Birth plans have become the next “big thing” for pregnant women who decide that they want to maintain some control in the labor and delivery of their unborn child, as well as in the post-partum care both she and her baby receive in the hospital. Some people do not know how to create a birth plan, or why creating a birth plan is an important aspect of their pregnancy.

When a laboring woman arrives at the hospital, there can be limited time to get her feelings regarding how she wants her labor to progress across to the nurses on duty. Birth plans are generally written by the pregnant woman, sometimes with the assistance of her labor partner several weeks prior to delivery. It should then be taken to your doctor or midwife at one of your prenatal appointments to go over your wishes and make sure that your provider is aware of any concerns you might have.

Flexibility
One thing to keep in mind when creating your birth plan is to maintain flexible. Even if you have the textbook perfect labor and delivery, chances are that something in your birth plan will not be able to be accomplished or achieved. It might be because of your hospital, or it might be as simple as you originally saying that you do not want pain medication, just to change your mind half way through labor. If you remain flexible regarding what you wrote in your birth plan, the day of delivery will go much smoother.

Creating your Birth Plan
So how do you create a birth plan? You can use our customized birth plan creator, or you can create one from scratch. If you create one from scratch, be sure to remember to include everything that you deem important.

Pain Medication
When doing your birth plan be sure to mention your wishes on pain medication. Do you want pain medication or not? If you do want pain medication, how much and what kind do you want? If you want medication, do you want to have just a shot through your IV of something to just dull the pain a bit, or do you want an epidural which will go in your back and pretty much get rid of all pain and contractions that you feel? Do you want the doctor or midwife to suggest to you medication, or not mention it at all?

Episiotomy or Tearing
Also, when creating your birth plan, be sure to let everyone know what you will prefer when it comes to having an episiotomy. An episiotomy is when the doctor or midwife cuts the perineal area that goes from your vagina to your rectum an inch or two before the babies head comes out in order to help the head come out easier. Some women prefer to be cut; other women prefer to tear naturally. Many women’s activist groups these days are promoting tearing vs. no episiotomy because some women won’t tear at all, or only tear a tiny bit, making the healing time less painful than it would have been with an episiotomy.

Visitors
Let the nurses know in your birth plan who you want to be allowed in the room and when. Some women are fine with having everyone in at once, and others prefer to only have their birth partner, or have other visitors come in one at a time. You might want the interaction and distraction during the early stages of labor, but not want a bunch of people in the room towards the end. There are also times when you may not want your parent or an in-law in the room at all, but you do not want to be the bad guy. Buy writing these wishes down in your birth plan, it enables your nurse to tell people who can and can not go in and when, and also makes the nurse be the “bad guy” so you don’t have to concentrate on those issues when you should be concentrating on pushing your baby out.

Immediately After Birth
Assuming you have a vaginal birth, you should include in your birth plan your wishes for the baby immediately after birth. Some women will choose to bank their babies cord blood and will have that set up ahead of time. Others want to make sure the cord stops pulsating before it is cut, letting the baby get the remaining nutrients that are important for their health. If you are breastfeeding, you may want to be allowed to nurse immediately, vs. having to wait several minutes for your baby to get cleaned up a bit and get eye drops. Your baby is most alert in the 30 minutes or so right after birth so it is an important time for you to be able to nurse and bond.

Just incase a c-section becomes a necessity, you should list your wishes for the baby while they are finishing up your surgery, in your birth plan. Put down whether or not you want your baby accompanied at all times by your birth partner. Let them know ahead of time your wishes on them giving your baby a bottle of sugar water or formula while you are in recovery. Make it clear if you want your baby brought to you in recovery or if you want to wait till you get back to your room.

Postpartum Care
Part of your birth plan includes your post-partum care. Most hospitals support and encourage your baby staying in your room with you at all times, vs. going to the nursery at night or while you sleep. You can make it clear in your birth plan what your preference is. Whether or not you want to room-in, or if you just want your baby brought to you for feedings letting you rest as much as possible. You can also list whether or not you want your birth partner to be allowed to stay the night.

