this by turning a baby’s head to one side or the other while they’re lying down.
• The Moro Reflex: This is also sometimes called the Startle Reflex. The baby looks startled when exhibiting this reflex as their arms suddenly fling out widely, and they spread their fingers. Sometimes the baby will cry. The baby may feel like they are falling, and this is the instinctive reflex. You can see this if you pull a baby’s arms up while they are lying down, and then let go of the arms. This one might be useful for parents to know about, because it can sometimes disrupt sleep. You can avoid it by keeping your baby’s arms tucked in securely, or by holding the baby close. Swaddling is sometimes helpful in preventing wakeups because of the Moro Reflex. You can also hold your baby’s arms tucked close to their body when trying to put them down for sleep, then slowly let go after they are completely relaxed onto the mattress.
• The Babinski Reflex: This is a reflex triggered by stimulating the bottom of the baby’s foot. The big toe will flex upwards and the other toes will spread out. It’s thought that this reflex helps a baby prepare for walking, and also with avoiding falls.
• The Stepping Reflex: This reflex might be the most surprising because it seems like a newborn is just too young for this! You can see this by holding the baby upright and setting their feet onto a surface. They can’t hold their weight up, but when they feel their feet on the “ground”, they’ll put one foot in front of the other as if they’re trying to walk! This reflex disappears at about 2 months, but will come back again when the baby is getting developmentally ready to walk (usually at the end of the first year). It’s thought that this reflex is helpful for feeding. A baby can use this reflex to push and scoot toward a breast for feeding when they are lying belly down on their mother’s body. This is part of a process called “The Breast Crawl” or “Self-Attachment”.

Why do these matter?

It’s true that knowing about many of these reflexes might not matter very much for a new parent. It can be fun to understand these things when you see them, but it might not affect the way you take care of your baby on a daily basis. It might be good to know about some of these reflexes as they relate to getting a good start with breastfeeding. You can take a class with us to learn more! These reflexes do, however, matter a lot to your baby’s care providers. A pediatrician or midwife will look for these reflexes in your newborn because seeing them in action is a way to know that your baby is healthy.

When a reflex is missing, it could be an early sign that the baby has some kind of developmental problem or health condition that needs to be addressed. For example, if the Moro Reflex is absent, it could indicate some kind of central nervous system dysfunction caused by a spinal cord injury or a condition like spina bifida or a tumor. So, these reflexes are a great way to track your baby’s early health and development. It’s also interesting to know that these reflexes disappear at slightly different rates, but that they should be all or mostly gone by about six months of age. If one of these reflexes continues much longer or comes back later in life, it’s usually an indication that something is wrong. Sometimes the primitive reflexes come back in adulthood if there is a brain injury, dementia, or a disorder like Parkinson’s disease.

Checking for these reflexes is a normal part of a baby’s first thorough physical exam which is usually done the next day after birth. It’s usually important and interesting for parents to be part of this exam, and when you know what they’re doing and looking for, it might even be fun!

Your own pediatrician or doctor will continue to look for these reflexes at the regular checkups over the next year. In the meantime, there isn’t much that parents need to do about these reflexes. They are automatic, and only needed for a little while. They go away on their own after a few months once babies are reaching certain milestones. If you’d like to keep track and watch, it might be helpful to let your pediatrician know if you suspect that any of the reflexes are persisting for longer than normal.

Resources

https://www.ncbi.nlm.nih.gov/books/NBK554606/#:~:text=Primitive%20reflexes%20are%20involuntary%20motor,child%20development%20that%20facilitate%20survival.

https://www.ncbi.nlm.nih.gov/books/NBK544297/#:~:text=The%20brainstem%20is%20the%20structure,%2C%20pons%2C%20and%20medulla%20oblongata.

https://www.healthychildren.org/English/ages-stages/baby/Pages/newborn-reflexes.aspx

Breastfeeding can sometimes be a struggle. The logistics and nuts and bolts of breastfeeding aren’t always easy to figure out at first. Getting the latch right can be tricky for the baby. Positioning might be awkward for the parent. You’ll probably wonder if you’re doing it right A LOT. Are you feeding your baby too much or too little? Should you be feeding your baby on a schedule, or is it OK to feed your baby whenever they are hungry? These are all very common questions and concerns and mean that sometimes it doesn’t feel easy or natural. Don’t worry, you are perfectly normal.

The good news is that there are a lot of things about breastfeeding that you don’t have to worry about, and it’s not always as easy as we might think to mess it up.

You Can Breastfeed While You’re Sick

There are only a very few rare illnesses that, if you have them, would make breastfeeding unsafe for your baby. It’s safe to breastfeed when you’re sick with most illnesses as long as you’re following some basic precautions. Make sure to wash your hands really well before touching your baby or your breast or any bottle or pump parts. You may also consider wearing a mask when you’re sick to reduce the chances of your baby getting sick. Your milk is safe, but if you’re very sick and worry about making your baby sick by being too close, you can also pump or hand express milk and let someone else bottle feed it to your baby. If you plan to continue breastfeeding, It’s very important to continue to breastfeed and/or pump through illness so that your milk supply doesn’t drop.

It’s amazing how your body will protect your milk supply, even through some pretty big obstacles. Most medications are safe to take while you’re breastfeeding, although it’s best to contact a lactation consultant to find out for sure. Your body usually protects your milk supply from things like medications, viruses, bacteria, dehydration, famine, and other harmful things. Breasts have a pretty incredible security system!

It Can Actually Be Extra Good to Breastfeed When you’re Sick

It’s very difficult or even impossible sometimes to pass on harmful things to your baby in your breastmilk. But you can very easily pass on helpful things.

Your breastmilk changes constantly. When you’re sick, your immune system kicks into gear and your body produces antibodies to fight off the virus or bacteria. Those antibodies DO get into the breastmilk supply and are shared with your baby. This helps your baby develop a healthy immune system. It can even help your baby recover quickly if they do get the same illness that you have. In this way, you can actually be protecting your baby if you breastfeed while you’re sick.

What If Baby is Sick?

If your baby is sick, it’s also best to continue breastfeeding in most cases. Breastmilk is still the best thing to offer, even if the baby has a gastrointestinal issue and is having diarrhea and/or vomiting.

Breastmilk is very hydrating, and of course also provides the nutrients the baby needs, along with your helpful antibodies that might be able to help the baby fight off the infection. In cases of extreme dehydration, it’s best to see your doctor. They may recommend IV fluids for some time.

With other kinds of illnesses like colds and flu, continued breastfeeding is encouraged. You may need to breastfeed more often when your baby is sick. If they are weak and tired, they may only eat a small amount at a time. If they are getting dehydrated, they’ll need more of the great electrolytes and fluids in breastmilk. A lot of babies also need more comfort when they’re sick, and nursing can be very comforting. Whenever you can, follow your baby’s lead. But also make sure you’re offering to breastfeed often even if your baby is not asking for it.

