Many years ago no-one talked about cued care, parents simply just looked after their baby. Families were larger and the majority of mothers were stay-at-home caregivers which meant baby care was synchronised around other siblings and a pattern of sensible responsiveness was used to meet baby’s needs. Being a stay-at-home parent is not relevant for all of these days but that in itself does not rule out cued care which is simply the intention to respond. It does not mean you should expect to drop everything to attend to your baby’s every grizzle or for your baby to be happy and contented all of the time. You are modelling cued care when you are doing your best to communicate with your baby in the blur of confusion and crying and this will mean your baby will feel protected.
The current infant care culture revolves around deliberately delaying responses and teaching your baby to ‘self-settle’ as soon as possible. The intent here is to prevent baby requiring parental assistance to get to sleep or to get back to sleep. Using this method, intervening to assist your baby to sleep can leave you worried that you are creating bad habits such as baby relying on your help to get to sleep. When teaching your baby to ‘self-settle’ fails to work, parents often seek out a pre-defined schedule to guide their parenting and entrench ‘self-settling’. Unfortunately, babies are not all programmed to follow an identical pattern because they are all unique, and by trying to follow a schedule you may end up feeling more lost than ever.
Some people are of the belief that babies do not feel pain or have emotions. I do not share this belief! Let me explain this controversial matter. Babies do suffer pain and emotion but there is a communication barrier. Cued care aims to break down that barrier by letting them know you are responding to what communication they can give. Babies have a biological drive to survive and commonly will cry because they are hungry. Feeling ‘Hangry’ is a real for them and this can be a painful and stressful experience especially if establishing breastfeeding has not been a smooth ride or if their cues have not been regularly responded to. Studies show that babies produce less of the hormone cholecystokinin (a hormone that signals satiation and satisfaction) so even if all is going well with feeding, babies just simply do not feel as contented after eating as the rest of us.
Some of you may be reading this and thinking that cued care sounds fab but seems unattainable. Well, read on because I have a couple suggestions of how to make cued care easier.
Study your baby instead of your phone:
Cell phones and internet-connected devices are a huge part of modern life with a baby and connect us with the outside world. It is rightly said that this may reduce the feeling of isolation and protects parents’ mental health. However, these devices may also be a barrier to attachment and bonding with your baby. We may be oblivious to the amount of time we spend on them accessing social media, internet and other applications, especially if those are being used to try find the cure to poor sleep! In truth, the answer is right in front of you. Be mindful about how much time we are spending on devices that could be taking your attention away from your baby and as a consequence missing your baby’s cues. Limiting screen time for parents will mean that you are more in tune with your baby and will also mean you that you can get on with parenting the way that you want to rather than listening to and reading articles that go against intuitive parenting. Balance is something many of us struggle with but is so important. When you are meeting up with a friend for a playdate – leave your phone in the car! You can return missed calls later and scroll news feeds during down time. Relax and enjoy the playdate.
Stop hurrying, hustling and stressing:
Have you ever wondered why your baby grizzles more than usual when you are in the company of others?
Being a parent today is about being everywhere and doing everything. We teach by doing and if you want to nurture calm then you need to slow down. Scale back the number of activities so you don’t need to be somewhere in particular at every moment of the day - you will find that you will have more time and energy to connect with your baby and pick up on their subtle communications. This will make you more capable of keeping your baby’s stress responses dialled down by creating an example of calmness. Babies are like sponges and they pick up on our stress and worry, likewise they will pick up on calm and relaxed behaviour. Try not to let stress and worry steal the joy of being a parent. It is worth noting though there is no need to avoid outings just because they fall around nap times. If you do rush home for nap time, your baby will be picking up on this chaotic frenzy and respond in a similar fashion.
If you are finding it challenging to look after a baby and get the housework done and dinner prepared, don’t feel ashamed to take a friend up on the offer of help or use some of the paid services that are available to accommodate our busy lives.
One of the main things parents do stress about is their baby not getting enough sleep to support their development. Average sleep requirements are just guides with a broad distribution, the truth is that sleep needs vary greatly between babies. Let this reassurance give you the permission to make the change starting today. Love grows brains and nurtures development, talk, sing and read to bubs from day one.