Feeding
In your birth plan you will list your intentions on feeding your baby. You can state whether or not you plan on breastfeeding, and if you do breastfeed how often and when you want to do it. That is important in the instance that you choose not to have your baby rooming in with you, but instead in the nursery. You should make it clear if you want to feed the baby on demand, when the baby is hungry, or if you prefer to feed the baby on your schedule, allowing the nurses in the nursery to give the baby formula when he gets hungry.

Miscellaneous
There are always other things you might think of when it comes to your hopes and wishes for a happy and healthy labor and birth. Things like taking pictures, video taping, having music playing, moving around, being allowed to take a bath or shower during labor, etc. If any of these things are important to you, or you can think of others, be sure to list them in your birth plan for the nurses and your doctor or midwife. Happy birthing!

By Christine Albury

It may sound daunting, but traveling with baby does not have to be a nightmare! A little preparation and forward planning is all you need for a successful trip with your tiny traveler.

There are certain supplies that are essential for any trip with your baby. The most important, of course, is enough food and milk for the journey. Always pack more than you think you’ll need and include plenty of finger foods if your baby is old enough — these are great for helping to keep him occupied! If you are breastfeeding and need to express milk, you can store it in a cooler, with ice, for up to 24 hours. You can also store bottles of pre-made formula in the same way — alternatively, you can add pre-measured powdered formula to the bottles, then top it up with cooled, boiled water as required.

Another option is to bring “ready to drink” cartons of formula. Whilst ideal for the journey itself, be aware that you may not be allowed to take these cartons with you into certain countries. Sealed containers of formula do not normally present a problem.

Solid foods can be packed into a cooler, although a better idea is to bring foods with you that you can easily prepare during the journey. Avocado pears and bananas are good examples, as they can be simply peeled, mashed and served to your baby at room temperature.

Always bring your own feeding bowls and utensils when traveling with baby – many eating establishments do not have cutlery appropriate for an infant’s use. A travel high chair is incredibly useful, too — and means that you can comfortably feed your baby wherever you go. Disposable bibs, or a wipe-clean plastic bib, can be very convenient when traveling and they certainly cut down on the laundry!

If you ask for food or milk to be warmed for you, be VERY careful to check the temperature on its return. Busy waiters or cabin crew may overheat the food and you will need to wait for it to cool down. With this in mind, ask for any food or milk to be warmed well before you’re actually going to need it!

Many parents worry about how to sterilize feeding equipment when traveling with baby. There are many products available to assist with this, from microwave sterilizer bags to disposable bottle liners. Most stores dealing with infant feeding equipment will offer a range of traveling accessories such as these.

Other essential items for your trip will include nappies/diapers and scented diaper bags. If you’re heading to a warm destination, adequate sun protection is a must! Also, consider bringing a small nightlight – if you’re breastfeeding, it can be very useful in a dark, unfamiliar hotel room.

To help your baby cope with the trip and to reassure him in new surroundings, be sure to bring his favorite blanket. This can also serve as a handy “curtain” to shield an airplane sky cot/bassinet from the light, or for naps in his stroller when out and about.

Dress your baby in light layers when traveling — not only does this make it easier to cope with fluctuating temperatures, but if your baby spills his food, for example, you can easily remove the top layer of clothing. Bring a change of clothes for yourself, too — baby’s mess tends to have a habit of transferring itself to his parents!

Enjoy your trip!

About this Article:
Christine Albury is the author of http://www.homemade-baby-food-recipes.com, a complete guide to solid feeding during baby’s first year. For more information about traveling with an infant, including tips on air travel and taking your baby overseas, visit http://www.homemade-baby-food-recipes.com/traveling-with-baby.html.

Gone are the days where you can just throw on your flip flops, grab your purse and run out the door. Once you have a baby you have to be much more prepared, and give yourself a lot more time. Not only do you have to get yourself ready, but you have to get your baby ready too. If you are planning a day out, or even just going out with your baby for a couple of hours, there are a few things you should remember to do. These things will make the trip much more pleasant for all involved.

The Diaper Bag
Don’t wait till you are ready to leave to stock the diaper bag. If possible check for supplies before you leave while baby is napping. Even the night before if you know you are heading somewhere. Make sure you have plenty of diapers and wipes to get you through your trip. Also make sure you have a couple of changes of clothes for your baby jut incase there is an accident.

