Ask Moxie

Q&A: biting, introducing formula, teething, and the 9-month sleep regression

Lisa writes:

"I know you've touched on some of my issues in your column, but here's a new combination: my son is 8 months old & is breastfed. About a month ago, he started taking a bottle a day of formula from my husband. About a week after that, he started taking it from me as well, so I dropped one breastfeeding session. (Previously he would usually only take a bottle of breast milk from him.) All was great until he got sick about 2 weeks ago, when he flat-out refused any kind of liquid in any kind of container except me. Now he's mostly over his coughing & sniffling, but still has no use for anything in a bottle or sippy cup. He's happy to play with them & chew on them, but won't drink from them.

In addition to the cold, he's teething like CRAZY. He got 2 teeth around 6 months & is cutting at least 4 more now. Around the time we started the formula, he had started biting me while nursing, but he had stopped with the introduction of the formula. While he was feeling the sickest, he wasn't biting, but now that he's feeling better, he's biting again.

Am I insane to even consider trying to deal with any of this until the teeth come in? Am I going to have any nipples left by that point? None of the things people have suggested for the biting do any good....when I yell, "NO BITING," he gets the biggest sh*t-eating grin you've ever seen..he knows exactly what he's doing! The very first time I yelped in pain, he cried, but not since. Fortunately, he's usually almost done when he bites, so I just sit him up & that's the end of the feeding. But YIKES! Help!"

Yowza. That's kind of a trifecta of nastiness. And I bet by now he's into the 9-month sleep regression and things are even crazier.

There's no way to be able to deal with all of this at one time, so let's separate it all out and prioritize. Personally, I think your nipples are the highest priority in this scenario. So stopping the biting is of primary importance.

Everyone's got some guaranteed way to stop the biting, until they have a second biter, at which point they've got two guaranteed ways to stop the biting... My first was an easy case. He bit me twice, at the same time each day for two days in a row. Each time I screamed in pain, pulled him off and dumped him unceremoniously off me, and buttoned up and walked away. It took two times and he stopped. My second child is much more bull-headed, and it took repetition after repetition for a week or so, until finally he stopped biting my nipples. And started biting my arm, shoulder, leg, ankle, etc. instead. Sigh. He seems to almost be coming out of his "lead with the teeth" phase, and he's 20 months now.

But enough about my wounds. I'm opening this up and asking everyone to share what worked for them to stop the biting. Someone's going to have the exact solution that will help you. It's my suspicion that the true key to stopping the biting isn't the way you react verbally, but that the feeding stops immediately.

Once you've got the biting under control, you can choose whether to deal with the bottles or not. If he's in the sleep regression or is still teething, my guess is that you're not even going to care about the bottles at this point and just want to get through this next month. If his sleep is fine and those teeth have popped, then you can go back to the bottles again.

There are plenty of kids who won't take a bottle or a sippy who will take a Nuby cup or straw cup (and be sure to read the comments). Try varying the temperature of the formula or milk to see if that makes any difference. In all likelihood, he was just on a strike because he was feeling bad. But even if he steadfastly refuses a bottle there are still plenty of options for you to try. You're probably still going to have better luck with your husband trying all this instead of you, because the breasts are just still too attractive to make any other container have any appeal while you're there.

Hang in there. The teeth will eventually come in.

Q&A: preventing illness in the winter and homemade gifts

Shannon has a two-parter:

"1. How do you protect your children from "germs"  during these winter months? I have a 2 yr old and a 3 month old - the little guy is fairly protected in his car seat when we are out and about, but the toddler is into everything. Should I be spraying Lysol everywhere we go?

2. We would like to give some home-baked goods for Christmas gifts, and therefore need a simple and surefire recipe I can throw together while watching 2 little ones. Any suggestions?"

I think that exposure to a certain number of germs is healthy, assuming your kids have no immune issues and aren't preemies in the RSV zone. The best defense against getting sick all the time is to feed them lots of fruits and vegetables and be anal about washing hands every time you come in the house, before eating, and any other time you think of it.

