At birth, babies are immunised by antibodies that have passed through the placenta. During the first few months of life, breastfed babies are also beautifully protected because mom’s milk is brimming with antibodies. This protection, although it offers myriad benefits, is temporary. This is where vaccines take over as watchdog.

But what are immunisations and how do they work?

In simple terms, vaccines are made up of weakened or dead germs that cause specific diseases.

By injecting this weakened microorganism into a healthy body, the immune system believes there is a real infection so it kicks into action, and the body goes into combat. Antibodies against the disease are produced, the germ is kicked in the guts and the immune system stores the information so that it can fight the same germ should it enter the body at a later stage. The end result is immunity against the disease… and before you can say Barney the Dinosaur, the score card reads Cute Kid: 1, Naughty Bugs: 0.

No parent likes the idea of a needle pointing in their child’s direction, but every parent has also heard that prevention is better than cure. Vaccinations may sting and may even have a side-effect or two, but the benefits far outweigh the risks.

The occurrence of diseases for which vaccinations are available has been enormously reduced or, in some cases, just about eradicate, which means that your little angel doesn’t need to ever experience mumps, smallpox, whooping cough or any of the other nasties that used to plague children centuries ago.

Vaccinations (also known as immunisations or, less commonly, inoculations) are inexpensive, safe, readily available, necessary for admission to primary school and, therefore, a logical step in raising healthy children.

Apart from the obvious benefit of vaccinations protecting our own children, medical professionals believe that we owe it to the rest of society to vaccinate too. Vaccines are not 100% effective, which means that those who have been immunised are still at risk of becoming infected by people who have not received the vaccine, should they fall ill. In order to prevent large outbreaks of various diseases, experts have established a minimum percentage of the population that must be vaccinated – this proportion is known as herd immunity. The more children who get vaccinated, the more successful the immunisation programme will be in the end. This is something to keep in mind, as it means that the decision of each individual to vaccinate or not has a direct effect on the health of society as a whole.

Whatever you choose to believe, it is vital to do your homework: speak to your doctor, research the pros and cons of immunisation, talk to other parents. Our minds are made up, and we are all for vaccinations.

Not only do schools throughout South Africa insist on a full immunisation record, but we’re not leaving anything to chance as far as viruses, bacteria and naughty bugs are concerned: with a vial of vaccine at the ready, we have the upper hand against those baddies for sure.

Where to from here?

Your baby will be immunised against polio and tuberculosis shortly after birth. After that, all immunisations will be up to you. Speak to your doctor about the various options and where you can go – you may decide to have your paediatrician administer all immunisations, or you may prefer to go to one of the hundreds of baby clinics around the country. Either way, you will receive a vaccination booklet, in which all shots are recorded.

A certified copy of this book will be required when applying for pre-school and primary school, so keep it in a safe and accessible place.

Immunisation list

The list below incorporates all required vaccinations.

You will notice that most vaccinations are repeated at a later stage, as denoted by numbers alongside the name.

To help you decode the various vaccines, here’s what they fight and what the abbreviations mean:

BCG-

Tuberculosis (Bacillus Calmette-Guérin Vaccine)

OPV-

Polio (Oral Polio Vaccine)

RV-

Rotavirus Vaccine

DTaP-IPV//Hib-

Diphtheria, Tetanus & acellular Pertussis (whooping cough) Vaccine
plus Inactivated Polio Vaccine
plus Haemophilus Influenzae Type B (meningitis) Vaccine

Hep B-

Hepatitis B Vaccine

PCV-

Pneumococcal Conjugated Vaccine

Measles-

Measles Vaccine

MMR-

Measles, Mumps & Rubella (German measles) Vaccine

Td-

Tetanus & reduced strength Diphtheria Vaccine

Your vaccination guide
Protecting and caring for your child

Apart from the routine vaccinations, note that non-compulsory vaccines are also available for chickenpox, flu, hepatitis A and specific strains of meningitis. Speak to your paediatrician for advice on whether you should vaccinate your child against these. The expanded immunisation programme in South Africa is as follows:

Birth

BCG- Injected into right arm
OPV (0)- Drops by mouth

6 weeks

OPV (1)- Drops by mouth
RV (1)- Liquid by mouth
DTap-IPV//Hib (1)- Injected into left thigh
Hep B (1)- Injected into right thigh
PCV (1)- Injected into right thigh

10 weeks

DTap-IPV//Hib (2)- Injected into left thigh
Hep B (2)- Injected into right thigh

14 weeks

RV (2)- Liquid by mouth
DTap-IPV//Hib (3)- Injected into left thigh
Hep B (3)- Injected into right thigh
PCV (2)- Injected into right thigh

9 months

Measles (1)- Injected into left thigh
PCV (3)- Injected into right thigh

18 months

DTap-IPV//Hib (4)- Injected into left arm
Measles (2)- Injected into right arm

6 years

Td- Injected into left arm

12 years

Td- Injected into left arm

The jab – What to expect

Be prepared

Don’t give your child any medication before the shot without asking your doctor first, and tell the clinic nurse or doctor about any medication you may have given your child should this be the case
Remember to take your child’s immunisation record book along
Pack your little one’s favourite toy or most loved teddy (and, shame, pack an extra plaster for teddy too)
Keep some paediatric paracetamol handy
Make sure you know where the clinic is – getting lost will just create stress
Don’t let your child pick up on any stress. Millions of parents are going through the same thing, so relax
Talk or read to your child or recite a rhyme before and during the shot. Distraction works brilliantly
Place a cold compress on the area to prevent soreness
Encourage physical activity later in the day will also prevent a sore arm or leg
Plan a fun outing for afterwards to encourage a brave face next time

Normal side-effects

Distress. Calm your child by asking him to put the plaster on teddy, or take him somewhere fun
Fever. A raised temperature means that the immune system is working. Administer some paracetamol
Redness. It is normal for the area around the injected site to be inflamed for two or three days
Bumps. A small bump without pus is another sign that the body is reacting as it should
Rash. This is a mild form of the disease you’ve vaccinated against, which should dissipate on its own

When to worry

Persistent fever. Call your doctor if fever becomes very high or does not normalise within a day or two
Pus. If there is pus in the bump at the site, or if the bump is larger than 1cm across, call your doctor
Allergic reaction. It is rare for a child to be allergic to an individual component within the vaccine, but it can happen. Symptoms include trouble breathing, hives, dizziness or palpitations and usually occur between one minute and three hours after the shot has been given. Check your family’s medical history to exclude allergies to various medications and vaccines.

References

doh.gov.za

sabceducation.co.za

kiddivax.co.za

savic.ac.za

kidshealth.org

Cost:

The cost of nappies is usually a great concern for most parents.

The cost of disposable nappies varies due to the range of disposables on the market.

The cost of cloth diapers also varies because of many factors. One being the quality of the cloth nappy. Another factor is the amount of washing that is done for each load of dirty nappies. The more you wash and re sanitize the higher the cost of the cloth nappy. Other factors are your time to launder the nappy, cost of electricity, soap, water, and wear and tear on your washing machine and tumble dryer.

If you compare the cost of the disposable nappies vs. the cost of washing your own cloth nappies, you will save money by using cloth nappies.

Skin care concerns:

The biggest worry parents have is keeping their baby dry and free from nappy rash. There are many things that can cause nappy rash like prolonged wetness, a soiled nappy being left on for too long, chemical allergies and lack of air circulation.

As each baby is different, some parents will find that disposables suit perfectly fine, while other babies will have reactions and will need to use a cloth nappy.

If a cloth nappy is not changed often, or sanitized properly this can also lead to rashes forming.

The best way to avoid nappy rash is to change dirty nappies often, whether it be cloth or disposable.

Convenience:

Cloth nappies now come with Velcro-fasting straps and replaceable liners. These flushable liners can be lifted off the cloth and flushed down the toilet.  If you don’t use liners, you can just deposit the older baby’s solids down the toilet.

Disposable diapers are more convenient as you can throw away the dirty nappy without carrying them around for washing.  Disposables also require fewer changes because of the super absorbent materials they use in manufacturing them.

Environment:

There has been much debate over the impact of disposable diapers and cloth diapers on the environment.