Schedule Extra Time
It takes a while to get baby ready to go. After making sure he has a clean diaper you have to get him dressed, get him in his car seat, grab the diaper bag (which should already be stocked), grab a blanket and maybe a couple of toys, pack some snacks if your baby is at the age to have snacks, and a bottle or sippy of some type of fluid. Once you have everything in hand, you have to get your baby out of the house and strapped into the car. This whole process can easily take 15-20 extra minutes before you leave.

While out it is likely that you will spend more time than normal doing even the simplest things. You will have to take time outs to feed the baby and change a diaper. Many times as soon as you change him, you will have to change him again. A simple 10 minute trip the store, can easily and quickly turn into an hour long trip, or longer.

Feeding Your Baby
Especially if you are breastfeeding and your baby won’t take a bottle, feed him before you leave the house. If you feed him he will not only be full and should be able to go a couple of hours without eating, but he will be happier and might actually sleep. If your baby will take a bottle, take one with you in case you need it suddenly, and if he is old enough take some snacks like cheerios and goldfish.

Naptime
Most babies will fall asleep in the car. If yours falls asleep easily in the car and you have a long drive to make, try to schedule it at your baby’s naptime. If your baby is asleep then running errands and such will go much faster. If your baby will not sleep in the car, the schedule your outings to coincide with the time your baby wakes up. This way he is well rested and happy, instead of tired and cranky.

Going out with your baby really is a test of timing, patience and good planning in order to guarantee that it will be a successful and fun time for everyone involved. While out just remember to listen to and pay attention to your baby’s cues. Babies are great at letting us know when they are unhappy or just simply want to be held.

It is time to start giving your baby more than just breast milk or formula. It is time to introduce him to the wonders of REAL food, stuff he has to “chew” on and actually swallow. When you go to the baby section of your local store though you are faced with rows and rows of baby food, in all different flavors, sizes, and numbers. How do you know which food to choose and where to start?

Stage One
When you first give baby food to your infant you will start with the stage one foods, normally this will start with cereal. Baby food companies make cereal that comes in thin flakes, that expands slightly when formula or breast milk is mixed with it; much like instant potato’s that you can buy in the grocery store. When you first start on cereal you will want to use a very small amount of flakes and a lot of liquid making it only slightly thicker than the breast milk is by itself. As your baby gets used to the swallowing of this thicker food, you will gradually add more cereal. Most pediatricians suggest that you start with rice cereal, but if you are unsure, be sure to ask at your baby’s next well-check.

After your baby masters the stage one cereals you will move onto the stage one packaged baby food. This baby food is finely pureed, chunkless food made from fruits and vegetables that help introduce your baby to these healthy lifestyle choices. While finely pureed, it is still much thicker than the breast milk or formula that you are giving your baby. Most of the time it is recommended that you start with the vegetables and give each vegetable for one for a week, before introducing a new vegetable to your baby. This is to help determine if your baby is allergic to any of the food. Also, vegetables are less sweet than fruit and will often help you avoid a situation where you baby only wants the sweeter foods.

Stage Two
Stage two baby foods are thicker, less pureed versions of the stage one foods. They contain a little more texture to help the baby get used to lumps in their mouth. They also expand on the fruits and vegetables by mixing 2 or 3 together in a jar. At this stage some companies that make baby food may begin introducing more variety to include meats and pureed noodles.

Stage Three
By stage three your baby should be a pro at swallowing pureed food. Stage three baby foods are much chunkier than the earlier stages and often include 3 or more items mixed in one jar. For dinners they will normally include a meat and/or pasta dish with a vegetable. There will be your fruits and vegetables, and also a wide variety of “desserts” for your baby.

After the Stages
After the numbered stages of baby food your baby is normally ready to be introduced to table food. They should be able to eat small pieces of cut up meats, veggies and pasta, and may even be able to feed themselves. There are still options that give baby variety however, that you don’t have to cook. Gerber makes food called Gerber Graduates that will be meals of non-pureed, single serving, baby sized portions that can be taken with you and eaten straight out of the package or heated up for your baby. These choices for parents are great for convenience purposes or on the go.

