If you have been feeling low or know of someone who is finding her new role as parent more of a challenge than a joy, you need to know more about PND – postnatal depression or distress. Linda Lewis, research psychologist and author of “When Blessings don’t count”, looks at this issue with great empathy.

I think, or should I say, I hope, that when you embarked on the journey of motherhood, at some stage during your pregnancy or after childbirth, you heard about a condition called Postnatal Distress.  For many women it may seem like a foreign concept – “How could I feel anything but joy and gratitude for my beautiful baby”. Yet for others, and I’m talking about up to 3 out of 10 moms, it can feel very different from this and more like – “I know I should be feeling joy and gratitude for my baby, and I wish I was, but being a mom is so different to what I expected.”

For mothers who feel the latter, I want to reassure you that I know that YOU know that you ARE blessed to have your baby and I know that you feel terribly guilty for how you are feeling but when it comes to postnatal distress, your blessings don’t count. What I mean is that you may have all the blessings in the world: a healthy baby, a supportive partner, a lovely family, great support, food on the table and so on but that does not change how you are feeling. And what you may be feeling is:

• Anxious or panicky for no good reason
• Tearful, weepy
• Unable to sleep even when your baby is sleeping
• Like your emotions are on a roller coaster
• Overwhelmed with the “foreverness” of this responsibility
• Scared of being alone with your baby
• Disappointed that you are not the mother you’d always thought you’d be
• Will I ever be ME again?

If  you identify with some of those statements then you need to know that you are not alone. What you are feeling is familiar to so many moms and yet so few speak about it. This leaves you feeling alone and so bad about yourself. There’s a few things you need to know:

• You are not alone
• When you get the right support this is going to pass
• You are not to blame – there is a biochemical component in your body which may be causing this
• Other moms may feel the same as you and yet look at YOU and think you look so happy and content – women are masters of faking it
• Moms feel ashamed of their difficult feelings and tend to keep them to themselves for fear of being seen as incompetent or ungrateful

Why is it so vital to recognise and acknowledge that you are feeling distressed?

• You have a baby to take care of
• PND affects the whole family
• A well mother makes for a well family
• We cannot deny that PND affects our children on an emotional and developmental level and so we are obligated to do something about it even if it’s just for your child’s sake.
• The longer you leave it

o The more chance of your  feelings and symptoms exacerbating

o The more your relationship with your partner will be compromised

o The more removed you will become from the life you used to enjoy

Now, the important question is: What can I do about it and there are many steps that you can take (which I talk about in my book) but I will mention the 7 most important ones here:

1. The most important thing is to DO something about what you are feeling. Don’t normalise it and minimise it and think that it’s just going to go away if you try harder .You need to take action NOW
2. Talk to a professional who understands PND (look at contacts below)
3. Join a support group (not a mom’s coffee morning)
4. Consult a doctor (preferably a Psychiatrist) about medication (most of which are safe while breastfeeding)
5. Have your thyroid checked
6. Rally in as much support as you can both emotionally and practically
7. Take care of yourself – you are the most important person right now and your wellness takes priority over everything else

Linda Lewis
Author of “When your Blessings Don’t Count: A Guide to Recognising and Overcoming Postnatal Distress”

Contacts
If you are in the Cape Town area you may call me, Linda Lewis,  on 021-6856172 about individual and group support.
The National helpline number for the Postnatal Depression Support Association (PNDSA) is 082-8820072.

QUESTION
I have a 4.5month old baby who is a terrible sleeper! She wakes sometimes up to 6 times a night. She doesn’t have good day sleeps, she will sleep for about 20 min 3 times a day! She is at crèche so for her to be in a set routine during the morning (I fetch her at 1pm) is a bit impossible! I started her on rice cereal last week, which she has 3 times a day. When it comes to her bottle feeds she won’t finish a full bottle most of the time – when she wakes up at night I give her some milk and she settles quickly and will sleep until she wakes up again! I am not sure if I should be giving her milk every time she wakes up as maybe this has just become a bad habit! She is 7.2kgs and all her milestones have been reached, she had a full check up with the paed last week and everything is on track, except for this bad sleeping pattern.

