Introducing Solids.. My Way.

Introducing solids, when, what, how much are the vital questions for a first time mom..

To begin with
My tryst with solid feeds started at the age of 5 months or in fact the day the kid finished 4 months and entered 5th.. a pinch of mashed banana it was, and strained dal water, especially moong dal as it is easier to digest.

Reason to Start
Continuing the baby too long on just bottle/breast feed results in iron deficiency was the one sentence which got me running to solids prior to which I was a little averse to starting. Oficially in AP, we start solids on 6th month 6th day with a ceremony called Anna prasana and until then we don't give rice to the kid and from the day we initiate the kid on it, not a single day should go without at least a rice grain in the baby's mouth :).

For the Starters
So, starting with dal water along with the milk feeds, then introducing mashed ripe banana taking out the seeds, and cereal (store-brought). I personally started with Farex available in India, wheat because I am told that it is easy to digest. We get Wheat, Rice, Wheat/Apple, Ragi/Rice for Stage 1 that is starters in this particular brand. I began with wheat, 1 scoop a day only in the mornings and then continuing with normal feeding throughout the day. After 15 days of introducing the cereal, increased the quantity and went on to 2 times a day 2-3 scoops and gradually introducing one flavor after the other.

Alternating Cereal Flavors
All the while we need to look at the baby's cues on what and how much she wants to. Also, if you have started on multiple flavors, it is recommended that you alternate between the flavors so that the kid doesnt get bored, like say ragi/rice in the morning, 'cos it is a little heavy, rice in the evening or wheat apple in the morning and wheat in the evening or maybe we can go to 3 feeds of cereal also, just depends on you and the baby.

Fruits and Veggies
Then gradually introduced mashed banana, cooked apple, ripe papaya, cooked carrot, cooked beetroot, etc. for solids and fruit juices just less than an ounce to begin with like carrot juice, beetroot juice, pomegranate juice. There was resistance but we just need to keep altering between solids/liquids/milk and keep their interest that is it :(. It is advised to start veggies first and then the fruits..

First Meal
Then when the official meal is started I began with frying Toor Dal and Moong Dal in equal measures and rice like say 1 cup both toor dal and moong daal and 1 cup rice and grind it to a course consistency of rava and then cook it in a small pressure cooker 1 spoon:4 spoons ratio of mix and water, leaving for about 5 to 6 whistles, adding carrots/green leafy veggies/beets/bottle gourd etc.

Indian Breakfast
After we start the rice items in about 6th month we can give all Indian Breakfasts like Idly dipped in ghee, chapati cooked with ghee, chapati dipped in milk/formula, rava kesari, upma, etc. Also, khichdi, saggu jaava, raagi recipes. The portions they take will be small but gradually they should be introduced to all consistencies and textures of foods. It is ideal that we start with veggies first and then move on to fruits.

Avoid Maggie, etc. in the first year of life due to MSG content.

Milk and Solids
The big question is... how do we adjust between milk and solids... there will be a change in the milk intake with introduction of wide variety of foods and also a change in the color/consistency/smell/frequency of the stool which is pretty much normal. However, give some gap of a week or so before introducing new foods or new combination to figure out if the kid is allergic to anything that is started and let them get used to the new changes.

Coming to the milk part, there will be a gradual cut down in the intake but ensure that the kid is having at least 15 to 20 oz of milk throughout the entire day. Give small quantities of milk in frequent intervals if the intake has gone down drastically instead of trying to give the usual 5-7 oz per feed.

Water
Introduce water too with the solid feeds with a spoon or a bottle, very little to begin with and a little more as the kid grows up. Ensure that the kid is fed both solids and liquids in equal portions and has a well-balanced serving of fruits and veggies along with milk and water on any given day.

Cookies and Biscuits
We can also give multigrain biscuits, Threptin biscuits (in India), sugar-less cookies, bread soaked in milk/formula as mid-meal snacks once the kid is about 7 months old.

small portions in frequent intervals is the best way is what I am told.

Do not force the kid to the point of aversion on any particular feed, if the kid is totally averse or has a dislike to something give it a break for a while and begin your attempts but by and large force just works the other way round and tends to make the kids adamant.

Nibbler

Also for the beginners, like at the age of 5 months when I started the solids, I found this very useful item called a Nibbler in the baby store, a mesh with a handle where in we can cut fruits like apple or even chapati and put it in the nibbler and give it to the kid to chew on, make sure you get 2 in case one falls down.