The impact of cloth nappies: The extra water used to wash the towelling nappy is said to be just as much an abuse to the environment as is the production and use of disposable diapers. Although when flushing solids down the toilet and washing the nappies in a washing machine, the contaminated, dirty water from both toilet and washing machine go into the sewer systems where they are properly treated at wastewater plants.  The treated waste water is more environmentally friendly.

The impact of disposable nappies: Although some disposables are said to be biodegradable; in order for these diapers to decompose, they must be exposed to air and sun.  Since this is unlikely, it is said to take several hundred years for the decomposition of disposables to take place, with some of the plastic material never decomposing. The untreated waste placed in these landfills is also a possible danger for contaminating the ground water.

With all the factors considered there really is no one best type of diaper that is good for every baby.  Deciding to use cloth or disposable diapers depends on your lifestyle, personal preference, finances and your concern for the environment.  The choice that is right for you and your baby may be different from someone else’s.

You can be fertile again within weeks of your baby’s birth, so you’ll need to decide about contraception even before you’re ready to have sex again.

Below is a list of types of contraception on offer:

PLEASE REMEMBER:
Talk to your health care provider about the pros and cons of each contraceptive method, and how they affect breastfeeding so that you are able to make a more informed decision.

The Female condom

The female condom is a thin polyurethane pouch that’s inserted into your vagina before sex to prevent pregnancy. Soft rings at either end hold the pouch in place. What’s great about them is you can use them as soon as you’re ready to become sexually active again.

The Male condom

You may find condoms are the easiest type of contraceptive to use, because these can just be kept handy when needed.

Diaphragms and caps

Diaphragms and caps are soft, circular domes made of rubber or silicone. You insert your diaphragm or cap into your vagina each time you want to make love.

The combined pill

Usually just called the pill, it contains two hormones, oestrogen and progesterone. You take the pill every day for 21 days and then have seven pill-free days once in every 28 days, where you would experience a light period.

Contraceptive Patch

The patch is a thin, beige square that you apply to your skin like a plaster. It releases a daily dose of oestrogen and progesterone through your skin, into your bloodstream. You apply a new patch once a week for three consecutive weeks and then go without a patch for a week before starting the cycle again.

Intrauterine system (IUS)

An IUS is an implant that fits inside your uterus. It releases a steady dose of progesterone for up to five years. The IUD works by sitting inside the uterus and stopping sperm from reaching the egg or stopping a fertilised egg implanting. The IUD, otherwise known as the coil, can be fitted six weeks after a vaginal delivery, or eight weeks after a caesarean. The delay is to allow the uterus to return to its normal size and, in the case of a caesarean, for scar tissue to heal.

Nursing your baby plays a large role in determining how soon your body will resume its menstrual cycles. As every woman is different, these time frames below are guidelines. If you have any concerns talk to your health care provider to put your mind at ease.

If you are not breastfeeding: Menstruation usually occurs between three and ten weeks after giving birth (the average being 45 days).

Breastfeeding moms: You may enjoy a few more period free months. If you’re breastfeeding day and night, it can take a year or even longer before you have your first period. If you’re lucky enough to have a baby who sleeps through the night from an early age, your period will likely return sooner in three to eight months. In most cases the more often you breastfeed, the longer it will be before you get your period again.

Take note!
Bear in mind that your body is still ovulating each month. So start using birth control as soon as you are ready to have sex again. If no contraceptive is used, chances are you could get pregnant even before having your first period. Unless you want back to back children, do not be fooled by the myth that breastfeeding is a natural birth control.

From my experience in this field many women often push through these difficult times and think it’s normal. It is normal to a point, but when it becomes unhealthy for yourself and your family, you should seek help.

Lastly, it is important for me to express that these symptoms are not meant for the biological mother alone. Research is proving more frequently that men and parents of adopted children are affected as much by this condition, and they themselves are also in need of the same support.

This article serves to give a basic overview of Post Natal Depression, its symptoms, causes and various treatment options.

When a mother has PND, it affects not only her, but also:

• her immediate family, including her partner
• her friends and acquaintances
• her functioning at work and at home

There are 3 types of Post Natal emotional disorders

1. “The Blues’ – (30-80% of all mothers). The Blues usually occur between the 3rd and 5th day post delivery. Symptoms include tearfulness, tiredness, anxiety, over-emotional reactions, up and down mood swings, feeling low, and muddled thinking. These symptoms usually only last 5-10 days. Often this is baffling for an unprepared new father, who cannot understand what is happening to his normally happy wife, who has just produced a beautiful, healthy baby.