ANSWER

You are having a tough time. What you describe is not usual for babies of this age at all. I have a strong sense that she has gastro-esophageal reflux, in other words reflux that has created a sensitive patch on the esophagus. This may be accompanied by spitting up milk curds or she may not posset at all. The reason I think this may be the cause is:
• She does not finish her feeds
• She wakes after 20 minutes in the day
• She wakes 6 times at night

Bearing in mind that you started solids, and her weight, she should not need so many feeds at night.

So I would go back to the doctor and ask him to recheck for reflux.

If that is ruled out then you may be dealing with a sensory sensitive little one and need to see an Occupational Therapist who deals with these problems.

Finally, I would stop offering milk every time she wakes at night. Her feeds should be 4 milk feeds a day and at most two at night. You can start to stretch her between night feeds with water. This may make her more comfortable (especially if she does have reflux) and will build an appetite so she takes her bottles more easily.

At the start of each new year, many of us make resolutions; promises or intentions to do something better or to stop something that we feel holds us back. Being a parent adds a new slant to our annual resolutions and for many of us our resolutions are intentions for the year ahead to be a better parent. This year Meg Faure took the Top 10 Resolutions on our Facebook site and wrote a simple ‘how to’ for each one.

1. Establish a routine for my baby. Routines are something many of us long for, to create a little order and predictability in our days. You can start a sleep routine based on Awake Times that are age appropriate for your baby from the first week of life.

Don’t be rigid but follow the guidelines in Baby Sense for when to settle your little one to sleep each day.

2. Listen to my intuition. In an age of too much information, it becomes hard to listen to your intuition. The best way to do so is to choose only two voices and one book or website to consider. Make sure your source of advice has similar values and ideals as you do so that when you hear advice it makes sense to you.

3. To have more patience and stay calm. Every parent has those days when they just loose their cool and shout or yell. While there is nothing wrong with feeling stressed, if you don’t stay calm things usually get worse - when you are stressed, your baby will become more winey or clingy or demanding which does no one any good at all. If you are feeling at the end of your tether: put your little one in a safe space with a safe toy, go outside and take a deep breath or three. If you don’t feel better, call a neighbor or someone who can support you and go for a jog or at least have some time alone. And whatever you do don’t feel guilty. We’ve all been there.

4. Spend more time outdoors. As soon as you see you have a sunny day coming up, plan an outdoor activity. A great idea is to get a large plastic sandpit and fill it will different things every few weeks – in summer, water play is great and in cooler weather, a sandpit or ball pond makes great outdoor activity. Just be sure to put up an umbrella over the play area to prevent sunburn.

5. To create firmer boundaries, especially around bedtime. There is a simple three step approach to creating boundaries:
A – Acknowledge what your little one wants “I know you want to …”
B – Boundaries need to be firm and consistent “…but we can’t….”
C – Choices are presented that are on your terms: “…. instead you can have X or we can rather do Y.”
Once this is laid out, be consistent and always follow through.

6. To remember I am a woman and have some ‘me time’ and get my body into shape. Almost every mum forgets herself in the process of becoming a mother. If you have a nanny or some help, go to gym or for a run twice a week. If like most mums you have to do this with your baby, schedule a walking group (or partner) three times a week. Pop your baby in a pram (stroller) or sling and go for a power walk. Not only will you feel better with a little ‘me time’ but you will get fit too!

7. To read to my baby every night and only allow 30 minutes of TV a day. Use TV as an emergency baby-sitter – for instance if you have a toddler and a new baby and need to feed and settle the new baby, there is nothing wrong with putting your toddler in front of the TV for a short time. Try not to sit your toddler in front of TV for hours on end. Rather create a sensory basket – a container with household objects each with a different sensory texture that your baby can explore. This will keep him occupied and grow his brain!

