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Dr Virginia Thorley, OAM, PhD, IBCLC, FILCA

International Board Certified Lactation Consultant

www.virginiathorley.com

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Babies' hands and how they use them - "I've finished my feed".

Posted on April 13, 2019 at 8:12 PM Comments comments ()
With a first baby, it can seem so hard to tell if your baby has finished feeding or not. I have been asked about this a lot. Certainly the amount of time isn't a reliable indicator, as some feeds will take a shorter or longer time than others - it is normal for the length of a feed to vary through a 24-hour period. Usually, your baby's hands will give you cues about whether she needs to continue the feed or is finished. While there can be exceptions, I have actually found these very rare.

At the beginning of a feed your baby's hands will be bunched up, often tightly into little fists. Anyway, they'll be closed, not open and floppy. As the feed progresses, the hands become more relaxed, often a gradual process. If your baby stops feeding, but stays at the breast, you wonder, 'Is she just taking a break, or is she done?' A few babies may release the breast and go to sleep, but other babies just stay on!

When in doubt, it can help to look at your baby's little hand to see if the fingers have opened up, or to lift her hand gently to see if it is floppy. To give an example, a mother I know found this a useful guide with her first baby. He usually came off the breast and grizzled after a feed, and checking if his hand was floppy helped her to tell if he'd finished the feed and was 'just being him', or it he needed to resume the feed. I often find this cue that a baby's hands give is reassuring to mothers.

Latest heatwave

Posted on January 5, 2018 at 9:41 PM Comments comments ()
With the current heatwave in much of Australia, including the southern states, it is timely to mention caring for you and your baby in extreme temperatures. My earlier posts on related topics have more information. Some quick tips:
- Stay indoors, especially if you have air-conditioning.
- Avoid the pool or beach in the heat of the day, unless it is an indoor pool, as a baby's skin can very quickly burn, including from reflected heat from the sand or water. Sunburn is a BURN.
- Keep the curtains or blinds drawn as letting the bright light in also lets the heat in. A darker room is a cooler room
- If you have a breastfed baby or toddler, your child will likely want to go to the breast for more frequent, short drinks. This is normal and helps keep up fluid intake to suit the weather conditions. Your baby will be able to get enough fluid, if allowed unrestricted access to the breast, as the milk adapts during the day to meet fluid needs.  More frequent feeds also help stimulate the milk supply to meet demand.
- If you have a baby who is weaned onto infant formula, giving cool boiled water may be necessary, as formula doesn't change during the day to suit the baby's needs. Check that there's still the same number of really wet nappies, with clear urine (not darker).
- Busy mothers sometimes forget to drink enough fluid. (Yes, me too.) So be sure to take a good swig of water any time you feel thirsty  (See my earlier blog post on this.)
- In very hot weather, sponging your baby with tap water may be necessary to cool him/her down. Check that the water from the "cold" tap isn't too warm or hot. If it is, you may need to cool it down before sponging your baby's skin.
- Finally, make sure you have fresh batteries in a portable radio, or your mobile device charged up, so that if the electricity goes off you can still listen for weather or fire warnings on the national emergency radio network, which is ABC Local Radio.
All of the above tips are tried and proven. I reared my own children in both the dry Tropics and the coastal Tropics, and I've also provided this advice and support to many mothers since then, whether on an individual basis or as a chapter in one of my books.

Your baby in wild weather

Posted on November 30, 2017 at 5:11 PM Comments comments ()
Today's forecast for wild weather and heavy rain in Victoria, Australia, makes this an opportune time for a post on this topic. First, in regards to overall safety, the ABC Local Radio station in your area is the emergency radio network for updated information. So, in case of electric power outages, it is important to have spare batteries for your portable radio or to recharge your other hand-held device. (If the power goes off, you can recharge your phone from your car battery via the appropriate jack.)
This is a time to get to know your neighbours, if you don't already. Neighbourly cooperation can be an asset in emergencies. During a recent cyclone in Central Queensland, when  the power went off, neighbours in one affected street with meat that was likely to go off without refrigeration shared it with others in a street barbecue, each bringing whatever food they could, to share.  This was reported on ABC Local Radio as a solution for some neighbourhoods, an idea that is worth sharing. 
Breastfeeding: This isn't the time to wean, as continuing breastfeeding provides first-class nutrition and protection against infection for your baby - as well as needing no special equipment, no safe water supply, no sterilising. no mixing.  It is there, as long as you and your baby stay together. All that your exclusively breastfed baby needs is the breast.  If your baby is older and is receiving other food, too, in an emergency you can still boost your milk supply by breastfeeding more frequently, if your child is willing (the opposite of weaning).  More milk taken and more stimulation = more milk. Even if you only want to do this for a short time during the emergency, this is worth knowing.  Remember, too, breastmilk provides a significant amount of important nutrients at any age, including prebotics. (See my earlier posts on this blog and the contact details for the Australian Breastfeeding Association on the LINKS page.)
If you are not breastfeeding your little one, the time to prepare is now. That means safe water for reconstituting the formula powder, enough to be boiled and stored ready for use for the next few feeds. Plus equipment for hygeinic preparation of equipment.  More detail can be obtained from your local Child Health Nurse.
All Mums, however they are feeding, need to remember to look after themselves, for instance, remembering to drink enough fluid, especially on very hot days. (See my other posts about mothers and fluid needs.)
All the best for the expected bad weather.  Being prepared can help you "weather" the  storms better. 