Other Options
In addition to the baby food on the market, there are several different versions of baby cookies and biscuits’ designed to help your baby learn how to hold food and chew it. These are called finger foods, and are generally dissolvable and easy to hold. When babies get the pincher grasp down and are able to chew on food a little bit more, a popular choice for a take along snack are original, plain cheerios. They can easily go in a bowl or baggie and be thrown in the diaper bag to be taken with you to friends, relatives, shopping, or out to dinner. Once your baby graduates from a diet strictly of breast milk and formula the choices for nutrition are huge and never-ending. Be sure to keep the options open and choices interesting as your baby learns more about the world around him.

by Cheryl Tallman and Joan Ahlers

Rice is easily digested and has low allergen aspects, so it is commonly recommended as the first food you introduce to your baby. Many of the recipes for making baby cereals are time consuming, but with the use of the freezer and a blender, homemade rice cereal is simple and convenient.

This recipe is perfect for infants, but by adding a few “extras” it will tempt the taste buds of kids and adults.

Ingredients:
3 cups of brown rice, cooked according to package directions
12 ounces breast milk, water, or infant formula

Directions:
Place the cooked brown rice in a blender with the breast milk/water/formula. Puree until completely smooth – you cannot make this cereal too smooth. Pour the cereal into ice trays, cover and freeze overnight. Once frozen, pop the cubes out of the trays, place in a freezer bag or container, labeled with the date and return to the freezer. Lasts up to two months.

To serve:
Defrost the cubes, and add breast milk or formula to develop a smooth consistency. For babies just starting solids, thin the cereal to a semi-liquid consistency. Warm the cereal, if desired. You can also change the flavor of the cereal by adding fruit or veggie baby food, once your baby has started to eat those foods.

Extras for the older crowd:
Ground nuts and maple syrup
Cinnamon, nutmeg, raisins and honey
Fruit preserves
Cinnamon sugar and dried fruit

About the Authors
Cheryl Tallman and Joan Ahlers are sisters, the mothers of five children, and founders of Fresh Baby (www.FreshBaby.com). Raised by parents who love fresh foods and entertaining, their mom, a gourmet cook, ensured that they were well-equipped with extraordinary skills in the kitchen. Both with long track records of business success, they decided to combine their skills in the kitchen with their knowledge of healthy foods and children to create Fresh Baby. Cheryl and Joan put a modern twist on the conventional wisdom that when you make it yourself, you know it’s better. Their goal at Fresh Baby is to make the task of raising a healthy eater a little bit easier for all parents. Fresh Baby’s breastfeeding accessories and baby food making supplies provide parents with practical knowledge and innovative tools to support them in introducing their children to great tasting, all-natural foods – easily and conveniently. Visit them online at www.FreshBaby.com and subscribe to their Fresh Ideas newsletter to get monthly ideas, tips and activities for developing your family’s healthy eating habits!

Your baby is growing and growing fast. The average baby weighs approximately 7 ½ pounds at birth when born at 40 weeks. Obviously, since most babies are not born at 40 weeks, babies are born at various different sizes. Non-preemie babies can be anywhere from five pounds on the low side to 11 pounds on the high side when they are born. The good thing about babies is that no matter what size they are when they are born — they will all grow, and during the first year will go through several growth spurts.

Growth spurts are normal in both breastfed and bottle fed babies. It may however be a little more noticeable in babies who are breastfed because it would be felt more by mom. She would have to nurse more frequently in order to build up her milk supply to satisfy her baby.

There is no set time for a growth spurt to appear, however there is a generality. A baby’s body is not a clock but they will generally go though a growth spurt between 7-10 days old, around three weeks, six weeks, three months, four months, six months and nine months. Most of the weight they gain during the first two years will be gained during this time and they will also grow in inches.

Growth spurts are less frequent after the first year but they still occur. Your baby will probably gain more in inches than pounds after their first birthday. Through out the toddler years and into adolescence however you will notice growth spurts.

Growth spurts generally only last 2-3 days, but can sometimes last as long as a week. During a growth spurt it is important to follow your baby’s lead. When he seems hungry, feed him. While still young be prepared to nurse more or offer more bottle of formula. If breastfeeding have a bottle of breast milk prepared and waiting to top your baby off if he still seems hungry after a nursing session is complete.