8. Not to stress about things that are out of my control. If you find yourself stressing about small things, ask these three questions:
a. Will my baby be injured by this decision or this action?
b. Can I change this situation? 
c. Can I just accept this situation for the next 15 minutes
These questions will give you time to measure the situation and will diffuse the feelings of stress.

9. To forgive myself for my shortcomings. Every day, forgive your self for the things your did or didn’t you. You are not perfect and being an imperfect but ‘good-enough’ mum is way better for your baby than a perfect parent (which really doesn’t exist). Research has shown that small failings help babies to adjust well to life and to become more secure in their interactions and relationships.

10. To tell my baby I love her everyday. Simply say the words – its really not that hard: I love you!

I am regularly asked "When is the right time to introduce cows milk straight from the fridge?" Must we continue with formula milks into the toddler years or can regular cows milk suffice? The answer is complicated and does depend on your individual baby. The main points to look at are:

1. Does my baby have allergies? If so continue on the formula he is on.

2. Is my toddler a good eater? If you have a poor eater, you may need a specially formulated toddler milk for fussy eaters.

3. Is my toddler on breast milk? Breast milk still offers wonderful nutrients into the toddler years. 

If your baby is on cows milk formula and is a good eater on only two milk bottles a day (as he should be at this age) using cows milk is a good option. I was interviewed on this earlier this year. Have a look at this video. 

http://www.youtube.com/watch?v=_Ng370590Ag&feature=youtu.be

By: Meg Faure, OTR.

A few years ago, my husband and I embarked on a three-month trip with a two and four year old. We have camped with our little ones from the time they were 9 months old and taken all three of them on flights from as little as 6 weeks old. I am a big fan of routines and an even bigger fan of sleep so how did we do all this travelling, many have asked. Well the key to travelling with ease and making sure that sleep is not too disrupted is to be prepared. Herewith my top 10 tips:

1. Keep one day-sleep in a consistent sleep space, as soon as you arrive in your new place. This will quickly mean that your little one settles back into his day routine.
2. Keep the ‘Awake times’ between 6am and 6pm correct for your little one’s age, regardless of time zone changes.

The Babysense Secret 2011

3. When flying with your baby or toddler, have something to suck on (Under six months of age – breast or formula milk or water and older babies a sippy cup or bottle of dilute juice). Always keep a bottle of clean water on hand.
4. If you are driving, leave extra time for stops. Do not breastfeed while driving; so leave time to stop for feeds and nappy changes and potty stops. A good idea is to leave either at 3am so your little one will fall asleep for the first 3 hours of the trip or leave just before dusk so you do some driving while he is asleep that night.
5. If you are flying overnight, ask for a bulk head seat with a crib and choose the flight for around bedtime (7pm if possible) and as soon as possible settle him to sleep – its harder to settle your little one on a flight if he gets overtired.
6. Pack an entertainment kit – I love those plastic suitcases and pack one object per sense and one cognitive activity. Here is an example of a kit I would pack for a toddler:
         TOUCH = Playdough
         VISUAL = Book or DVD or IPAD with games
          IMAGINARY = Car or dolly
         AUDITORY = Music on ipod
         TASTE = Biltong or dried mango
         COGNITIVE = Simple puzzle
7. Pack two changes of clothes per trip and double the nappies you think you will need – I promise you will need them!
8. Keep bedtime routine the same every night, even if you are going out – your baby will fall asleep in the pram or car on the way out and you will be more likely to have a relaxed dinner.
9. Bear in mind your baby’s sensory personality – Settled babies will be easy on holiday; Sensitive babies will be as difficult as they are at home; Social butterflies and Slow to warm up babies will be better if the routine is kept the same and you don’t go out after dark. Read Your Sensory Baby (The Babysense Secret DK, 2011) for more tips according to the personality.
10. And finally Keep Calm and Carry On – in any trip, there will be moments of chaos and tears but the funny thing is that when you look back you will only remember the good times!
 