My hope is that one day soon no-one will talk about cued care at all, it will just be the default mode of parenting. For now we need the term to educate parents and begin to change infant care practices that have become so embedded in society. We are well educated about maternal anxiety and depression, and now acknowledge paternal depression. Childhood anxiety is on the increase and I wonder if we are overlooking infant mental health? Take me back to the days where the term cued care didn’t exist it was just what was done. This could be the answer to better mental health for the whole family.
Denaye Barahona, simplefamilies.com
Possums conference, Brisbane 2017, possums-au.breastfeedingconferences.com.au/index.php
Parents are commonly concerned when their baby does not sleep through the night, especially if the largest stretch of sleep is not when they sleep. The results of this study give us a guide of appropriate developmental expectations for infant sleep, and help determine the optimal timing for prevention and intervention of sleep problems. From a developmental perspective it reflects an understanding of infant’s physiological capabilities in self-soothing and sustained sleep, showing the large variability of this from one baby to another.
This NZ based study enrolled 75 parents of healthy, developing infants and parents completed sleep diaries for 6 days each month for 12 months. Parents recorded the time and at what state the infant was placed into the cot and then the duration of time until the infant fell asleep. Parents also recorded the time and duration of each night-awakening and the time that their baby woke in the morning. Accuracy of parent reports were assessed by using videosomnography (diagnosis by behavioural observation).
The sleep of each infant was classified based on the three criteria below:
1) 2400hrs to 0500hrs
2) 8 hours of uninterrupted sleep
3) 2200hrs to 0600hrs
The findings of the study showed that self-regulated sleep (without behavioural intervention) became apparent most rapidly in the first four months, with 50 percent of infants meeting criterion 3) at 5 months. From 4-9mths age infant sleep length tended to plateau and began to lengthen again between 10 and 12months. However at 12 months age, 32 percent of infants still did not meet criterion 3) - many babies do not sleep through the night by one year of age but are still perfectly healthy and this is not necessarily problematic.
The authors of the study recommend that criterion 3) should be used to define ‘sleeping through the night’ for babies from the age of 4 months. The reason for this is because it is harmonious with family sleep patterns, and falls within typical sleep times of the parents. Additionally, it is recommended that prevention of sleep challenges should begin before 3 months, emphasising the importance of working with infant sleep biology to determine healthy sleep habits in the long-term.
Many families aim to put their baby to sleep at 7pm but why do we place this expectation on our baby? A later bedtime may be better suited for baby’s actual sleep patterns and may also be beneficial in synchronising their sleep with their parents. It is actually possible to aid in the prevention of sleep challenges by achieving a synchronised sustained period of sleep during the night after completing day to day activities and self-care tasks. For example moving bed time routines out to a later hour can not only help with preventing sleep challenges but perhaps even more importantly, reset parents’ expectations of their baby’s developmental capabilities.
One of the main limitations of this study was that there was no data provided on the method of infant feeding (i.e. breastfeeding or formula feeding) as this does seem to impact sleep duration and quality of sleep. Many parents believe that supplementing their babies with formula feeds will encourage earlier sleeping through the night. A separate study has found that although breastfed babies do wake more frequently in the night, they often get better quality sleep as they settle back to sleep more easily.
Additional research is now needed to establish the factors that precede and predict infant sleep problems.
For full aticle please see:
Sleeping Through the Night: The Consolidation of Self-regulated Sleep Across the First Year of Life
If we were to look at cultures purely in terms of their infant care practices, norms and values, which culture would you choose to be born in to? Think carefully, as this choice can make a huge impact on how you develop as a healthy, happy baby. Because the thing is, it does not matter which culture or country an infant is born into, its biological needs are the same – but does the culture a baby is born into meet these needs? Or does it promote crying, fussing, feeding and sleeping issues?
The western culture’s predominant norms and practices around infant care often stray very far from what a baby biologically requires. In fact, when describing how both historically and cross-culturally unusual our parent-infant sleep practises are, researches have come up with this acronym to describe the worst offenders - W.E.I.R.D (western, educated, industrialised, rich and democratic), (Heinrich et al., 2010).
The western way of child rearing is one of the biggest mismatches between culture and what a baby biologically expects.
Human babies are mammal babies, more specifically secondary precocial. This is because typical brain growth cannot be completed before birth. Human babies have 25% adult brain growth at birth, compared with 50% of other primates. Humans produce mainly single infants that have well developed internal and sensory organs (can see, hear and call) but our babies have poorly coordinated neuromuscular control, so cannot follow or even cling to their caregiver. Our milk is low in fat and high in sugar, so our infants need to be fed frequently.