Do NOT use antibacterial soap, as it's counterproductive (causes super-germs that can't be killed) and not good for kids. instead, just use regular soap (liquid or bar) and wash for the length of time it takes to sing "Happy Birthday" all the way through. Purell is fabulous for use outside the house, as the alcohol will kill germs without all the negative effects of the antibacterial agents in those hand soaps.

If you're washing hands a lot, eating well, drinking lots of water, and getting enough sleep, the kids should be able to fight off the normal germs and there's no need to disinfect everything they touch. Once your kids are in daycare or preschool, though, all bets are off. They will get sick. And they'll bring it home to the baby. There's not much you can do about it, so use the same precautions to help them try to stay as healthy as possible.

For your second question, how about a fudge wreath? Pretty simple, but almost everyone likes fudge. (Although I'd beg you not to put raisins in fudge. Please. For the children. Also, be very careful with nuts in gifts.)

Does anyone else have any easy food gifts to make that Shannon can do with two teeny kids "helping?"

Q&A: keeping a baby warm in the cold winter

MC writes:

"A semi-ridiculous question for you: How in the world does one keep a baby warm in the winter? I get that when we go outside for a walk we need to put our daughter, who's now five-and-a-half months old, in a snowsuit or some such thing once it gets really cold. In the meantime, we've been putting her in a sweater and a hat for the chilly Maine fall, and that seems to be working, although her hands and cheeks get quite cold. But I'm mainly wondering about keeping her warm inside the house. I tend to run cold, and I think she does, too; from November until March or so, I wear that silky long underwear pretty constantly. Is there a version of this for babies? If not, how do you keep their little legs warm? We can pile on the layers on top, but I have no idea how to keep her ankles and calves warm; they're already chilly and it's only October!

Other cold-weather related questions that make me wonder how humans have survived in the frigid north lo these many years:
~At what temperature should we keep the house? Last year we had the thermostat set to 65 when we were home and just piled on the sweaters and blankets. And it goes down to 57 at night. (We are cheap, and oil is expensive.) Is this too cold for the girl?
~What do we dress her in when we go out in the car when it's cold? I know she's not supposed to wear a coat when she's buckled into the carseat, so does that mean if we're out and about doing errands that we warm the car up, bundle her up, get in the car, take the coat off, put her in the seat, then put the coat back on before we get out of the car again?
~How much exposure to cold weather is ok for babies? If she could get up and run around I'd feel fine about taking long walks with her in the winter, but this year she is just going to sit in the stroller (we are having trouble transitioning to the front carry in our various slings...), which I would think means that we're going to end up with a baby popsicle before too long.

I feel like a complete moron for asking these questions, but in the hopes that I'm not the only moron out there thought I would run them by you."

I love winter, but it does present a whole new set of dressing questions for parents.

Bear in mind, please, that my answers are based on my experience living in NYC where it rarely gets below 25 degrees F (-4 degrees C), we have limited control over the heat in our apartment (it blasts all winter and the only way for us to control the temperature is to open or close our windows), and we don't have a car but use strollers or slings all the time. Those of you who live in cold houses, super-cold climates (MN, WI, the UP, ME, ND, SD, IL, and everyone in Canada except Vancouverites), and have cars are all specifically invited to comment on MC's questions.

Inside the house
You could do pants with feet on them, blanket sleepers, stretchy cotton sleepers with feet (sometimes called "sleep 'n' play"s so you won't think the baby can only be in them while asleep--Could we Americans be bigger idiots?). Or you could get those shoes/slippers that are like knit socks but with leather bottoms. I think if her feet are warm then her hands will be fine, and she's probably too old to accept having her hands covered, although for a tiny baby I'd use the cotton long-sleeved shirts with the cuffs that fold over to cover the baby's hands.

More suggestions than that, I do not have. Our problem has always been fighting the stifling heat from our landlord's overzealous cranking of the furnace. But I should be grateful because there are tons of people in this city whose landlords turn off the heat as much as they can.

Ideal house temperature
My dad is what some would term "frugal" with his money, so the thermostat in our house was always low while I was growing up. I was cold often as a kid, and all my dad said was "put on a sweater." Do you know what this does to a person? It turns her into the kind of adult who turns the thermostat down (if given the option) and tells the people living with her "put on a sweater."

