The Big Book of "Why" for Parents: 75 Tips and Tricks for New Parents

PART 1

BEFORE THE BABY IS BORN

A baby is something you carry inside you for nine months, in your arms for three years, and in your heart until the day you die.

—Mary Mason

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Why do I need to choose a doctor before my baby is born?

Seems like a weird idea, right? I have to choose a doctor for a baby that I haven’t even met yet? The answer is an absolute yes for all kinds of reasons.

Let’s just come out and say it—not all doctors are created equal. There are good doctors, great doctors, average doctors, and even bad doctors. You will want to find out who the good ones are before you ever have your baby.

But how do you find the good doctors? This gets a little tougher.

First, I would recommend going online and looking at how they are rated on different websites that grade physicians. Make sure that you read the reviews strategically. You generally are looking for the great ones and the terrible ones. Some of the terrible ones could be legitimate cause to pass on a practice. The glowing 5-star reviews deserve a little scrutiny too. If 10 different patients all gave a glowing review in a short time period, used similar language, and no other reviews seem to correlate … well … just look closely, okay? The Internet is a weird place. Be careful out there.

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Let me give you a personal example. I have a one-star review from someone I haven’t even met. She is an activist from California who was attacking me because my first book didn’t come out against circumcision. She was going on and on about how inhumane I was and a terrible doctor. I have never done a circumcision. I have never even seen one done. I told her off and she gave me a one-star review. The website refuses to remove it so I am stuck with a review from someone who has never even met me. So, if you see a doctor who has a bunch of glowing reviews and a couple of bad ones, they are likely a good choice. Don’t throw them out just because of upset, crazy people. Like I said—Internet. Weird, very weird.

Second, ask your friends and neighbors. There is a good chance that the people you hang out with will share some of your same values and beliefs. They will also know your personality and how you will fit in to certain offices and with different physicians. I will tell you that most people you talk with will have limited experience in this realm. If they like their doctor, they may have only seen one doctor. It is hard to compare who is best when you have only seen one or two.

The last way I would explore options is to ask your OB/Gyn or the hospital where you are delivering. This may provide the most accurate overall assessment. They tend to know the different doctors better and all the options out there. They don’t have anything personal in the selection and can likely give the best advice on a physician’s reputation in the community.

Once you have gone through the investigation phase, now it is time to start narrowing down the list. I recommend you narrow down the list to two or three practices that you have some recommendations for so it doesn’t seem overwhelming.

There are a few practical things that you should look into about each of the offices that you have on your list. First, do they take your insurance? This can be found out on your insurance’s website, from your insurance agent, or just by calling each of the practices and asking.

Second, are their hours of operation going to work around your hours? Doctors will vary their hours to fit their lives or to offer something different to their patients. I have seen offices that are open on bankers’ hours, I have seen offices with really long hours, and I have seen offices that are only open in the afternoon and evening. Make sure the hours they are open work for you and your schedule. Think ahead to going back to work and to when your child is in school. Find out about weekend and holiday hours as well. They might be a fantastic doctor, but if your life conflicts with their schedule in a way that makes it difficult for you to see them, that’s a deal breaker.

The last pragmatic question is a biggie—are they taking new patients? It would be terrible if you got your heart set on a specific practice only to find out they won’t even take your new baby.

Now comes the fun part. Go see the office and meet the doctor. This visit is important for all kinds of reasons. One—this gives you a chance to interact with the front office as you make the appointment and then come into the office. Are they nice, do they answer the phone, are they helpful, do they smile? Check out the office. Is it clean? Is there some way to entertain a little one while you are waiting for the doctor? Do you like the way it looks? Now go talk to the doctor. Do they seem nice? Do they answer your questions? Do they seem in a hurry? Do they fit your personality?

When I have expectant parents come and talk to me, I always try to tell them the same thing: The most important part of finding a pediatrician is, do you feel comfortable talking to them? Most of the time we pediatricians find out what is wrong with your baby by the story. We listen closely when you are asking us what is wrong with my baby? Most of the time you are telling us what is wrong at the same time you are asking the question. We are examining your baby to make sure that what we learned from the story is correct, but most of the time the key is in the story. If you don’t feel comfortable talking to us, then you won’t give us the whole story and your child’s care will suffer. Just like regular people, doctors come with all kinds of personalities. Some personalities will get along with you better than others. Make sure your pediatrician fits in with you and your family.

Once you have narrowed down your search to your chosen pediatrician and pediatric office, then it is time to get ready for introducing the baby. Make sure you know what you will need as far as paperwork before that first visit. Ask when you will need to see them first. Some pediatricians will see you in the hospital, and some will see you when the baby is 3 to 5 days old. It is just nice to know what to expect in the chaos that is soon going to happen.

This is a very important decision for you and your family. Your pediatrician will be invaluable in guiding you down the path of raising a happy, healthy child. Take some time and set yourself up for success with the right practice and the right doctor.

