Sleeping & Eating Disorders in Infants

Video Transcript

"Hi, I'm Dr. David Hill and today we're going to be talking about sleeping and eating disorders in infants. Infancy, the time from birth to twelve months of age, is a time of tremendous change. There's an enormous difference between what a newborn does in terms of eating and sleeping and what a child who's about twelve months old is going to do in terms of eating and sleeping. So, in order to figure out if something is going wrong, you have to know how things are supposed to be going right. Let's talk sleep. A newborn is going to have no idea of what night and day are about. This is the first time this child has even seen any sort of light and the structures of the brain that help us regulate our body rhythms in response to light are still learning what to do. So most parents of newborn, especially in the first two to four weeks of life, come in and say, "My child has days and nights all mixed up. They're eating and way go all night long and they sleep all day long." That's normal. Over the first couple of months of life however, the brain is going to get used to light and dark cues. You can speed this along a little bit by making sure the child's environment is as dark as possible at night and then there's plenty of light in the environment during the daytime. By about two to three months of age, your infant is going to start sleeping significantly more at night than during the daytime; although, patients still probably going to need to feed every couple of hours or every four hours; it will be slowing down at night with time. Now by four months of age, we expect an infant to be able to sleep probably six or eight hours in a row; sometimes all night long because the stomach is bigger; the child doesn't have to get up and feed all the time. So if your baby is still feeding every couple of hours, at four or five or six months of age, it's time to think about changing the feeding schedule or time to think about moving to some more calorically dense foods to help the child regulate sleeping habits. Now a child who is over six months of age really should be sleeping through the night and some things that interfere with that are cause sleeping with the parents for example. However, a baby learns to sleep is how that baby is going to keep wanting to sleep. So if the baby is always been in bed with you and you try and move him or her into the crib; you're in for a fight. He or she is not going to want to sleep in that crib for awhile and you're going to have to let your infant learn a new way to sleep. Likewise, feeding in the middle of the night really ought to be gone by six to nine months of age. If your baby is use to nursing or having a bottle every time he or she wakes up a little bit, he or she is not going to have an easy time going back to sleep. You're going to have to give that child a chance to learn to sleep with some other way without feeding especially as your infant's teeth start to emerge; this is going to become a greater and create a problem because sugar which is in both breast milk and formula then stays on the teeth all night long really increases the baby's risk for cavities. So helping with sleeping and eating during infancy is going to evolve gradually; is going to involve gradually stepping up the amount of time that your baby sleeps at night and letting your baby learn to sleep without food and without lying in bed with you. Eating disorders in infancy are even perhaps little harder to diagnose; but it helps to know what ought to be happening. An infant's diet is going to be solely compose by daily breast milk and in some cases, formula up to at least four months of age. Sometime between four and six months of age, your infant is going to want to start experimenting with solids. It could be some cereals that are fortified with iron; some pasty meats; some fruits and vegetables; ideally you'd introduce one new during every two or three days. You'd use single ingredient foods rather than multi-ingredient foods to begin with; so you know if your child's having a reaction to a food. A baby who is not taking any solids by six months of age probably you need to be thinking about, "Could there be something wrong with swallowing?" Might the baby have bad reflux? Was the baby premature or developed mentally delayed and can't figure out yet how to take solids? Likewise, you want to start introducing new foods on a regular basis. Babies may not accept new foods the first time they see them. They may take them multiple, ten, fifteen tries to accept the new food. But keep bringing that food back and eventually the baby will usually learn to accept something novel. Remember, the baby's trusting you to introduce everything into his or her world. If you do think the baby is spitting up too much; seems to have issues with textures or simply won't eat at all; you definitely want to have your baby examined by a physician. There can be anatomical problems with the esophagus that make it difficult for babies to eat solid foods. There can be problems with the palette; there can be problems with coordination and most commonly, there can simply be gastroesophageal reflux which is among the easiest of these things to treat. So remember, take your baby's age into account when assessing how well he or she is eating or sleeping and be sure and work closely with your baby's doctor to address any concerns you might have. Talking about eating and sleeping disorders in infants, I'm Dr. David Hill."