The overall message here is that breastfeeding is a very good thing to do when you or your baby is sick. You don’t need to worry that you’ll pass on your illness in your breastmilk. In fact, remember that the opposite is true! You’re actually passing on your disease-fighting abilities in your breastmilk and providing recovery and healing.

Resources
https://www.unicef.org/parenting/health/breastfeeding-when-sick
https://www.cdc.gov/breastfeeding-special-circumstances/hcp/contraindications/index.html
https://www.aafp.org/pubs/afp/issues/1999/0401/p1754.html#:~:text=Not%20only%20does%20breast%20milk,easily%20digestible%20proteins%20and%20fats.
https://www.healthychildren.org/English/health-issues/conditions/abdominal/Pages/Treating-Dehydration-with-Electrolyte-Solution.aspx

The American Academy of Pediatrics recommends that all breast fed infants younger than 12 months old need a daily dose of vitamin D. That might be surprising to you! It was to me. It was a pretty new recommendation when I started having babies in 2008, and I wasn’t even made aware of it by my pediatrician.

Not all babies and children are deficient in vitamin D, but a lot are. Even if you’re not sure if your baby is deficient, it’s a good idea to go ahead and supplement.

Why the Deficiencies?

Vitamin D is the sun vitamin. Before humans were indoors so much, vitamin D deficiency was probably very rare. It is absorbed through the skin, so if you’re outside a lot getting direct sunlight on big patches of skin, it’s plentiful. Until recently humans didn’t use sunscreen or live as long as we do now. Because of the risks of skin cancer, we don’t usually spend a lot of time in direct sun without sunscreen anymore. Sunscreen and clothing block much of the vitamin D production. And this is probably the right thing to do.

We live so much longer now. If we are exposed to all that sunlight for all those years, our risks for skin cancer are increased. It’s very hard to get enough vitamin D without lots of sun exposure, because vitamin D is not easy to get through food sources. There are very few foods that are good sources of vitamin D, and most of them are fish.

Why Do People Need Vitamin D?

Vitamin D supports bone health. Vitamin D increases your body’s ability to absorb calcium and phosphorus. These are minerals that are critical for building strong bones and keeping your bones hard and resilient as you age.

When babies and toddlers are severely deficient in vitamin D, they can develop a condition called rickets. Rickets is a disease that causes a softening of the bones which means they can actually start to bend as the baby grows. Older kids and adults can also have an increased risk for broken bones when they are deficient in vitamin D.

How to Give an Infant Vitamin D

Vitamin D can be found over-the-counter at your local drugstore or pharmacy. Sometimes it will be found in the baby aisle with all of the other health and hygiene products. You might also find it with the other vitamins. For babies, you would definitely want to get it in liquid form.

It will come in a small dark glass bottle with a dropper lid. Make sure you read the label. Some of the brands make it very concentrated, and others dilute the vitamin D quite a bit. Usually the more concentrated liquids are more expensive, but they last a lot longer since you’ll only need to give your baby a very small amount. The dose size might even be just one drop!

The recommended dosage for babies is 400 IUs. When you read the bottle label, you will be able to see the concentration shown in IUs. The recommended dose for adults is 600-800 IUs. The bottle will usually tell you how many drops you need to reach the recommended IU level. The vitamin D I use has 600 IU per drop. I like this one because I can use just one drop, but I wouldn’t want to buy this one for a baby since that’s more than the recommended amount. Also, some brands recommend that you refrigerate after opening, so make sure to read the label!

To give your baby the vitamin D, you can either put the drops into a bottle of expressed milk and feed it to your baby that way, or you can just put the drop right into the baby’s mouth. It’s best to get it under the tongue to be sure it goes in. If the vitamin D dose is more than just a couple of drops, it can be hard to get the baby to take it straight. In that case, having some milk to mix it with is a great idea. If you have some pumped milk, you can definitely use that. If you’d rather not pump, that’s ok too! A lot of times you can get enough milk through hand expression and avoid the pump struggles.

What If My Baby is Formula Fed?

As long as your baby is getting at least 32 oz of formula per day, there is no need to supplement with vitamin D, because formula is fortified with vitamin D. In the first month of life, a newborn will not likely be eating 32 oz of formula per day, so it’s good to supplement for at least that first month. Once your baby is eating 32 oz or more per day, they will be getting the recommended amount of vitamin D and you can stop supplementing with vitamin D.

If you are giving your baby breast milk AND formula, you’ll want to supplement with vitamin D until your baby is getting 32 oz of formula per day, and continue to supplement if you never need to give your baby that much formula.

Can You Give Too Much?

Vitamin D is fat soluble so you want to make sure not to give your baby too much. Getting a little too much once in a while is not going to be a big deal, but don’t purposely and routinely give your baby more than the recommended 400 IU dose unless directed by your doctor.

How About Supplementing Mom’s Breast Milk?

A lot of people wonder about getting more vitamin D in the breast milk by making sure the lactating parent is getting enough vitamin D. It is technically possible to fortify the breast milk enough that way, but it’s tough to tell exactly how much vitamin D you would need to take to get there.

In studies, it has been found that taking a very large amount of vitamin D can enrich the breast milk with the right amount of vitamin D for the baby. But it’s hard to tell if that would be too much vitamin D for some people, so it can’t be recommended as the universal strategy for everyone. If you would like to consider this alternative to giving your baby direct supplementation, it would be a good idea to talk to your care provider before starting.

When you fantasize about being a parent for the first time, you might picture playing with your kids. Maybe you can’t wait to toss or kick a ball around. You might imagine a dollhouse and figures or teaching your kid how to use a yo-yo or skateboard.

Then you get your newborn home, and that can seem like a very far away fantasy! Newborns are very tiny. They can’t walk or talk or even control their bodies much at all. They can’t pick things up or hold onto things well yet. They even have trouble holding their heads up without help. So can you really play with a newborn? Yes! Well, sort of.

There is a lot you can do to entertain and stimulate them, and you can have fun doing it too. Play is about fun, but it’s also a way to encourage great brain and body development. Babies are growing and developing SO quickly at first! The kind of stimulation they can get from play is really helpful for making quicker and sharper neural connections and pathways in the brain.

It also might be helpful in strengthening their little body parts so they can start moving more on their own. Maybe even most importantly, remember that with babies, play time is mostly about making a very direct and focused connection. Even my big kids at 12 and 15 want to play with me, but they say it doesn’t count if I’m distracted and not really into it. They are absolutely right.

Ideas for How to Play with a Newborn

Try some yoga. One of my favorite things was “Mommy and Me” type yoga classes. These are a great way to find fun things to do with your baby that are also really beneficial for you and your physical recovery. Most of the time, it’s recommended that your baby be at least one month old before you start taking them to these classes. You can usually keep going until your baby starts to crawl. At that point, some places will also offer yoga classes appropriate for crawlers and toddlers. Those are fun too!

Infant massage is also a great way to connect and “play” with your baby. I got to attend a Baby Strokes baby massage class recently just to see what it was all about. There were two newborn babies there, and they DID seem to be having fun! This might not seem like playing to you, but some of the techniques can be really stimulating to a tiny baby and fun for you too.