2. Post Natal Depression – (0 – 30% of all mothers). PND is a continuum of The Blues and may develop slowly in months following the arrival of the new baby. PND has similar symptoms as the Blues, but it is a more serious illness as the symptoms are more severe and last longer – up to a year if untreated.

3. Post Natal Psychosis – (0.1-0.2% of all mothers). This is the most severe of the postpartum illnesses. Symptoms include heightened or reduced motor activity, hallucinations, marked deviation in mood, severe depression, mania, or both, confusion, and delirium. Symptoms varying in length depending on appropriate care.

What is PND?

Up to 30% of all new mothers, in all cultures and circumstances, develop Postnatal Depression (PND) during the first year after the birth of a baby. This is a clinical depression, and it is nobody’s fault. The new mother experience feelings of despair, anxiety or unhappiness which can become debilitating.

Over time she becomes more angry, weepy, tired, anxious, panicky, and generally overwhelmed. She may be too exhausted to leave the house, yet afraid to be alone. Her moods are likely to be unpredictable; she loses enjoyment of life and of her usual interests, including sex. Her confidence disappears; she can’t sleep normally; her eating patterns change. She feels that her life is out of control; she may want to harm herself or her baby; she may contemplate or attempt suicide. It’s a confusing situation for her as she feels trapped and at the mercy of a demanding baby, but also may feel unable to accept help in caring for the infant, because of feeling guilty about not being the ‘perfect mother’, or because she is unable to trust anyone else with the task.

She may perceive her partner and her family and friends as uncaring and unsupportive. She feels abandoned when hubby goes to work, or when her friends leave. Resentment builds up when she has to prepare supper and take care of the home, yet also feels guilty because she feels that she is failing everyone around her at being a “good enough” wife or mother.

However, it in important to note that with appropriate support and psychological intervention this condition can be overcome.

How can you help your wife/friend with PND?

Depression is not the result of lack of willpower, or a weak character. The person cannot “snap out of it” or “pull herself together”. The more you try push her in this direction the deeper she will fall into this trap of depression.

Here are some ways in which you can make life a little easier for the new mom:

• Get professional help – Contact a health professional. You can’t manage this alone.
• Listen to her when she talks about her feelings and don’t feel pressurised to offer solutions
• Don’t criticise – she already has feelings of inadequacy and failure so this will disenable her even more
• Give unconditional acceptance – You don’t have to agree with her perceptions and distortions. Just believe that she is living in a dark world that is real for her.
• Don’t take things personally – Your loved one’s depression is not your fault, nor is it hers.
• Don’t push her into doing things for which she is not ready.
• Don’t patronise – learn when your help is welcome and when it makes her feel incompetent.
• Stay calm! – Remember that you are the “well” one.
• Be supportive – This means anticipating her needs and accepting her feelings.

Article courtesy of Hayley Asbury, Clinical Psychologist based in Hillcrest, KZN.

Babies are wonderful creatures. We adore them. But let’s be honest: they come with their challenges. Of these, nighttime waking has to be the one that parents are most desperate to overcome.

Parenting a baby who resists falling asleep or who wakes up constantly during the night (usually with a decidedly grumpy disposition) is a tough business, usually resulting in very cranky, sleep-deprived moms and dads.

So the million dollar question is: how do I get my baby to go to sleep and stay asleep?

Well, there’s good news and bad news.

The good news is that there are hundreds of sleep experts out there who have loads of advice for exhausted parents of little night owls. The bad news is that not every baby responds to every technique.

There are two very distinct schools of thought when it comes to babies and their 40 winks. On the extreme left, we have proponents of the ‘crying it out’ method. And on the extreme right, we have campaigners for the ‘nurturing to sleep’ method. It’s a controversial subject and, again, it is a personal choice for every family.

Still, there are some golden rules that most experts agree on. We’ve dug deep, done our research, added our two cents’ worth and would love to share our 11 tips for getting your baby to sleep through the night.

