The Bottle Battle

Our toddler insisted on putting them on her little sister!

When our first baby was three weeks old, I introduced the bottle to her. It contained pumped breast milk, and she devoured it. Thereafter, every evening, I would give my breasts a break while my husband fed her a bottle of pumped milk.

I returned to work part-time when she was four months old, and whichever family member was watching her had no difficulty feeding her in my absence. In fact, she enjoyed bottled milk so much that now, more than 10 months after I weaned her, she insists on a bottle of (thankfully cow's) milk to fall asleep.

Things went a little differently with our second baby. She was so calm, and did not suck my breasts to excess, so I found no reason to hand her over for a daily bottle-feeding session. On the few occasions that someone else tried to bottle feed her while I ran some errands, things did not go that well. However, I was gone briefly, and left only after an extended nursing session, so I was not overly concerned.

By mid April, we decided to clamp down. We would try to bottle-feed her daily as to prepare for my return to part-time work in June. Things did not go very smoothly. We had experimented with four different bottles until we realized that it had little to do with the brand of bottle. Our little one simply wanted a warm breast, not a cold plastic nipple, and she knew if she complained enough, she would get it!

I was beginning to worry that I wouldn't be very productive at work; I imagined my husband bringing our starving baby to my workplace for feeding sessions every three hours! However, after much persistence on our part, we finally had some success this past week. Our baby would only accept bottled milk from her father, and on condition that I was out of the house. Additionally, the milk had to be on the warm side. While she has yet to drink an entire bottle, she came close on two occasions this week. Much to my relief! 

Playing with her sunglasses!

The allergist and his extracts

CC picks dandelions in our courtyard

A few months ago, I read the Alchemist by Paulo Coelho. It is a very profound allegoric novel. Prior to reading this novel, I had never heard of an alchemist. Upon reading the description, I thought immediately of our modern-day allergists with their countless vials of extracts. As a medical student, I had observed a pediatric allergist test his young patients for a number of foods, pollens, and antibiotics. The skin testing used by allergists is considered somewhat controversial as a food allergy can be inferred based on your skin's reactivity to an extract (and not ingestion).  In the more common version of the test, the allergist applies the purified extracts to the skin, then either scratches, or pricks the skin under the extract.  The excess extract is then blotted with a cloth. After a 10-20 minute delay, the allergist measures the skin's response to the extract. Positive and negative controls are also used (histamine and water respectively).

Example of skin testing on forearm

My observational stage with the pediatric allergist took place eight years ago, and I would have never imagined that I would be consulting, within ten years, a pediatric allergist for my child.  Food allergies are very rare in both my husband and my families, so I was very surprised to discover that our daughter reacted with a mild rash to dairy products.  We have been avoiding dairy since I made this discovery. I was hoping that like many children with dairy allergies (up to 80%), she would "grow out of it".  I was not too worried until I discovered that my baby was also allergic to peanuts.  At the recommended age (in the absence of family history of peanut allergies) of 12 months, I introduced peanut butter. She only took one lick, but within a minute she developed a rash all over her body. I pulled her out of her highchair, and administered the appropriate dose of Benadryl. Within 30 minutes, the rash had dissipated, she calmed down, and fell asleep shortly thereafter. I did not sleep very well that night, although my daughter did, probably under the influence of the Benadryl. I was instantly worried because I realized that peanut allergies are often associated with life-threatening anaphylactic reactions. Shortly after this discovery, our pediatrican prescribed an Epi-pen for the baby, and referred us to a pediatric allergist.  I was perplexed by my daughter's peanut allergy. Not only was there not a family history on either side, but I had also avoided peanuts while pregnant and subsequently while breast-feeding. Breastfeeding has also been demonstrated in many studies  to reduce the risk of food allergy, and I had breastfed the baby up until a few weeks ago!

