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Caring for your baby (feeding, sleep, teething and more)

Feeding and teething

Sleep

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Feeding and teething

If you've been following the hypoallergenic chart in our baby feeding and sleep program then you can consider eggs, shellfish, wheat and corn, unless you have concerns and are waiting closer to two. It's also time to starting thinking about when you're going to switch from breastmilk to goat or cow's milk and from bottle to cup. 

Food sensitivities and allergies

An anaphylactic allergy occurs when the body reactions to a substance mediated by IgE antibodies to produce histamine and is a medical emergency. With subsequent exposure to the reactive substance, the body mounts a stronger response each time making them quite dangerous after the initial attack. A true allergic reaction generally follows the same symptom picture no matter if from food or from something in the environment. Signs to watch for include red patches or welts on the skin, swelling or itchy lips or eyes, runny nose, fatigue, and difficulty breathing. 

A sensitivity on the other hand is a delayed IgG mediated response which makes the suspect food a bit more challenging to identify. And just to confuse things more there are food intolerances! Intolerances do not involve the immune system at all but cause irritation in the digestive system, which can lead to gas and bloating or diarrhea and constipation. 

80-90% of children with true food allergies are allergic to one or more of the following: dairy, eggs, peanuts & other tree nuts, shellfish, soy, and wheat. Food sensitivities can be triggered by the same list but can also be from a variety of other sources. Most sensitivities do not show up in obvious ways until a few days after ingestion so even if your baby initially did well on a food, continue monitoring them. Cooking the majority of your baby’s first foods can reduce the risk of allergy development. 

When starting new foods with your infant or child, monitoring for food allergies is important. The first exposure is usually a mild reaction; however, with subsequent expose, there is a high chance of a more dramatic reaction so care is needed when trying that food again. Ideally waiting two months and do not introduce anything new until the symptoms clear up. One way to slowly introduce a food you are concerned about is to place it on their cheek away from their mouths for 10-20 minutes to see if any redness or swelling develops. After this, wait 12-24 hours and monitor for symptoms, if none occur, then can try a small amount of their lips and again monitor for symptoms. This is a good strategy for first introduction of common food allergies such as peanuts – always chose natural non-hydrogenated peanut butter. It is ideal to speak with your healthcare provider if you are concerned about food introduction. 

If your child is developing seasonal or environmental allergies, they most likely will have more nasal congestion which could resemble a cold. The chart available in this post helps to distinguish between a cold, flu, and allergies.

Tips for introducing new foods

Since there is no reason to rush the introduction of solids, we believe in introducing foods as follows:

  • Always document the introduction of new foods on your baby's chart so that it will be easier to determine if your baby has a reaction and what caused it.
     
  • We want infants to develop a lifelong love for vegetables early because they're so good for us! When introducing solids, consider starting with vegetables and then fruits (because who wants to eat their vegetables after they have had sweets?). Even proteins can be introduced before whole grains as stomach acid and enzymes for protein digestion are almost at adult levels by six weeks whereas carb enzymes are not at adult levels until 18 months. Consider waiting until at least nine months before introducing whole grains.
     
  • To help monitor possible allergies, take a week to introduce each new food. Consider introducing each new food in the following manner.
     
  • If you are concerned about an allergy, you could rub some of the food on your baby's cheek first to see if it gets irritated or shows any other sign of reaction. 
    • Day One – Introduce a bite or two of the new food at either breakfast or lunch meal only
       
    • Day Two – Feed your baby as much of the new food as they want at either breakfast or lunch only (one meal only)
       
    • Day Three – Feed your baby as much of the new food as they want at two meals
       
    • Days Four to Seven – Feed your baby as much of the new food as they want at two or three meals. If there are no concerns by the end of the week, then start with the next new food.

You may find that texture and how you present the food to your baby and toddler becomes important, which means that it’s time to get creative! A few great tips are below.

  • Introduce new textures slowly 

    Transition to solids slowly by moving away from finely pureed foods to pureed foods with a bit more texture. Then slowly introduce finger foods, making sure they are cut into very small pieces because your child may not be chew her food as well as you might like. You can do this even if your child doesn’t have a full set of teeth yet but please do not ever leave your child unattended while they are eating to make sure they're not overfilling their mouth with food! 
     
  • Try plain foods first then slowly add new things

    Transitioning out of purees may take a long time and there is no need to rush the process. When your child first begins to eat solids, avoid offering foods with more than one texture (like pizza or pasta for example) because it may be too many new textures at once. Also, begin with desirable finger foods like O's that are rather bland, but kids seem to like them and it gives them practice with solids.
     
