Trying to wean a baby from nighttime feedings
This phase of parenting was going better than expected. The couple's cute 9-month-old was making fantastic developmental leaps during the day and gradually cutting back on his tiring overnight bottle feedings.
The two parents were having fun with their baby. They were also anxiously awaiting the arrival of the family's beloved nurturing grandmother, who was returning home after an extended visit with relatives overseas.
Grandmother's flight finally landed and she was overjoyed to see her little grandchild, but horrified to learn that his parents were not feeding him each time he uttered a cry overnight. How could these two adults deprive her little one of the important nutrition he needed over those long hungry night hours?
What to do, the parents wondered? I suggested that they really encourage grandma's love of travel. Just kidding. I told the parents that they should stand their ground and continue to wean their child from his overnight feedings.
After all, their child was growing well and getting plenty of good calories from his daytime regimen of three hearty solid meals plus 20 to 24 ounces of formula. Quickly eliminating unnecessary nighttime bottles was the way to go at his age, allowing the entire family — including grandma — full nights of smooth, healthy sleep.
In his Pediatrics in Review article on childhood sleep problems, Dr. Lewis J. Kass notes that many babies sleep through the night by 4 months of age and that by nine months, 70 percent to 80 percent of infants are able to "settle" or sleep all night. The sleep specialist assures parents that overnight feedings are not nutritionally needed after 6 months of age.
Between four and 12 months of life, infants can experience nighttime arousals during their typical 90- to 120-minute sleep cycles. While these sleep interruptions are normal and expected, Kass explains that babies are also blessed with the natural ability to "self-soothe through the arousals and return immediately to sleep."
Dr. Kass urges parents to begin sleep training — "letting the baby cry" — after 6 months of age. The researcher acknowledges that each family situation is unique and that there is no "right or wrong" answer regarding just how long parents need to wait before going in to check on their crying infant.
In a second Pediatrics in Review entry, Johns Hopkins pediatricians Barbara Howard and Joyce Wong write that while most infants sleep through the night by 6 months of age, it's not unusual to see a recurrence of night waking among 8- to 10-month-olds.
This period of night waking is also not hunger-dependent, but rather a developmental phenomenon caused by a combination of age-appropriate stranger anxiety, the ability to recall and to miss people and objects that are now out of sight, and an increased ability to move independently around the crib.
When these older infants wake overnight, Howard and Wong advise allowing them some time to self-console. Parents should avoid soothing the babies with nighttime feedings, which will simply reinforce future wake-feed patterns of behavior known as "learned hunger."
• Dr. Helen Minciotti is a mother of five and a pediatrician with a practice in Schaumburg. She formerly chaired the Department of Pediatrics at Northwest Community Hospital in Arlington Heights.
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