The one I got is of brand Nuby with non-toxic BPA free plastic and costs around 400 rs/- from Brooks, Mogalraja puram, Vijayawada. Sunbaby ones cost around 135/- and are good too. Must say, it is a boon to begin with so that the kids do not choke on the solids, it also acts as a soother and satisfies the kids urge to chew on something while sending in some fruit juice/pulp into the mouth which kind of teaches the coordination of biting, sucking, chewing and gulping it down. Absolute paisa-vasool item I must say for the beginners.

Diaper Days

The type of cloth diapers that I prefer, the ones with Velcro rather than the one with tie-on threads.. the first variety is complete cloth.. and the second is the type with polythene lining where we insert a cloth sheet in the loop and keep changing just the sheet..

It has been my conscious decision to use cloth diapers rather than the store-bought ones which are easy to manage but costly for the purse. Seriously, what made me go for the diapers, the price, the green parenting, what??? I must say both but to be honest, initially it was 50-50 but as time passed it came on to 75-25. For me, it was/is/will be like money going down the drain.. err.. piss and poop.

If we stay abroad where it is very cold, no place to dry the diapers, no place to store the stinking ones before cleaning, or no help to do the cleaning stuff and all, there is NO CHOICE. We have to go with the diapers but here, the place where I live, the village has ample of help in that aspect. The washerwoman, yeah we still have the concept in our village and her family has been doing it for us from generations and this is the last generation into the washing occupation, does all the washing, drying, and folding stuff which relieves me of a huge load. How can even begin to thank her and would remain deeply indebted for all that she does. Yes, I pay her but no I cant actually pay her enough for all that she does.

Up to the age of 6 months, I must say I have used just about 6 diapers that too for the doctor visit and nothing else.. it is always the cloth diapers, home-stitched langotis, store-bought langotis, and now chaddis or the knickers.

First 3 to 4 months was a cakewalk with help, frequency was more but the smell wasnt there but as and when she was introduced to solids, the stink factor came in.

I just have separate buckets for each type of cloth.. the toilet clothes, the potty clothes, the bibs and cloths to clean her mouth and body, the chaddis and finally the dresses she had to change during the day. I throw them all in their designated locations. Early in the morning, I soak them all in their own buckets with detergent and around 9 to 10 a.m., the lady washes them dries them under hot sun and in the evening she comes, folds them and arranges them in the racks separately. THANK YOU MA'M.

IPV vs OPV

Polio -- this is the one word which kind of changed the dimension of my life. Born a healthy child and supposedly infected by it after being administered the drops at the age of 6 months, the trauma I had to go through to get my kid immunized with it is unspeakable and cannot be expressed.

Though, the final report is that my leg problem is not polio, it is the muscle wastage because of some nerve damage due to incorrect needle prick rather than anything.. the term still scares the hell out of me... limping for life, termed handicapped by many, looked down upon unnecessarily, it is the one word that kind of describes my existence, survival or whatever.

So, when it was time for Sreya to be put through this ordeal, one can only imagine as to what all the thought process went into it... so, the doctor seeing me scared the hell out of my wits gave me whole lot of reassurance and helped me out in a lot of ways treating and preparing me mentally before treating Sreya for which I would be eternally thankful to him. He assured me that it was not VAPP (vaccine-associated poliomyelitis paralysis) that I have and however, he suggested me an option for my fear, IPV, God-send for the paranoid me.

Eradicating that very deadly polio is very very important for our future generations and in almost all the developing countries OPV (oral polio vaccine) is widely distributed and administered free of cost and it is ensured that the message is reached far and wide and every single kid benefits from this. However, IPV (inactivated polio vaccine) is something like a dead-virus vaccine in layman terms which eliminates even the remotest possibility of VAPP... How???

How does a vaccine work.. in layman terminology is an effective method of containing infectious diseases.. the bug (bacteria/virus) either killed or inactivated in the form of vaccine is introduced into the body and the body cells fight against it and develop an immunity towards that particular agent (as far as I can gather). So, in very remote cases, there is a possibility that the induced bug acts up and the vaccine becomes the source of infection, very very very minimal, but still there is a possibility. IPV is thus an inactivated form of the vaccine which contains all the three serum types of the vaccine which eliminates even that remotest possibility.

Then, how come it is not available to all the people.. because of the incremental cost of producing the vaccine. OPV is easy to administer, even a layman can do that, just giving the drops and like they say something is better than nothing and since polio is almost eradicated, it is just a post-eradication measure, the mass polio vaccination, that is. It is also believed my some people that once complete eradication of the disease is declared OPV may be the only mode of acquiring the disease (an assumption at this point). So, IPV at any rate is better than OPV.