Try going outside. My babies loved being outside. I would walk with them in a carrier or stroller, or I would just lay a blanket under a tree and we would look up at the sky and the leaves. Again, this can be very stimulating to a tiny baby, and it’s so fun to see their reactions to new things. To make it more interesting for you, try meeting up with some other parents and babies at a park or just change up your location occasionally. Looking for new parks and outdoor spaces can be a great way to get to know your area a little better too.

Reading aloud to your baby is something you might like to do, and it really is a great way for your baby to absorb language. Using different sounds and voices can also make it extra interesting to a little one. Even if you’re not reading to your baby, talking to your baby can be very stimulating and entertaining to them. I used to talk to my babies as if they could understand me. I would talk to them about what I was making for dinner or talk through diaper and outfit changes.

Make faces! Tiny babies might be very entertained by this. It’s a bonus if you can shake your head back and forth really fast.

Tummy time. You might hear that you’re supposed to do this, but maybe you don’t know how. Tummy time just means putting your baby down on their bellies. There are a lot of good reasons for doing this. A change of position is great. Babies get to use different muscles and work on different motor skills while they are on their bellies. A lot of babies don’t love it at first though. Start trying tummy time early on, even in the first few days of life. Keep trying a little every day, and at some point, your baby will find new things to do while on their tummy. If your baby really hates being put on the floor, try tummy time on your chest. Stay focused on your baby and participate to make it more entertaining. When you start putting your baby down on the floor, get down on the mat or blanket on your belly opposite your baby. Make eye contact and funny faces to keep the fun going for longer. You might put a favorite object or toy just out of reach and your baby might have fun trying to reach it, or just looking at it from a different angle.

Sing to your baby. I really believe they love our songs and our voices. You can also make up hand gestures or body movements that go along with the song which can make it even more interactive. For example, “The Itsy Bitsy Spider” means you make spider hands and rainfall gestures. You can even mimic a spider crawling on your baby for some tickles. If you can pick a few songs that you like to sing and that have child appropriate lyrics, your baby will start to recognize the songs and later ask for their favorites. My 12 year old actually still requests his favorite mom songs at bedtime sometimes. He says it relaxes him.

Tickles! Touching and massaging babies can be great for entertainment and bonding, but be careful about tickling. It might be true that newborns aren’t actually “ticklish”, but it’s hard to tell. They don’t really have the ability to react to things in the same way that an older baby does. It is generally recommended that you NOT tickle a baby until after six months of age. That is when they can show you if they like it or not. Just like some adults don’t like to be tickled, it’s the same for babies.

Peek-a-boo kinds of games might not be understood completely by a newborn, but you can start playing anyway. Even just your faces and hand gestures and sounds can be interesting to a newborn.

Water fun. Especially if it’s hot outside, your baby might like to be held in a small tub of cool water, or you can trickle water onto their skin. Bath time might also be a great place to play. A lot of babies LOVE the water.

Play at Home Mummy is a fun Instagram account for play ideas mostly for older babies and kids, but it’s entertaining to look around and get ideas.

I had a rough pregnancy. It’s hard to admit to some of the feelings I had while I was pregnant the first time. Not everyone feels ready to be pregnant. Not everyone is excited. I was one of those. Sometimes, we feel like it’s shameful to have those feelings, but I think it’s important to get this out into the open and talk honestly about the full range of emotions that are possible and NORMAL during pregnancy and when getting to know our babies.

Before I got pregnant, I had no interest in babies. I admit that I would get annoyed if I had to sit near a baby or child in a restaurant or on an airplane. After being married for eight years, my husband had baby fever, but I most definitely did not. Even so, I had to start thinking about having a baby. I finally gave in, because I was approaching 30 and “not getting any younger”. We agreed when we got married that a family would be in our future, and I don’t like to go back on my word. So, I got pregnant. That’s not very romantic or exciting. It was an obligation and a rational decision. Then it happened quickly, and I was shocked.

I was also extremely sick for the first few months. I couldn’t eat or even drink water without vomiting. I felt like I had contracted a tropical disease or parasite. I wasn’t happy about that. I also had to eventually stop going to my favorite yoga class because my instructor told me not to come back to her classes once I was six months pregnant. She didn’t know how to handle a big belly safely, so I had to resort to prenatal yoga. I was not happy about that either. I didn’t think I needed it, and I didn’t want to be around a bunch of pregnant people! My fears were realized in that first class when I sat next to a woman just 12 WEEKS ALONG who shared that she already felt the spark of spirit and personality in her baby and felt so connected. I did not feel connected with my 30 week old fetus. I felt no spark of personality. What did this mean? Was there something terribly wrong with me?

I worried that I might end up not liking my baby. I thought I might be a terrible mother. I was not bonding with my baby at all. My biggest fear leading up to the moment I met my baby was that I would just be annoyed with my child all the time, like I was around other people’s kids. Then I went into labor at 38 weeks. That was two weeks early! I wasn’t ready! I was still hoping to feel some connection with my baby, but it hadn’t happened yet and there was no going back.

I worked hard during labor. It was powerful and intense and amazing, and then she was there. My daughter was in my arms. AND I LOVED HER SO MUCH! It was immediate. I loved her, I wanted everything for her, and I immediately knew that I was even capable of killing for her. Whoa. That was a lot of intense bonding happening all at once. I was relieved, but also a little overwhelmed by some of these very new feelings. There was something very primal and instinctual about it. She’s 15 now, and we are still very close. I’ve loved all of her ages and stages.

With my second child, it was different. I had very mixed feelings. That time, I knew I would love him, but I also loved my daughter so intensely that I worried I couldn’t love him as much. I worried that I wouldn’t be able to give my first born the kind of loving attention I always had, because this new baby would interfere. These worries probably kept me from feeling much of a bond with my son during pregnancy. But then he was in my arms and I loved him. I knew I would do anything for him too. The immediate bond wasn’t as intense. It was more of a slow burn, probably because I still wanted to give so much of my love and attention to my first baby at the same time. We bonded differently, but we bonded.

When You Develop a Bond

Some people will feel a bond as soon as they find out they are pregnant, and others will need more time to feel it. If you didn’t feel it during pregnancy, and then you don’t get the immediate rush of connection at birth, the most important thing is to keep your baby close.

• Allow your baby to stay on your body as much as possible, skin-to-skin.
• Allow your baby to breastfeed as much as possible.

Both of these practices can lead to the production of oxytocin. Your body makes oxytocin automatically in response to skin-to-skin contact and nipple stimulation. Oxytocin is a hormone made in the pituitary gland that is responsible for bonding. When we see a cute puppy (or baby), we feel an oxytocin rush. I like to call it the “warm fuzzies”. When we hold hands with our partners, or kiss, or have sex, we release oxytocin. It gives us the positive feelings that we start to associate with that person or puppy or baby, and we want to stay with them and take care of them. We bond.