Every primate baby is designed to be physically attached to someone who will feed, protect and care for them. They have been adapted over millions of years to expect nothing else and humans produce unusually helpless primate babies!
When you take this into consideration and then think to some of the predominant advice around caring for a new born e.g. teach them to self-settle independently, space their feeds, do not let babies fall asleep at the breast, put babies to bed awake, carry out feed/play/sleep cycles, leave babies to cry or leave them to cry but give them verbal ‘reassurance’, do not let your baby form ‘bad habits’, don’t let your baby sleep on you, enforcing feeding and sleeping schedules or routines and never co-sleeping (for families that have no risk factors and are doing it completely safely), you can start to see what I am talking about.
The dominant western approach to infant care has evolved far faster than baby’s biological needs ever could and this is why there is such a mismatch.
So where does this ‘expert’ advice that pervades western culture come from? During the 1920’s, doctors John B Watson and Frederick Truby King advocated the ‘scientific’ approach to infant care. The focus of their approach valued independence, self-control and self-reliance. It is this focus which you can still see today in many approaches to infant care – particularly in the management of crying, fussing, feeding and sleeping challenges.
It is this approach which encourages independence, self-control and self-reliance that research clearly shows has no beneficial outcomes for infants. In fact, some variations of this approach can at times result in negative outcomes.
So, what can you do to ensure that you are doing your best to meet your baby’s biological needs, to provide them with a loving environment that helps to achieve optimum development, bonding and attachment? Quite simply – physical contact and emotionally connecting with your baby – day and night. 24/7.
Physical contact does so many amazing things for parents and their babies. It reduces maternal anxiety and promotes involvement in their infant’s care, is great for breast feeding initiation and long-term breast feeding success, reduces stress, promotes oxytocin, beta endorphins, prolactin and sleep, conserves heat and energy, can reduce pain levels, premature babies experience less agitation and have more stable vital signs.
You only need to google ‘The still face experiment’ to see the stress inducing effect that a non-responsive caregiver has on a baby – even when in very close proximity.
Rest assured, there are no rules required to meet the biological needs for babies. As mothers, we can just remind ourselves that our babies can communicate to us what they need and through our own biological changes during pregnancy and childbirth, our brains are now primed to learn how to understand our baby’s ways of communicating - to build good two-way communication and trust.
Instead of a culture based on maintaining control and pushing independence, a culture of respect and kindness towards our babies and focusing on meeting their biological will ensure that over time the gap between what dominant western approaches to infant care advocate and what babies genuinely need will continue to narrow.
Prof. Helen Ball, Possums Conference, Brisbane 2017.
Pennie Brownlee. The only person who can do a Pikler is dead: Or why isn’t it a good idea to say ‘We do Pikler at our centre’. February 2015.
Heinrich, J., Heine, S., & Norenzayan, A. (2010). The weirdest people in the world? Behavioural and Brain Sciences, 33, 61-135.
Have you ever wondered why no matter how many babies you have you never quite feel complete and ponder over the possibility of another? This is an addiction to the feel good hormone, Oxytocin. This powerful hormone has the important job of reproductive success and species survival: nature’s way of patting you on the back and telling you “Good job. Have more babies.”
Making babies, having babies and feeding babies. Oxytocin is produced during sexual activity and orgasms, its analgesic properties are helpful in labour and birth, and its release is triggered in both mother and baby when a baby suckles at the breast.
Alternatively most of us know what it feels like to experience the ‘fight of flight response’ and it’s not what you would describe as desirable – a pounding, racing heartbeat, cool sweaty skin and hyperarousal. These symptoms present through a stress response which is activated by the sympathetic nervous system with intertwined hormones adrenaline noradrenaline, such as cortisol. These responses are very much tied in with labour which can be painful and stressful. Stress hormones during childbirth can either slow down or accelerate labour depending on the stage. Historically this response was important for survival: if you were giving birth in the wild and there was a threat to your survival (such as a sabre-toothed tiger suddenly appearing!), you would have an out pouring of stress hormones and blood would be shifted away from your placenta to your vital organs. As a result labour would stop so you could run away to safety where labour could resume. However, if you were in the final stages of labour when the tiger appeared, you could not run so it makes biological sense that these hormones at this latter stage would assist with giving birth quickly, so you could scoop up your baby and run to safety.