However, there is something called secondary immunization following exposure to the same or closely related antigen..like say, we exposed the kid to polio vaccine and then we need follow that exposure with secondary immunization just to be sure. So, my pediatrician says it is always a good idea to take the kid to OPV camps when they are announced just to ensure the secondary immunization.

I did extensive reading on this, brain-picked my pediatrician and finally went ahead with IPV.. a simple choice for many parents but a crucial one just for me because of my problem.

So, done with IPV for the kid, I would just follow it through with OPV at the designated time at a designated place.

Good luck with vaccines guys!!!

For more reading on the same..

http://www.abtassociates.com/reports/2003412377280_88928.pdf

check the link.

Vaccination Schedule -- India.

At Birth
BCG -- This vaccine site should bulge or come up as a mark within a month of its administration, the typical teeka maccha for Indian kids. We need to inform the doctor if the site does not show any change after a month or so.
OPV0 -- oral polio vaccine
Hepatitis B1

(got it done 3rd day of life)
*****

6 Weeks
DPTw1/DPTa1
OPV1/IPV1
Hepatitis B2
Hib1

(Got the combo vaccine Pentaxim which was supposedly the fever-less vaccine with IPV HIB, TT and all put together for 5 diseases -- It was purely personal choice, please follow your doctor's advise).. so it was just 2 needle pricks for her, instead of 4 or 3 on both the thighs.
*****

10 Weeks
DPTw2/DPTa2
OPV2/IPV2
Hib2

(Got the combo vaccine Pentaxim which was supposedly the fever-less vaccine with IPV HIB, TT and all put together for 5 diseases -- It was purely personal choice, please follow your doctor's advise).. so it was just 1 needle prick for her, instead of 3 on both the thighs..
*****

14 Weeks
DPTw3/DPTa3
OPV3/IPV3
Hepatitis B3
Hib3
(Got the combo vaccine Pentaxim which was supposedly the fever-less vaccine with IPV HIB, TT and all put together for 5 diseases -- It was purely personal choice, please follow your doctor's advise).. so it was just 2 needle pricks for her, instead of 4 or 3 on both the thighs.

9 Months
Measles/OPV

1 Year
Chicken Pox
Hepatitis A first dose (optional).

15-18 Months
DPT wB1/DPT aB1 (booster dose)
OPV B1/IPV
HIB B1 (booster dose)
MMR -- Measels/mumps/rubella
Hepatitis A 2nd dose (optional)

2 years
Typhoid 1st dose

5 years
DPT wB2/DPT aB2
OPV B2/MMR
Typhoid 2nd dose

10 Years
TT 3rd Booster

15 Years
TT 4th Booster

Also, there are some optional vaccines
ROTARIX between 2 to 6 months... 2 doses (liquid drops). Got this done.
Varicella vaccine -- less than 15 months of age
Hepatitis A
Pneumococcal Conjugate Vaccine -- greater than 6 months of age.
Prevenar -- consult doctor for dosages

Different doctors have different approaches and treatment, so consult and discuss with your pediatrician and get his/her opinion before going ahead with any choice. Some conservative physicians do not prefer the combination vaccines and some do not inform all the parents because of the price factor as they are slightly on the expensive side for the fear of an allegation of minting money and let us know only if we can afford it.

Combination or single, all of them have the same effect.. claiming fever-less and painless and all is secondary, the fact is that the child gets immunized properly.

First Aid Box and Emergency Meds -- India

Back in India, we get medicines in the medical hall as and when we want to just by showing the prescription or even over-the-counter.. no specific restrictions.

The number of drops to be given and the brand name given varies from doctor to doctor. The number of drops to be administered is critical and varies from kid to kid based on the kid's weight, so just make sure you get yourself updated with the doctor as to how much of what drug should be administered.

DO NOT USE MEDICINES UNLESS ABSOLUTELY NECESSARY AND YOUR DOCTOR PRESCRIBES IT.

So, I would list out the contents of Sreya's medicine kit..