QUESTION:

I need some advice please. My little girl is 3 months old, 6kg and happy alert and as normal as any other baba her age. She is not unwell, to my knowledge, and does not have reflux. BUT of late she flatly refuses to drink some of her bottles of formula. She pushes the teat out with her... tongue, bites the teat, turns her head from side to side to almost get away from it. I have tried feeding at longer stretches of time, feeding with little distraction, etc. Today she drank 150ml at 7:30am and only drank again at 1:30pm, then not much in the afternoon and not much again at 7:30pm before bed. She is not teething, does not have thrush, is not screaming and does not seem to be in pain. Her bottles have been the same since week 3, her teat sizes are right for her age yet she won't eat. Night feeds are fine as are early morning and last feed of the day. But otherwise she refuses to drink. Its like she has forgotten how to drink from a bottle. It sometimes gets to the stage where she is flatly refusing to drink even though I know she is starving and when she finally cottons on that the teat is there waiting, 9 times out of 10 she's too tired to eat and then starts screaming due to tiredness and hunger. Any advice?!

ANSWER:
Your little one’s symptoms and behaviour sound very much like silent reflux and I definitely feel it warrants investigation with your paediatrician. A baby doesn’t have to regurgitate milk up in order to have reflux. Silent Reflux can often create more discomfort than visible reflux and is also not as easily diagnosed. One of the symptoms of silent reflux is going off the bottle, screaming around feeding and a dramatic drop in intake. It is important to sort this out as soon as possible in order to prevent long term feeding refusal! Something else to investigate is an allergy to the milk and this can also cause great discomfort when eating! Hope you come right.

In the last trimester of pregnancy, your little one’s sensory systems begin to make connections in the brain and learning starts. However, unlike other mammals, human babies are born relatively immature. Consider the newborn antelope, springing across the African veld, following the rest of the herd only hours after birth. Her ability to keep up with her mother as the herd moves on is essential for the survival of the species but it is also made possible because of her relative maturity at birth. The human babies are born way less mature, with limited ability to act on their world.

The human baby can not only not fend for himself and survive without a parent, but can not even sooth or settle himself, depending on his parents to settle him and sooth his cries. This is particularly so during the first three months of the newborn’s life (the fourth trimester). The easiest way to settle your baby at this time, is to mimic the womb world:

Touch - For nine months the only form of touch your baby has experienced is skin to skin – his naked skin against the womb walls, the feel of the cord and the sensation of his own touch. In the labour ward place your newborn baby naked: skin-to-skin on your chest. Cover yourself with a blanket or towel to keep your baby warm. Miraculously, a mother’s chest can increase or decrease by 2 degrees to regulate her baby’s body temperature.  This perfectly natural position is commonly called Kangaroo Mother Care and you can aim to ‘kangaroo’ your baby for as many hours as possible in the early days. It is important to know that if your baby is born healthy by caesarean section, he can be warmed up on your chest instead of being removed to a clinical incubator.

Swaddling is very important in the early days, as it’s the best way to imitate the tight hug of the womb environment. Swaddling provides deep-touch pressure and also stops little limbs from shooting out when your baby is unsettled, which is a common cause of night wakings in the young baby. A swaddled newborn is a more settled baby and will sleep for longer stretches.  For the first nine to twelve weeks, swaddle your baby for all sleeps and when unsettled or colicky. Ensure your baby has some time to kick free of the swaddle when awake.

It is important to swaddle your baby’s hands near to his face so he can suck on them to self soothe and regulate his body temperature if becoming warm. Swaddling with the hands by the sides is not a good option as your baby will not be able to self soothe or to regulate his temperature.

Smells – Your newborn’s sense of smell is finely tuned at birth. The smells he loves best are the familiar smell of the womb and the sweet smell of breast milk. Do not to wash your baby immediately after birth. Wipe him down if he is a little bloody but do not wash off the vernix. There is evidence that unwashed babies bring their hands to their mouths sooner after birth than washed babies. Sucking on his hands is one of the first, really clever and important strategies a baby will use to self-calm and is important in the development of self-regulation. Aside from vernix, the soothing smells of you is the best olfactory input at this stage. In the early days, keep your new baby’s space free from any scents, as his smell system is so sensitive. An item of clothing that smells of mum or dad in the cot is comforting.