Oxytocin in this sense is just the opposite: activating the parasympathetic nervous system encouraging relaxation and growth, a feeling of calmness safety and security which promotes bonding and attachment. After having a baby you quickly forget about the associated pain and stress and immediately begin to bond with your baby; oxytocin’s side effects present as that lovely hot flush that new mothers get and baby is wide-eyed ready to bond. Activation of the reward, pleasure and motivation centres is happening during this time. No other mammals attend antenatal classes to be told how to care for their baby so there needs to be a hormonal system in place to kick in straight after births so that mother finds contact with her baby very rewarding. Mother Nature rewards us for the dedication to caring for your baby for maximal chance of mother and baby survival and species survival. It’s not hard to see why this hormonal system has been selected for during mammalian evolution.
Breastfeeding on demand is how you can keep your baby’s sympathetic nervous system dialled down and prevent activation of the fight or flight response. This is especially important during the first 4-6 months of a baby’s life during the phase of high neurological sensitivity. Oxytocin is working its magic - mother feels an overwhelming need to protect, provide and nurture her baby making her feel good and this motivates her to keep doing what she is doing. Baby feels safe and secure and remains calm when it has all its needs have been need met, including feeling satiated with a tummy full of creamy milk and sensory nourishment through physical contact. Babies that receive plenty of physical contact with their caregiver cry less and breastfeed for a longer duration.
Many parents have a specific time frame that they think their baby should be sleeping through the night by and can find it disheartening when they continue to wake during this period. Despite eating solids well and having plenty of protein they still wake up.
But they can’t be hungry so why?
It's important to understand that babies (not just new-borns) feed for reasons other than just to satisfy their hunger and met their growth demands. Often night wakings will be for the physical contact, feelings of security, pain reduction and the calming effects of oxytocin. When we as parents have set times in our mind that baby should be sleeping and not feeding, and we stop responding to our baby’s cues, and they can become stressed. This can lead to negative effects on development as well as prolonged and unpleasant night waking, which is what we want to avoid. This can be managed by being responsive to your baby’s needs. It may not be a consistent pattern but it won’t last forever either. We have all had days and nights that have been tough and it’s amazing to think that over time our minds seem to be very clever at washing away those unhelpful feelings associated with those distant memories.
Just one more baby… it can’t be that hard right?
-Adapted from a talk given by Dr. Sarah Buckley at the Possums conference, Brisbane 2017.
Breast milk sharing is rapidly gaining popularity in NZ, and for good reason. Everyday kiwi women who are complete strangers are connecting through Facebook pages like mothersmilknz and human milk 4 human babies NZ where women can both donate and seek out breast milk for their infants.
These pages are not only a great village of support for new parents, but they also offer another option to formula where cost is no barrier. For parents that cannot provide breastmilk for their infant but feel strongly about exclusively feeding their baby breast milk, this option can feel like a blessing.
There are polarising opinions about breast milk sharing, which can sadly lead to parents seeking donor milk in secret, feeling that many people will judge them with their opinion that it’s disguising and wrong. However, not all of us feel this way and alternatively, know that breast milk is the ideal food for all babies and the biological norm.
Sharing of breast milk is not a new phenomenon. It was a standard practice in 1975 in hospitals until the rise of HIV and the introduction of formula, which resulted in the shelving of this practice. Wet nursing was also practiced and still is in some cultures where family and close friends will feed each other’s babies from the breast for convenience. Historically, wet nurses were employed by wealthy families when mothers did not want to suffer what some perceived as the indignity of breastfeeding.
The health benefits of breastmilk are of specific importance for premature infants whose mothers desperately want to provide breast milk for their infant in the NICU (Neonatal Intensive Care Unit) but physically cannot produce milk in the volumes, in the time that is demanded of them.
Donor milk is treated like gold in the NICU due to the protective components of breast milk, which includes immunoglobulins, anti-bacterial proteins as well as the many oligosaccharides which provide bioactive factors, prebiotic, immunomodulatory & antimicrobial effects.
Immunocompromised premature infants are transitioned onto milk feeds quickly to protect their vulnerable digestive system from a serious medical condition called NEC (necrotising enterocolitis) that is associated with high mortality and morbidity rates. Donor breast milk is also hugely beneficial in aiding the rapid growth for these babies which is required for their progression through the NICU and therefore earlier discharge home with their caregiver.