  • Make meals more fun

    There are so many things that you can do, just to name a few:
    • start with tiny portions (it seems less overwhelming that way)
       
    • cut things up into fun shapes, such as thin apple or cheese spears because it’s easy to hold and it might get your child to use her back teeth if she has them
       
    • grate raw food, like carrots with cucumber (it is less likely for kids to choke on and we like the idea of giving kids raw food)
       
    • present less appealing foods, such as vegetables, beside your child’s favourite foods as an incentive for her to eat more
       
    • adding your child’s favourite toppings or dips to food can be helpful (for example, squeeze lemon juice or add a little butter, coconut oil or cheese to veggies, add spices like cinnamon, or put ketchup, mustard or salsa on the side)
       
    • use fun names for vegetables (broccoli could be called trees and cauliflower could be snow covered trees, etc.) - older siblings can help with this!
  • Don’t force your child to eat foods they don't want to eat, and don't stop giving them what they love to eat (unless there's a good reason to)

    If your child doesn’t seem to want to eat a certain food, don’t make a big deal about it. Wait a few weeks or a month then gently try to introduce it again, they may come around. Don't give up try and remain calm, no matter how frustrated you may be (and it is frustrating!). Some children take many exposures to new foods before really loving them! Also, don't stop giving your child what she loves to eat, keep giving it to her as well as trying new things. Note that if things don't improve over a couple months and there may be reason for concern, you may want to check with your child’s healthcare provider.
     
  • Empower your child

    Let your child squish and touch the food, this is part of the process and shouldn't be discouraged. You can also give your child their own child-size spoon or fork and let them try to feed themselves if they shows an interest. You may need to feed them with another spoon or fork to make sure they get enough food before they get the hang of it. Don’t forget to let your child know that you are proud of them even if you have a huge mess to clean up! 

Iron in your baby's diet

After 6 months of age the iron stores your baby was born with start to become depleted. On top of this, if you are like so many moms who start their pregnancy with low iron it may be even more of a concern. Since iron begins to store in the third trimester of pregnancy, babies born prematurely (before 37 gestational weeks) may be at further risk of iron deficiency. This is another excellent reason to continue with your professional quality pre-natal vitamin during breastfeeding.  

As your infant grows the demand for iron and many other nutrients increase. Iron is especially important for brain development while low levels have been casually linked with cognitive and behaviour issues later in life. In most cases, infants will get enough through their diet; this is why it is important to ensure your infant’s diet has diversity. There are many foods that provide adequate levels of this important micronutrient.

Here is a chart showing the amount of elemental iron in a variety of foods. Also included is a table of foods rich in vitamin C, an important nutrient for helping the iron from food be absorbed. Avoiding dairy in the first year of life can also help prevent iron deficiency from occurring. In private practice, it is common to screen a child around 2 years of age to assess their iron levels just like we would in an adult. Your healthcare provider might screen as early as 9 months if there are any risk factors or cause for concern. The Institute of Medicine recommends 11 mg per day of elemental iron for infants 7 months to 1 year. The daily requirement decreases to 7 mg per day from 1-3 years.

There is such a thing as too much iron so make sure you consult your healthcare professional before supplementing with iron, especially non-food sources.

Transitioning from breast milk or formula to other milk 

Your child’s healthcare provider will let you know when it is okay to transition away from breast milk or formula and what type of milk is best to start with. The general trend right now seems to be to do this when babies are around the age of one. 

Dr. Beverly Huang ND generally recommends, after age one, to first transition children to sheep or goat’s milk before introducing cow’s milk. According to Dr. Beverly, “sheep’s milk is naturally sweeter than goat or cow’s milk and sheep and goat’s milk are more similar to the profile of breast milk compared to cow’s milk.” 

If you are having difficulty transitioning your child from breast milk to formula or other type of milk, start by mixing the two in a bottle (or sippy cup). Start with ¾ breast milk and ¼ formula/milk, then go down to ½ and ½, followed by ¼ breast milk and ¾ formula/milk and so on. Always throw away the leftover portion, especially of it contains formula (for health safety, never reheat!). Like most other things that involve your child, you should ask her healthcare provider if they are comfortable with this process before you do it.