Vegetables and toddlers

Posted on November 29, 2017 at 5:01 AM Comments comments ()
Toddlers and vegetables have been a topic of concern for mothers for years. In this post I'm not going to give an overview, but just mention something that worked in our house. At one stage one of my boys wouldn't eat potato but he  would eat yellow vegetables (carrot or pumpkin). His brother was the opposite - he would eat potato and disliked yellow vegetables.  Later, they reversed their preferences - so confusing! What both boys would happily eat was "yellow potato". Yes, you guessed, both types of vegetables mashed together. They would eat it just mashed together and they would also eat variations of it, made into potato cakes with an egg mixed through, or as "bubble and squeak" with left-over peas or greens.

Fluids - tea, soup, and more

Posted on November 11, 2017 at 11:23 PM Comments comments ()
When we think of drinking enough fluid, the first to come to mind is water and many of us now carry a reusable water bottle or have it nearby during the day. As mentioned in some of my previous posts, don't forget that soups and other light liquids can also provide us with fluid and some nourishment.

Rosemary tisane (recipe):
Currently I am making a rosemary tisane, a refreshing drink.  (In case you were going to ask, I understand it is caffeine-free). I have a rosemary bush in my garden and I cut 3 or 4 sprigs from that and place it in a 2-cup teapot. I pour boiling water over the sprigs and allow them to steep for a few minutes. (My teapot is glass and so I judge when the tisane is ready  by the colour of the water.) I have a cup of rosemary tisane beside me now. I prefer it unsweetened, but a visitor the other way preferred a tiny amount of honey in hers.

Soup:
You might like to read my earlier posts in this blog about soup. Do you have a recipe for an easy soup you would like to share?

Sugary drinks:
The current health and nutritional advice is that sugary drinks, such as cola, soda, and other soft-drinks and even fruit juice, are not good choices. This, however, is a different topic.

Got a quick question?

Posted on June 5, 2017 at 9:42 PM Comments comments ()
I notice from the site activity report that there are more visits to my blog than to other pages.  When visiting the blog, if you are a new mother and live some distance away, you might like to see access details for a secure online video platform where you can chat with me about a quick question - or even do a video consultation with you and your baby.  This is a new service I can now offer. A widget for accessing this platform can be found on my homepage, to see if I'm online and go ahead with a video call, or request a time if I'm not online.

Your baby in heatwaves (exreme heat)

Posted on February 11, 2017 at 7:30 PM Comments comments ()
The current extreme hot weather this February, and over the last few weeks, is very difficult for mothers of babies, especially very new babies who cannot regulate their temperatures as well as adults can. Even adults are struggling in extreme heat.
Have a look at my earlier posts on this blog for specific topics. Here is a summary of key points that are relevant right now:

- If you have air-conditioning, please use it for your baby. It doesn't have to be at the coldest setting, but enough to let you and your baby feel comfortable.
- If you don't have air-conditioning, work out the best way to make use of fans.
- The best place for your baby, if you don't have air-conditioning, is well away from external walls of your house or unit, perhaps in a central passageway.
- Light clothing, or just a nappy, is all your baby needs indoors.
- Draw the curtains or blinds to keep the glare (and heat) out. Bright light only makes it hotter.
- Sponging your baby down will help keep him cool. If the water in the "cold" tap is hot (which it is at my place right now), you may need to put a small bowl of the water aside for a few minutes to cool down.
- Avoid the beach with a baby, especially a very young baby. It can be a very hot place to be, with some spots on the beach even hotter. The dangers result from direct sunlight and reflected light from the sea, sand and other bright surfaces.
- It's  best to avoid backyard pools till the sun is low, e.g. after 5 pm,  for similar reasons.
- If you have to go out, avoid being in direct sunlight in the heat of the day if at all possible. A hat for your baby and a light wrap to keep the sun off delicate skin is important if you have to take your baby out into strong sunlight between your car or bus and the supermarket or other buildings.
- If you are in a shopping centre with its air-conditioned public areas, I'm sure you know that is a good place to stay for a while, sitting, meeting with friends, or window shopping. Air-conditioned libraries are also good places to hang out for a few hours.
- Breastfeeding as often as needed will keep your baby well hydrated and safe on the hottest days as the composition of the milk changes to meet needs. (See my other blog topics on hot weather.)  It often means lots of small breastfeeds to assuage thirst and longer breastfeeds when it is cooler, e.g. after the sun goes down.
- You may need to place a small towel between you and your baby during feeds if skin contact is hot and sweaty. 
- If your baby is sleepy and not showing interest in the breast, sponging her down with cool water will often help her feel comfortable and ready. You may want to sponge her down part way through the feed, too.
- If you baby is lethargic and sleepy and not as alert as usual, and her urine looks dark or she isn't passing much urine, medical help is indicated.