TAKE-HOME POINTS:

1. Find out the pediatrician’s reputation online, with your friends, and with the medical professionals.

2. Find out if the practice takes your insurance and if the days and hours of operation work with your schedule.

3. Go visit the practice so you can make the most informed decision about your baby’s caregiver.

4. Ask them questions that are important to you as a family; don’t just depend on the questions that you can find on the Internet.

Why is breast milk best?

This is a bit of a loaded question. Breast milk is best because it was what babies were meant to eat. Science is great and all, but mom’s natural milk cannot be topped by a lab. Mother Nature made it just for babies, and it is wonderful stuff. Even scientists who are always trying to convince us they can do it better have had to agree that study after study has proven that breast milk beats all the man-made formulas we have come up with over the years.

That said, formula does still have a place. I have been a pediatrician long enough to know that formula has absolutely saved some babies’ lives. Formula is incredibly useful and very healthy for babies. Yet if we are comparing head to head between breast milk and formula, breast milk wins every time.

But why?

Let’s start off with bonding. There is something special for a mom to be able to make milk that contains everything that her baby needs to grow and thrive. When everything works the way it is supposed to, breastfeeding your baby is very empowering. It’s a girl power, superhero kind of thing. When you are a breastfeeding mom you are the one who can fix it, you can conquer the evil of hunger single-handedly. Being the sole source of food can offer a great bonding experience all on its own. Now add in the warmth, the snuggling, and the closeness that the two of you will share multiple times a day. Trust me, at some point Dad is going to get jealous of the special bond you have with your breastfeeding baby. It will not be happening at the 2 a.m. feeding, but it will happen.

Next, let’s talk about taste and temperature. Evidently, baby taste buds were made to love the taste of breast milk. Trying to get a breastfed baby to take anything else can sometimes be quite the chore. It has the perfect amount of everything and tastes like exactly what they want. Plus, when it is coming straight from mom, it’s at the perfect temperature. You can’t duplicate that with a bottle, no matter how hard you try. If a baby takes a break in feeding, when they come back the breast milk is still the perfect temperature. It is always fresh too.

Okay, so we have covered bonding, taste, temperature, and freshness. What happens next, after they have consumed the milk? Yep. Breast milk wins again. I don’t think there is a pediatrician on the planet who will argue formula is easier to digest. Babies eating breast milk have less problems with gas or bellyaches and are very rarely constipated. It’s kind of like they were made to eat the stuff. An extra little bonus is that breastfed babies have better smelling poop. Don’t get me wrong—it still smells like poop, just not as stinky.

The benefits don’t stop there. As long as you don’t calculate the time it takes to breastfeed (which, to be honest, the time commitment is going to be great no matter what type of milk you feed your baby), breast milk is free. Mom is going to be hungrier than normal for sure, so I guess there’s a small cost there. When you compare Mom eating bigger portions to the cost of bottles, formula, bottle liners, dish soap to clean everything, gas for the car to buy all this stuff … well, you get the idea. Plus, you don’t have to run to the store at 3 a.m. with a screaming, hungry baby to buy more breast milk. So, there’s that.

Convenience is also one of the categories that breastfeeding can win, with a little caveat. Breast milk is always with you as the mom. This can present an issue if the baby is not with Mom. Pumping breast milk is definitely not convenient, but given all the other benefits it’s a small price to pay.

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I saved the best for last. Let’s talk about health. It would be impossible to say that your baby would be healthier drinking formula than breast milk. Long-term studies have shown that babies who breastfeed have fewer vomiting and diarrhea illnesses, fewer issues with constipation and gas, and fewer problems with obesity. There are other studies underway that are trying to demonstrate breastfed babies’ improvement in intelligence and overall health as well.

It is pretty easy to argue that breast milk is the best for your baby, but it isn’t always possible for moms to breastfeed. There are moms who physically can’t produce breast milk for many different reasons. There are medical conditions in babies that force them to drink specialty formula. There are situations in life that make it difficult for a mom to be able to breastfeed. I don’t think you should feel guilty as a mom if you choose to not breastfeed. I think most of us as parents are trying to do the best we can to take care of our families. We’re all just trying to give them the best start in life we know how to do.

TAKE-HOME POINTS:

1. Your baby was made to eat breast milk.

2. Breastfeeding is a great way to bond with your baby.

3. Your baby has taste buds that appreciate the taste of breast milk.

4. Breast milk is FREE.

5. Your baby will probably be healthier eating breast milk.

6. The best thing for your baby is to feed them. If breast milk is not a possibility, do not grade your value as a parent on the type of milk your baby drinks.

7. We in the baby profession all know that breastfeeding is hard and comes with sacrifices. If you have breastfed your baby or even tried to breastfeed your baby, give yourself a pat on the back. You deserve it!

Why are there different types of formula?

I think the best place to start when talking about formula is at the beginning. There have always been babies who couldn’t eat breast milk. The reasons for this are varied. Sometimes Mom had to stay late at work because some people don’t grasp the concept of deadlines. Sometimes Mom is not able to produce breast milk. Sometimes the baby is not able to eat from the breast. Some babies have an intolerance to mother’s milk. Tragically, mothers died in childbirth in years past, in far greater numbers than they do today. All of these situations involve an infant who needs nutrition, and breast milk isn’t an option.

