10 Common Baby Questions Answered

First of all, let’s acknowledge something important: you’re probably doing okay. And you are not alone in feeling the pressure on new parents to get a baby sleeping through the night as early as possible. The upshot: that’s very unlikely to happen before 4 to 6 months. It takes months for babies to learn night is night and day is day, and that we sleep at night.

There are two things parents can do to help that process along:

• First, develop a routine and schedule that gets them used to falling asleep at the desired times. Having dinner, taking a bath, reading a story, singing a lullaby, getting pajamas on — every family has a different routine, but going through those motions at consistent times will help a baby learn when to expect to sleep.
• Second, help your child learn to fall back to sleep on their own if they wake up during the night.

When breastfeeding is part of the routine, babies may occasionally fall asleep because of the soothing nature of nursing. Learning to fall asleep on their own, or to self-soothe, is a skill that babies must learn, and you can help teach them by putting them into their crib or bassinet drowsy but awake. It’s sweet to cuddle with your baby, but you don’t want your baby to learn that they require cuddling to fall asleep.

Until then, it helps to expect to be very tired. Getting up every few hours is just part of having an infant, and it helps, if you can, to try to get some sleep when the baby sleeps. Don’t be afraid to loosen your tidiness standards a little, back out of commitments and ask for extra help during these early months. Ask the grandparents or family members to come over and take a shift. Ask a friend to come watch the baby while you take a nap or shower. You can always pay it forward for someone else.

And remember, babies do cry, and that can be frustrating and sometimes even discouraging, especially if your baby wakes up crying during the night. If you want to put the baby in a safe place like a bassinet or crib, it is perfectly OK to leave the room for a few minutes to take a breather and calm down.

— Dr. Stephen Hawkins, sleep medicine specialist

Babies, especially infants, don’t have a lot of ways to communicate what they want and how they’re feeling. Until they have enough words — which typically takes a few years — they express their thoughts and feelings through their behaviors.

Every parent knows the fussy baby checklist: hungry, tired, dirty diaper, something hurts. But every parent knows, too, that sometimes nothing works. Sometimes a baby is just really, really upset, and there’s nothing you or anyone else can do about it. At those times, it can be tempting to do everything possible to stop the crying and make the distress go away.

No parent or caregiver ever thinks they could intentionally harm a child. But it happens. An adult loses patience, just for an instant, and shakes a crying baby. That momentary lapse in judgment can bring a lifetime of sorrow. Shaking a baby can cause serious — and sometimes fatal — head injuries or permanent disabilities called shaken baby syndrome (SBS). You can prevent SBS by educating everyone who cares for your child about the dangers of shaking a baby, and how to appropriately respond to crying.

Most of the time, a parent’s best bet is to keep calmly soothing the baby and wait it out — the baby will probably calm down on their own pretty soon. A baby unhinged can be frustrating, though. If you’re getting upset, it’s always okay to set the baby down in a safe place like a bassinet or crib, leave the room for a few minutes, take a break and calm yourself down.

When things have settled a little, it can be helpful to consider whether there may be a pattern of melting down. Does it happen at a certain point in the day or after a certain activity? Was the baby overtired or overwhelmed by something that was happening? If there’s a pattern, there’s an opportunity to change things up and try to prevent it from happening again.

While there is no magic trick to stop baby’s tears, there is help:

• To speak to a caring pediatric nurse any time, day or night, call Children’s Hospital Colorado’s ParentSmart Healthline at 720-777-0123.
• Call the Fussy Baby Network® Colorado “Warmline” at 877-6-CRYCARE (877-627-9227).

— Dr. Ayelet Talmi, pediatric psychologist

Doctors don’t always know the exact cause of a crib death, which is known as SIDS (sudden infant death syndrome) or, more recently, SUID (sudden unexpected infant death). Some babies may be at high risk due to genetics, medical causes, prematurity or any number of other factors that may not yet be known. And for very young infants, immaturity of the breathing centers of the brain may also contribute. As it stands, there’s not much anyone can do about either of those factors.

