Allergies, gas and more
Should I buy the new formulas that contain DHA/ARA?
In 2001 the FDA approved the use of DHA (docosahexaenoic acid) and ARA (arachindonic acid) in formulas. This combination of fatty acids is found in breast milk and is important for brain and vision development. Although the enriched formulas more closely mimic breast milk, most experts still aren't convinced that they provide extra benefits, and they cost about 20 percent more than standard formulas.
"There is no clear-cut advantage for most babies," says Nancy Krebs, M.D., chair of the AAP's committee on nutrition. Research so far is most convincing for preterm infants: All babies receive DHA/ARA while they're in the womb, so preemies may be able to make up for some of the nutrients they missed out on by receiving the enriched formulas. More studies are currently under way, but until the results are available, talk to your pediatrician and weigh any potential benefits against the cost. "There's no right and wrong," says Dr. Krebs, "and this will not make or break your child's development."
I gave my baby formula for the first time, but when she spit up, it looked like cottage cheese. Could she be allergic to it?
Probably not -- welcome to Spitup 101. Just as bowel movements look different in breastfed and bottle-fed babies, so too does spitup, says Dr. Stern. The protein in formula forms a hard, thick curd in the stomach and takes longer to pass through, so the spitup is less fluid than a nursing baby's. That's also why a formula-fed baby's stools are firmer and less frequent.
What's the best way to prevent gas in my baby when I feed him?
Gas usually happens when your baby tries to consume too much too soon and ends up gulping a lot of air along with the milk. If you're bottle-feeding, hold the bottle flatter or use a tilted one. If you're nursing and your breasts are very engorged, try pumping them slightly before you start feeding.
There's no solid evidence that if a mom eats such potentially gas-producing foods as broccoli, cauliflower, and onions it will affect her nursing baby. But some infants do develop cramping when their mothers drink milk -- they have trouble digesting the cow's-milk protein that can pass through the breasts. If that's the case, talk to your pediatrician, who may suggest that you either cut out or limit your milk intake while you're breastfeeding and get calcium from other dairy sources, such as yogurt or cheese.
If your baby seems especially uncomfortable after nursing and you've recently had a particular food or beverage, you may want to scratch it from your diet and see whether that helps.
It's also important to burp your baby frequently to let gas escape from his tummy. Use whichever position he seems to like best -- draping him over your shoulder, resting him tummy down on your knee, or sitting him up on your knee and rubbing his back. "You don't have to use much force on your baby to release gas bubbles," says Hopkinson. "Gently rubbing or patting his back should be enough."
When can I start to give my baby a little bit of fruit juice?
Wait until she's about 6 months old, according to the AAP, and stick to 100 percent fruit juice rather than fruit drinks. Even then, you should limit intake to no more than four ounces per day. (If you want to quench your baby's thirst on hot days, you can dilute the juice with water to increase the volume for her to drink.) Large amounts of juice can cause diarrhea or excessive weight gain and may fill her up so she has less room for breast milk or formula.
Once you've mastered the practical stuff, feeding your baby can be a wonderful bonding time, relaxing and rejuvenating for both of you. So hold her close and enjoy the calm -- it won't be long before she's wearing sauce all over her face and pitching peas at the dog.
Laura Flynn McCarthy's last article for PARENTING was "The Truth About Bonding," in the December/January 2002 issue.