Transitioning from a bottle to a sippy cup (and away from the nighttime bottle feeding)

You may find that your child is ready to transition to a sippy cup at around the same time that you transition them from breast milk or formula to another type of milk. An easy way to make this transition is to start each bottle-feeding with a sippy cup nipple for a few minutes before offering a bottle. Eventually your child will get used to drinking out of a sippy cup and you won’t need to switch to a bottle at all. 

You may also want teach your child how to drink out of a normal cup. Chances are they will want to try this on their own if they see you drinking out of a cup or if they have an older sibling that can do it!

If you plan to use a potty training method that requires you to switch to underwear for day as well as nighttime, you may want to ensure that your child no longer requires a bottle (or sippy cup) with milk in it before bed – if you offer your child liquids before bed they may be more prone to have an accident at night. You could try to replace a liquid feeding before bed by giving them a snack such as yogurt instead. For more about potty training, see toddler page.

Using bottles and pacifiers 

The need to suck is an innate way for a baby to feel calm and relaxed; some babies even suck their thumbs in the womb! This need is stronger in some infants more than others. In the early weeks of breastfeeding, it is important for a newborn to first learn how to attach to their mothers nipple to ensure proper latching, stronger suction, and reduce chances of sore nipples. Introducing a pacifier or bottle too early can, on occasion, confuse the newborn as there is a difference between the two and how the mouth is orientated. If breastfeeding is not an option or if milk flow doesn’t come in and supplementing is required most infants will adapt but it may be beneficial to discuss with a lactation consultant. 

It is a good idea to start weaning off a bottle and the need for a pacifier between ages 18-24 months. This is when the upper gum-line and palate start to reshape and how an overbite or “buckteeth” can develop. The intensity of the sucking is what will determine if any dental concerns arise. Another concern is when a bottle is used for night feeds as this can lead to tooth decay; so avoid letting your baby fall asleep with a bottle in their mouth. A good strategy is to see a pediatric dentist approximately six months after your baby’s teeth have come in to avoid any major dental issues. 

Your baby's tongue thrust mechanism

Tongue thrust reflex prevents infants from choking on foreign objects and causes them to push food out of their mouths. Prior to 4 months, a baby's swallowing mechanism is designed to work with sucking but not chewing – between 4 and 6 months, most infants develop the ability to move food from the front of the mouth to the back instead of letting it wallow around in the mouth and get spit out.  

A baby's tongue extrusion reflex begins to fade between 6 and 12 months. At this point they have the ability to prepare food in their mouth before swallowing. This is also when they will be able to get a better lip seal around a cup -- prior to this time a bottle or sippy-cup may be a cleaner option.

Check out our nutrition tips recipes, and meal plans.

Teething

Teething can have a huge impact on your baby's overall mood and demeanour, but also can impact how they are eating and sleeping. You may have already experienced this!

Symptoms of teething can be similar to those of a cold or flu such as fussiness, pulling at the ears, difficulty sleeping and slightly loose stools. Other common symptoms include drooling, scratching along the jaw line and biting/gnawing on things such as their hand or your shoulder.

Out top solutions to teething are listed below.

  • Teething toys - there are gazillions of toys for teething on the market, including teething bling for Mom to wear for easy access (and help serve as a great distraction when you need to give your baby something to play with).
     
  • Bioron Laboratories' Camilla - this is a must have! It helps with teething but we've found it is also amazing for calming and soothing, especially, if your child is crying hysterically (like on an airplane which is the worst). Literally keep this handy all of the time!
     
  • Wearing an amber necklace around the neck, all day and night - while controversial, this can be very effective method but some parents have to see it to believe it. If want to try an amber necklace, consider one where each bead is knotted individually, so if the necklace happens to break the beads will not break loose from the string. Also consider putting it on your baby as a newborn so that they don't even notice it's there. If you put it on them when they are older, they may notice it and play with it. Don't forget to take it off at bath time (and avoid getting it wet) as this could have an impact on the integrity of the string it is made with. 

There are also drool bibs on the market which are worth buying as they can save you having to change your baby's top once every hour to keep them dry and comfy cosy.

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Sleep

Sleeping through the night asap

Lack of sleep is something most parents anticipate when their new baby arrives. With all of the new scientific studies out there, we all know how bad lack of sleep is for us! It is not realistic to expect 8 hours of perfect, uninterrupted sleep with a new baby but a gradual improvement in the quality of sleep can be expected as your baby grows, develops, and their need for nutrients at night decreases. Determining the best time to establish a sleep routine for your infant is highly individual, there is no rule for or against when to start. 