What I'm trying to say is that she'll adjust to the temperature you have the thermostat on. Just make sure that you've got her layered up good. You do know the place to check a baby's body temperature is the back of the neck? (I'm mentioning this because I didn't actually know this until my second child--I'd been checking the hands. When I found out I felt like a cold-weather incompetent. But at least I can drive on ice.) If the back of the neck is warm, even if the hands are cold the baby is warm. If it's cold, she needs to be snuggled for a few minutes and another layer of clothes put on. If you're really worried about the cold, watch some soothing TV and snuggle under an afghan on the couch for awhile.

The general rule is that babies should have one more layer on than the adults in the same room do.

In the car
There are these cool down covers that you can pop over the carseat or zip up with the baby in them (there's a hole for the head to stick out). You put the baby in and zip it up in the house, then click the seat in and warm up the car, then take off the cover.

Of course you could get the same effect by putting a heavy folded blanket over her in the car seat to take her to the car. When the car is warm, take off the blanket.

Once she's old enough for the convertible carseat, you can dress her in a fleece snowsuit (you can get really nice LL Bean or Lands' End ones on Ebay--search in the "Baby" category on "snowsuit" and "bunting"--since babies grow out of them so quickly that people only use them for one season) over her clothes, then pop her into the carseat and cover her with a blanket. When the car's warm, take off the blanket. The fleece snowsuit is light enough that it doesn't interfere with the carseat straps and not so warm that you can't have the heat opn lightly in the car.

When you get out of the car, wrap her in the blanket or pop the quilted cover on again.

Being outside
Human babies are adaptable. Get a stroller bunting bag to zip her in, or dress her in a snowsuit and blanket, and go. As long as you're not replicating the Iditarod, she'll be OK for walks in the cold that are OK for you. If the hair in your nostrils starts to crackle, both of you should be in the hosue anyway.

One sling carry that I never see anyone else doing (but that both of my boys liked in that phase when they were too big to lie down but not big enough for the hip carry) was sitting and facing out. I'd put the baby with his back to my chest, and cross his legs so he was sitting Indian-style in the sling, facing out. The front edge of the sling was up over the tops of his feet so he couldn't roll out, and I'd shift the baby's weight so he was leaning back into me. The baby could look out, but was still sitting supported.

This carry also has the benefit of putting the baby's face right below your neck, so you can wear a baby this way under your coat, and zip the coat up just to under the baby's face and both of you will still be warm.

A note about snowsuits
Buy big, if your baby is under 15 months or so. You'll be using this thing for 4-7 months, depending on where you live, and even if your baby is swimming in it now, s/he will grow a lot this winter and you don't want to have to buy a new one in March. Check local consignment shops, thrift stores, and Ebay for good deals on newish snowsuits/buntings.

This post is making me want some hot cocoa.

Green smoothies: An Apology

I have to make a public apology to regular commenter Elizabeth. When we were having this discussion back in May about sneaking healthy things into your family's food, she emailed me to say that she's started putting a little frozen spinach into fruit smoothies. She claimed that you couldn't taste the spinach at all. I attempted to be polite, but just couldn't imagine how you wouldn't taste spinach in a fruit smoothie.

I was wrong. Elizabeth is right. You can put spinach (and I'm assuming other greens) into a fruit smoothie and you won't taste them.

I'm thrilled about this discovery, because my kids are great about eating red and yellow and orange vegetables, but leafy greens are a crapshoot. El Chico will eat any kind of greens slathered in ranch dressing, but it's mostly about the dressing, and I'd rather have him just eating the greens.

In the past week I've made the following smoothies that went over like gangbusters with my husband and my toddler (El Chico wasn't willing to drink anything green, and drank some of the last one but stalled out to play with his matchbox cars):

#1
Half a bag of baby spinach
A big handful of frozen mango chunks
Half a can of coconut milk
A splash of water to get the blender started.

#2
Half a bag of baby spinach
A big handful of frozen mango chunks
Half a banana
Enough unsweetened cranberry juice (thinned with water, because unsweetened cranberry is too strong) to make it blend.