Before you read on, just remember

• Be patient. The magic probably won’t happen overnight
• Be flexible. Every baby is different, so try various approaches and see what works best
• Be ready to sleep when baby sleeps. Grab every opportunity to drift off into dreamland
• Be realistic. Newborns typically sleep for two hours at a time, 3-month-olds for 5 hours and 9-month-olds for 9-12 hour stretches. Don’t expect the impossible!
• Be confident as a parent. As Dr Sears says: “Your baby’s sleep habits are more a reflection of your baby’s temperament than your style of nighttime parenting.”

And  now…

Introducing our top tips:

1. Offer every possible home comfort

Start with warm sheets, comfy sleepwear and a pleasant and consistent room temperature. Then give him his favourite mommy-scented teddy bear or light blankie to snuggle with.

2. Remove all possible discomforts

Make sure that baby’s nose is unblocked, that he’s wearing a fresh nappy and that he isn’t put to bed in pyjamas made from synthetic fabric. Don’t expose him to airborne irritants such as cigarette smoke or aerosol spray.

3. Distinguish night from day

Make sure that daytime is vibey, active and stimulating and that nighttime is calm and relaxed. Keep baby in brightly lit rooms when napping during the day so as to prevent him from oversleeping.

4. Give sleep aids a go

Clever gadgets that mimic the sound of the ocean or rainforest have soared in popularity and may just be the ticket to peaceful sleep. White noise such as the sound of a fan is said to work too.

5. Establish a consistent bedtime routine

Follow the same rituals every night – this programs baby to know bedtime is coming up. A warm bath, dim lighting and a lullaby at the same time every night will be his cue to sleep.

6. Let Daddy have a turn

Sharing nighttime duties not only gives both parents the chance to catch up on much-needed sleep but also prevents baby from associating sleep with just one person.

7. Avoid overtiredness

Overtired babies are cranky and don’t settle easily. Overcome this by bringing bedtime forward a bit, and making sure that baby has regular short naps during the day.

8. Perfect your massage technique

Research shows that baby massage is really beneficial – helping baby relax and sleep better as well as easing the symptoms of colic and infant acid reflux. Go on a short course with Dad, and massage the problem away.

9. Go old school

When all else fails, walk your baby in a dimly lit room, cuddle him in a rocking chair, read him a story or sing to him. High-need babies respond particularly well to a nurturing approach.

10. Teach your baby how to put himself to sleep

First prize is to teach him to settle himself should he awaken during the night. This may involve letting him cry it out for a few nights, which will be hard on both of you, but many experts believe that it’s the only way forward.

11. Have baby sleep next to you

In the other camp, some experts believe that nothing helps a baby thrive more than close contact with parents – day and night. If you don’t have a problem with the idea, try it: you may be on to a winner.

Cheese can also be introduced as early as 8 months. Introducing both yoghurt and cheese is an excellent way for babies to get the fat that they need during the first year of life and because the culturing process has broken down the lactose and removed many of the milk proteins, it makes both foods much easier to digest.

Cow’s milk, on the other hand, still contains milk proteins and lactose which are more difficult for baby to digest. In addition, cow’s milk has higher sodium levels and also hinders the absorption of iron in the body which can lead to Iron Deficiency Anaemia.  Furthermore, the nutrients in Breast milk and Formula are superior to cow’s milk and therefore shouldn’t be substituted with cow’s milk until after the age of 1.

Put simply, wind is air that is trapped in your baby’s stomach. Air gets swallowed along with milk during feeding, or when baby cries. The pressure exerted by this trapped air causes abdominal pain and discomfort, which means that your baby is not a happy chappy. Babies’ digestive systems are still developing, which means that their tummies sometimes take in more air than they should.

TWIST AND SHOUT
How do I know if my baby has wind?

Your baby may have wind if he stops feeding, wriggles around, cries or is generally niggly, particularly when put into a lying-down position after feeding.

THAT’S MUCH BETTER
How to alleviate wind in babies

Babies will eventually outgrow this problem, but in the interim there are a number of things that you can do to alleviate the discomfort:

Breastfeed

Studies show that breastfed babies tend to have fewer problems with wind than formula-fed babies. This is due largely to the fact that, when breastfeeding, babies can control the flow of milk, meaning that less air is swallowed. Breast milk also appears to contain natural substances that ease the stomach.