It’s so important to remember that there is no perfect normal. Everyone’s bonding experience with their children is different, and all can be normal, even when it takes a little longer or happens more gradually.

Delayed Bonding

There are times when things go a little haywire though. Sometimes, that bond can take months to solidify. Difficult, high intervention, or traumatic births can interfere. Breastfeeding problems can sometimes get in the way. Postpartum depression or other mood disorders can definitely interfere.

When left untreated, one of the most distressing symptoms of postpartum depression is the inability to bond with your baby. If you are still not feeling any connection with your baby after a couple of weeks, it’s a very good idea to see a doctor and consider medications, therapy, or both. It’s very likely that you won’t be scheduled to see your OB until six weeks postpartum, but that’s a long time to wait. Please consider getting help sooner than that. I’ve never met anyone who regretted getting help for postpartum depression. Most of the time people say that they wish they had done it sooner.

I’m happy to report that I now love all babies. I am the weird lady asking to hold your baby (well, at least before COVID) at a party, or making funny faces at them on the airplane. I love kids of all ages. They make me laugh and smile, and I especially love it when they choose their own outfits and have dirty faces and messy hair and ask TONS of questions. I don’t get annoyed by babies or children at all anymore.

I am also happy to say that I ended up LOVING prenatal yoga and recommend it to all pregnant people. I didn’t bond with my baby during pregnancy, but I did end up bonding with many of the women in my classes. I keep in touch with some of them even today. Our kids grew up together. We learned how to be parents together. That was definitely a big perk that came from switching yoga classes.

Don’t worry if you don’t feel a strong bond with your baby while you’re pregnant. For many people, they can only picture the baby as a fantasy baby from TV or movies. It doesn’t feel like “yours” yet, or even very real. They might seem like mythical creatures in there. We don’t know what they’ll look like or act like. Or they might feel more like a physical condition. It might be really hard to imagine them as anything but a miserable parasite. It can be hard to recognize pregnancy as the growth of a person. It’s very easy to forget that there is a little person in there having their own kind of experience. For a lot of people, pregnancy is a long list of physical complaints and a lot of weirdness. Give yourself some grace. Try not to worry or have stress about the fact that you can’t see past that or feel a bond with your baby. Taking care of your body is a great way to take care of your baby.

Help Creating a Bond

If you really want to try some things to create a bond during pregnancy, there may be a few things that can help. Even if you don’t feel excited to do these things at first or you feel really silly doing it, it might start to shift things for you.

• Sing a special song to your baby. They can hear you starting at about 16 weeks of pregnancy. I like to recommend choosing one special song that is child appropriate, since someday your baby will be able to understand the words. Sing the song every day. It might become part of your bedtime routine later on, and it can be really soothing for babies right after birth. Your voice, and the melody of their song will be the ONLY familiar things in the room right after they are born. Your voices are best. Headphones might be too loud, and that’s not what they’ll be hearing right after birth. It’s amazing to see a baby calm down and turn to look at their parents when they hear their voices right after being born.
• Talk to your baby. You might like to get into the habit of telling your baby about your day. You might like to tell them what your daily pregnancy tracker said about them. “You are now about the size of a tomato. You have fingers and toes. You have eyelashes now. I can feel you moving.” You might read a book out loud. It doesn’t have to be a children’s book! They can’t understand yet.
• Meditation can be a great way to tune in and focus. Think about what your baby might really look like or might be doing in there. Feel your baby move, and imagine what that looks like or feels like to your baby. Your baby can hear your heartbeat. You could also focus on feeling or hearing your heartbeat. Then you’re doing that together.
• Journaling can be helpful. You might write letters to your baby as journal entries. Write down what you’re doing and feeling related to your pregnancy or preparations you’re making for your baby’s arrival.
• Having pictures taken of your pregnant self is a great way to see it from a different perspective. Maternity photo shoots usually produce amazing pictures. Seeing yourself in pictures as the beautiful pregnant life-carrier that you are might give you a big boost and a new appreciation for the baby sharing this journey with you.

However it happens, the bond you will eventually have with your children is probably unlike anything you’ve ever experienced, and it is definitely something to look forward to. Just remember to be gentle with yourself if it doesn’t happen exactly as you imagined or hoped. Keeping yourself stress-free is another way to encourage that oxytocin to flow!

Things have changed a lot since the days of the mucus-like baby rice cereal. If I were a baby, I wouldn’t be all that interested in solid food if that’s what I was offered! Milk tastes much better. There are many thoughts behind offering that as a first food.

Should you Start with Rice Cereal?

Rice tends to be a staple food in a lot of cultures. Rice is easy to digest and doesn’t often cause allergic reactions. And rice has a very mild flavor, but I believe this way of thinking might do more harm than good. Who said baby food needs to be flavorless?

I’ve been a parent for more than 15 years, and while the evidence-based recommendations for baby’s first foods HAVE changed some since I was feeding babies, the idea of the baby or toddler “palate” has not. Most people in the United States believe that babies and toddlers can’t handle a lot of flavor. This is just not true, and it can lead to some problems that can persist for a long time.

The Toddler Palate Myth

When babies are getting only very bland food, they might get used to that and then struggle to accept new foods that are more colorful or flavorful. Bland foods tend to be white or brown. Some examples show up regularly on restaurant kid menus and on plates at home and in schools. These foods might start with rice cereal, and then progress to bread, crackers, plain pasta, chicken nuggets, grilled cheese sandwiches, french fries, other fried foods, hot dogs, mac n cheese, and pizza. Just because these foods are trendy for kids in the United States does not necessarily mean it’s true that this is ALL they are programmed to like. Babies and toddlers might be somewhat limited in what they can or will eat, but it’s probably not as much as most people think. While having these foods in moderation is not necessarily a terrible thing, they are just not very nutritious options. There is definitely an epidemic of children who will not eat anything BUT this list of options. That’s when it can be a problem. We worry about diabetes, obesity, behavioral and learning problems in school, tooth decay, and other health concerns that were not much of a problem in our recent human past.

This “pickiness” that develops can be a problem for parents and families. It might mean you’re limited in where you can go with your kids. It has to be a restaurant with something they will eat! You might worry about how they’ll behave when offered a meal at a friend or grandparent’s house. In some homes it means separate meals for parents and kids. I’ve known families with multiple children where EACH CHILD gets a different meal prepared for them, and it’s never the same as what the parents are going to eat. That might seem OK or normal to some people, but it might feel very frustrating and time consuming for others. It also might be disappointing that you can’t share some of your food loves with your kids.

I was raised in a home where we ate whatever Mom made. We didn’t have other options. Her parents lived through the Great Depression, and she knew how to make good nutritious meals that didn’t cost a lot of money. I also had family based in two different countries and cultures, so I grew up appreciating lots of different kinds of food and got very excited when I was old enough to branch out and try even more new and exotic things.

