Babies, The Care and Handling of

The Care and Handling of Babies

WebMD Live Events Transcript

Feeding time, bath time, and play time; what's colic all about? What equipment do you need? You have lots of questions, and parenting expert Ann Douglas had lots of answers, when she visited WebMD Live on June 15, 2004.

The opinions expressed herein are the guests' alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

MEMBER QUESTION:
My 10-day-old baby feeds for one hour and then sleeps for two to three hours. When should I wake her for feedings and when should I let her wake naturally on her own?

DOUGLAS:
If your baby is at a healthy weight and your doctor doesn't have any concerns about your baby's overall health you can probably not worry about waking your baby up for feedings. Your baby is already feeding at three-hour intervals, and that's a pretty normal schedule for a healthy newborn.

If you stick with a demand feeding schedule your baby will naturally start feeding more often if she needs to increase your milk supply, because she's hungrier all of a sudden. That's the beauty of demand feeding, after all; it's totally based on supply and demand and takes a lot of worry out of feeding a baby. So this is one thing you can scratch off your worry list. Good luck.

MEMBER QUESTION:
My baby is 9 weeks old. About a week ago, he was sleeping from 7p.m.-8 p.m. until 6 a.m. with only one nursing in the middle of the night. We thought he would be sleeping through the night any day now. But, instead, now, he is waking up crying several times a night and only nursing for five to eight minutes before falling fast asleep. Why is this happening and how do break him of this new habit?

DOUGLAS:
It sounds to me like your baby may be going through a bit of a growth spurt. Sometimes babies who have been sleeping through the night or almost sleeping through the night fairly reliably will start nursing much more frequently in an effort to boost mum's milk supply. This tends to happen every couple of weeks and it's very normal. It's also a temporary phenomenon, and this more frequent nursing schedule should settle down after a week or two when your milk supply has increased enough to meet your baby's needs.

In the meantime try to get a little extra rest if you can during the afternoon or early evening so you have the extra sleep you need to cope with the added nighttime parenting demands.

What you also want to bear in mind is it's important to help your baby distinguish between night and day in the interest of promoting healthy sleep patterns over the long term. If you get in the habit of keeping your interactions with your baby to a minimum in the middle of the night, simply feeding your baby, changing him as necessary, and putting him back to bed without a lot of conversation and playtime, you will find he will quickly learn the difference between nighttime, when nobody spends a lot of time playing together, and daytime, when everyone is very social in your family.

Hope this helps to reassure you.

MEMBER QUESTION:
I have a 3-month-old baby who sleeps about 13 hours a night (7 p.m.-8 a.m.), with one feeding in the middle around 3:30 a.m. Should I try to move the 3 a.m. feeding up to 11p.m. and wake her up for a feeding before we go to sleep? Or should we not mess around with our good fortune, and just let her be? Can I expect that feeding to disappear at some point on its own? In other words, at what age do babies sleep through the night?

DOUGLAS:
Personally I would opt for plan B -- not messing with a good thing. The fact you're able to get basically 13 hours of sleep each night with one nighttime feeding will make you the envy of the majority of parents on your block. I would simply wait until your baby, who is still quite young, by the way, to give up that one nighttime feeding on her own.

It's quite unusual for a very young baby to consistently sleep through the night, although one of my four children did so from three weeks of age. It is more common for babies to start sleeping through the night at around 6 or 7 months of age; however, I would add that one of my other children was still waking in the night at a little over 2 years of age. So there's really no such thing as a "typical" age at which children reliably sleep through the night. It varies a great deal from child to child.

"There's really no such thing as a "typical" age at which children reliably sleep through the night. It varies a great deal from child to child."


MEMBER QUESTION:
Where do you fall on the "let 'em scream" vs. "always pick them up" continuum, when it comes to sleep training?

DOUGLAS:
I tend to be very responsive to the needs of young babies. I'll give you an example from my own recent adult life, which is the closest example that I can give to another adult to try to draw a parallel that will make sense to us at this stage of our lives: Last year my mother died, and I found there were a number of nights when I was unable to sleep and feeling lonely, sad, and extremely restless and upset. If I had turned to my husband, woken him up and had him to say to me in a harsh voice, 'It's in middle of the night, go to sleep, I don't want to see you until the morning,' or something equally unsympathetic he would have found most of his things on the front lawn in the morning. I needed someone who understood when I was sad in the middle of the night I needed comfort and reassurance.

