You Can Get Baby on a Schedule

They're born unaware of day and night, clueless about clocks and sporting appetites that can seem near-constant. So can parents really get babies onto a daily schedule?

No baby is ever completely predictable, pediatricians say, and some fall into patterns more easily than others. But parents can do a lot to develop routines that make everyone's life easier, said Dr. Deena Obrokta of Liberty Pediatrics, a Newport News-based affiliate of Children's Hospital of The King's Daughters.

"It definitely is possible," Obrokta said. "Babies only know what Mom or Dad teaches them, so what they learn about sleeping and eating is what their parents show them. And all kids, no matter how young, like to know that their parents are in control."

As any new or expectant parent knows, the supply of advice on getting babies to sleep and eat well is huge - and maddeningly varied. But there are some basics that every parent can follow, beginning with modeling the difference between daytime and nighttime.

When the sun is out, parents can stimulate babies moving them around, talking and singing to them and holding up brightly-colored toys. At night, they should do much less: keep the lights low, the house quieter and feedings as short and efficient as possible. As Obrokta puts it, "Keep it boring."

Parents also should realize that individual babies have built-in patterns of sleep and wakefulness, said Dr. Phillip Snider, a family practice physician with Bon Secours Medical Associates at Virginia Beach. "Some parents get lucky and have a baby that sleeps several hours at a time almost right away," Snider said. "Others don't. Their bodies pretty much regulate themselves, but you can make adjustments."

If babies don't fall asleep at regular intervals, parents can try putting them down after a few hours of activity - ideally, mid-morning and early- to mid-afternoon - to see if they'll nap, especially if there are signs of fatigue such as eye-rubbing, yawning and irritability.

Putting babies down when they're still awake also helps them learn how to fall asleep on their own, Snider said. Infants who are constantly rocked or nursed to sleep are more likely to feel uncomfortable if they wake up without a parent around - and often less likely to fall into a good sleeping pattern.

(If babies do fall asleep first, though, don't be crazy enough to wake them. Instead follow this tip from Obrokta: instead of lowering them into a crib flat on their backs, which triggers a startle reflex that can disrupt sleep, put them shoulder down on one side and gently roll them onto their backs).

Establishing a routine before naps and bedtimes also makes a difference, pediatricians and parents say. Danielle Hooks, a mother of four from Newport News, doesn't recall her children - older kids Phillip, 15, and Jeremy, 14, and younger siblings Jenna, 4, and Peter, 2 - having a reliable "bedtime" until they were toddlers, but she had a set pattern of bath, story, song and bed well before then.

"It got them to wind down even when they were very little," Hooks said. "Kids don't always want to go to sleep, but I think they like knowing what to expect and what they're supposed to do."

As for eating, doctors recommend feeding on demand during a baby's first two or three weeks at home, especially if the mother is breastfeeding and trying to establish a good milk supply. Young babies need to eat every two or three hours because they can only process a small amount of food at a time.

Past the one-month mark, beginning to delay feedings even for a short time may be smart. "You want to get a baby out of that instant gratification mode," Obrokta said. "If they've eaten recently and want to eat again, try to wait at least 15 minutes. Or if that's hard, you can start at five minutes and build up to 10 and 15 minutes, and so on."

Many parents make the mistake of overfeeding babies, she added, which can cause pain, belly swelling and reflux. "It's difficult because we're programmed to feed and nurture," she said. "But if the minute babies cry you always think, 'Oh, I have to feed them,' you can be doing them a disservice - in addition to making your life more hectic and difficult."

By about 6 months of age, babies may be able to sleep for nine or more hours at night without eating. Should they wake, especially more than once a night, many doctors advise against picking them up right away (even though the crying can be rough to hear). They may settle back down on their own or simply need a little soothing talk or a backrub from a parent.

Six months also is the point where a shift can come with daytime feedings, Snider said. "You're still going to need to feed them more often than you do a toddler, but you can start pulling back and getting them on more of a schedule," he said.

Have babies sit with the family at meals, he said, where they can practice with spill-proof cups and, by 8 to 12 months, eat finger and finely-cut foods (with some exceptions for safety reasons). He recommends weaning babies off bottles after their first birthdays.

Finally, parents should be aware that babies can fall off a schedule at any time, especially after a major change such as a vacation or first visit to day care but sometimes for no apparent reason. "You just adjust and try your best," said Hooks, the Newport News mom of four, "because things are never going to be totally smooth."

Source: Tidewater Parent Magazine