Parenting

Practical parenting series: Eating and sleeping in the first year

The first months of an infant’s life can be a challenge for parents, to say the least, but parents’ actions during the first few weeks can set the tone for how the baby sleeps and eats well into its first year.

Dr. Andy Sagan, pediatrician at Swedish Covenant Medical Group Pediatrics, spoke to a near-capacity group of parents in the auditorium at the Sulzer Regional Library last week. The event, co-hosted by kickSprout, addressed common questions from expectant parents as well as parents who were experiencing challenges during the baby’s first year.

Sagan began by explaining that there is no one right philosophy of parenting, but that the following opinions were based on his experiences as a pediatrician and father. He stressed several ideas throughout the evening:
1. Parents should have proper expectations
2. Parents should think in terms of routines
3. Parents should decide what type of parenting style they want to have

Infant feeding

Breastfeeding
When it comes to establishing lactation and avoiding common pitfalls, Sagan said there are several common issues that can be easily avoided by keeping your expectations in check.

For example, it can often take three to four days for the milk to start to flow, and mothers should expect this delay. The breasts provide colostrum during the baby’s first few days, and this can satisfy an infant.

Babies will act hungrier during the first few days and will keep parents up more, but Sagan said it’s important that the mother avoid exhaustion. Sagan said new parents can tend to forget that there’s a lot of recovering to do after childbirth, and he noted it’s important to regulate visitors, do what you can to feel comfortable and get rest.

Introducing bottle feeding
Sagan delved into some admittedly controversial issues related to bottle feeding and introducing bottles to breast feeders. Bottle feeding should be introduced some time before the end of the first month, Sagan said. While this may seem early, there are practical reasons behind it, such as if a mother gets a virus and someone else needs to feed the baby, or if a caregiver will be feeding the baby after the mother’s maternity leave ends. This way the infant will be comfortable taking milk from a bottle when needed.

There are also varying theories about whether the milk should be warmed or cold, and how large the bottle nipples should be, but Sagan said what you do should always come down to what the baby can and will tolerate without choking or spitting.

Starting solids
Starting solid foods is an important moment because it signals it’s time for parents to determine the baby’s daily eating routine. At this time, parents choose if they want to follow a “directive parenting pathway” or have the baby dictate feedings in a more “laissez-faire” style.

Parents working to introduce solid foods should focus on the how, when and where, Sagan said, versus the what.

“Think about routines,” he said. “The baby will learn almost everything you teach it.”

For example, mothers who breastfeed in a particular location in the home can go to that area less and less often as the child is weaned off of the breast.

Sagan emphasized that there are no set guidelines for how to feed your baby: There have been so-called rules passed along for generations, such as feeding vegetables before fruits, always putting liquids into the child before solids, and even more controversial issues of avoiding foods that could cause allergies, but many of these have been systematically disproven, he said.

Allergy-causing foods are a hot topic in the pediatric community, Sagan said. A few years ago, the Academy of American Pediatrics withdrew suggestions that parents withhold certain foods (nuts, eggs, dairy, for example) during the first year of a baby’s life.

“It turns out the data doesn’t support withholding certain foods,” Sagan said. “Have a discussion with your doctor if you have concerns [with your child’s diet] because of your own personal medical profile.”

Infant sleeping

Expectations for early infant sleep
Parents should expect that newborns will sleep 14 to18 hours a day in the first month, but they sleep in short intervals and often get their days and nights mixed up, Sagan said. The good news is that around 6 to 8 weeks, the parents can expect the child to sleep for five to six hours at a time.

Sagan said parents can prepare for sleep training even in the first few weeks of the baby’s life. Here are some of the tips he provided:
• Nights should be quiet and days should be busy.
• Babies should be exposed to some natural light during the day to help establish good circadian rhythms and production of sleep-inducing melatonin.
• Babies should be put to sleep in a drowsy state.
• Establish rituals for sleep (this goes for nap time as well)such as walking quietly around a dimly lit bedroom or saying “goodnight” to objects around the room in a calm tone of voice.

Sleep training
Sagan spoke to some length on sleep training and the ideas behind the “cry it out” method.

There are many books that can teach parents about the “cry it out” method of sleep training, but what it comes down to is how it suits the parents. At around 4 months, parents can introduce sleep training with the ritual of going to sleep in a quiet, dim and peaceful location, having an initial “put down” with the infant, and then comforting a fussy infant less and less until they fall asleep. If the child grows loud and complaining, it’s up to the parent whether it’s ok to go back in the room.

“We live in a practical culture and we have needs,” he said. “It [sleep training] is really easy to do, it works, and has been done for several generations.”

Sagan said other methods can also be successful but require additional parental participation and work.

One question that arose during the Q&A came from parent Tanya Chwojko of Uptown. Her daughter had always been a good sleeper but now is teething and won’t fall asleep on her own. She asked if she should try and let her “cry it out” even if it lasted more than a half an hour. 

Sagan said that would be the best solution: “The first night, she might cry for an hour, three hours, four hours, but she’s still going to be a loving baby in the morning,” he said. “The next night it will be half of that, the third night it might not happen.”

Sensible, practical parenting

Ultimately, Sagan said it's important to be practical in your approach to parenting, and that planning ahead can go a long way toward success for you and your baby. 

"In my practice, I have a simple rule that I try to give parents: Try to do now what you plan to do later, so you don't have to fix later what you should have done now," he said.

Parents, what advice would you give to new parents? Share in the comments!

• Login
• Comment