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Historically, many steps were taken to try to solve this problem. There were wet nurses who could be paid to breastfeed a baby that was not their own. Then there were animal milks, such as cow or goat milk most commonly. There were also recipes that people would share on how to make a formula to feed their baby. Unfortunately, these breast milk substitutes weren’t very healthy and there was a high infant mortality rate due to malnutrition. [Just a little piece of trivia: The closest animal milk to humans is donkey milk. Because donkeys have never been bred to produce excess milk, it has never been available in a commercial form.]

In the mid-1800s, the first commercially produced formula became available, though it was not widely used. It was not until the 1940s that commercially sold formula became what was prominently used over wet nursing. At this time the market had a few different formulas fighting to be seen as the miracle pill moms needed.

In the late 1950s, breastfeeding started to lose favor with moms and formula became the main way to feed babies. New formulas were heavily marketed to moms as an alternative to breast milk. As more and more babies switched to formula, it became evident that not all babies tolerated the same formula. As science advanced, so did nutrition and infant formula. Formulas began to be developed to tackle problems like an intolerance to lactose (the main sugar in milk), allergies to the protein in milk (casein and whey), and some even more specific problems such as PKU or high calcium. This leaves us today with a wide variety of different brands and types of formulas that are very confusing for parents and physicians alike.

This seems an opportune time to remind you there is a Why? in this chapter titled "Why is breast milk best?" Breast milk is best. Don’t let shiny labels and marketing campaigns on formula containers cause you to lose sight of that.

Some of the confusion comes with the different brands of formula. In the United States there are four main companies that make commercially available infant formula. Each of these companies have different types of formula to help with specific niches, and each of these brands must have a different name for the different types of formula they sell. The important thing for you to know as a parent is there is actually very little difference from brand to brand. The specific brand would argue that they are very different, and of course that theirs is the best. When you look at the formula contents, the differences are minor and seem to be more for marketing purposes. Remember that all of the store-brand formulas are made by the same company. You can freely buy from one store or another and not worry about upsetting your baby’s belly. The only thing that is different about these formulas is the label and the price. By doing some comparison shopping you could save a lot of money as the price could vary quite a bit from one store to another. Don’t forget to use those coupons as well.

When starting off feeding your baby a formula, try not to get bogged down in the price or the name or even the description on the label. This is one area in life that more expensive does not indicate better. The most expensive formulas that you will find are made for very specific problems like milk protein allergy and are not the healthiest for most babies. Don’t get bogged down in all the symptoms listed on the container. It is your pediatrician’s job to make sense of the symptoms. The symptoms for drinking too much or not burping can look very similar to a milk protein allergy to the untrained eye.

Each of the brands will have their main formula, sort of their base model. This is their attempt to get as close to breast milk as possible. No company can claim to be like breast milk, because they just can’t duplicate it, but they do try to get as close as they can. This entry level formula is the one a pediatrician would recommend that you start with.

Notice that I say your pediatrician would recommend. Stop playing doctor! I mean it. Hold up right there.

Do not turn yourself into a nutritionist or even worse a mad scientist.

Do not attempt to interpret your child’s gas, fussiness, stooling pattern, or how often they are or aren’t hungry as a reason to change formula.

Do.

Not.

Do.

It.

All the variations of formula are not nutritionally equal. Some of the formulas out there are for very specific problems that a baby might have. These problems need to be diagnosed and cared for by your baby’s doctor. If you swap out the basic formula for a Soy-Almond blend fortified with Unicorn tears, you may end up doing more harm than good. Babies don’t like to change their diet on a whim. Furthermore, these changes can make it even harder for your baby’s doctor to figure out what might be wrong with your baby in the event there is a legitimate concern.

TAKE-HOME POINTS:

1. The goal with formula is to choose one as close to breast milk as possible. This is often the basic/entry formula.

2. If your baby is having any issues, be sure to talk to your pediatrician about the problem.

3. Do not just change formulas. Swapping from one basic brand to another basic brand due to availability should be fine. (Again, despite marketing, they’re almost the same thing!)

4. Just because it is more expensive, does not make it better!

Why do I need to boil water to make formula?

Now if you are like most people you will actually be surprised by this question. What? Was I supposed to be boiling water to make my baby’s formula? No one told me this!

This goes to prove that people do not read the instructions on the back of formula cans. That said, chances are you don’t have to worry about boiling your water. But let’s first discuss the how’s of mixing formula. You need to do it properly or you risk upsetting baby’s tummy. There’s a lot to cover here. Welcome to formula class. Here we go!

First thing’s first, the boiling. The actual instructions are going to say something like, ask your doctor about the need for cooled, boiled water to mix your formula with.

I saw that. You went and read the formula can and figured out that you’ve never asked your pediatrician that question. That’s okay. That’s why I wrote this book. Here’s the answer.

When they make the formula at the factory, they have no idea where it will be consumed or what water will be mixed with it. Water quality varies greatly throughout the United States. There’s no way they could possibly account for every scenario. There are still places in the United States (believe it or