The third contributing factor, however, is the sleeping environment. And there is something parents can do about that.

The main environmental factors that contribute to crib death are suffocating and overheating. Using a firm mattress with a fitted sheet and removing blankets, pillows, stuffed animals, bumpers and everything else from an infant’s crib goes a long way toward mitigating those risks. Avoiding smoke exposure or sedating drugs of any kind is also important.

In that same vein, while the conventional wisdom once held that placing an infant to sleep on their stomach would reduce the risk of suffocation from choking on spit-up, years of research on tens of thousands of babies has shown that the opposite is true. Placing a baby to sleep on their back is far safer than placing them on their stomach, and by far the safest thing parents can do to keep their babies safe while sleeping.

To some parents, neither the bare crib nor the back-sleeping sound like much fun, but it doesn’t have to last forever. By the time babies can roll over, it’s fine to let them sleep on their stomach if they want to flip themselves that way. Very young babies won’t notice if there’s stuff in their crib or not, and by the time they’re old enough to appreciate it’s there — after 1 year of age — they’re out of the woods.

— Dr. Stephen Hawkins, sleep medicine specialist

The American Academy of Pediatrics (AAP) recommends exclusive breastfeeding for about the first six months of a baby's life, followed by breastfeeding in combination with complementary foods until at least 12 months of age. Moms can continue breastfeeding for as long as she and her baby prefer. The benefits of breastfeeding are dose-responsive, which means that the health benefits babies get from breastfeeding is related to the amount of breast milk they receive. This is supported by the positive health outcomes of exclusively breastfed infants when compared to infants who never or only partially breastfed.

Breastfeeding provides a protective effect against respiratory illnesses, ear infections, gastrointestinal diseases, diabetes and allergies including asthma and atopic dermatitis. The rate of SIDS is reduced by over a third in breastfed babies, and there is a reduction in later obesity in breastfed versus non-breastfed infants.

According to the CDC, one of the most highly effective preventive measures a mother can take to protect the health of her infant is to breastfeed.

Learn more about Lactation Support Services from Children’s Colorado.

— Dr. Maya Bunik, pediatrician and breastfeeding specialist

Babies don’t come with fuel gauges, and, unlike bottles, neither do breasts. In many ways, it’s a leap of faith to decide there’s enough milk in the breasts to feed a baby, especially considering how difficult it can be to interpret an infant’s feeding cues. Is your baby hungry, or just gassy? It can be hard to tell.

The upshot: the vast majority of women — about 95% — make enough milk if they receive early support because milk supply is established in the first 3 to 4 weeks. Most babies only need between 1.5 and 2 ounces of milk in the early months, and even as they get older, not more than 4 ounces at a time. What makes it tricky is that a fussy baby isn’t always hungry, but most babies like to suck and will suck as long as you let them. That doesn’t mean that they need or even necessarily want to eat, and it is possible to get sore nipples and even overfeed.

Some babies tend to fall asleep during nursing. Tickling or holding their hand during a feeding session can keep them on task. Getting a weight check can be reassuring if there are doubts about intake.

Unless your baby seems to be losing weight, though, it’s probably safe to say they’re getting enough, especially if they are pooping and peeing regularly.

— Dr. Maya Bunik, -pediatrician and breastfeeding specialist

You may want to express or pump breast milk and store it if you are going back to work, to allow other family members to feed your baby, or just to have on hand when you’re away from your baby. Whatever the reason, you should learn how to properly store breast milk. The following are general guidelines for safely handling and storing breast milk:

• Wash your hands before expressing or handling your milk.
• Use only clean containers to store expressed milk. Use collection containers specific for the purpose of storing human milk. Don't use ordinary plastic bags or formula bottle bags for storing milk.
• Freshly expressed milk can remain at room temperature for up to four hours.
• Use refrigerated milk within 48 hours.
• Freeze milk if you will not be using it within 24 hours. Frozen milk is good for at least three months.