My children have had a similar experience. I love to cook, and I love to share food with them. As babies, they ate lots of avocados, vegetables, fruit, meat and beans. They also had oats, rice, pasta and bread, but the variety was there. The foods were given WHOLE. It looked like what it was. A blueberry was presented as a little round blue ball of juicy fruit, and not a blue-colored yogurt product. Sweet potatoes were little cubes or sticks and not a puree. Meat was given in little shreds or even still on the bone! Rice was not a cereal, but sticky grains that they could ball up and eat with their hands.

My kids have always been good eaters. My daughter eats most things, but my son will literally eat ANYTHING and wants to be a chef when he grows up. He is 12 years old, and has his own favorite cookbook so he can make amazing meals for the whole family! Can this be true for everyone? I honestly don’t know. I really believe that some kids are just going to be more sensitive and less adventurous with food. They might decide they like something and be very reluctant to eat anything else.

Some kids really do have more food aversions than others. I also believe that we can take steps to help mediate the effect that has on their diets. They might not end up being the kid who will scarf down raw kale, sushi, and hot sauce, but they can have a varied diet with lots of healthy and whole foods. We can work on NOT falling into traps that keep our kids from eating what we want them to eat. I think that starts when they’re babies, and then we stay consistent.

Spoon Feeding or Finger Foods?

So what does this mean for a six month old baby who is ready to graduate to solid foods? Should you offer rice cereal only? Should you blend up food into purees and feed your baby with a spoon? I was not a fan of this method. I tried spoon feeding rice cereal with my first and gave up very quickly. You might call me lazy, and you might not be wrong. I was breastfeeding exclusively, and after some struggles at the beginning, we had gotten to a point where we were really good at it! It didn’t hurt anymore. My daughter always got as much as she needed. There was no mess and no struggle. Then I started trying to introduce solid food! I had to buy groceries, and actually MAKE food using dishes! I had to wash dishes afterward. And what happened when I finally gave the food to her? Most of it came right back out. She wanted to play with the spoon and chew on it. The floor was filthy, my daughter was covered in gross looking rice cereal, and I was not impressed.

I found out that I didn’t HAVE to feed her solids yet. Her pediatrician said that breast milk was complete nutrition and that she would be fine. So, I waited. We got to a point where she was VERY interested in food though. I feel a little ashamed to admit that her first food was a pickle. When she was about eight months old, she grabbed a huge pickle out of the bucket of pickles sitting on our table at a New York style deli. Before we even realized that she had taken it, she had sucked it dry until it was just a shriveled piece of pickle skin. That is NOT bland food! That’s when I realized that I should give her more things to try. I started looking into options other than spoon feeding purees and rice cereal though. I did not want to go back to that mess. I found out that I could just give her small pieces of soft food. She was old enough to grab it with her fingers and get it to her mouth herself, so no spoon-feeding necessary!

This worked for us. She ate little clumps of cooled cooked rice or oatmeal. She ate avocado pieces, bananas, steamed sweet potatoes, carrots, and green beans. She ate scrambled eggs, little shreds of chicken and lots of whole soft beans. She ate just about everything that we ate, only in small quantities that she could pick up with her fingers. She didn’t have any teeth, so the food also had to be pretty soft or very tiny. But other than that, there weren’t many restrictions to what she could have. That might surprise a lot of people!

Now I know that the way I chose to feed my babies is called the Baby-Led Weaning method for starting solids. We have a fantastic class to help you learn more about this that is taught by a registered dietician, Janel Davis. Baby-led weaning means that you watch your baby for signs that they are ready to move on from just milk, and then offer them nutritious finger foods that they can safely eat themselves.

When to Leave Milk Behind

This doesn’t mean you have to stop breastfeeding! It’s important to continue breastfeeding and gradually introduce solid foods. At first, a baby will not be able to get enough of the right nutrition just through solid foods. It’s mostly just a fun experiment when you’re getting started! I interviewed Janel Davis, RD when researching this article. She says, “Till one, food is for fun.” Until the babies are a year old, they will mostly play with the food, try some, love some, reject some. It should be a mostly low-stress experience for parents, although it can be really messy still! As long as the baby is still getting breast milk or formula, it’s not important that the baby eat perfectly balanced meals every day. Let them just have fun with it at first, and have lots of different experiences with colors and textures and flavors. You don’t have to worry about exactly how much they’re getting.

Gradually, solid food meals will take the place of more of the milk feedings until food becomes the majority of what the baby eats in a day. A lot of times, milk ends up just being a comforting snack at the beginning or end of the day or before a nap. At this point, a baby might be close to two years old and has plenty of teeth and motor control. They are able to eat enough at family meals to provide for their complete nutrition.

Getting Started

First, it’s very important to know WHEN your baby is ready to start trying food. Janel Davis recommends looking for two things.

1. Your baby should be able to sit up without help. If you still need to prop your baby up in a sitting position, you should wait to feed solid foods. They are at a higher risk for choking if they don’t have the muscle strength and control to sit up on their own. It may also mean that their digestive system is not quite ready yet.
2. Your baby will be showing some interest in your food. If your baby is grabbing at your food and very interested in watching the family eat, it might be a good sign that they want to eat too!

Then, bring your baby to the table at mealtimes. The Baby-Led Weaning Method means they learn to eat like the family. They eat when you eat, and they may even get the same foods! You can pull the high chair close to the table, or instead of a typical high chair, you might consider purchasing a special chair for babies that pulls right up to your dinner table. They are height adjustable and usually have a baby seat and straps so they are secure. These chairs are great, because they can be adjusted to keep your child at the right height as they grow.

What to Feed Your Baby First?

According to Janel, first foods should pass a couple of tests.

1. It should be about the size of your two smallest fingers pushed together. That’s a piece approximately three inches long, and 1-1.5 inches wide. That’s so the baby can grab it easily with their hands. At first, they are clumsy and may have a little trouble coordinating the grip, so it helps to have food that size and shape. It will look like a stick or a spear.
2. It should pass “The Squish Test”. It should be soft enough to give a little when you poke it, but it shouldn’t completely fall apart or ooze when squeezed. An orange slice is a great example of squishy enough but not too squishy.

Here are some great ideas about first foods recommended by Janel. These are suggestions, but you’re not limited to ONLY these things! Remember that it should pass the size and “squish” test, then you can get creative!

Fresh fruits

• Avocado
• Banana
• Orange slices
• Kiwi fruit
• Melon slices
• Mango slices

Steamed or roasted vegetables

• Broccoli or cauliflower spear
• Sweet potato sticks

Meat

• Chicken drumstick
• Pulled pork
• Shredded chicken or fish

Watch this video interview with Janel Davis, RD, for some more information. Also, consider taking the Starting Baby On Solids: Let Baby Lead the Way class at Breastfeeding Success for more detailed information about infant nutrition and even some great recipes!