As a nursing mom you may also feel more hunger or thirst while your baby is going through a growth spurt. As your baby eats extra calories from you, it is important for you to replenish yourself and keep your energy up. If you are feeling extra hungry or thirsty, eat and drink a little more, but be sure to keep it healthy.

By Elizabeth Pantley, author of Gentle Baby Care

Choosing your baby’s doctor several months before her expected arrival is a good idea. This way, you won’t feel rushed and can take the time to make the right decision. During the first few years of life, your baby will have frequent visits for routine checkups and illness; so selecting a healthcare professional you trust is important.

Decide which type of healthcare provider

Different types of healthcare professionals are qualified to care for your baby:

A pediatrician is a medical doctor with specialized training in caring for children from birth through adolescence.

A family physician or general medical practitioner (GMP) is a physician who is educated and trained in family practice, which is medical care that covers every member of the family for well and sick care. You already may have a family physician for your own healthcare.

A nurse practitioner (NP) is a registered nurse (RN) with advanced education and training. Nurse practitioners often work in partnership with a licensed physician.

Once you’ve determined what type of professional you would like to consider, find prospective doctors through these sources:

• Recommendations from friends who have children
• Your obstetrician
• Your local hospital’s referral service
• Medical schools and medical directories
• The American Board of Pediatrics

Determine your insurance company’s requirements

Check out the rules of your insurance policy prior to choosing your baby’s doctor. You may have to designate your baby’s doctor for your health insurance carrier, or you may be required to have your selection approved in advance. Many health plans have strict rules about which doctors you can visit, so it’s important to determine if your choice of primary care physician also decides which specialists and which hospitals you will be able to use if your baby should need specialized care, since oftentimes these are linked together by the rules of a health plan.

Consider your parenting philosophy

Choose a doctor who has a similar philosophy with regard to important parenting issues, since most parents turn to their pediatrician for advice and guidance on more than just health-related issues. While this similarity in outlook is not crucial, it certainly makes for a more complete and enjoyable relationship that allows open conversation and precludes the need to avoid topics on which you disagree. A like-thinking pediatrician understands your starting point when advising a particular course of action, and is more likely to prescribe one that suits your ideals. An easy way to find out what a doctor’s opinion is to ask open questions, such as, “What are your recommendations about breastfeeding and bottlefeeding?”

Here are just a few of the important topics you should consider:

• Feeding – Does the doctor support your goals for breastfeeding, bottle-feeding and weaning?
• Sleep – What is the doctor’s opinion on sleep-related issues, such as co-sleeping and letting the baby cry herself to sleep? Are her views similar to yours?
• Immunizations – Will the doctor provide you with ample information to make decisions about various vaccinations? Do his standard recommendations suit you?
• Discipline – Does the doctor believe in the same approach towards discipline as yours?

Take the time to interview prospective doctors

Most medical professionals are happy to provide a brief interview meeting at no charge. This gives you an opportunity to meet the doctor and ask questions. Here are a few tips to make this a productive event:

• Make an appointment.
• Arrive early and observe the waiting room, staff and other patients. Is the staff helpful? Is the atmosphere child-friendly? Is the office clean and tidy? How long do people wait for their appointments?
• Be prepared with a brief list of questions.
• Stick to your most important topics.
• Refrain from small talk or lengthy explanations.
• Remember that your main purpose is to listen, not to talk.

Before your interview

If you do a little research and handle the technical details before your appointment, you can use your time with the doctor to obtain answers to your most important questions.

You can obtain information about a doctor, such as certifications and residency background, from:

• The American Board of Pediatrics
• American Academy of Pediatrics
• The American Medical Association
• Royal College of Physicians and Surgeons of Canada

You often can get information from a receptionist or secretary at the doctor’s office. First, ask for a brochure or other written information about the doctor and the practice. If the following information isn’t covered, then call the office and ask for the following:

1. The background and experience of the doctor. (Asking for a verbal answer from the doctor during your upcoming appointment may well take up a large portion of your meeting.)
2. What are office hours? Are there evening or weekend hours?
3. How is billing handled?
4. What insurance is accepted?
5. What are your after-hours and emergency procedures?
6. What hospitals is the doctor affiliated with?
7. How do you handle questions by telephone?
8. Will my doctor personally see us for every scheduled appointment?
9. If he is unavailable, who will see us?
10. How many doctors share this office?
11. Do you have a special waiting room or a separate entrance for sick children, or how do you separate them from others?
12. Do you have a lactation specialist in the office? If not, can you recommend one?