Sight - Create a visually soothing space by dimming the labour room’s lights and bringing your baby to your chest, 20-25cm /8 inches from your eyes, which is the perfect distance for him to focus on your eyes.  Decorate your baby’s room in muted and clam colours and have a light dimmer switch or a nightlight so that the room can be dimmed when your little one is fractious. A calming sensory space is important, as the visual system is a very powerful system for your new baby.  Do not place any toys or mobiles in the cot or crib. The cot must be a calm sleeping space only, not a stimulating play area. For encouraging eye-focus, a few contrasting colour toys or pictures (red, black and white) should be in the room, but keep them near the changing mat where it is appropriate for your baby to be awake and stimulated.

Sounds - The newborn is familiar with and soothed by your voice. For a period of time, immediately after birth, your new baby will be calm and alert, listening and focusing well.  Talk quietly to your baby to calm him after birth. White noise and womb sounds are calming in the early weeks. Buy or make a recording of white noise or play a CD with tracks of calming music ‘mixed’ with the steady beating of a heart. 

Movement – Babies are best soothed with movement and rocking. In the early days many babies do not settle unless held. Do not worry about ‘spoiling’ your baby or that your baby is ‘manipulating’ you. The reality is that in the fourth trimester, a baby does not have long-term memory that would create expectations for how he needs to be soothed. Rather, the newborn has a sensory need for the womb and the holding and rocking reenacts the womb space for the new born. A sling therefore is a wonderful tool for soothing fractious newborns and regulating state.

The first three months are a period of enormous transition and adjustment for you and your baby. By mimicking the womb world, you can calm your baby effectively. Swaddling, white noise, and carrying your baby are just three examples of strategies that imitate the womb world and calm babies in the fourth trimester.

References
Eliot L. Whats going on in there? How the brain and mind develop in the first five years of life Bantam Books 1999
Faure M The Baby Sense Secret Dorling Kindersley (to be released 2011)
Faure M & Richardson A Baby Sense Metz Press 2010
Graven S & Browne J Auditory Development in the Fetus and Infant. Newborn & Infant Nursing Reveiws. Volume 8, Issue 4 2008
Hepper P. Unraveling Our Beginnings: On the Embryonic Science of Fetal Psychology. The Psychologist 18 (8) Aug 2005, published by the British Psychological Society.
Hopson J. Fetal Psychology Psychology Today, October 1998
Meisami E. et al Human Olfactory Bulb: Aging of Glomeruli and Mitral Cells and a Search for the Accessory Olfactory Bulb Annals of the New York Academy of Sciences, 1998
Trevathan W. Human birth: An evolutionary perspective. New York: Aldine de Gruyter 1987

The uterus is undisputedly the ultimate environment for the development and nurturing of a fetus. The sensory systems develop throughout pregnancy and affect the brain’s development.

Fetal sensory development

Your baby begins to develop on a sensory level from the moment of conception. The first sense to develop is the sense of touch, emerging at 3 weeks gestation – before you knew your were pregnant. By the twelfth week, your baby can feel and responds to touch on his entire body, with the exception of the top of his head, which remains insensitive until birth.

The auditory system is completely intact by 20 weeks gestation but it is a few weeks before the nerves conducting sound are functional. At 23 weeks your baby can respond to loud noises and may jerk or even begin to hiccup after hearing a loud sound.

Taste buds emerge at 8 weeks and by 13-15 weeks your baby has taste buds similar to adults’. Anything you eat can flavour the amniotic fluid. While we are not exactly sure when the baby starts to perceive taste, we do know that a baby born prematurely (33 weeks) sucks harder at sweetened nipples and when saccharine is injected into the amniotic fluid in the third trimester babies suck faster.