#3
Half a bag of baby spinach
A big handful of frozen raspberries
A banana
Enough water to get the blender started.

#4
Half a bag of baby spinach
1/5 to 1/4 of a pint of Stonyfield Farms After Dark Chocolate frozen yogurt (the richest chocolate frozen yogurt I've ever had)
A banana
Enough milk to make the blender run.

I hid spinach in a chocolate banana milkshake. Bwahahahahaha. I am drunk with power.

You can't taste the spinach. Am I the last one to know this? What should I try next? Parsley?

Q&A: flu shots

Monica asks:

"What are your thoughts on the flu vaccine for babies? In my case, my ped doesn't offer the vaccine without thimerosal and I can't find one willing to vaccinate my son in the near future. Would you get the regular vaccine or skip it all together?
 

Also, why can my son sleep through a thunderstorm, but not the sound of my footsteps as I creep out of his room!?"

I don't want to open a whole vaccination can of worms, so let's make this clear that this is only my thoughts about the flu vaccine. Not vaccines or vaccination in general.

Now, I like to look at the benefits vs. the costs. The benefit is, obviously, not getting the flu. But I'm not convinced (and haven't been for years) that the flu shot is actually that great at preventing the flu. My suspicions were confirmed when I read about a study appearing in The Lancet (British medical journal) of elderly people who got the flu shot. A summary of the study results is here, but the money quote is

The researchers found that flu vaccines, when well matched to circulating flu strains, reduced the risk of hospitalization for flu or pneumonia by 45% for elderly (65 or older) nursing home residents. For people living at home, flu vaccines were 26% effective in preventing hospitalization for flu or pneumonia. However, vaccination didn't significantly lower the risk of laboratory-confirmed influenza in either group.

And those benefits, note, are only when the flu shot is well-matched to the flu strain that goes around. Which happens sometimes, but not every year. I don't know whether we can assume that the effects are the same on kids as they are on the elderly, but we don't have any studies of the flu shot on kids yet.

Then there's the anecdotal evidence that that last 3 times I got the flu shot I got the flu within days. (Who knows why? All I knew was I got the flu.) Now, "the plural of anecdote isn't data," (thank you, Jo Leery Polyp) but I have to think that if anyone's going to have the same results of a flu shot that I did, it'll be my kids. Someone who's had a great experience with the flu shot in the past is going to have a radically different view of the benefits than I do.

The costs: There are a bunch of toxic and/or allergenic ingredients in flu vaccines (MSG, thimerosol, a few different antibiotics, formaldehyde, and eggs). Not much of those in each shot, but since I go out of my way to avoid MSG, formaldehyde, and mercury, I'm not crazy about the idea of shooting them straight into my kid's bloodstream.

So, what's the answer? Well, it's different for everyone. If you have a child with a compromised immune system, you will probably get the shot. If you have a kid allergic to eggs or poultry or certain antibiotics, you won't get the shot. The rest of us just have to pick a side by going with our guts.

The odd thing about all of this is that the media makes us think the only way, or even the best way, to protect ourselves against the flu is by getting the flu shot. That's not true at all. The single best way to avoid the flu is to wash your hands a lot. A lot. Many times a day. Not with antibacterial soap, but with regular soap and water. And makes sure you scrub for the length of time it takes you to sing the "Happy Birthday" song. You still probably won't spend as much time each day washing your hands as you do thinking about whether or not to get the shot.

The other great ways to avoid the flu are to up your Vitamin C intake during the winter, drink plenty of water, make sure you're eating plenty of vegetables (easier said than done with a 3-year-old), get as much sleep as possible, and stay away from sick people. You can also try the herbal remedies like echinacea and Airborne, or the homeopathic Oscillococcinum (apparently it can be used to prevent flu by taking 2-3 of the teeny little pellets--not the whole vial--once a week during flu season).

Monica, for your second question I can only say that he does that for the same reason mine can sleep through 3 fire engines screaming down the street past his window, but wakes up when I crack the door to make sure he's still OK.