Q: I’m really struggling with breastfeeding my four-month-old. Latching on is fine, but I don’t seem to be producing enough milk and it’s painful, and I find it tiring to breastfeed through the night. I planned to breastfeed for at least a year, but can’t see me doing that now.
Dru Campbell (Lactation consultant and firstname.lastname@example.org) says: “There are lots of issues people have with breastfeeding – the most common include sore, painful nipples and a concern that milk supply is not adequate.
“Breastfeeding can feel tender in the beginning, but should not be painful. If it is painful, or there is any trauma to the nipple, it means the attachment is not correct. In this case, I would recommend seeing a qualified midwife, or an International Board Certified Lactation Consultant (IBLCE) to review the position and to latch your baby to the breast.
Sometimes just a small adjustment in the positioning, or attachment of your baby can make a significant difference.
“Many mothers who are breastfeeding are concerned about their supply. There are many signs that will show you that your baby is getting enough breast milk, such as a weight increase of 120g–150g per week in the first four months of life, six wet nappies in 24 hours and yellow, frequent stools.
“The most common reasons for mums to cease breastfeeding are pain, infection and a concern she is not producing enough breast milk for her baby.
“Infection of the breast (mastitis) can occur if the breast is not being emptied effectively. It can also occur if there is excessive expressing, which results in the breast producing more than the baby requires. This can cause milk to leak within the breast and can develop into an infection.
“Demand-feeding can assist to reduce the risk of developing mastitis. You will know that your baby is getting enough breast milk if he or she is putting on weight and is having at least six wet nappies in 24 hours.”
Q: There is a lot of worry about kids eating sugar. Is chocolate a definite no-no? If so, until what age?
Annabel Karmel (Children’s cookery author - www.annabelkarmel.com) says: “I think parents are very particular about what they feed their children. They want to make sure that the food is low in salt and sugar, and they also know that children need foods like iron, essential fatty acids, vegetables and fruits.
“This is good – but things like chocolate are still OK in moderation.
If you banish them altogether, then they will become a ‘forbidden food’ that kids will crave even more. It’s all about getting the balance right.
“There are easy ways to reduce your sugar intake, so it might be worth cutting back as a family. For example, you can make your own pasta sauces as opposed to buying them in jars as they’re often full of sugar and salt. Another good one is to avoid sugary breakfast cereals and give eggs a go in the morning. I would also recommend making your own frozen fruit lollies – just pop a little fruit juice in the mould with some fresh fruit and water and freeze.”
Q: My one-year-old used to sleep through the night, but for the past five months she has been waking up at 4.30am, or 5am, and appears to be up for the day. She goes down for a short nap (20 or 30 minutes) at about 8.30am. How can I get her out of this habit? Also, she currently shares a room with her big sister, so I tend to go in at the slightest noise so she doesn’t wake my older child. What should I do?
Cecile de Scally (Midwife and educator at Baby Senses -www.babysenses.me) says: “Unfortunately the habit of attending her will encourage the waking. As a one-year-old she still needs a day sleep of at least an hour. With a bit of assistance and guidance, she can get back into a routine.”
Q: What are the guidelines for antibiotics, in terms of how often kids can have them?
Dr Hoda Makkawi (Consultant of family medicine at EuroMed Clinic - www.euromedclinicdubai.com) says: “Children might require antibiotics if they have a viral infection that lasts seven to 10 days – sometimes it might be accompanied by a fever. After 10 days, if symptoms are not better, or if the fever is rising, then antibiotics have an important role in the treatment.
“There is no maximum or minimum number of antibiotics you can give to a child. However, I would always recommend erring on the side of caution and only giving antibiotics if they are absolutely necessary.”