I believe our babies deserve the same kind of responsiveness from us in the middle of the night, so that when they cry they have a genuine need. It's our job as parents to try to figure out what it is that they need and to help to meet that need. That said, I do believe there are times when babies are simply overtired and that the best favor we can do is to try to help our babies get the sleep they so desperately crave. So if you have met all your babies other needs and you suspect your baby simply needs to cry five87yg minutes to settle into a deeper sleep I don't think that is being harsh or unkind.

I think this is one of the most difficult parts of parenting a newborn, and it's one of those issues we have to sort out for ourselves by letting our own parenting radar guide us. One thing I would stress: You should never buy into any sort of formula that goes against your parenting instincts. If you decide to try a sleep training program that has you, your baby, and partner in tears, chances are it's not working for your family and you may want to modify the program or abandon it.

Most families find babies do learn to sleep through the night with a little gentle coaxing from their parent. What we don't want is for this to become a major battleground. Life's too short for that.


MEMBER QUESTION:
My 6-month-old insists on sleeping on his tummy. I can put him down on his back and he will roll himself onto his stomach. Any barriers, such as a rolled up blanket, no longer work because he is so active in his sleep. Should I be concerned about SIDS?

DOUGLAS:
According to the American Academy of Pediatrics, once babies can safely roll themselves from their back to stomach you no longer have to worry about putting them on their back as a sleeping position. Of course you're still going to start your baby out on his or her back when you lay your baby down at bedtime. If your baby rolls over in the middle of the night you don't have to panic, because your baby is fully capable of rolling back over onto his or her back once again.

The concern with younger babies is they aren't necessarily capable of rolling in both directions. They can get stranded on their stomach, which can lead to pooling of stale air around the nose and mouth area, something that has been possibly linked to an increased SIDS risk. Therefore, you would want to do what you have been doing up until now -- namely, putting your baby to bed on his back.

For more information on this very important issue you will want to read the SIDS guidelines on the American Academy of Pediatricians web site: www.aap.org.

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"If you end up with a colicky baby, you, as generations of parents before you, will find the patience and creative resources necessary to weather this particular challenge."

MEMBER QUESTION:
You have a wide variety of kids, age wise. What's your opinion on babies' personalities, as far as gauging their future demeanor? Are fussy, grumpy babies primed to be surly kids and teens? Are quiet, clingy babies introverted later in life? Do happy, burbling smilers become gregarious easygoing people? Just curious.

DOUGLAS:
First of all, I will have to ask WebMD to forever bury this link so my kids will never find it!

This is a totally unscientific answer, but I can tell you our one child who was a colicky baby went on to become a very persistent toddler, a somewhat difficult preschooler, and is now a challenging teenager. So I think this child has carried a bit of that "colicky" temperament with him through life. My other kids, who have been a bit more happy-go-lucky, have also retained a great deal of that inborn personality, in my opinion.

I also believe, however, that we parents have an opportunity to bring out the best or worst in our kids. I'm sure that when we were nervous first-time parents we probably drove our firstborn child around the bend with unnecessary trips to the doctor to check out every possible ailment.

I think over time I have relaxed considerably as a parent and I have certainly learned how to deal with my children's various temperaments. My wacky sense of humor has become one of my most valuable parenting assets, even though my children consider it to be an instrument of torture.

MEMBER QUESTION:
My husband and I will be moving cross country shortly after the baby is born. When can babies fly? What precautions need to be taken?

DOUGLAS:
You can fly with a baby right from day one. Some airlines will want you to fly with an infant seat, so be sure to check with the airlines about regulations regarding the use of infant car seats on airline flights. Even if the airline doesn't insist upon this, you may want to purchase a separate seat for your baby so you can have use of an infant seat for your baby during the flight. This is important, both for safety reasons and because it can give your arms a much needed break during the flight. You know how heavy a baby can be. Imagine holding on to your baby on a five-hour flight, plus the waiting time in the airport and so on.

When you are flying with a baby you will also want to bear these other tips in mind:

  • See if you can reserve a seat at the front of the economy area of the airplane, because there is a bank of seats where there is a lot of extra foot room. This will give you some added space to move around or to stow a diaper bag after takeoff.
  • If the flight is relatively smooth, you may be able to get up and walk around a little bit with your baby during the flight.
  • During takeoff and landing, you may find that breastfeeding your baby or offering your baby a bottle helps to deal with the pressure change problems that will otherwise cause your baby discomfort in the ears.
  • If you're wondering how you're going to get your baby and luggage through the airport, plan to take your stroller with you. You can stow your stroller with the flight attendant at the very last second as you board the plane. Naturally, you'll want to check with the individual airline regarding carry-on baggage limits in case your baby's stroller counts towards your number of pieces of carryon baggage.
  • You may want to plan your flight to coincide with your baby's sleepiest times of day, assuming your baby has some sort of predictable pattern at this point.
  • If your baby cries during the flight don't be freaked out; other parents with children have been in your shoes in the past and no one has the right to judge. Enjoy the flight.

