Wed, 31 Jan 2001

What is the right age for teething

By Donya Betancourt

Dear Dr. Donya,

I am worried because my 11-month-old daughter has not started teething and I do not see any sign that she will be teething soon. Her friends already have three to five teeth.

This is my first experience and honestly I do not want to compare her with other children, but is there something wrong with her? Does this mean she is late in her development? For your information, she is active and now learning to stand up by herself. She can also say a few simple words.

Sometimes it is very difficult to feed her because she will close her mouth or only take a few spoonfuls in. Currently, I am giving her rice porridge with any of the following: carrot, spinach, green peanut, chicken, liver, egg or fermented soybean, and a little bit of salt three times a day. She also consumes fresh fruits (apple juice or papaya) once a day, baby formula and sometimes baby biscuits. Am I doing the right thing? How can I tell if she does not want to eat? I need your advise on feeding babies.

Thank you very much for your advise and looking forward to hearing from you.

-- Anik

Dear Anik,

Your daughter seems to be developing normally. The average age for a normal baby to start teething is around six months. But the teething age can vary from four months to 18 months. It is true there are certain diseases that can affect the development of teeth, but these are very RARE.

Your baby's menu is great and there is no need to "fight" with her during meal time. If she does not want to eat, don't force her, but offer her the meal again about an hour later. At her age, she can eat many kinds of food but make sure they are nutritious. At this age, children love finger foods as they are appetizing. She can also eat them by herself. This will also stimulate teething. You are doing well, take good care.

-- Dr. Donya

Dear Dr. Donya,

I am a first time mother of a seven-week-old baby girl. I breast-fed her during the first month but because she was having feeding difficulties, I started expressing my breast milk into a bottle, which also enabled me to keep track of the amount of milk she was consuming. This method helps when I am going back to work as it will be easy for anyone to feed her while I am away.

I try to keep her off the breast so that she can take to the bottle faster. However, she becomes very restless at night when I put her to bed with the bottle. She seems to want to be breast- fed. However, when I breast-feed her, she sucks a little and then starts to cry. Am I making it worse for her?

My question is, can I totally wean her off my breast while still feeding her with my expressed breast milk?

My other question is, what is your view of babies sleeping on their stomach? My baby cannot sleep for more than an hour on her back -- she seems to get startled easily and wakes up crying. On her stomach, she sleeps longer (four hours at times). Only when she does not want to sleep on her stomach, will she resist being put on her stomach. I hope you will be able to help me here.

-- JK

Dear JK,

I have a few thoughts about what you have asked. First, if you plan to breast-feed your baby only until you are ready to return to work, yes it is OK to make the switch from breast to bottle. However, personally I think it is too early to completely shift from breast to bottle because the baby may experience "nipple confusion". This condition will make feeding more difficult than it should be.

When breast-feeding, she has to press the nipple to get milk, but for bottle-feeding, pressing the nipple means stopping the milk.

As long as you have breast milk, you can continue to feed her before you go to work, after work, at night before sleeping, and on weekends because breast milk is perfect in terms of hygiene, nutrition and temperature. Moreover, the baby's suckling action can stimulate breast milk production better than pumping.

You could bottle-feed your baby with breast milk or formula once or twice a week when they are three to four weeks old because between two months and nine months of age, babies generally refuse the bottle if they are not used to it. You can gradually increase the frequency of bottle-feeding depending on how fast you want your baby to get used to the bottle. But it is normally five to seven times per day for a baby who is one to three months old.

Sleeping on the back is the recommended position for babies to reduced SIDS (Sudden Infant Death Syndrome). If a baby has never had the opportunity to get used to sleeping on his stomach, he will easily take to sleeping on his back. So, from the beginning, you should have put your baby to sleep on her back.

-- Dr. Donya

The writer is a pediatrician based in Sanur, Bali. If you have any questions, please feel free to write her at drdonya@hotmail.com, or you can reach her at features@thejakartapost.com.