It is SO important to know when to start feeding your baby solid foods, and what kinds of foods your baby can eat for safety and good nutrition. It’s another thing entirely to get yourself and your kids to do it! The nutrition and safety aspect is critical, but so is the behavioral and parenting side of the story. You might know exactly when and what to feed your baby, but do you know HOW to get them to eat it? Some of this information for starting out can be found in the class for babies, but what if you’ve already been feeding your baby for a while and you’re encountering some issues? Are there ways to repair problems and maybe even prevent feeding issues in your future?

In a lot of cases, I do think parents have some control here. Parents can do some things to encourage healthy eating for their kids. It might mean ignoring some of the mainstream “wisdom”, and introducing some discipline and routines that don’t come naturally to you. If you already have a “picky” eater, it can be especially hard to shake things up in a big way. A few years ago, I spent some time writing down the things that helped me and my kids enjoy easier and healthier eating. Starting out with good habits early can help prevent problems and set you up for a better experience later.

Here are some older posts for some tips on setting up some good habits, and HOW to get your kids to eat.
Part 1
Part 2
Part 3
Part 4

What will your baby look like at birth?

Cute? No, probably not. Sorry!

Pretty much everything they show on TV and in movies about birth and newborn babies is very wrong. Birth almost never happens like that, and babies don’t look like that as soon as they’re born. They use babies that are at least a couple of months old to play newborns in the movies. They’ve gotten over the worst of the newborn weirdness by then. There are some people who look at their newborn baby and think they are absolutely beautiful. Others of us (me included!) look at our newborn baby and think, “That can’t be mine! What’s wrong with it?!?!” Luckily, the answer is almost always, “nothing”. Your baby might not look healthy and fine, but they are!

How long will my baby be ugly?

Luckily, they start to get cute pretty quickly. A lot of the strangeness comes from being fresh out of the womb. They have been waterlogged for nine months. They have stuff all over them that has been protecting their tender skin.

Babies also get pretty squished during a vaginal birth, and that can leave some marks. Within a few hours, most babies will start to look a little more normal. This does not mean they will look completely normal in every way though. They do look better pretty quickly and we can stop worrying.

Unfortunately, most of the time weird conditions and behaviors will keep coming up for the next couple of months! By the time babies are about three months old, they should look like the cute babies we see on TV and out in the world. Most of us haven’t seen brand new babies. Most newborns don’t get out much, and when they do they might be all bundled up and in blankets. We don’t get to see the truth of newborn ugliness until we have our own.

What can I expect right after birth?

There are a lot of things we might see when a baby is first born that usually go away pretty quickly. There is a lot of variation. Depending on how quickly and easily the baby was born, the baby’s natural skin tone, and how long the baby was in there, you may or may not see some of these attributes:

• Blue, gray, or other weird skin colors – Until a baby is breathing well and has good blood oxygen saturation, their skin tone might be sort of pale or bluish. This usually improves within minutes. Once the baby is breathing well, the skin tone might STILL not look normal; it depends on the baby’s natural skin tone. Some babies will look pink, others might look bright red, or even purple! I have a darker olive skin tone, and my first baby was a very deep red color. It was pretty shocking! My second baby was mostly purple. I didn’t expect this, but I was reassured that they were normal and healthy. Their skin tone changed gradually over the next few hours and looked a lot more normal by the next day.
• Swollen face/eyes – A lot of babies will have a swollen face or swollen face and eyes. I remember thinking it looked like my daughter had gone a few rounds in a boxing ring! My son did not look very swollen at all. When a baby spends time in the birth canal, they get a little squished and this can cause some swelling. My son was born very quickly, so he was not as swollen. Also, babies tend to be a little swollen because they were submerged in water all those months!
• Hair – Some babies look very hairy when they’re born. It’s a soft fuzz that might cover a lot of their body. This is called lanugo. All babies have it in the womb to help protect their skin. A lot of it falls off before they are born. When a baby is born on the early side, they may have a lot more lanugo than a baby born later. Most of this body hair will fall off over the next few days and weeks.
• Skin goo – Babies are born with some goo on their skin. Some will have a little, others will have a lot more. Some of this is blood. It is very normal for the baby to have some of your blood on their skin. You might be bleeding for a number of reasons. It could be that you experienced some tearing on your baby’s way out. There is also blood in the uterus that needs to come out and will continue to come out vaginally over the next few weeks. This is completely normal and nothing to be worried about, although it might look sort of gruesome. They are also born with some white waxy stuff on their skin. This is called vernix. It is there to protect their skin from getting too waterlogged in the womb. The common practice now is to leave it on them or rub it in because it’s good for them!
• Swollen genitals – Your baby might have swollen breasts, labia, and/or scrotum. This can be shocking if you don’t expect this, but it’s very normal. This can be caused by exposure to hormones and also just the birth process.
• Cone head – Babies can be born with a misshapen head, and it’s most always cone-shaped. A newborn baby’s skull is not fused together yet so that it can mold to fit the birth canal for easier birth. The skull bones are actually multiple separate plates that can overlap each other as the baby’s head is squished and descending through the birth canal. This will normalize pretty quickly and your baby will have a nice round head soon!
• Crossed eyes – Newborns often have crossed eyes, but that’s nothing to worry about. Babies don’t see all that well at first and have a hard time focusing on things that are at certain distances, so they will look cross-eyed sometimes.
• Birthmarks – Some birthmarks are subtle and stay with you for life. Others are caused by birth and will go away with time. A lot of babies are born with red splotches or dark spots that will eventually fade and go away. Sometimes these are really big and dramatic.

What can I expect later?

Newborns do start looking cuter pretty quickly after birth, BUT then other stuff might start to happen. For the first three months or so, you’ll probably notice a lot of big changes, and some of those might look weird or even hideous. They are technically newborns until three months old, so just hang in there! Whatever it is, it’s probably normal and nothing to worry about. A lot of parents are taken by surprise when their baby doesn’t have perfect baby skin or they start to notice these other strange characteristics or behaviors:

• Dry, flaky skin – Babies will lose a layer of skin after they’re born. Remember they were soaking in fluid for a very long time, so it makes sense that the top layer would need to come off. There is no need to provide extra moisture or lotion if you don’t want to. It will stop once that layer is gone, especially if you don’t use drying soaps or shampoos.
• Yellow skin – Jaundice is a condition that babies are sometimes born with, but some develop it a little later on. This is usually just called breast milk jaundice and will go away if you continue to breastfeed frequently. It can make your baby look very yellow or orange.
• Acne – Babies can get acne! My daughter had breast milk jaundice and acne at the same time. She was a little bit ugly. Of course, by that time we were so in love with her that we hardly noticed. However, we didn’t print any pictures from that time! The jaundice went away after a few days. The acne was much better after a couple of weeks, and then she was REALLY adorable.
• Jerky movements and gestures – A newborn doesn’t have a whole lot of control over their body yet. Their arms and legs might flail around awkwardly. They might scratch themselves, hit themselves and you, wake themselves up with a big jerk of their arms. I like to imagine that some of this is just that they are using their little muscles and getting the hang of NOT being in water and crowded. Some movements are actually special reflexes that only newborns have. These are a couple of the more common and cute reflexes that newborns have and then LOSE once they get a little older:
  • The Moro Reflex – This is what we’re seeing when a baby is falling asleep and their arms start to relax down, but then they startle awake and jerk their arms forward like they’re trying to grab hold of something. They are! Humans and other primates historically tended to hold their babies A LOT, and babies are born with the instinct to not be dropped or fall out of a tree.
  • The Rooting Reflex – Babies will open their mouths wide like they are ready to eat when the side of their cheek is rubbed. Even if a baby just ate and isn’t hungry anymore, they will respond that way. Babies need to eat OFTEN as newborns because their bellies are tiny and because at first we only have a very small amount of milk released at each feeding time. This reflex helps the baby and the parent remember to feed more often and to help the baby open wide to get a good latch.
• Rude faces – Newborns tend to make a lot of funny faces and sometimes they look a little rude! They don’t have much control over their facial expressions yet. They might make a face that looks like they are trying to poop, but then you don’t see anything in the diaper. Sometimes when they ARE pooping, the facial expressions can seem pretty intense and we wonder if there is a problem. It’s most likely just that pooping is a new and strange sensation and your baby is reacting to that. Sometimes they look very surprised or disgusted for no reason. They might smile and look very happy when passing gas. They might look very focused and determined, or suddenly stick out their tongues. It can be endlessly entertaining to watch a newborn baby make faces.

Whatever your newborn looks like or is doing in those early weeks, just remember that they do change very quickly and most things are nothing to worry about. I know that a lot of times we are not encouraged to do an internet search for health conditions, but when it comes to newborn weirdness, it might be worth a quick search just to ease your mind a little. Doing a search for “My baby has acne.”, will show you that this is a very common thing and you can stop worrying. Most things are like that, so a quick search can give you some peace of mind. If you are concerned, it’s definitely a great idea to call your pediatrician or family doctor. Babies have so many visits at first, that it might also make sense to just make a list of all the weird things you’re wondering about so you don’t forget to ask while you’re there for a check-up.

If you’re thinking, “I don’t know what COLOSTRUM or JAUNDICE even are”, you are not alone. These are things that most people don’t learn about until they have a baby of their own. Even then, your baby might not ever have jaundice. One of the best ways to prevent it is by ensuring that your baby gets plenty of colostrum right from the beginning.

What is Colostrum? 

Colostrum is the first milk that you produce. Your body is preparing to make milk from early on in the pregnancy, and by the end of the second trimester, your body is probably ready to feed a baby. This is how even babies born prematurely can often get breast milk. Colostrum is what comes out first. It’s very dense and nutritious and just what a newborn baby needs. It’s different from mature breast milk in a lot of ways.

1. There is only a very small amount. You might only feed your baby a teaspoon at a time, or even just a few drops! This is actually a good thing. While a baby is learning to suck and swallow food, it’s helpful to only have a smaller amount to work with. This allows the baby to gradually build strength and coordination.
2. It is thicker and more yellow.
3. It’s higher in protein and lower in fat and carbohydrates so that a small amount is all they need.
4. It is extra rich in immunoglobulin A. This is a substance that protects the baby from infections while their immune system is developing.
5. Colostrum is also designed to feed the good bacteria that’s trying to get established in your baby’s gut. Babies are born with a sterile gut, but they need to colonize it with a great microbiome quickly so they can digest food and fight off infection. A microbiome is an army of microorganisms that inhabit your body or a particular part of the body. We need these armies to protect us against germs, break down food for energy, and help make the vitamins we need to stay healthy. The baby gets their first big dose of microorganisms from your vaginal microbiome during birth. Microorganisms are bacteria, bacteriophage, fungi, protozoa, viruses.It might sound bad to hear that the baby will be getting bacteria and viruses from you, but there are a lot of different species of these microorganisms. Some of them are bad and make us sick, but others are really good! Those are the ones you are passing to your baby. We need a big collection of the good ones in the gut to digest food well and stay healthy. Colostrum is designed to feed these new microorganisms in your baby’s gut so they reproduce and spread. Once this happens, your baby will be able to digest food better and will be even more protected from harmful bacteria and viruses.
6. Colostrum is very important for so many reasons. Some people even collect colostrum before they go into labor just to make sure they have some on hand in case they have to be separated from their baby for any reason. See this recent blog post to find out more about collecting your own colostrum using hand expression.

What to Do Right After Birth

The best thing we can do for a great start at birth is to make sure your bare baby is placed directly onto your bare skin immediately after birth. This skin-to-skin contact (SSC) does many things. It helps your baby adjust to being outside the womb. Babies tend to breathe better and regulate their body temperature and blood sugar levels better. It’s also a signal to your body that the baby is here and it’s time to start making and releasing milk.

It’s also a great idea to delay any unnecessary procedures or assessment until you’ve had time to give your baby the first feeding. Some of the things that might be delayed include shots, ointments, weights and measurements. These things can come a little later and will give you and your baby the uninterrupted time you need to get a good start with feeding. It’s important to rest, relax, enjoy, and watch your baby for signs of readiness.

A baby might get very alert and start to seem restless. They might lift their head right up and start bobbing around looking for a nipple. A baby might try to eat their fist or open and close their mouth like a fish! When you can notice these signs and allow the baby to find a nipple quickly, the first feeding will usually be at just the right time and be successful.

If your baby doesn’t seem interested after 30 or 45 minutes have passed, it’s also ok to offer a nipple anyway. If your baby doesn’t want the nipple or seems especially sleepy, it’s a great idea to ask for help from a lactation consultant. They might offer some great suggestions to get your baby to latch on, or they might recommend that you hand express some colostrum to give your baby.

What is Jaundice?

Jaundice is a condition that happens when bilirubin levels in the blood are high. Bilirubin is basically just a waste product that our bodies make from the normal breakdown of red blood cells. Usually, our liver takes care of the waste and it’s removed from the body. When the liver isn’t functioning right, or when there is too much of this waste product to pass through completely, it can build up and be reabsorbed in the intestines. You may be able to see that a baby has jaundice because their skin color looks more orange or yellow in tone. Newborn babies are at a higher risk for jaundice for a number of reasons.

1. Their livers are immature and slower to pass the bilirubin.
2. They have more bilirubin because they have more red blood cells with a shorter lifespan. That means more broken down red blood cells to move out.
3. Newborns are born with a substance called meconium (see this article about Newborn Poop!) in their intestines. Meconium is what we see in their diapers for the first couple of days. It’s the waste that has built up in their gut while they were in the womb. It’s not made of food, since they don’t actually eat while in the womb, but babies do swallow the amniotic fluid. So meconium is made from lots of little hairs and skin cells and fluid. If the baby is not passing the meconium quickly enough, the bilirubin stays trapped in the intestines and can be reabsorbed, causing jaundice.

How can colostrum help?

When a baby is getting plenty of colostrum from the beginning, it helps them pass the meconium. By quickly clearing out the meconium, the bilirubin is not able to build up and be reabsorbed in the intestines.