Interview questions

Arrive at your appointment to interview a medical professional with your list of questions. Don’t ask about issues that sound good but don’t really matter to you; the meeting likely will be short, maybe five to 15 minutes (ask in advance how much time you will have).

Stay focused on your own priorities. Relax and be friendly, but stay on track. Here is an assortment of sample questions to help you create your own list:

1. Can you explain how we will work together during our baby’s first year?
2. Will you examine our baby at the hospital (or at our home) directly after birth?
3. What is your typical advice to new parents about… Circumcision? Breastfeeding? Bottlefeeding? Sleeping through the night? Immunizations?
4. Can we come to you with questions about non-medical issues, like feeding or behavior?
5. What do we need to know about our newborn’s health and care?

After your interview

Consider the answers to these questions to help you make your final decision:

• Is the office conveniently located for you?
• How long did you have to wait in the waiting room?
• Did you feel good about the office and staff?
• Did the doctor listen thoughtfully to your questions?
• How willingly and thoroughly did the doctor answer questions?
• What was his attitude when he answered them?
• Do you feel comfortable with the doctor’s specific child-rearing philosophy?
• Did you feel that you could freely ask questions?
• Did the doctor appear knowledgeable and current with his information and advice?
• Would you feel comfortable bringing your baby to this person for care?
• Would you feel confident having this doctor handle an emergency with your child?

Copyright Elizabeth Pantley. (McGraw-Hill, 2003)

About the author

Elizabeth Pantley is the author of several books, including Gentle Baby Care : No-cry, No-fuss, No-worry — Essential Tips for Raising Your Baby, The No-Cry Sleep Solution: Gentle Ways to Help Your Baby Sleep Through the Night, Kid Cooperation (with an introduction by William Sears, MD), Perfect Parenting, as well as her latest The No-Cry Sleep Solution for Toddlers and Preschoolers and is also president of Better Beginnings, Inc. She is a popular speaker on family issues, and her newsletter, Parent Tips, is seen in schools nationwide. She appears as a regular radio show guest, and has been quoted in Parents, Parenting, Redbook, Good Housekeeping, American Baby, Working Mother, and Woman’s Day magazines.

Visit Elizabeth’s web site http://www.pantley.com/elizabeth.

by Roni MacLean

It’s important to realize that not all babies with reflux will require medication or have difficulties with their reflux. Many infants, usually called happy spitters, will benefit greatly from some simple steps that you can start trying right now. Many of the things listed below will help with your baby’s discomfort and spitting up, eliminating the need for medication.

If, after trying all the below listed tips, your baby is still spitting up, or having difficulties with their reflux, read about whether or not medication may be needed and what medications will likely be used at InfantRefluxDisease.com.

Positioning Steps for Improving Reflux

1. Positioning During and After Feeds
   Keeping the child upright during and for at least thirty minutes after feeds can help to reduce reflux by allowing gravity to work at holding the food in their tummies. As well, after feeding, try to keep them as motionless as possible for at least thirty minutes after feeding. Formula fed babies may require longer periods since formula is digested slower than breastmilk.
2. A Word About Car Seats
   Some car seats position baby in such a way that they hunched and slouched over, putting added pressure on their tummies which can increase reflux episodes. Look for a car seat that allows baby to be reclined enough that they aren’t slouched yet, inclined enough that they are fairly upright.
3. Sleeping Position
   As with positioning after feeding, keeping baby propped during sleep is essential when they have reflux. It can help reduce painful reflux episodes and reduce the risk of aspiration. For more info on propping baby, visit InfantRefluxDisease.com.
4. Prone vs. Supine (Front vs Back)
   The American Academy of Pediatrics recommends all babies sleep in the supine position (on their backs) because it has been shown to reduce the risk of SIDS. This is fine for babies with reflux as long as the baby is safely propped up to at least 30%, we found the higher baby is propped the better. Having said that, many babies with reflux prefer sleeping in the prone position (stomach), also elevated of course, and may have less reflux episodes in this position. Discuss this with your doctor and he can help decide if it’s okay, and how to safely manage allowing baby to sleep in the prone position. It’s very important to discuss this with the doctor before trying it as babies with reflux are already at an increased risk of SIDS.
5. Carrying
   Try carrying baby around as much as possible in a baby carrier through out the day. Carried babies tend to cry less and crying will make reflux worse, plus, it keeps baby upright.