The first New Zealand milk bank was opened in 2014 in Canterbury to provide breastmilk for babies whose mothers are unable to provide their own and priority is given to this group of vulnerable infants. Donor milk is pasteurised to prevent transference of disease form donor to recipient by heating the milk in a water bath to 62.5 degrees for 30 minutes and then quickly chilling the milk to 4 degrees. Miraculously this time and temperature combination does not destroy the all of the immunological protective benefits of breastmilk. Due to the success of the Canterbury Milk Bank, more funding has become available and another milk bank could potentially be opening in Auckland.
Donor milk banks ensure quality control by maintaining standards during transportation and storage, formal screening and guidelines for pasteurisation of donor breastmilk. Unfortunately these standards are not met when mothers freely share breastmilk on social media. We cannot ignore the risks that are associated with feeding babies unscreened or unpasteurised donor breastmilk, and this poses similar risks as blood products.
For parents who choose to give their baby another woman’s liquid gold, safety is left to the common sense of the donor and recipient. However, below is a list of guidelines how this can be done more safely based on ADHB's recommendations:
Some questions a recipients might like to ask her donor:
If the donor agrees to provide a blood sample, below are the recommended tests:
Pasteurisation of milk at home – here is what you need to do…it's easy!
Thanks on behalf of the receipts to those generous milk donors out there that have provided or are providing for other babies, you are saving lives and making lives better. Hopefully, this information will help make it safer for babies and help reduce any stigmatisation around the art of sharing liquid gold.
If you have excess milk and think you would like to donate your milk, your efforts would be greatly appreciated, please follow the links below.
Hands up if you:
1. Find cooking separate meals for adults and children day after day a bit tedious, let alone far too time consuming
2. Have kids that eat OK, but know what they like and don’t like and some days don’t eat much at all
3. Start to feel stressed about whether your toddler is eating enough when they start waking more in the night than usual
If this is you, then what the most up to date research is telling us about how to help toddlers develop healthy eating habits and how their eating affects – or more importantly does not affect – their night time waking, is going to be a great relief to you.
We love it because it’s easy, fun, makes meals times more relaxed and enjoyable as possible!
Before we start with the top 5 tips, here is my favourite meal time stress reducer. Research shows that encouraging more solids in toddlers (6-12 months of age) that are waking frequently during the night does not affect the number of times they wake for reassurance overnight. It does reduce the amount that they need to be fed overnight, but even when feeding less, their amount of night time waking, needing reassurance, does not reduce.
This tells us that if your toddler is being regularly offered a wide variety of healthy food, is eating and drinking well, there is no need to actively encourage them to eat more in the hope of reducing night time waking.
So, now that we have taken the pressure off solid intake and night time waking, here are our Top 5 Tips to help your toddler develop healthy eating habits:
1. No toddler will starve when there is food around to be eaten
It’s quite natural for toddlers of eat cyclically, some days eating like a horse and others like a mouse. Try not to worry about this, but keep offering your toddler a wide range of healthy food, knowing that they will eat when they are hungry. If you are needing to use heavy distraction to encourage your toddler to eat e.g. TV, toys, iPad, etc., it may be that your toddler is not that hungry. Experiment to discover your toddlers natural eating rhythms, don’t worry if they don’t eat what you offer them at that time (although it can be frustrating) so that meal times are relaxed and enjoyed for what they are. This will help your toddler to learn to regulate their own intake, enjoy and appreciate food, which is important in developing healthy eating habits.
2. Offer babies a wide range of food groups between 6-12 months – before they get fussy!
After approximately 12 months of age, many toddlers get very fussing with what they will and won’t eat. This is a form of self-preservation, as they become more mobile and inquisitive this fussiness about what they will and won’t put in their mouth can save their lives, as they don’t eat those poisonous berries in the neighbours garden. Between 6-12 months of age the easiest way to help your toddler eat a wide variety of food and eat the types of food you like to eat, is to simply offer them the same meals that you prepare for the rest of your family. If you are cooking healthy food (with no added salt) and have a balanced diet, this is fine, just adapt (puree, mash, soften or leave it as it is) the food to suit the stage of eating that your baby/toddler is up to. This works if you are doing baby lead weaning or not or you are somewhere in-between.