1. Cotton.
   
2. Vicks VapoRub (when the kid is a little older say 3 months or so)
3. Vaseline (in case of constipation/touch the tip of an earbud with vaseline and insert in the bottom when the baby is struggling to pass the stool). DO NOT OVERDO THIS.
4. Fever/pain drops.
5. Saline nasal drops for cold.
6. Drops for Cough -- if the cough persists, we need to see the doctor immediately to be treated with antibiotics, so better be very cautious not to expose them to cough and cold.
7. Drops for Vomiting -- slight spitting is normal, spit while burping is normal.. if they vomit more than 10% of what is fed to them continuously, then we need to inform the doctor.
8. Drops for diarrhea -- it is normal to pass stool after each feed especially when breast-feeding and so do not worry about the number of times unless it is really really watery and way too many times.
9. Oral rehydration salts in case of excess vomiting/diarrhea.
10. Drops for Tummy ache/colic -- if the baby folds her legs, stiffens the body in pain, or winces in pain when the tummy is touched it is stomach pain.
11. Drops for earache.
12. Drops for eyes -- when the eyes are tearing and crusting, clean the eyes with cotton balls dipped in clean drinking water very gently and mildly.
13. Syrup for constipation/tight stool -- It is normal for kids not to poop for more than a day, so no worries if it doesnt happen every single day and the baby has no crankiness or hard tummy.. in fact, my doc says it is okay up to 3 days to go without stool and only then it is a problem. So, if it goes beyond that or if the baby is really straining hard and unable to bring out the stool, then go for these drops.
14. Fudic cream -- When Sreya had some skin tear at the ear because of her ear rings, the doctor suggested this. She asked to avoid powder like Nebasulf because it tends to form a layer and tighten on the skin and tough to get it out and that creams are a better option for infant.. external application only.
15. Earbuds -- only for external clearing of the ear.. never inside the canal.
    

I also have Zinda Tilismat which is a Unani medicine to apply on her chest and back and the nose if she has cold which works wonders.. I personally take it internally as well but for Sreya, strictly topical application.

Some doctors also give vitamin drops..
My doc gave me Zincovit and Sunzyme, the digestive enzyme drops.
Iron drops can be done away with because the kids can have severe constipation issues with them unless absolutely necessary and doctor says it is a must.

Sunni Pindi Preparation

I used to use Shubra Herbal bath powder for Sreya until the time she was 6 months old, but now I have switched to the home-made herbal powder, the smell of which is really really divine and very very good to the skin too... yes, I did the patch test on myself and then her and then only started it.. if you happen to be in India and have time and energy to go for it then why not.. not just for the babies but also for the mothers who need that little bit of pampering which they are badly deprived after the baby... even if it is a 2-minute bath ritual.. believe me you will feel fresh.

So, my friend Dolly told me about it and sent the necessary ingredients..

Ingredients
Bath herbs -- Purchased at a herbal/ayurvedic store.. we need to buy ingredients for 1 kilo powder and they will pack them all about 30 to 40 varieties and it costs 100 rs/-.
Pesarapappu - green gram - 1/2 kilo
Barley - 1/2 kilo
Oatmeal powder - 1 cooker measure-cup full.
Dried and Powdered rose petals, preferably red -- 1 cupful.
Mudda Karpooram -- camphor -- 25 gms for infants -- 50 to 100 grams for adults. (strong initially but gradually the smell becomes very mild).
Pasupu -- turmeric powder (preferably from pasupu kommu) or banjara's turmeric powder (not for small babies only for moms if they intend to use).

Prep
dry the herbal ingredients under hot sun and just coarsely powder them in a mortar and pestle.. rotlo danchukondi.. then grind them to a fine powder in the mixer.




Sun dry the barley and green gram thoroughly and make them into fine powder.

Mix the oatmeal powder, the ground barley and green gram powder, herbal powder, rose powder (homemade out of red non-hybrid variety petals sun dried and powdered), and crush the camphor and add it up to the rest of them.

The final part seems so simple but the grinding a bit tedious.. In India you can get them powdered at a mill though and I must say it is one of the reasons I looooooooooooove India!!!

Simple Sunni Pindi
Green gram (pesara pappu)
Barley grains
Oatmeal Powder,
Amla Powder,
Rose Powder (same as above)
Bavanchaalu and Kacchooralu (for that heavenly smell)
Turmeric (pasupu) if it is for elders (avoid for kids)

Fine grind barley and green gram half and half say 1/2 kg each and a 100 grams each of the rest, if for elders you can also add orange peel powder (homemade) etc. which would be good.. if you body does not get dark by using neem, you can as well add a little neem powder (but in my case and a lot of my friends, they tend to get darker, so we do avoid)... and mix them all up..