Bolster

Another reason that breastfeeding helps prevent (or lessen the severity of) wind is that breastfed babies are held in a semi-upright position. If you are bottle-feeding your baby or if you have a very strong flow of breast milk, try to prop him up with a cushion, which will prevent him from gulping in too much air while swallowing the milk.

Baby massage

Studies show that baby massage can help soothe tummy pain. Good for all babies and not just those with wind, infant massage is an ancient practice that has recently enjoyed new-found popularity due to its many benefits, which include pain relief, relaxation, good blood flow and parent/child bonding. Get into a routine by massaging baby at the same time every day, in a dim, pleasantly warm room, when he’s at his happiest. Rather than mineral-based baby oil, use grapeseed or almond oil. Massage baby all over, using light, comforting pressure. When you get to the tummy area, massage in a circular, clockwise motion.

Burst the bubbles

Several medications exist which claim to ease the discomfort associated with excess wind. Often prescribed for babies who also present with colic, these treatments work by producing larger air bubbles, which are then released as the baby burps. It’s the smaller air bubbles which are harder for infants to expel, and which cause the agony. Some mothers swear by gripe water, a classic remedy which is said to warm the infant’s stomach, neutralize acid and help in the breaking down of air bubbles. Speak to your doctor or paediatrician for advice if you would like to tackle the problem with medication.

Burp

By far the most successful treatment for wind is an effective burping technique. Each baby responds differently, so it’s a case of trial and error. There are tried and trusted positions, though, that have shown to do the trick. We’ve listed our top 4 below. Whichever position you choose, don’t forget to drape a burp cloth near baby’s head.  And burp baby often: once mid-feed then again at the end should suffice, but do it more often if necessary.

1. With baby’s bottom on your leg (seated), let him lean slightly forward with his head on your hand, then gently hold his jaw forward with your thumb and forefinger, lightly patting his back. This stretches his spine, relieving abdominal pressure.

2. Seat baby on your leg, placing one hand on his back and the other on his chest. Lift his head upwards, towards your chin. This will elongate his body, allowing the air to make its escape.

3. Sit down and stretch baby over your lap face-down, his head hanging over your one leg and his body over the other. Rub or pat his back in this relaxing position until he burps (or falls asleep!)

4. Standing, hold your baby over your shoulder with his chest against yours. Cup your hand slightly and rub or pat him lightly on the back until the pressure is relieved and the air is expelled.

REFERENCES

www.netdoctor.co.uk

www.medicinenet.com

www.mayoclinic.com

www.nmihi.com

www.babiesonline.com

Infant acid reflux, also known as gastroesophageal reflux or GER, is a painful condition that affects more than half of all babies in the first few months of life. GER occurs when there is a backward flow of stomach contents into the oesophagus and out the mouth, resulting in spitting up or vomiting.

Although very stressful for both parent and baby, GER is common in healthy infants. Normally peaking between 1 and 4 months of age, reflux usually resolves on its own by the time the infant is between 6 and 12 months old.

If GER goes undiagnosed, parents are sometimes led to believe that their parenting skills are faulty because baby is overly fussy and niggly most of the time, when in actual fact the poor little thing has acid reflux.

In contrast to the more commonly occurring reflux (GER), the rarer condition of gastroesophageal reflux disease (or GERD) is far more serious.  Affecting approximately 1 in 300 infants, GERD causes further complications such as failure to thrive, slower growth rate, aversions to food, inflammation of the oesophagus, pneumonia, chronic sinusitis and other complications.

What’s up, baby?
Signs and symptoms of infant reflux

Experiencing regular bouts of GER is very common, and is an almost expected part of babyhood. Only a small percentage of infants with GER will experience severe symptoms.