3. Model healthy eating
Toddlers feel safe and confident eating what you are eating as most toddlers are very risk adverse when it comes to trying new foods, as per tip number 2. If you want your kids to eat their vegetables, sit down with them as they eat theirs and have your own portion too. Show them how to eat and enjoy healthy food. Better still, if you can, try to eat as a family, making meals a safe, loving and enjoyable experience – not based around the quantity of food eaten.
4. Avoid saying “Eat your vegetables and you can have some pudding!”
It’s fine to offer food as a reward for good behaviour – that will not create an unhealthy relationship with food. What can create an unhealthy relationship with food is offering food rewards for eating certain foods, for example, avoid rewarding eating vegetables with a piece of cake. All it will do is reinforce the dislike of vegetables. Interestingly researchers have also found that telling toddlers that the food is good for them to encourage eating is unhelpful.
5. Having to offer foods many, many, many times before a toddler will take an interest is perfectly natural behaviour
Again, this behaviour comes down to self-preservation, they want to be completely sure that this new food is OK. When you are in the thick of this continual rejection, do not be perturbed – it’s normal. Most parents when questioned offer a new food 3-5 times before they stop offering it, claiming their toddler does not like it. Keep persisting, while you are getting through this stage, make like you have amnesia, and keep offering a little of the foods they have not yet warmed too. Offer it up with the foods that they think are yum and just wait, one day it will make it into their mouth. Until then, you will have a thriving compost heap.
Recently the Otago Daily Times (and the NZ Herald by extension) published this article: Sleep lessons halve obesity rates in children. Eye catching isn't it? Well we took issue with the title and the reporting as well as the study itself. In response we wrote a letter to the editor which they declined to publish as they felt the criticism should be directed to the researchers.
We disagreed so have published the letter below:
Letter to the Editor
With regards to your article entitled Sleep Lessons Cut Obesity, published on Wednesday 8 March, I am concerned about both the misleading headline and quality of research promoted in the article.
I am a fully qualified senior nurse with a Masters in Health Science. I am also a co-founder of The Baby Sleep Practitioners, providing specialised advice to families about baby sleep, feeding and emotional needs.
Overall, the study the article references was poor quality and the methodology was inappropriate for the study design. Thankfully, this has been acknowledged by the investigators.
1. It was very disappointing to hear that health professionals providing advice in sleep education group discussed outdated methods, for example: putting new-born babies down to sleep while awake without using any settling techniques; feeding in a dark area and the use of extinction methods in some cases.
2. Even though the results between the 3 groups were statistically insignificant with no difference in sleep quality or duration it was still reported that the sleep intervention group had reduced obesity. This minor difference 0.4kg weight/0.7cm length could be explained as subject bias - parents are likely to record results inaccurately, either unintentionally or intentionally.
Sleep deprivation resulting in poor memory unintentionally skewing data or by recording more activity, less unhealthy food and less wake ups intentionally to make themselves feel better about their situation through their own self believe.
The investigators did acknowledge that the non-sleep intervention control group could not be isolated from external sleep advice – it would be impractical and unethical. This includes strong influential routes such as sleep consultants, social media, the internet, magazines and well-meaning friends and family.
3. Progression of developmental milestones is one of the many factors that seems to be overlooked in this study. For example a baby learning to crawl or walk would clearly have a direct effect on BMI especially given the wide range of what is accepted as developmentally appropriate.
4. I agree that obesity is becoming a problem in preschool children and that the evidence suggests that an overweight pre-schooler leads to an overweight adult. This is of concern due to the associated poor health outcomes, for example the increased risk of heart disease and type 2 diabetes. However formula fed and breastfed infants need to be treated differently without perpetuating mother blame in society around how we feed our babies. It is inappropriate to be labelling a breastfed infant as overweight. A breastfed baby cannot be overfed as any excess weight is required to sustain a baby through periods of illness when ones immune system is developing. This excess weight will be latter lost if the toddler leads an active lifestyle with a diet consisting of variation that is quantity controlled by the baby preferably through self-regulation of sleep and appetite. Therefore, a mother should never feel guilty about putting her baby to the breast for any reason.
Formula fed babies are less likely to lose excess weight gained in infancy and education should be focused on paced bottle feeding and encouragement of babies to feed themselves solid foods with the aim of slowing down the rate at which they eat. The rate and which a baby eats is an important part of developing self-regulation but also will ensure a baby still grows to its genetic potential. If this study or a similar study was to be repeated in future I would advise that the rate at which a baby eats should be an area that needs to be focused on.