Smell develops alongside the sense of taste. Since smells are essentially chemicals that are found to be present in amitotic fluid, it stands to reason that your baby can smell in utero as the chemicals pass from the amniotic fluid onto the smell receptors in the nasal cavity. The nasal cavity is protected by a plug of tissue until 28 weeks, but thereafter your baby will smell and respond to scents.

Your baby’s tiny eyelids open at 26 weeks and at 6 months we know that babies can see light in utero. At 32 weeks gestation your baby can track a bright torchlight shone and moved across your pregnant belly.

The sense of movement and gravity from the balance (vestibular) system in the ears develops very early and begins to function at five months gestation. Like the sense of hearing and touch, the sense of movement is relatively advanced at birth.

The world of the womb

Knowing that the sensory systems perceive the intrauterine world by the second and third trimesters, we may wonder what the womb world is like on a sensory level.

The womb world is devoid of light touch - deep pressure touch and the sense of warmth are greatest inputs to the sense of touch. By the third trimester, the elastic uterus provides constant, deep pressure, like an all-day hug or massage.  This tight hug keeps your baby curled up, with pressure on his back and his hands towards the midline. In this position, your baby can suck his hands and his immature reflexes, which are starting to emerge in utero are contained so that he feels secure. The temperature in the womb is always perfect, a temperature we call neutral warmth. Threatening touch, such as pain, high or low temperatures and tickle are completely absent during gestation.

In the womb, the overwhelming sounds (about 85 decibels) are the background sounds of your body. Your baby hears the gushes of amniotic fluid and blood flowing in the veins and of course your heartbeat and digestion. These background noises contribute to the constant white noise he hears. The consistent sound of the heartbeat is a particularly soothing sound and babies who are played a beat at the pace of the average heartbeat (72 beats per minute) fall asleep easier and cry half a much after birth. Sounds from the outside world are subdued (55 decibels) but the clearest sound he hears is your voice as it is carried not only outside the body but also through your bones in the form of vibrations. Dad’s voice is the second most familiar sound to your baby and it is nice to know that within hours of birth your baby will recognize Dad by his voice.

Because all tastes you experiences pass into the amniotic fluid, your baby is prepared for the flavours your family eats even while in utero.  The preference for sweet tastes is hardwired and babies prefer sweet flavours, swallowing amniotic more vigorously after you eat something sweet.

Even though your baby is interested in and tracks a bright light, the reality is that he is rarely exposed to bright lights and there is very little visual stimulation in utero. In general the womb world is visually muted and often it’s quite dark. There are no bright colours or contrasting shapes in utero on which your baby can hone his developing visual skills. For this reason the visual system is relatively immature at birth.

In utero your baby is buoyed by amniotic fluid and whirls freely in a contained liquid bubble. Since water decreases the weight of an object by 50 times, your baby has the wonderful sensation of being 1/50th lighter than on earth.  He is lulled by the constant rocking and swaying motion of this gravity-reduced world, gently rocked to sleep. When the lulling movement stops – such as when you rest or lie down, your little one may become wakeful and busy. During the third trimester, your baby’s vestibular system has matured sufficiently to sense gravity and to turn to the appropriate ‘head down’ position in preparation for birth.

The fourth trimester

By understanding the world of the womb, you can make your little one’s transition to the real world smoother. Next month, Meg will look at using the concept of the womb world to settle your newborn baby.

References

Eliot L. Whats going on in there? How the brain and mind develop in the first five years of life Bantam Books 1999
Faure M The Baby Sense Secret Dorling Kindersley (to be released 2011)
Faure M & Richardson A Baby Sense Metz Press 2010
Graven S & Browne J Auditory Development in the Fetus and Infant. Newborn & Infant Nursing Reveiws. Volume 8, Issue 4 2008
Hepper P. Unraveling Our Beginnings: On the Embryonic Science of Fetal Psychology. The Psychologist 18 (8) Aug 2005, published by the British Psychological Society.
Hopson J. Fetal Psychology Psychology Today, October 1998
Meisami E. et al Human Olfactory Bulb: Aging of Glomeruli and Mitral Cells and a Search for the Accessory Olfactory Bulb Annals of the New York Academy of Sciences, 1998
Trevathan W. Human birth: An evolutionary perspective. New York: Aldine de Gruyter 1987