Common symptoms include:

• Spitting up or regurgitation
• Vomiting
• Prolonged coughing
• Wet burps and hiccups
• Excessive drooling
• Sour, bad breath
• Poor feeding habits and diminished appetite
• Fussiness after eating
• Restlessness during sleep
• General irritability and colicky behaviour
• Frequent crying
• Choking or gagging
• Wheezing and asthma-like symptoms
• Frequent colds and respiratory infections
• Eroded dental enamel
• Blood in the stools

More concerning symptoms include:

• Poor growth due to constant vomiting
• Substantial pain, resulting in refusal to feed
• Marked irritability
• Breathing complications
• Persistent projectile vomiting
• Vomit that is green, yellow or resembles coffee grounds
• Blood loss

Generally, GER is easily treated. Should an infant display serious symptoms, however, the best route is to seek immediate medical advice.

What goes down…might come back up
Causes of reflux

In normal cases, food travels down the oesophagus, upon which the muscles in the tube contract downwards , pushing the food down into the stomach. Once the food has been swallowed and has entered the stomach, a band of muscle known as the lower esophageal sphincter (the LES) closes like a one-way valve, trapping the stomach contents and acids and preventing these from refluxing back into the oesophagus. If the LES fails to close (due to the fact that this mechanism is not yet fully developed), these stomach acids flow back into the oesophagus, irritating and burning the tube lining on its way back up.

The degree of regurgitation depends on the severity of this reflux action. If the swallowed food and stomach acids reflux only partially up the oesophagus, the baby will still experience pain but won’t spit up or vomit. This can be worse for the baby and his parents, because reflux isn’t immediately apparent so can go undiagnosed.

As the reflux becomes more severe, the baby will then regurgitate first a little, and then a lot. When the refluxed stomach contents enter the back of the infant’s throat, the baby could experience gagging, choking, sore throat, coughing and eroded dental enamel. Sometimes, the gastric contents are aspirated into the lungs, causing respiratory infections and asthma-like symptoms.

First line of defense
Breastfeeding and GER

GER can’t be prevented per se, as the condition is a result of baby’s still-developing bodily systems. That being said, research has shown that breastfed babies have fewer and less severe reflux episodes than babies who are formula-fed.

There are several reasons why breastfeeding helps minimise the symptoms of reflux:

• Breastmilk is easier to digest than formula
• Breastmilk is less likely to be refluxed into the oesophagus
• Breastmilk is emptied twice as fast from the stomach
• Breastfed babies eat smaller meals more often, so will spit up less

Yet more proof that breast will always be best!

There are a few things that breastfeeding mothers can do to prevent reflux episodes:

• Identify the breastfeeding position that minimises forceful letdowns as much as possible
• Allow your baby to drain the first breast before switching sides
• Avoid overfeeding
• Modify your diet for a while to see if it makes a difference – some babies are intolerant to various foodstuffs, including wheat, eggs and soy

Down with acid!
Dealing with GER

Living with a baby who is suffering from GER is stressful, exhausting and very taxing for the rest of the family.  However, there are things that can be done to lessen the discomfort and complications caused by reflux.  Although what works for one baby may not work for another, the following treatments and lifestyle changes should go a long way to improve symptoms:

Changes in feeding routine and positioning

• Continue breastfeeding (see our notes on breastfeeding, above)
• Make feedings as calm and peaceful as possible
• Maintain skin-to-skin contact
• Nurse or feed your baby when he’s sleepy
• Keep him in a semi-upright position during feedings and try to keep him in this position for about 15 minutes afterwards
• Feed your baby smaller amounts, more frequently
• Burp him often
• Offering a dummy after feeds, which may help prevent him from overfeeding and spitting up
• After feedings, hold your baby upright or prop him up at a 45° angle for at least half an hour
• Elevate the head of his cot

Medical treatment

• Various medications are available to assist with treating the symptoms of GER, such as acid blockers, proton-pump inhibitors, antacids and those that assist in improving coordination of the gastrointestinal tract.  Speak to your doctor about your options
• The homeopathic ColicCalm is very effective in controlling reflux and managing discomfort
• Although surgery to correct problems associated with GERD is very rare, various procedures are available for those little sausages unlucky enough to have such a severe case of reflux

Look after yourself

We understand how overwhelming it can be to have to care for a baby with GER. Make sure that you get enough sleep, eat well, keep in touch with friends and family and take advantage of those who offer to look after your baby while you enjoy some time-out. Your baby needs you to be a tough cookie, so do all you can to care for yourself too. And just remember that this, too, shall pass!