Clothing and Reflux

1. Avoid Tight Clothing
   Tight clothing, particularly clothing that’s tight around baby’s tummy, can make reflux worse by increasing pressure on the LES (lower esophageal sphincter). Make sure baby stays in loose fitting, elastic waists whenever possible.

Food/Feeding Tips

1. Food
   Breastfeeding is definitely best for a baby with reflux because it is more hypoallergenic than formula and is digested twice as fast as formula. If breastfeeding is not chosen or not possible by the mother, formula changes can help some babies. If the baby has a milk or lactose allergy or intolerance giving the baby formula that is milk based can make reflux worse. Read about the different types of formula available at InfantRefluxDisease.com and discuss this possibility with your pediatrician.
2. Thickening
   Some babies with reflux will respond well to thickening their feeds with cereal. Thickening formula can help for a few reasons. The added weight of the cereal in the food helps to keep the food from splashing around in the baby’s belly and can help keep it down. Babies who are having difficulty gaining weight may also benefit from the added calories. Generally, it’s
   recommended that about one tablespoon of cereal should be added for every ounce of formula. If the formula isn’t thick enough, it won’t work. Also, some babies may react poorly to rice cereal which is generally the first tried, so adding oatmeal instead may work better for some babies. As always discuss this with your pediatrician before trying it.
3. Feeding Time
   When and how much a baby is fed can also have an impact on their reflux. Smaller more frequent meals through out the day work much better than larger, less frequent meals. Also, avoid feeding baby right before bedtime, particularly if the baby is already a poor sleeper.
4. Breastfeeding
   If you are breastfeeding, try eliminating the foods that can make reflux worse. Dairy products are a big offender, as is caffeine, fatty foods, spicy foods, citrus fruits. If eliminating these things seems to help, you can slowly (about one thing a week) start to introduce one thing at a time back into your diet and watch baby’s reactions. This will help give you an idea
   of exactly what was making the reflux worse, so that you (hopefully) don’t need to give up everything you love, just one or two things.
5. Burping
   Stopping to burp baby frequently (at least after every ounce) during feedings can help.
6. Avoid Certain Foods and Liquids
   More so for older children and babies, there are certain foods that are known to make reflux worse (eg. whole milk, chocolate milk, fried or creamy style vegetables, tomatoes, citrus: such as oranges, grapefruit, pineapple, anything prepared with whole milk or high-fat, cold cuts, sausage, bacon, fatty meat, chicken fat/skin, all animal or vegetable oils, chocolate,
   carbonated beverages, chicken, beef, milk, or cream-based soups). If you are breastfeeding, as mentioned above avoid these foods in your own diet, particularly milk products.

Other Suggestions

1. Provide a Pacifier
   Sucking on a pacifier or dummy, can increase saliva production. Saliva is alkaline which can help neutralize some of the acid that may come up.
2. Infant Massage
   Try infant massage, it’s been shown to improve digestion and will help relax baby.

About the Author:
Roni MacLean, Founder of InfantRefluxDisease.com, MacLean started researching reflux and GERD shortly after her daughter was born with GERD in May of 2000. She has spent the years following her daughter’s birth learning everything she could. MacLean felt the need to reach out and help others going through what they had been through by sharing all that she had learned. Early in 2001 she launched InfantRefluxDisease.com as an informational website to help guide other parents. MacLean’s dedication to the GERD community continues to this day. She has written the highly acclaimed, Life on the Reflux Roller Coaster, published in 2004, which was the first book ever published entirely on this subject. She continues to dedicate all her spare time to the website that started it all, InfantRefluxDisease.com, which has since grown into one of the best sources of information on reflux and GERD in children online.