When my son weaned onto solids we discovered that he had allergies to cows milk, wheat, gluten and eggs (blood tests were done at this age) we were referred to two dieticians by pediatricians, this seems to be the standard path. Both dieticians were not much help, it's not rocket science to figure that foods containing allergens must be avoided. At age 3 we asked our paed to refer us to an allergy clinic and wish that this had been our 1st call. We were never told to avoid nuts, as a result I gave nuts to him from young as a source of protein. He now has peanut and tree nut allergies (very bad!) He had a reaction to 1 nut before which I avoided not knowing that all nuts should have been avoided. If we had waited with nuts till older he may not have become sensitized. My dad is only allergic to Brazil nuts so I thought that if no reaction to others he would be ok. Please if your baby has severe allergies, go to an allergy specialist early and get the right advice

We asked Kath Megaw, the paediatric dietician in who wrote Feeding Sense, who is very up to date on allergies to respond:

I am so sorry to hear about your son’s allergies and the struggle you have had with him. Having a severely allergic child is extremely taxing on everyone in the family and so I can understand your frustration in not feeling helped. Not all dietitians specialize in the field of allergies and thus you are 100% correct in saying that you need to take an allergic child to an allergy specialist or allergy-trained dietitian. It is however incorrect to assume that should your son not have been exposed to nuts that today he would not have a nut allergy now. Sensitization to allergens is a mind field at the moment in the medical profession and we are still discovering and uncovering the best protocol and method to prevent sensitization. In the latest Allergy journal publication a chapter published by one of the world’s top allergist in the UK spoke extensively about the prevention of allergies.

In summary the only conclusive things we can say is that exclusive breastfeeding up to 17 weeks of age is protective against possibly eczema and maybe asthma. Introduction of solids after the age of 4 ½ months offers no further protection to allergy development. Moms restricting allergen rich foods during pregnancy or breastfeeding (other than their own allergens) offer no protection and may actually increase the incidence of allergies. As is the case of peanut allergies in the UK. Limiting introduction of allergen potential foods (after 4 ½ months) in non-allergic babies is no guarantee that they will not develop an allergy to a particular food and will do more harm, as they will have a higher chance of being fussy eaters. If you have an allergic child then Allergen food introduction needs to be done under guidance of a specialist and sensitization is likely to happen at whatever age you introduce so avoid delaying introduction unnecessarily. Once an allergen has been diagnosed avoid ingesting the allergen for at least 18 months to 2 years before challenge.
 

ANSWER:
Kath Megaw (co-author of Feeding Sense)

Shame that sounds like quiet a challenge. Babies often favour one breast over the other and it is not uncommon for a baby to choose 1 breast exclusively at some feeds. The concerns for me are that his sleep is so poor and it appears he is hungry as he feeds so frequently at night. Without sitting down and having a proper consult it is difficult to make too many suggestions so the following are my recommendations and should they not prove helpful - I would encourage you to get some face to face advice.

1. Let dad try and give the bottle at the 10pm feed and then stretch him for 4 hours during the night. Give him a dummy and let dad do the stretching so that he can get the message that it is not feeding time.

2. It is a good idea to get going with solids in the mid morning try something other than rice cereal - try a fruit like pear or apple puree and do this by feeding him off your finger if he is not keen on the spoon. You can also try some sweet potato mid afternoon.

As mentioned their is a lot about your situation that I would need clarity on to make more specific suggestions - so if the above is not helpful then a face to face consult with a relevant professional would be a good idea!

Meg Faure (co-author Sense series) In addition to Kath's advice, i would see an OT to determine if there is a sensory basis to the short sleep cycles and associated feeding problems.