ADULTS
- For you (and other adults), urine is a good guide to hydration. Your urine should be clear and light in colour. If it becomes darker, this is a signal to drink more fluid, immediately.
- It is easy to forget your own needs when you are busy with a baby.  Keeping some water beside you when you sit or lie down to feed is a good idea - and old tip, but a good one.
- It is good to see most adults now carry a water bottle, often a large, refillable one, so that they can stay hydrated on the go all day.
- Light, cotton clothing is cooler than tight clothing or synthetic fabrics.

Stay cool and hydrated

Posted on January 17, 2017 at 6:46 PM Comments comments ()
In the current heatwave conditions in Australia, it is important to remember that it isn't just any day, but a special situation.  Your needs and your baby's needs are paramount.

How to keep cool

If you have air-conditioning, even in one room, this is a great help in keeping your baby cool, and yourself, too. Without air-conditioning, hanging wet towels on the backs of chairs and directing an electric fan at them, can make the air that circulates a little cooler. (Evaporation cools.)
It can be important to sponge your baby with cool water if she becomes hot or red. You may need to do this several times a day. On scorching days, the water in the "cold" tap may actually be hot in some regions. If this is so, pour some water into a bowl and put it aside for a short time till it is cool and safe to use. 
You will realise that this is not the time for dressing your baby in onesies and jackets.  Indoors, just a nappy is often enough in a heatwave. If you absolutely have to go out and cannot avoid it, loose cotton clothing is best, with a cotton wrap to keep the sun off delicate skin, e.g. when you take your baby from the house to the car.
Of course, going out may be a Good Thing if you don't have air-conditioning. Lots of mothers and pregnant Mums spend a few hours at an air-conditioned shopping centre or a cinema. Does your local library have quiet activities for very young children? 
Beaches are NOT safe places for babies in hot weather.  Besides direct sunlight, there is reflected light (and heat) from the sand and sea, and the windscreens of cars in the parking lot. The same applies to pools that aren't fully shaded. So check out how good the shade is, first. 
Infant-care lambskins are useful as a surface for a baby to lie on as they absorb about one-third of their weight in water before they feel wet. I was lucky enough to be one of the mothers with a new baby in a trial of infant-care lambskins, while living in a remote arid region, and it was a good experience. (No, I have no conflict of interest in mentioning this as I had no financial benefit from the long-ago  study.)
For yourself, loose clothing is your coolest option.  This isn't the time to catch up with heavy housework - just the basics. Forget what you "should" do - it's more important to focus on keeping you and your baby cool. This can be a time to watch a DVD. You may find you are not hungry in the middle of the day, and a cool soup or a sandwich or small salad might be all you feel like eating.  Then in the evening your appetite is up again. Like so many Mums now, you probably carry a water bottle so that you can take a swig any time you need to. Your urine is a good guide to whether you are probably hydrated; if it becomes dark, that means you need to drink more fluid straight away.

Feeding

A breastfed baby needs to have unrestricted access to the breast, which will supply all fluid needs, changing through the day in response to your baby's demands.  You may find that your little one takes quick "snacks" at the breast in the heat of the day, spending longer at the breast and having big feeds after the sun goes down and in the early morning.  A study of breastfed infants in the hot, extremely arid Negev desert found that they remained adequately hydrated if they had unlimited access to the breast. (This may not apply to formula-fed babies, who may need small amounts of additional water on the hottest day - but check with a Child Health nurse in your area.)

Finally

A darkened room is cooler. Drawing the blinds or curtains keeps out the heat, whereas opening them, or having sheer or lace curtains, lets in the heat with the light. With thin curtains, or with the curtains opened wide, often even the wall opposite the windows feels hot to the touch.  

Links and FAQs

Posted on July 9, 2016 at 11:44 PM Comments comments ()
If you are just browsing this blog and haven't visited the other pages, do take a look at my Links and FAQ pages for information on popular topics and answers to common questions. Links that may interest you are the most up-to-date information on when to introduce solids in relation to the allergy issue (NEW) and the website of the Infant Sleep Centre in Durham.


New topics - your suggestions?

Posted on February 9, 2016 at 6:35 PM Comments comments ()
I notice from the activity report that this blog receives a lot of visits. While topics that were started some time ago continue to receive visits, I am open to suggestions about NEW topics, especially if you are a new mother, the mother of an older baby, a partner, or a grandparent. What do you wish you knew before your first baby was born?  What was the best piece of advice you received?

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