A study (note 1) comparing newborns on a sleep-training program to a control group followed newborns from birth until 6-9 weeks of age. The study found infants on the sleep program had significantly better sleep patterns than the control group. Additionally, the parents in the sleep-program group obtained more uninterrupted sleep, reported less stress generally, and felt more competent when responding to their infants at night compared to the control group. Insomnia is so common! It is also common for people to report that their sleep problems began as children. Therefore, establishing a sleep routine in infancy may influence sleep patterns as your baby grows up. It is also interesting to note that up to 30% of children have sleep problems in their first four years which means less sleep for the parents during this time as well.

Many Calmmother mama’s have verified the earlier a baby is started on the routine, the easier it is to have their baby sleeping through the night and for the infant to get themselves back to sleep by self-soothing. Just like an adult, when an infant knows what to expect and is in a routine, anxiety and stress levels can be reduced. When your baby is getting more sleep, YOU are getting more sleep! More sleep for baby and mom reduces the risk of maternal depression and improves your child’s mood during the day.

Always consult your healthcare practitioner to discuss the sleep program you have in mind and to ensure your baby is a good candidate for that program. Some circumstances may include: low birth weight, weight loss, low immunity, premature birth, or other health concerns your healthcare provider may have.

The Calmmother feeding and sleep guide, which gently helps your baby transition to 10-12 hours of uninterrupted sleep by 12 weeks, is available here.

Answers to FAQ's about baby feeding and sleep are available here.

Dropping naps

Dropping a nap too early can cause a less than ideal chain reaction for your family. Not only does lack of sleep cause your baby to be overtired and cranky, it may mean that it will be more difficult to put them down at night. Less or not enough sleep during the day may require an earlier bedtime to ensure that your child is getting enough sleep in a 24 hour period.  

According to Dr. Pamela Smith, ND, "most newborn sleep between 11-17 hours in a 24 hour period with the average around 14 hours. However, this amount of sleep is usually in 1-4 hour blocks with approximate hours equal during the day and at night. By 2-6 months of age, the nighttime sleep starts to dominate the amount of daytime sleeping." 

When using our feeding and sleep program, or when it comes to sleep generally, the amount of sleep that a baby needs in a day will vary. As a starting point, you should do what works best for you and your family. 

We have found this method of dropping naps to be a smooth transition:

  • 0-6 months - baby naps a minimum of 1.5 hours between each of the daytime feedings until they are at least six months old (this means four daytime naps per day: early morning, late morning, afternoon and late afternoon)
     
  • 6 months - drop the late afternoon nap before dinner around six months, preferably after baby is consistently sleep 10-12 uninterrupted hours through the night (if you've used our program then your baby likely has been sleeping this way since 12 weeks or 3 months)
     
  • 9 months - drop the late morning nap around nine months or when baby is ready -- when you drop this nap, your baby may need to have two naps during the day, in the morning after breakfast and after lunch, for 1.5 to three hours each
     
  • One year - drop the early morning nap after breakfast when your baby is around a year old, and continues to have a 1.5 to three hour nap after lunch (coincidentally, this is when many daycares tend to have nap or quiet time). For more about dropping naps for toddlers see this page.

One way to help keep things smooth and easy when dropping naps is to make the transition slow, for example, reducing nap time by half an hour at a time until phasing the nap out completely. It is also important to teach your baby to be able to lay or play quietly in their crib (or bedroom) when it is nap time until it is time to wake up. After your child stops napping, if you would still like quiet time each day, convey to your child that it is quiet time and that they need to play alone. Quiet time can help give everyone in your family a much needed break. 

Consult your child's qualified healthcare provider if you are concerned that your child is not getting enough sleep or has a nutritional deficiency.

Creating a consistent and healthy bedtime routine

These are our top 3 tips for creating and maintaining a consistent bedtime routine for children.

1.     Create bedtime routine ASAP! 

Hopefully you've figure out what sleep habits work for you and your family when your baby is a newborn or soon after. This is particularly helpful if you also have older children with their own scheduled activities. Know what is convenient and your preferences in terms of after school activities, your bedtime routine (dinner, playtime, bath time, snack time and story time), and what bedtime and breakfast times fit within your family's schedule.

If you have more then one child with varied age gaps, you may want to choose a bedtime routine starting point that is based on the youngest child. For example, if you have a a 15 month old and a 4 year old and bedtime for the 15 month old is 7pm, consider having the 4 year old start quiet time at 7pm, either playing quietly or reading in their room and go down for bed at 7:30pm. Staggering bedtimes helps mom and dad out and also allows for each child to get some individual parent time. 