References
www.keepkidshealthy.com
www.medscape.com
www.webmd.com
www.netdoctor.co.uk
www.medicinenet.com
www.askdrsears.com
www.coliccalm.com
www.niddk.nih.gov

Benefits to Baby
There are tons, so grab a cup of Rooibos before reading on

• The perfect package deal. Miraculously adapting itself as baby grows, your baby thinks that breast milk is a delicious, made-to-order, right-on-tap feeding solution. With the ideal balance of all the components necessary for bodily systems, it is a symphony of nutrients. So you can be rest assured that baby is getting all the carbohydrates, liquids, fats, vitamins and minerals that he needs.   Baby’s first drive-through experience!
• Protection against baddies. Research has shown that babies who are breastfed during those crucial first six months, have a lower risk of the following medical conditions (amongst many others) in both childhood and adulthood:  asthma;  pneumonia;  allergies;  vision problems;  German measles;  Hodgkins disease;  obesity;  rheumatoid arthritis;  osteoporosis;  high cholesterol;  multiple sclerosis;  tooth decay;  bacterial meningitis;  eczema;  influenza;  respiratory, ear and gastro-intestinal infections.  Wow, that’s incredible, isn’t it?  Amazingly, nursing moms also produce antibodies to diseases that may exist in their current environment, which means that breastfed babies have an ever-evolving disease-fighting army guarding them round the clock.  Even better news is that breast milk is the ultimate medication for your little one on those under-the-weather, snotty days too.
• The best building block. Breastfeeding is the best platform for your little superhero: It jumpstarts the immune system; facilitates dental, jaw and intestinal development; enhances the effectiveness of vaccines; optimizes hand-eye co-ordination; leads to enhanced social development; promotes better speech development than formula-feeding would, and boosts your bright spark’s  IQ.
• A chill-out zone of note. Could there be any better way for you and baby to bond? Not only do those endorphins that are swimming around in breast milk act as an on-site tranquilizer and mood-enhancer, but they provide natural pain relief for baby too.
• Pretty perks. Breastfed babies have gorgeous skin, smell good, smile more, sleep better, spit up less and offer less unpleasant nappy changes. So less eewww and more coochie-coo.

Benefits to You
You’ll be surprised

• Even better than Woolies. Breast milk is free, expertly made, tastes amazing, comes in beautiful packaging, is always at the ideal temperature, and is ready to be served, whenever and wherever your baby needs it.
• A little bit of ‘just you and me’ time. Just as those endorphins get baby to relax, feel groovy and block out pain, you get to share in the magic too.  What a bonus.  As for the opportunity to bond with your baby while nursing goes, nothing beats those moments when you get to stare contentedly into your little miracle’s eyes while giving him the very best start in life.
• The fast-track to recovery. Breastfeeding moms get rewarded in more ways than one.  For one thing, post-delivery recovery is much faster than in moms who choose to formula-feed.  For another, weight loss is much easier to achieve whilst breastfeeding due to the amount of kilojoules that breastfeeding consumes. Interestingly, unless a woman breastfeeds, it’s highly unlikely for the uterus to shrink back to its pre-pregnancy size.  This is because breastfeeding stimulates the secretion of the hormone oxytocin, which in turn causes contractions in and shrinkage of the uterus – in women who have had both Caesarean and vaginal deliveries. An added bonus is that happier babies sleep better, which means that you also get more sleep, the importance of which can’t be overstated!  Onset of menstruation is delayed during the nursing period too… just one more reason to smile.
• Health = Wealth. Breastfeeding substantially reduces your risk of ovarian, breast and endometrial cancers, prevents onset of post-natal depression, osteoporosis and rheumatoid arthritis, and promotes general good health on both psychological and physical levels.
• A lifetime’s worth of brownie points. Breastfed babies are healthier. Fact. Knowing that you have single-handedly nourished your gorgeous little child, providing priceless protection against illness and the best platform for happiness and health is reason enough to feel like a million bucks.  The fact that UNICEF, the La Leche League, the World Health Organisation, hundreds of celebrities and millions of health practitioners around the world agree with you, is just icing on the best cake in town.