— Dr. Maya Bunik, pediatrician and breastfeeding specialist

The American Academy of Pediatrics has long recommended new mothers abstain from marijuana during pregnancy and breastfeeding due to research suggesting some of its effects may be passed on to the baby through breastmilk. A new study conducted by researchers at Children’s Colorado and published in JAMA Pediatrics backs up that recommendation: The study looked for the presence of THC, the psychoactive component of marijuana, in breastmilk — and found THC stayed in breastmilk up to six weeks.

The researchers studied women who had a history of marijuana use during pregnancy or a positive urine test for THC, said they intended to breastfeed and were willing to abstain from marijuana for six weeks after delivery. They provided milk, blood and urine samples during those six weeks. Of the 394 women who were screened, 25 enrolled. Seven of these women were ultimately able to abstain from marijuana use for the duration of the study.

The study found that, while the concentrations of THC varied from woman to woman (likely depending on their level of use, BMI and metabolism), THC was excreted in the breast milk of these seven women for up to six weeks. In fact, all of the women still had detectable levels of THC in their breastmilk at the end of the study.

Additionally, studies from the 1980s have shown that children born to mothers who used marijuana during pregnancy experienced long-term issues with cognitive and executive functioning, including impulsivity, as well as deficits in learning, sustained attention and visual problem-solving skills.

— Dr. Maya Bunik, pediatrician and breastfeeding specialist

Green poop. Yellow poop. Even grey poop. Infants poop in some startling shades, from neon yellow to olive drab, and for parents not accustomed to the varicolored poops of infancy (and even sometimes for those who are), this can cause concern.

Real talk: it’s probably no big deal. Since very young infants consume nothing but milk or formula, the color of their stool is almost invariably the result of harmless factors related to the lining of the intestine and how milk is digested. Occasionally something the mother ate may contribute to stool color, but that’s no reason to change the maternal diet. At about a month of age, some breastfed babies may have a 3 to 4-day stretch with no stool and then they have a big blowout. This may occur because breastmilk is highly digestible.

Some very serious liver conditions may cause white or whitish poops, so look out for that. Most babies also have stools that are watery. In general, though, unless you see blood or mucus that looks like snot in an infant’s stool, there’s no need to worry.

— Dr. Maya Bunik, pediatrician and breastfeeding specialist

Babies learn by exploring their environment, through seeing, hearing, touching and (sometimes kind of grossly) tasting. They learn from exposure to new things and from repeated exposure to things that have happened before. When things happen over and over again in the same way, babies start to predict and expect what will happen next. They develop expectations about the people in their lives. These expectations form the foundation of early relationships between babies and their caregivers and this foundation is what helps babies be ready to learn and thrive.

It’s a balance. Interacting with something new and different will inherently be of interest to a baby because it’s novel. On the other hand, if everything is different all the time, babies don’t know what to expect and the lack of predictability and continuity can make it difficult to learn.

That’s why the routines of caregiving are so important — they give your baby the firm foundation on which to build their view of the world. They’ll do the learning part on their own. It’s up to the caregiver to lay the foundation.

— Dr. Ayelet Talmi, pediatric psychologist

The most important thing is also the simplest: be there and be available. The simple, daily tasks of parenting — picking a baby up when they wake, changing diapers, playing, feeding, soothing — happen hundreds of times over the first years of life. These tasks teach babies what to expect from caregivers, how to build strong relationships, and how to engage with others and with the world. These interactions are the foundation of brain development.

The reason these interactions are so important has to do with the way a baby’s brain develops. Each interaction creates connections in the brain, and the more an experience happens, the stronger those connections get. The daily tasks of interacting with an infant and the relationship exchanges between a baby and their caregiver are creating the brain architecture that will set the stage for the rest of their lives. Babies learn the fundamentals of how to self-regulate, how to calm down when they’re upset, and how to engage and respond to the world all in the context of their closest relationships.

The best part? It doesn’t require anything fancy. All it requires is you.

— Dr. Ayelet Talmi, pediatric psychologist