MODERATOR:
What are the essential pieces of equipment you really need for your new baby? And what is being sold out there that you say we really don't need/want?

DOUGLAS:
It is so important to learn to distinguish between the necessities and frills before you step foot in a baby store; otherwise I can practically guarantee you will spend 10 times as much on your new baby. Let's run through a list of the bare basics, bearing in mind even some of these items may be given to you by friends and family members before your baby even arrives:

  • An infant car seat. Even if you yourself don't drive, chances are you will need an infant car seat to get around town. Whether you take taxis, rely on car rides from friends and relatives, or just have occasion when you may be taking your baby on an airplane or other mode of transportation, such as a bus, this is definitely one of the most essential items you will need to purchase.
  • A baby carrier. Either a front style or a baby sling works, depending on your preference. What I suggest you do in this case is visit friends who have babies and ask if you can try on various types, perhaps actually holding their baby in the carrier, or if they aren't willing to share their baby, a stuffed animal instead, just to get a sense of how the carrier or baby sling works and how complicated it is to get the baby in and out.

    You'll also want to consider how easy it would be to clean this particular product. Obviously you want an item that is totally machine washable and can be reassembled quickly and easily without having to spend hours pouring over the manual trying to figure out which snap goes where.

    When your baby gets a little older, you may want to pick up a backpack style carrier, but these are for much older babies and toddlers, not newborns. So don't worry about picking up one of these quite yet.
  • A stroller or carriage. You'll want to pick one up right away. While umbrella strollers are your cheapest option, they don't provide babies with a lot of support, so they're best used as a supplementary stroller that you keep in the trunk of the car for times when you need a stroller on the run. More traditional foldup strollers are what most people tend to buy (other than people who purchase jogging strollers because they know they will be jogging or running on a regular basis with their baby).

    While the foldup style strollers are a lot heavier and can take a little bit of fiddling to unfold and fold, they tend to be sturdier and provide better back support to babies. Many can also be used in a flat position, which allows them to serve as carriages for very young babies.

    Again, you'll want to look at how easily they can be cleaned, and when you're purchasing a stroller you'll also want to consider how easily you can buy replacement parts such as wheels. A stroller can be an expensive piece of equipment, so you may want to pick up a wheel or two for when baby No. 2 comes along.
  • A safe place for baby to sleep. Last week we talked about the pros and cons of co-sleeping, so I won't repeat that here, but if you are going to have a bassinet or crib you need to make sure the bassinet or crib conforms to current product safety standards. The best way to do that is to visit the consumer product safety commission web site at www.cpsc.gov. You can find out what the current government standards are for cribs and make sure any cribs you are considering meet the safety standards.

    You will also want to read up on safe sleep standards regarding bed linens in a baby's bed. Again I want to refer you to the American Academy of Pediatrics web site, www.aap.org.
  • A plastic bathtub. You can bathe your baby in the kitchen sink or big tub, but it's a lot easier to have a plastic bath or tub.
  • A high chair. You won't need it right away but you will want one before baby's first birthday.
  • A baby gate. Depending on the layout of your house you may need more than one, so start checking out the safety products aisle at your local baby store to see what kind of baby gates best suit your home environment.

The next two items are not necessities but qualify as nice to have:

  • A baby swing. Not every baby will even want to go in a baby swing, but if they like it they can give your arms a break if your baby likes to be rocked over and over again.
  • A playpen. Unlike in generations past when playpens were used to keep babies from touching the rest of the world, playpens today are often used to keep babies safe if mum has to go out of the room for a minute or if you're visiting someone and you simply can't adequately babyproof a particular room. Some of them are designed to double as changing tables or portable beds, so they can be very useful to have on hand. You need to check however, to ensure that the playpen in question will be SIDS friendly.

You're going to probably end up with a long list of baby clothes, diapering supplies, blankets, and health care items, such as thermometers and various diapering lotions. There is an extensive list of these items in both The Mother of All Baby Books and the brand-new Mother of All Pregnancy Organizers , so I won't go into an exhaustive list here, but again, use your common sense and don't over buy. Remember, everyone in your life is going to drop by with a baby present for the new arrival so you don't want to have too much ahead of time.