There are too many weak areas in this study – before the results can better stand up to scrutiny and peer review, conclusions should not be drawn and promoted.
Amy Sherpa, RN, MHlthSc (Nursing)
The Baby Sleep Practitioners®
Specialised nurses for your baby’s feeding, sleeping and emotional needs
Having a baby can be one of the most wonderful experiences of our lives and often it’s something that many of us have had absolutely no experience in. Not a scrap of it. The learning that takes place is exponential. That, on the back of exhaustion, hormonal changes, financial stress, relationship changes and the feeling like your sanity is balancing on a knife’s edge, puts families in an extremely vulnerable position.
Caring for a baby is one of the most important things many of us will do. I would say it is the most important thing – and yet we get pretty much no up to date education on many of the challenging and vitally important aspects of this.
In the media the bulk of the content is either showing picture perfect families who don’t have a bother on them, or we see trivial, outdated and at times harmful ‘information’ around life with a baby.
They’re having a laugh. That’s what I’m thinking as I read a baby magazine waiting to see the Dr, and I bet my 4-month baby would be too, if only he knew what the ‘experts’ were advising. ‘Don’t rock your baby as you can’t replicate this in their cot…’ I thought to myself, how the heck am I supposed to get my baby to sleep without rocking or feeding him?
Are they trying to make me feel guilty or incompetent because I do this? Does this person know anything about baby sleep biology? Clearly not!
‘Do this’, ‘do that’ and ‘DON’T do this!’ What has parenting information come to? A prescriptive list of Do’s and Don’ts? It’s looks like a list of rules you’d give to your 15-year-old baby sitter.
In NZ mainstream media I think that the most prevalent advice out there falls under the banner ‘parenting for dummies, by dummies’. But here’s the thing – we are not dumb. We want up to date information and intelligent discussion around challenging aspects of parenting. Surprise.
I recently had the TV on in the morning and it caught my attention that they were about to discuss how to travel over the holidays with your kids. OMG. I braced myself and sat down to watch it. Of all the issues they could discuss they chose this. Do they think we are simple? Who does not know to pack food for their children on a long car trip, relax and have regular toilet breaks? Needless to say, I was pretty offended.
Being a parent of a 2 year old and 7 month old and working in the baby sleep industry, I have got my eyes pretty open to what it going on out there - and it’s not pretty. There is SO much guff around that undermines parents confidence in their ability to learn and grow with their baby, and to figure out how they are going to approach things in a way that optimises their babies health and growth, whilst encouraging them to do it in their own unique way.
I always wonder when I see sleep packages for sale with continuous pop up boxes showing you names and locations of parents worldwide that are purchasing this routine at that precise moment. There are just so many, as I start to feel like i’m the only one in the world who is not purchasing this, my baby is going to be I think - are these people even real?
Anyone who knows anything about health education or improving health literacy in an area of health care, knows that it’s key to empower people. We need to feel good about ourselves, our abilities and what we are trying to achieve, as well as understanding the key concepts behind what we are doing. Teach a man to fish! Handing out rules, do’s and don’ts and the like don’t help, in fact they can cause harm – they stop you thinking critically about your own situation, using your own common sense and applying it to your own situation.
With great education and empowerment parents can better understand baby sleeping, feeding and health and can use this information to guide their unique journey with their child.
I am so tired of reading and hearing advice that makes out our babies are born with an innate drive to make our lives difficult, and that we are quite helpless at knowing how to care for them. When you see headlines in popular baby literature like ‘why is getting my baby off to sleep so difficult’ or ‘why am I so hopeless at getting him to sleep’, ‘suddenly it’s not so easy to get baby to sleep’, ‘Your baby should be awake around 45 minutes to an hour’, ‘you need to teach your baby to self-settle’, ‘getting your baby to fall asleep’ and those examples are only from one article - avoid, avoid, AVOID!!
With all this ridiculousness, it’s no wonder we can end up confused, stressed and feeling inadequate. It is these kinds of outcomes that put women at risk of developing postnatal depression and increases the risk of family violence, let alone the poor outcomes for babies themselves due to poor advice. How sad is that?