2.     Be consistent

Whatever sleep routine you choose, make sure that you are executing it in the same order every night as often as possible. Little children do well when they know what is expected and what is coming up next. So having a snack follower by bath time, brushing teeth, story and then bedtime allows them to know what to expect next (and also less whining and asking for things outside of the routine).

3.     Do not negotiate

If you give an inch, they may try to take a mile. If you build a snack, drink of water or potty into the bedtime rountine your child can't ask to get out of bed for the toilet, a bedtime snack or a drink after you have put them to bed.

For potty training purposes, transitioning to a small snack before bed rather than a drink can be helpful to avoid accidents at night. See this post about potty training.

Our top 5 tips for sleep training babies over one year, toddlers and small children

1.     Develop and follow a consistent feeding and sleep routine as soon as possible! 

Hopefully you've figure out what sleep habits work for you and your family when your baby is a newborn or soon after. This is particularly helpful if you also have older children with their own scheduled activities. Know what is convenient and your preferences in terms of after school activities, your bedtime routine (dinner, playtime, bath time, snack time and story time), and what bedtime and breakfast times fit within your family's schedule.

This also includes cutting out naps when it is appropriate. As discussed by Dr. Pamela Smith, ND in her post about how much sleep each child should have based on age, every child’s need for sleep is going to be different and can vary based on their age and activity level. This includes hours napped during the day plus the hours at night.

2.     Make your consistent bedtime routine a family conversation

Whatever your process, explain things clearly and make sure your child understands that the bedtime routine is not negotiable. If you've been using the Calmmother baby feeding and sleep program then you're child will likely be familiar with a well established routine. If this is new to your child, talking them through the routine and explaining what happens and when (and if appropriate, even why you do it). Your child should understand that everyone needs sleep so that they can get enough rest and be alert for the next day. Using the same words for consistency can also be helpful: it's bedtime, I love you, time to close your eyes and go to sleep.  

If your child is too young to understand words, you can use pictures on a chart or a picture book (or demonstrate yourself) to show what the rountine looks like before bed. I did this with my two youngest boys when they were little -- and they loved it because we would look at the chart everytime we were finished a step in the routine!

3.     Be firm and break habits before they start

Parents should aware and okay with the habits they allow in their home. This involves knowing your preferences and which habits you are comfortable with. For example, if you don't want you child to be dependent on a soother to put them to sleep, consider only giving your child a soother when necessary from the beginning or ween them off of it (I.e., only use if you are in public and your baby is having a meltdown).

The same goes for other sleep props such as baby swings, rocking chairs, sound machines, as well as stuffed animals and special blankets for toddlers. If you're comfortable with light shining into your child's room, consider leaving their door open and either having a nighlight plugged into hallway outlet or even leaving the hall light on.

4.     Be persistent

Do not allow your child to incorporate new things into their bedtime routine, such as extra stories, a nightlight or a glass of milk before bed. 

If your child is asking for a bottle before bed, try transition to a bedtime snack instead, like cheese of yogurt. From one year onward, consider limiting liquids after dinner (1.5 to 2 hours before bedtime) to help with potty training, otherwise if can be difficult to get them to sleep through the night. For more on potty training read this post.

You may need to shut the nightlight (or hallway light) off if your child gets out of bed so that they know you're serious. Or more drastic, shut their door and hold it from the outside to teach your child that they cannot get out of bed. Again, explain what is going on to your child especially if this is new to them. 

If your child wakes up in the middle of the night and come to your bed, walk them back to their own bed without saying anything. This prevents them being able to negotiate with you! You may have to walk them back to bed a few times in the middle of the night for a few days before they know your serious about bedtime. 

You may need to repeat the same thing over and over again until your child learns that you will not back down and that bedtime is simply not negotiable.

5.     Be prepared for long nights and tears (your tears and theirs)

Unfortunately with older children, sleep training may mean tears (sometime hours of them before bed or in the middle of the night), especially when you reinforce what you say. You want your child to take you seriously. Giving in will undermine your authority.

Always check on your child if you are concerned with their wellbeing. This is where a baby monitor with a camera may come in handy.


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Sources

1. Wolfsen, A., A. Futterman, and P. Lacks. 1992. Effects of parent training on infant sleep patterns, parent’s stress, and parental perceived competency. Journal of Consulting and Clinical Psychology. 60(1) 41-48.

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