On the other hand you don't want to come home from the hospital or have the midwife leave to only have one baby outfit on hand. It's a matter of balance, I suppose!

MODERATOR:
In some states you must have a car seat to take your baby home from the hospital. I recall having a nurse come to the car, inspect the car seat, and make sure it was installed properly before I could take my newborn home.

DOUGLAS:
That's an excellent point and another excellent reason to make your car seat your first purchase.


MEMBER QUESTION:
What is colic? How can I tell if it is colic or something else? Can colic be prevented? How is it treated? I think this is the thing I am most worried about.

DOUGLAS:
I'm going to start by giving out the official definition of colic so we're talking about the same thing. It refers to sustained periods of crying that lasts for at least three hours a day and occur at least three times a week. We're talking about one very unhappy baby here!

There are also some other characteristics about colicky babies:

  • They tend to experience very abrupt shifts from calmness to frantic screaming.
  • They have trouble sleeping.
  • They are more likely to have problems with constipation than other babies.
  • They're often described as being uncuddly and they can be extremely difficult to soothe.

About 15% to 20% of babies can be described as colicky and certain babies are more likely to be colicky as others, namely babies whose mothers had a prolonged labor, had an epidural, and/or required a forceps delivery, or babies whose mothers smoke. Colic is most likely to occur at some point between the second to sixth weeks of life and tends to taper off dramatically by the second month of life. So it doesn't last very long, but while it is happening it can make the baby's and parents' lives miserable.

Just in case you do end up with a colicky baby, let me suggest a few techniques for soothing a colicky baby:

  • Try to recreate the uterine environment as much as possible. It sounds strange, but babies respond well to subdued lighting, white noise such as dishwasher sounds, and being wrapped tightly in a blanket or otherwise bundled up. Of course, some colicky babies hate being swaddled, so you'll have to experiment with this particular technique.
  • Babies also tend to be soothed by motion, so walking, taking a stroller ride, or taking a drive around the block are all tried-and-true methods for soothing a baby.
  • Skin-to-skin contact works well, so take off your shirt and lay your baby across your chest or lie your baby down on a towel and give your baby a full body massage.
  • Some parents find that taking a warm bath with their baby helps to soothe them and their baby, and anything that can help to soothe the frazzled nerves of parents and babies is something you want to consider doing during this challenging time.

I hope these tips help with your colicky baby, but try not to worry about this possibility. If you end up with a colicky baby, you, as generations of parents before you, will find the patience and creative resources necessary to weather this particular challenge.

"What you want to give your baby is a toy that can be played with in infinite number of ways, and can therefore stimulate your child's creativity and imagination in all kinds of wonderful directions."

MEMBER QUESTION:
What are some toys, either bought or homemade, that you think are great for interacting with a baby?

DOUGLAS:
I'm just going to name a few of my perennial favorites for playing with babies:

What could be more basic than blocks , or more fun? Obviously they are better for older babies, but they are versatile when they start to enjoy dump and fill play. You put all the blocks in a container and they dump them out all over the floor.

I also used to enjoy playing with those stackable plastic donut rings that Fisher-Price probably still makes and probably will still be making when I'm a grandma, because young babies can chew on them, older babies can stack them, and toddlers use them as plastic food.

Other toys my kids enjoyed during the baby stage include shape sorters , all kinds of water toys , and of course, anything from my pots and pans and plastic container cupboards. Funny how anything belonging to mum is 100 times more interesting than a toy!

One thing we don't want to do is buy into the trap of thinking babies need electronic gizmos. The problem is they can only be played with in a particular way. What you want to give your baby is a toy that can be played with in infinite number of ways, and can therefore stimulate your child's creativity and imagination in all kinds of wonderful directions. I guess I'll get off my soapbox, because it's almost time to wrap up, but I'll leave you with that thought.

MODERATOR:
Ann, do you have any final words for us?

DOUGLAS:
I just want to stress that sometimes we worry so much about our ability to cope with parenting challenges, like the colic that our baby may have or a particular sleep challenge. I just want to remind everyone that we are so creative and so capable and we really do know our own kids best.

So trust yourself and realize you have what it takes to figure out the solutions to whatever challenge you are currently dealing with or whatever challenge is waiting for you around the bend. Have a fabulous week!

MODERATOR:
Thanks to Ann Douglas for sharing her expertise and experience with us. For more information, please read her book, The Mother of All Baby Books , for tips on all aspects of parenting during the first year.



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Reviewed on 12/28/2004 7:01:45 PM

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