Shakespeare wrote about “the infant mewling and puking in the nurse’s arms” when describing the first stage of life.  Spitting was common then and it’s common now—affecting all babies.  But obviously some more than others.  My colleague, Dr. Ben Gold, an expert in the field, lists 3 causes:

  1. A smaller stomach,
  2. A less stretchable stomach, and
  3. The angle the stomach and esophagus make with each other is less than 90 degrees.

I add a 4th:  The strength (or tone) of the valve (the lower esophageal sphincter) between the esophagus and stomach.

Breastfeeding has been associated with higher IQs and other measures of cognitive and developmental abilities, but the studies were often dismissed because breastfeeding and IQs also parallel social, cultural and occupational differences. In other words, who's to say that breastfeeding made Johnny smarter when it could have been that his parents were also better educated and wealthier than Jimmy's and therefore they could have provided other advantages to increase his scholastic performance.

As horrible as it sounds, necrotizing enterocolitis, often just called NEC, is where part of the intestinal is injured or dies.  It seems to develop when feedings are introduced into a vulnerable intestine with an area of diminished blood supply.  That vulnerability seems to be increased by bacteria in the intestine and any increase in the thickness or calories of the feedings.  The lining loses its blood flow or develops an infection and babies who are ill or premature don't have the immune systems and capability to fight this off on their own.  Their feedings need to be stopped, antibioti

Once a baby is brought into the world, he or she is suddenly without the source of nutrition that has been providing what is needed to build tissues and organs and to create the enzymes and structures that must begin functioning almost immediately. Healthy full-term infants can usually function well. Their organs are already at a capacity that's ready to do what they must. They can feed on a mother's breast milk or infant formula and obtain what they need to gain and grow.

To feed from breast or bottle, it takes an ordered, coordinated pattern of sucking, swallowing, and breathing. Without that pattern, babies can aspirate breast milk or formula into their lungs. Most infants can manage that by 34 weeks of age, some slightly sooner.

Early premature babies (those born before 36 weeks) need a formula that is higher in protein and most vitamins and minerals. It has 20 percent more calories than routine formulas (it has 24 calories per ounce) to assist growth. These are sterile liquids and only available in hospital nurseries and intensive-care units.

A too tight attachment of the tongue to the floor of the mouth can interfere with breastfeeding or the ability to suck on any nipple. A cleft palate or a small jaw can also create problems, but at least a tongue tie can be relieved by a quick, easy procedure clipping the attachment, called the frenulum. These babies often are unable to touch the roof of their mouth with their tongues or they don't extend beyond the gum line. The tongue can even have an abnormal shape.

Believe it or not, hand expressing is actually an effective method of retrieving the breastmilk your body produces. This can be done in place of pumping or afterwards, often with several extra ounces collected. Begin at the upper portion of your breast and gradually massage downwards until your fingers are squeezing around your areola and nipple. Some mothers find it is most productive to do this as they lean over. You can also watch this technique visually on this video posted on the Stanford Medical School website:

“Hand Expression of Breastmilk”

I was interviewed on the radio (KISS FM) the other day -- and again the question came up about when to introduce baby to solid foods. I reiterated what I wrote in What to Feed Your Baby. I recommend that babies start eating solid foods somewhere between 4 and 6 months of age, with the exception that babies with reflux may do better with a small amount of cereal in their bottle to control their regurgitation. The first part of my recommendation conforms to the American Academy of Pediatrics guidelines. We are in synch, though I don't simply make my recommendation for that reason.

Congratulations on having a successful pregnancy and delivery of multiple babies. (Bet you're glad that's over). Since multiple births are often delivered early, you may want to read the blogs on premature infants as well <>. For more information you may want to refer to Chapter 11 in What to Feed Your Baby, too.

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