Three days on from Christmas and my stomach is stretched beyond comfort and my head is aching from lack of sleep (I lay awake until 3am on Boxing Day doing the maths to work out if 2017 is a prime number – it is, as I had suspected for a couple of weeks now). I swear that I will not over-eat ever again and that I will swim my socks off regularly until all those extra unnecessary calories are burned.
One of the questions I hear every week from at least one parent is “How do I know when my baby has had enough milk?” If you have not spent much time in the company of babies, this would seem an easy question to answer: when a baby stops suckling, he has had enough! But, as all new parents know, it is not that straightforward. Babies suckle in weird ways: in the evening (and sometimes all through the day) they can spend over an hour boobling merrily away, suckling for a short while before dozing for a longer while and then waking and having another good nosh. Rinse and repeat ad nauseum.
Then they come off, immediately start rooting and squeaking again, go back on, decide it was a bad idea; come off again; yell and wiggle some more, have another good go on a boob or two, come off and and then chuck back what seems like a week’s worth of milk before diving back onto the boob all over again. Occasionally, when I have over indulged over the festive season, I think, somewhat wistfully about the Roman love of the vomitorium and how much easier it might have been be than all the post-Christmas exercise. Some babies seem to have retained the Roman habit! When my first son was tiny he could vomit so splendidly that it seems that I might as well simply run around the room gaily squirting my milk directly at the walls and soft-furnishings and cut-out all that time spent lovingly nursing my boy!
The idea put about by health care professionals that babies “feed” for half an hour on each boob and then come off and settle happily for a couple of hours is quite obviously information about an alien species. This may be how babies hang loose for those first couple of days in hospital but, within a week of being at home, things are very different. I will look at the causes of the constant evening boobling and nonsense in the next blog but let’s think about that vomiting.
Many mums are now told that their babies have “reflux” and that they can medicate it away. If their baby displays the rest of the miserable picture described above but doesn’t throw back any milk, they may be told that their baby has “silent reflux” which can also be medicated away. I sometimes have groups of mums at the local South Oxfordshire drop-in with 100% hit rate for reflux (silent or otherwise). Some pharmaceutical companies are laughing all the way to the bank at the same time as many parents are crying all the way to the shops to buy yet more useless medication.
Reflux simply means “bringing back”, so it is perfectly accurate as a diagnosis when there is vomit all down your back but that does not mean that the vomiting is abnormal or needs medicating. If your clothes are a sick-free zone then, if your baby is doing the suckle-squirm-yell-suckle dance all evening then chances are that your baby has the normal, healthy and life-protecting horror we used to call “colic” (about which much, much more next time).
So, if your baby is peeing lots, being happily dirty with a nice splurge of yellow or greeny-yellow poo every day or so and is otherwise well, then the vomiting is simply nature’s highly evolved way of ensuring that your little one does not over-eat. Why does she take down too much in the first place? Because, your milk contains lots of gut-soothing endorphins which calm her hormonally-sensitive gut from its immature spasms. She takes down the milk, gets the gut-calming benefits from the endorphins and then splurts back the unneeded milk. And, of course, being permanently at the boob, snuggling away, keeps your tiny one warm and safe from all those hunting bears in the forest which come out at dark …
Now human milk is also highly evolved (natch) and is super thin and easy to throw back. Babies need to keep their stomach only lightly full because, if it stretches up too much, it can make breathing more difficult. Evolution is about survival so stop worrying that your baby is a slightly wonky model that needs fixing and accept that, whatever it looks like, evolution has actually put some pretty damn fine protection strategies in place. No need to try to cure evolutionary protective strategies with medicine that can make your baby constipated. No need to give thickened formulas which stop the protective vomits. You will soon find that your baby will gain weight even when he is a happy chucker: my biggest vomiter – number one son – also gained weight the best. He just was very, very colicky and so soothe-suckled far more for those great milk endorphins and the needed to off-load all the unnecessary de-endorphinised milk.
If you have a baby that pees loads, vomits regularly, is otherwise well but gains weight very slowly, there may well be a pesky posterior frenulum (some people call this a tongue-tie but that is not my favourite term). I will cover tongue-tie in due course but, for now, if you think this is you, get checked by a specialist.
In short, lots of pee tells us that your baby is getting and keeping down plenty of milk and the vomiting is just your baby’s way of being a Roman!