Common Questions for Pediatricians
By Lisa Thornton, MD
New research from a nationwide survey of pediatricians ranks infant feeding, pooping, and sleeping among the most common questions for pediatricians in the United States. Listed below are some specific questions I a typically asked when I see moms in my practice.
How can I give my baby the best start?
The best thing you can do to give your baby a great start is to provide a loving, nurturing, safe environment where your baby's needs are consistently met. This seems so simple because for parents this comes as a natural part of loving their newborn, but it serves an important purpose.
In the first few months of life, your baby is developing a sense of what the world is like. Is it warm and loving, or cold and dangerous? Will people take care of me and keep me safe, or will they abandon me? Will I be fed when I'm hungry or not? Will people respond consistently to my needs or will they ignore me?
For a baby, stress is created when his or her basic needs for love, food, protection, and rest aren't met. Babies who experience stress on an ongoing basis without the buffer of a loving parent often have difficulty with learning, focus, relationships, and health later on in life. Learning to deal with stress is an important part of development, but it's critical that loving adults guide a child through the process, which begins in infancy.
What's the best way to help my child learn?
You don't need fancy, expensive toys with lots of bells and whistles. The secret sauce that will boost intellect is language, which is critical to cognitive development.
Infants who live in homes where people talk a lot develop earlier language skills than those who live in homes where silence is the norm. Parents should use every opportunity to talk to their baby. There should be constant narration from parent to child. Soon, the baby will begin to coo back often mirroring the parent's tone of voice. Even at birth, babies love to hear the sound of their parent's voices they have been listening to in the womb since conception. Talking to your baby is the best way to help him or her develop cognitive skills for a lifetime.
How many diapers should my baby soil in a day?
Babies should wet between six and eight diapers per day and have three to four of pasty bowel movements.
Is it okay to allow my baby to suck his thumb or a pacifier?
The sucking instinct is so natural for babies that prenatal ultrasounds often catch the baby sucking his or her thumb inside mom's uterus. Not only does sucking provide nourishment, it also helps babies calm down. Babies who suck their thumbs can comfort themselves when upset. Infants who are able to self-sooth have tendencies to cry less than those who never learn this skill.
Some parents prefer to use a pacifier instead of a thumb. There are drawbacks and benefits to both options. The thumb is always there when the baby wants it, which is a benefit in the early months, but it may make it tough to break the habit later on. A pacifier can be removed when it's time to wean, but during infancy parents must have a large collection to make sure one is quickly available when needed. Whichever options you choose, sucking can help your infant feel safe and happy even when you aren't around.
Is it okay to pick my baby up every time she cries?
Yes, in fact, it's important that you consistently respond to your infant's cries in the first few months of life to help her develop a sense of safety and trust. Infants have very few ways to communicate; crying is the most effective way to let parents know the baby needs something. Some parents worry that they will spoil their baby, but that's not possible. Infants do not use crying to manipulate parents. As your baby learns that you will respond to her needs, she will cry less frequently. By approximately six months of age, she will begin to understand that her needs will be met. At that time you can begin to set some limits.
How much sleep does my baby need?
A typical newborn will sleep 16 to 18 hours a day. It may not feel that way to new parents who are sleep deprived because the baby breaks those hours into short segments by taking three to five naps during the day. This sleep patter is in addition to waking one to two times during the night.
Between two and four months, babies sleep 14-16 hours per day and begin to lengthen their nighttime sleep and take fewer daytime naps. By four to six months, most babies will sleep 10 hours at night and may awaken once for feeding with two to three naps during the day for a total of roughly 14 hours a day. A typical six-month-old baby will sleep through the night without waking for a feeding and will take two to three naps during the day.
When will she finally sleep through the night?
About 6 out of 10 babies sleep through the night by 6 months, and 8 out of 10 will do so by 9 months. Remember, all babies wake up during the night, but those who "sleep through" have learned how to nod off on their own (see the above paragraph on pacifiers and thumb sucking)
How do I know if my baby is getting enough to eat?
Newborn babies naturally lose about 5 to 10 percent of their birth weight during the first 3 days of life and then gain it back within one to two weeks. It's important to feed your baby every three to four hours while he or she is gaining back those early losses, so wake baby for feeding if necessary. After your baby has returned to his or her birth weight, it's okay to feed upon awakening.
Most newborns eat 8 to 12 small meals per day and nap in between feedings. Babies are hardwired to know how much they need, so they will eat that amount and stop by turning away from the nipple or closing their mouths. Your baby may just be taking a break, but if you offer more and he or she refuses, consider the feeding done. If your baby has eaten enough he or she will be satisfied for at least two hours.
By the end of the first month, your baby will typically consume 4 ounces per feeding and will eat every three hours. By six months, he or she will take about 6 to 8 ounces per feeding every four hours.
Ultimately, growth is the best indicator of whether your baby is getting enough nourishment. Characteristically, babies will triple their birth weight in the first year. Your pediatrician will weigh your baby at every visit and will plot the weight on a graph. Your child should show steady weight gain along a smooth curve on the graph. If you're curious, you can ask your pediatrician to share the growth chart with you.
I know breast is best, but I've decided to use infant formula. Which type and brand of baby formula should I use?
When it comes to choosing baby formula, the first question to consider is whether to use a cow's milk-based formula, a soy formula, or a lactose-free formula. Most pediatricians recommend starting with a cow's milk formula and most babies tolerate it well. No baby formula brand is superior to another and parents can switch formula brands without causing harm to their baby. If your baby has trouble digesting cow's milk, your doctor may recommend switching to a lactose-free or soy-based formula.
About the Author
Pediatrician Dr. Lisa Thornton is an assistant professor in the departments of Pediatrics and Surgery at the University of Chicago's Pritzker School of Medicine. She is a guest host on the ABC News Now web cast “Healthy Life” on ABCNews.com and the former host and medical consultant for the weekly health magazine show, “Health Corner,” which aired on Lifetime TV for 5 seasons.