With much trepidation, we met with a pediatric allergist yesterday. Would I discover that my daughter was also allergic to other tree nuts, and a number of other substances that we had not yet tried? Would I be living in fear of an anaphylactic reaction for years? As it happened, the allergist tested only for dairy and peanuts. As she explained it, the risk of false positives and false negatives was high enough, that to test substances that our baby had not yet been in contact with might create false hope, or false fear. Even though the baby was overdue for her afternoon nap, she behaved relatively well for the skin testing. After the extracts, along with negative and positive controls were applied, the baby discovered a large toy truck in allergist's office. This occupied her time, and the 10 minute delay flew by. The allergist got out her special ruler, and declared the skin test positive for peanuts, but negative for dairy. I was somewhat relieved, as I had discovered just how ubiquitous milk products were. Whether in the guise of caseine, whey, or skim milk products, dairy was present in a large number of prepared foods, including lactose-free products. I got the OK from the allergist to re-introduce dairy products such as yogurt and cheese. As for peanuts, the allergist would be re-testing at 31/2  to 4 years of age. And as for other tree nuts, she suggested that we introduce minute amounts of crushed nuts, gradually increases the quantity to a full nut after a few days.

While I have been in no rush to test other nuts, I have already successfully introduced yogurt and cheese sticks. But mostly I am happy I can kiss my daughter after having ingested dairy, and not have to worry about transmitting allergens into her system.  As for Peanuts, thankfully we live in an environment that is relatively conscientious of nut-allergies. Many food products geared towards children mention the words "may contain traces of peanuts", or alternatively "peanut-free". I was surprised to learn from the allergist the other terms for peanuts that may be used in ingredient lists: earthnuts, ground nuts, goober peas, monkey nuts, pygmy nuts and pig nuts. The good news, said the allergist, was that our baby's response to peanuts, although positive, was relatively small. This meant that her chances of falling into the 20% group of children that "grow out of" peanuts allergies was good.

Until then, I have a feeling that I will be attending all birthday parties, restaurant outings and after-school activities with my daughter. Or prevent her from attending. I am turning into my mother (see last post), but at least I have a valid excuse!

Baby Gaga

April 4 2011. CC spots a bird; despite the simultaneous rainfall and snow!

Much to our delight, the Brat has been babbling for some time.  Mostly Gaga, Dada, Papa and Mama.  My husband and I refer to each other in the baby's presence with the french appellations for mother and father, so we are not sure if Papa and Mama refer to us, or if they are random babbling sounds.  However, the other day, I was quite certain our baby spoke her first word.  If I had to venture a guess, ball or baby would have been at the top of her first-word list.  I was mistaken.  The word uttered both surprised and frightened me.

It was a few mornings ago.  We had brought the baby to our bed at around 6:30AM in an attempt to coax her into getting a little more sleep.  It didn't work.  Instead, she found her way over to my side of the bed, and started beating on my chest.  That is the Brat's way of saying she wants breast milk.  I was reluctant on this occasion to give in, as I had recently fed her, and she was shortly due for breakfast.  But as I usually do, I relented.  She nursed for a few minutes, then pulled away.  Her face was adorned with a wide grin, and she very clearly uttered "MIL".  I turned to my husband in surprise.  He too had heard it.  While I was pleased that our baby was progressing from babbling, I was instantly gripped with a fear that I would never be able to say no to her nursing requests demands.

I instantly thought of my older sister who still breast-feeds her 31/2 year-old son.  They hold entire conversations on the subject.  She suggests to him that it might be time to stop (as most of his nursing requests come in the middle of the night), to which he replies, "not yet mommy, maybe when it's time to go to school." I had the chance to witness a few interactions between my sister and her three year-old son this last summer during their visit to Canada.  He was very clingy, despite other immediate family members being around.  He would even attempt to follow her into the bathroom!  My sister says that he sometimes wakes up 10 times per night demanding "more milk."  I firmly believe that at this point in time, breastfeeding is the main barrier preventing our baby from sleeping through the night.  My husband and I are planning a trip sans baby in mid-June.  My goal is to wean her by then.  She will be 16 months old.  Far older than most North-American babies at time of weaning.

Currently, the Canadian Paediatric Society recommends exclusive breastfeeding for the first six months of life for healthy, term infants.  "Breast milk is the optimal food for infants, and breastfeeding may continue for up to two years and beyond." (http://www.cps.ca/english/statements/n/breastfeedingmar05.htm).
The American Academy of Paediatrics, for their part, says that "there is no upper limit to the duration of breastfeeding and no evidence of psychological or developmental harm from breastfeeding into the third year of life or longer." (http://aappolicy.aappublications.org/cgi/content/full/pediatrics;115/2/496).  What about psychological harm to the mother?!