Broccoli will keep your baby awake
Yoghurt will sabotage your baby's sleep
So many of my clients have been concerned about giving their baby the ‘forbidden foods’ with fear it will disrupt their baby’s sleep. I was equally concerned about this advice so I went and did my research! I have skim read many chapters of baby sleep books (because they were so boring), browsed the internet, revised my physiology of the human body and looked more in depth into the evidence of what hormones control sleep (my brain hurts). Before I launch into my findings, a couple of quotes from the internet just about made me fall off my chair.
‘Yoghurt will sabotage your baby’s sleep’
‘Food pouches are cupboard drugs’
I hope your now understand my drive to get to the bottom of this. The internet can be a dangerous place as your sole source of information on health topics as a vast majority is not scientifically sound and many use pseudoscience to confuse the casual observer.
It seems apparent to me that someone came up with this supposedly scientific reasoning as to why certain foods will sabotage your baby’s sleep and what foods will help your baby sleep. It does not stop here, did you know you also MUST not give your baby red meat or acidic foods before bedtime because it is difficult to digest and might give your baby a tummy ache? Don’t miss the advice around portion size, this MUST only be the size of your baby’s fist otherwise you may be breeding obesity. Rules, rules, and more rules…I am tired of them! Especially because they are a waste of time listening to, let alone investing time in following them.
If it was true that red meat was difficult for babies to digest then giving it at lunchtime instead of dinnertime is not going to help. Foods take 24-48hrs to pass through the human digestive system. If you avoid high fibre foods like broccoli to help baby sleep better, the unintended outcome will be constipation – then your baby really will have trouble sleeping.
Let me answer the question, will introducing solids make your baby sleep through the night? NO. However, if you are following rules like the above then I would probably guess that since starting solids your baby has been waking MORE frequently.
In a nutshell, there is no evidence that the introduction of any sequence of foods is any better than any other. The latest guidelines recommend a variety of foods from 4-6mths. With the only exception being cow’s milk not to be given until after 1 year of age. The risk of botulism from eating honey is pretty much non-existent: Honey imports are very tightly controlled by the Ministry of Primary Industries (MPI) and there have been no notifications of human botulism in New Zealand through the notifiable diseases surveillance system since records began in 1987.
It’s like someone came up with this idea that nobody challenged and so instead everyone copied and pasted it onto their website. Giving parents false hope that giving their baby banana and avocado and avoiding broccoli and yoghurt will solve all their problems.
The truth is that all these foods are very nutritious as are baby food pouches and we should be trusting that our baby will self-regulate their own intake. Yes, babies do eat a lot from an early age even before they are active enough to burn it off but this is developmentally appropriate and once children reach primary school age they begin to change shape, and becoming taller and leaner.
Unfortunately, if your baby is having sleep challenges, then eliminating foods from their diet is not going to be the magic quick fix.
More importantly than all of this is the early learning that occurs from birth until 2 years, and how parental influence can effect food preferences and eating behaviour which will in turn shape growth and development. The rules above can influence dietary patterns for example fussy eaters or grazers and result in a dietary deficiency in micronutrients such as iron (being a very important mineral for growth). Certain foods needs to be offered up to 10 times before some babies will become familiar with it and accept it.
Back to this supposed scientific reasoning - certain foods contain an amino acid called tryptophan that causes sleepiness and foods that contain tyrosine which is an something of a stimulant. Without delving into the more heavy-going side of human metabolic feedback these hormones are involved in the control of the thyroid and the thyroid can control our sleep: it is true. However, this system runs largely independently from our dietary intake and the amount we consume via these foods has no more impact than an alkaline diet can affect our overall body’s pH.
Your baby’s digestive system is immature and still developing but this is the rationale for offering them a wide variety of foods so that they can adapt and learn to tolerate all foods. Often when babies wake in the night we hunt for reasons why that happened and during the introduction of solids looking at the foods, a certain new food can be an easy target. However, this is way more often than not the wrong reason and we confuse correlation with causation. Why are people trying to over-complicate things and looking for complex solutions when the simple solution is steering then right in the face? Everything in moderation.
Firstly, my intention of writing this blog is for mothers that cannot breastfeed or choose not to breastfeed to feel at peace with that option and feel supported to do so. It is NOT my intention to fuel a breastfeeding versus bottle feeding debate – us mums, we are better than that and quite frankly we don’t have the energy for it!
Amy and Elspeth