Stores To Get herbs shown in the picAny vanamoolikala shop... to be specific, the place my friend gets them..
1. The lane behind ESI Darga on the road.
2. In the lane where there is Anjaneya Swamy Temple next to Green Bawarchi Hotel in Banjara Hills/Jubilee Hills area... sorry about being so vague but I havent been to that place, so cant be more precise!!

Also, these days due to the high demand the guy has cut down on the amount of stuff he used to give... sigh!!!! :(((((.

I AM NOT SURE/AWARE OF ANY STORES SELLING ANY OF THE STUFF OTHER THAN THE ONES MENTIONED ABOVE IN THE POST, SO PLEASE DO NOT WAIT ON ME FOR CHECKING THEM OUT....

Bathing Routine

It is important that the baby's cord fall off before we get into actual bathing sessions. Just use a wash cloth and some luke warm water with mild baby soap in the water. If the baby is in India, you can bathe the kid with water but no rubbing and all, just mild soap application and dirt cleaning if any, no rigorous rubbing near the navel at all.

Procedure to bathe a kid in the first few days of life
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Do not give massage to the body, just apply mild soap, clean the body and give bath once a day in tropical climate like in India or maybe alternate day or so in colder places like US. The other days just give mild soap-water sponge bath and apply moisturizer or cream suggested. It is best that the kid's body is free of anything in the first few days.

Applying oil to the baby's head
Yes, we can apply coconut oil, baby hair oil, or castor oil on baby's head mildly. If giving head bath daily, it would be good to apply a little more oil before head bath.

Headbath
If in tropical climate like India, people give head bath regularly to the kids every day in the morning up to a year.

Twice daily bath
Again, if in tropical climate like India, we can start it from 11th day if it is mid summer or from 21st day in normal days. No head bath in the evenings at all.

After bath
Pat dry the skin with a soft towel, apply cream when the skin is still moist. If applying powder or corn starch apply and dress in loose fitting clothes.

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One main aspect of baby care is bath. Back in India, it is a daily affair but might vary on the type of climate, the baby skin and all and need to take a doctor's opinion for the same.

For me, Sreya was a summer baby born in April in Krishna district in AP, so bathing her is a daily affair infact daily twice affair from day 11th day onwards.

So starting from the beginning, the first day of her life she was just wiped off with clean soft old used cotton sarees and rubbed with coconut oil by the midwife after the delivery, no water used is what they told me. So, technically her bathing session began the 2nd day of her life with the nurses giving her a mild soap and hot water rinse rather than a bath. The moment we set our feet at home, I had a lady in the village assigned specifically for her bathing sessions which I must say is a boon.

oka peeta meeda koorchuni kaalu rendo peeta meeda jaapukuni babyni padukobettukuni snanam cheyistaaru.

We used hot water, paala meeda meegada or perugu meeda meegada for the pre-bath massaging and then Subhra herbal bath powder slight massage and then washing with Johnson Baby soap, and Johnson Head to Toe/No tears Shampoo for head bath every morning. Believe me with all the massaging and stuff (I am told we did very mild massaging and the babies in the villages really get wild ones :)), the baby gets so tired and sleeps peacefully for minimum 2 hrs after the bath, so I used to feed her after her bath and let her sleep. The bath also includes exercise for the baby pulling her legs, hands, stroking her head (supposedly to keep it round after the delivery trauma) which I felt was good.

After 11th day, we started the evening bath too but not as rigorous as the morning session.. just plain soap and water wash minus the head bath.

Doctors specifically recommend no rigorous nalugu, maalish, or massage whatever for newborns as their skin is delicate. Just mild strokes for longer time would do and even we can do away with sunni-pindi/bath powder if the baby has a rash or becomes really red at bath time. Touchwood, Sreya enjoyed her bathing sessions, so we continued with everything in mild doses.

The actual massaging and stuff started once she entered her 3rd month and her skin was not as fragile with doctor's consent, mild exercising sessions became a little rigorous and I started massaging her with baby oil. Again, doctors advised no use of any type of oil massaging in the first and preferably second months of life. I used Johnson oil to start with and now shifted to Himani Ayurvedic oil after she turned 6 months old. An exercise routine in the morning with the oil and then a little play break and bath afterwards works wonders for them. Personal experience says that she gets one-on-one time with me, her exercise, and good sleep after all tiresome activity :).



This is an Indian, AP baby routine wrt to climate and body preference.. waiting for more inputs with regards to babies in US.