Q: My daughter is 13 weeks old, and was a big baby from birth. I know that the regulations advise that you don’t wean babies until they are 26 weeks old, but I weaned my first two children at 16 weeks, before the official advice changed. My 13-week-old daughter seems hungry all the time and wants to join in with us at mealtimes! What should I do?
A: You’re right about the updated Department of Health guidance (since 2003) to give a baby only breast milk for the first six months, but it is just guidance, not a rule set in stone. Larger babies may well need more nourishment than milk alone can provide, and you have to take into account your baby’s development. If your baby seems hungry and wants to join in at meals, then it may be time for her to have some tastes of simple, solid foods. I would not wean a baby before four months, but between four and six months parents should be able to be guided by their own baby’s growth.
Q: I’d like to breastfeed my baby when she arrives but am worried about the occasional eczema flare-up I get around my nipples. At the moment I use a mild cortisone cream on the rash – could this be harmful to the baby? And will breastfeeding irritate my condition?
A: It doesn’t follow that your eczema will be worse after your baby is born, although breastfeeding will be a new experience and you can’t know how your skin will react. Hydrocortisone cream is mild enough to apply even to a baby’s skin. Obviously, swallowing it is different, but even so it is likely to be safe for your baby if you use it for a short time. Even the stronger steroids are sometimes prescribed, though usually for only 10 days at a time. If you do use hydrocortisone cream, the best time to apply it would be 2 hours or more before you feed your baby and of course apply only as much as you need.
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You may be able to avoid steroid cream altogether by using simple emollients like lanolin and always drying your nipples thoroughly before putting your bra on. If need be, you could try calendula ointment, which is widely used for sore nipples. Nipple shields can help protect sore nipples, but they are not always the answer that’s hoped for because they sometimes change the way a baby sucks and could even reduce your milk supply.
Q: This is my first pregnancy and I was confident about breastfeeding until one day when I was swimming a lady told me I was massive for 34 weeks and my breasts would never produce enough milk for my hungry baby. So far I’ve gained 28lbs and my breasts have gone from 34 B to 38 C. I am really concerned. Is she right?
A: This lady is wrong on two counts. Firstly, she can’t tell from your weight gain or your girth just how big your baby will be. The average weight gain in pregnancy is about 28lbs, but 32lbs or more isn’t unusual and it doesn’t mean that your baby will be huge. More importantly, even if your baby is bigger than average, you should still be able to satisfy his hunger. Breast milk is produced on a supply and demand basis, so the more a baby sucks, the more your breasts will produce. That’s how women manage to breastfeed babies of all sizes, and why breastfeeding twins and even triplets is possible. The size of your breasts during pregnancy are not a guide as to how much milk you’ll make, as no baby puts in an advance order for his meals. Even small-breasted women can produce plenty of milk and it’s inaccurate (as well as hurtful) for anyone to suggest that they can’t. This is one example of the myths and old wives’ tales about pregnancy that can be damaging. My advice to you is to relax and ignore such unhelpful remarks. If you hear anything that you’re not sure about, check with a midwife, or the NCT.