Baby's sleep concerns

When, where and how baby sleeps is a hot topic. Everyone has an opinion as to what is best for mother and baby. It is important to remember when considering these issues that "what is important" is important only as it relates to *you* - in other words, what is important to some, is not important to others, and it's really nobody's business "how" (or where & when) you & baby sleep! "Crying it out" isn't an option for many parents and luckily, it doesn't *have* to be. There are many options to the "cry it out" method which are not as harsh and which provide parents and babies with loving, gentler solutions to getting more sleep.

Most breastfeeding experts encourage mother to co-sleep with her infant. Some frown on co-sleeping, but experts like Dr. Williams Sears, father of 8 breastfed children, put it simply, indicating that "the best investment new parents can make, is a bigger bed", and supports co-sleeping. He offers wonderful information on sleep concerns, that can really help a parent understand "how" a baby sleeps as well as ideas to help reduce or eliminate sleep "problems".

Dr. Jay Gordon, pediatrician says "...Don't let anyone convince you that this is a harmful choice or that there will be "no way" to get him out of your bed if you don't do it now. Don't believe anyone who says that babies who cuddle and nurse all night long "never" learn to self soothe or become independent. This is simply not true but it sells books and the myths stay in our culture." and Dr. James McKenna, PhD, says " By sleeping next to it's mother, the infant receives protection, warmth, emotional reassurance, and breastmilk - in just the forms and quantities that nature intended."

Nursing to sleep and sleeping all night are also hot topics. There are many out there that would have a mother believe she is creating problems for herself and her baby by doing what comes naturally - hopefully the information here and the links to additional info, will assure the mother that her choice to co-sleep, to nurse baby to sleep, and/or to comfort nurse baby are all choices that are supported and encouraged by experts and many, many parents.

FUSSINESS

Young babies, both breast and formula fed, are often fussy. It is not unusual for this to happen during the late afternoon and evenings, and is usually NOT due to hunger, wet/dirty diaper, or anything that mom or dad can fix. It is usually NOT related to milk supply, although some mothers may worry about this.

One of the best explanations of normal infant fussiness is shared here with permission from Kathy S. Kuhn RN BSN IBCLC and lactation consultant for Parentsplace.com:

Normal infant fussiness starts at about 1-3 weeks, peaks at about 6-8 weeks and is gone by about 3-4 months. Most babies will "fuss" about 2-4 hours per day, no matter what you do. They want to be "in arms" or at the breast very frequently and fuss even though you attempt to calm them. They often seem "unsatisfied" with their feedings and even seem to reject or cry at the breast.

It most commonly happens in the evening hours, and usually the baby will take their longest stretch of sleep after this fussy time. The best thing to do is offer the breast as much as the baby wants it. If she fusses at the breast try to calm her in other ways such as "dancing" with her, gentle bouncing and rocking, and just giving big doses of TLC. You can tell it is normal fussiness if it occurs about the same time each day, if your baby has other times of the day when feedings are calm and she seems happy, and if she is growing and gaining well per her pediatrician and having plenty of wet and soiled diapers.

Many times during a baby's fussy time they will refuse the breast. After several frustrating attempts at nursing, the parents may "break down" and offer a bottle of expressed breastmilk or formula thinking that the fussiness is related to low supply or something wrong with mom's milk. Kathy gives a better understanding of this particular concern here, as well as explaining what happens when baby is offered a bottle and "guzzles" it down:

Parents who don't know this is "normal" frequently respond as you did by giving a bottle because they think the baby isn't "happy or satisfied" with the breast. When the bottle goes in the baby's mouth the mouth fills with milk, the baby is obligated to swallow and the action of swallowing initiates another suck. The suck again fills the mouth and the cycle repeats, giving an appearance of the baby "gulping the bottle down hungrily".

This of course only contributes to mom and dad's fear that the baby wasn't getting enough at the breast and they keep offering more and more bottles (understandably). Which then causes a true low milk supply. Often the baby falls asleep peacefully after this episode which also reinforces to the parents that the bottle was just what the baby needed. What has really happened is the baby has by coincidence come to the natural conclusion of the fussy spell (most parents give the bottle as a last resort which means the fussiness has been going on for awhile) and/or the baby has withdrawn because "gulping" down the bottle was actually stressful and NOT what the baby wanted but she could not stop the flow, so exhausted, she falls asleep. So don't offer bottles during any fussy time.

COLIC AND THE BREASTFED BABY

Colic is usually defined as sudden and unexplained outbursts of inconsolable crying. According to Dr William Sears, in The Baby Book, "if you wonder whether or not you have a colicky baby - you don't!"

Colic results in at least three hours a day, three days per week, for at least three weeks of inconsolable crying. It usually begins in the first three weeks of life and seldom lasts longer than 3 months. The baby is often healthy and thriving.

You may hear any or all of the following:

"It must be your milk, its....":

1. too weak
2. something you are eating
3. too strong

           or.....

1. you feed him too much
2. you're not feeding him enough
3. you hold him too much
4. you don't hold him enough

... it can be frustrating for mom and dad to try to figure out what is going on.

There are many myths as to what may cause colic, which science has (thankfully) offered some info to either support or dispel, and many folk remedies to treat it (be careful with these!). Too often ALL segments of crying are labeled as colic, and it may take some good detective work to determine if it is "true colic" or a result of something else. Dr Jack Newman's page on colic is an excellent starting place. Additional information can be found at Dr. Sears website and Dr. Jay Gordon's website.

BREASTFEEDING AND REFLUX

Many parents have never heard of reflux. Reflux, or GER (Gastroesophageal reflux) is a condition where irritating stomach acides are regurgitated into the esophagus, causing pain similar to adult heartburn. It usually occurs more when the baby is lying flat, and is often marked by frequent and/or excessive spitting up. It can be a hidden cause of colicky and night waking babies.

Babies that experience frequent (and often forceful) spitting up, obvious tummy pain day & night, marked fussiness after nursing (drawing up legs, knees to chest), arching or writhing as if in pain, extreme fussiness and crying may be experiencing reflux. A baby may experience all, or only some of the above symptoms. It is important to talk to your health care provider if you suspect your baby may have reflux, and to eliminate other issues which may "mock" the symptoms of reflux, like oversupply and food sensitivity (dairy). Also remember that breastfeeding a baby with reflux is one of the best things you can do to help!