Later on, if a baby seems to be eating well and getting plenty of milk, jaundice can happen as a result of not getting quite enough milk. The baby is getting enough to grow and make dirty diapers, but not quite enough to keep the bilirubin flowing out. This is not uncommon, and is usually called breast milk jaundice. In most cases, breastfeeding should continue. The more a baby feeds at the breast, the more milk will be produced, and that can help flush the bilirubin out. Sometimes it just takes a little longer.

There are cases where a baby needs extra support for jaundice. When this happens, the most common therapy is with light. It’s not invasive and doesn’t even involve medication! The baby is put under special blue lights, like fluorescent lights. They get some tiny goggles to protect their eyes from the bright light and are kept warm but uncovered so their skin can absorb the light best. This particular light spectrum can break up the bilirubin so it can leave the body through dirty and wet diapers. Some settings can offer biliblankets instead. These can often be used for light therapy in your room or even at home!

References:

National Library of Medicine – StatPearls article about the Anatomy of Colostrum

Dunn AB, Jordan S, Baker BJ, Carlson NS. The Maternal Infant Microbiome: Considerations for Labor and Birth. MCN Am J Matern Child Nurs. 2017 Nov/Dec;42(6):318-325. doi: 10.1097/NMC.0000000000000373. PMID: 28825919; PMCID: PMC5648605.

CDC Article about Jaundice

I would never have read an article about baby poop before my baby was born. Most people don’t want to know ANYTHING about baby poop…….UNTIL they have a baby of their own. Then, watch out, because it might become a very weird obsession.

If you are getting a chance to learn about baby poop before your baby comes, then good for you! It doesn’t look like most people expect it to, and it goes through a lot of very strange changes over the first few days, weeks, and months of life. That can be really surprising–and even worrying–for a lot of new parents.

First, Meconium

A baby’s first poop is actually called Meconium. It’s very different from the poop we know, because it’s not made of digested food. Meconium is made up of all the things that get into the baby’s digestive system while they are in the womb, but that doesn’t actually include food. They are not eating and drinking like we do.

Babies get everything they need from your blood. Your blood transfers across the placenta and into the umbilical cord. The umbilical cord is many blood vessels that carry oxygen and nutrient rich blood TO your baby, and some that carry waste products and carbon dioxide BACK to the placenta so your body can dispose of it. So, there is no actual poop in the baby’s digestive system. The baby is only swallowing amniotic fluid, so Meconium is a substance made of the things in amniotic fluid that are not absorbed as liquid such as little hairs and skin cells that the baby sheds while floating around in there.

Meconium is what you see when your baby has the first bowel movement. It has no smell, and it looks a little like tar. It’s dark, usually blackish-green in color, and very sticky!

Your baby should pass all the Meconium after a couple of days and things will start to look a lot different.

It’s nice that diaper changes are not a smelly problem yet, but a Meconium smeared bottom can be a big challenge. It’s very sticky, so basic wipes don’t usually do the job. Try using warm water or add a little gentle soap to the water, and use a washcloth to wipe the sticky bottom. Another useful trick is to prepare your baby’s bottom with a layer of diaper cream or even just coconut or olive oil. This will provide a barrier so the poop won’t stick the next time your baby has a bowel movement.

Transitional/Colostrum Poop

For the first couple of days that you are feeding your baby, the breast milk is called colostrum. There isn’t very much of it, but it’s extra thick and rich in exactly what the baby needs to get a good start with digestion. Don’t expect to see one big poo everyday. At first, breast milk poop will probably look green or greenish yellow. That’s the transitional poop. There is still a little meconium passing through, and it’s mixing with the yellow breast milk poop to make it look greenish. That’s totally normal! It might still be a little bit sticky too.

There are usually many dirty diapers per day at this point, but because they are eating small amounts, it might just be small smears on the diaper. There might be a little smell at this point but probably not as bad as you might be expecting!

Breast Milk Poop

After approximately five days, the poop should look like it will be until your baby is a little older. Once your mature milk is in and you have a good supply, there may be more poop in the diapers. You may see a dirty diaper after every feeding or just 2-5 per day.

On average, babies poop about four times a day by Day 5 of life. Fewer dirty diapers at this point could mean your baby is having trouble getting enough milk, but if your baby is gaining weight well it could just be normal for them. The poop will be soft or even runny, yellow (it might be as bright as mustard!), and you might notice a funny texture. Some people describe it as seedy, pebbly, or like cottage cheese. There will be more of a smell, but most people aren’t too bothered by it. Some might even describe it as sweet-smelling!

After about six weeks of age, babies will usually start having fewer dirty diapers and sometimes might only poop once a week!

My daughter was one of these babies. Right at that six week mark, she suddenly stopped pooping every day and it ended up becoming a once a week event. I was very worried about that at first, but was reassured by my pediatrician that she was gaining weight well and was very healthy. This just happens sometimes with breastfed babies. Some babies are good at using everything they get very efficiently and with very little waste.

When this happened with my daughter and I finally understood that she was healthy, I got to enjoy this break from dirty diapers. I even used this as an opportunity to try out cloth diapers. I knew I wouldn’t need to wash dirty diapers, just wet ones, so I saved a lot on disposable diapers for those months and learned enough to feel confident to continue using cloth diapers even after that. I never switched to cloth diapers full time, but even just using them when we were at home helped to save a lot of money and waste.

If you’re interested in learning more about cloth diapering, this is a great introductory video leading to an instructional video series by Whitney at Enlightened Baby, a local Austin baby store.

Solid Foods Poop

Everything changes again once your baby starts eating solid foods. A lot of babies are ready to eat solids by six months, although it’s also OK to wait longer if your baby doesn’t seem interested. Consider taking our Starting Your Baby On Solids: Let Baby Lead the Way class if you’d like to learn about how, when, and what to feed your baby when they are ready for more than milk.

Once your baby is eating solid food, the poop will change again. It will likely get more solid and more brownish, and more stinky. Breast milk has many benefits, and better smelling poop is definitely one of them! At this point, your baby’s poop will resemble what most people know poop to be. Just like yours, it may change depending on what they ate that day, how hydrated they are, and whether they are generally healthy.

Formula Poop

Things are different if a baby is formula-fed. Formula is a lot more stable than breast milk which means that the calorie, carbohydrate, fat, nutrient and water content will stay the same for every feeding.

There’s a lot more variation with breast milk. From very early on, formula-fed babies tend to have fewer bowel movements per day. They are usually bigger, more solid, and also yellow, although they might be more brownish-yellow and have less of the strange breast milk poop texture. Formula poop tends to have more odor. If your baby is formula-fed from the beginning, the poop likely won’t change all that much until they start eating solid food. The number of dirty diapers will stay pretty consistent.

I know it seems weird to be thinking about poop so much and looking at pictures of dirty diapers, but when you start changing those diapers, you’ll see! Fortunately, the obsession does go away (for most of us at least) once they start using a toilet and wiping themselves…..out of sight, out of mind.