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Just Ask Children's

10 Common Baby Questions Answered

Babies, for first-time parents especially, can seem like an impenetrable mystery. They’re totally helpless, they can’t talk or express themselves, and when they cry — as they often do — it can shatter new parents' already-fragile, sleep-deprived nerves. Good thing they’re cute.

Another good thing: Just Ask Children’s is here to help. We recruited three of our finest child health experts — Pediatric Clinical Psychologist Ayelet Talmi, MD, Sleep Medicine Specialist Stephen Hawkins, MD, and Maya Bunik, MD, Clinical Director of Children’s Hospital Colorado’s Primary Care Child Health Clinic and breastfeeding expert — to answer parents’ top question on everything from nursing to poop to getting those little guys to sleep through the night.

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 with their behavior.

Most of the time, what a baby under a year wants will be pretty apparent from context: is she hungry, tired, hot, cold, in pain? Does she have a messy diaper? Still, there may be times when it’s unclear, or when it’s not possible or practical to give the baby what she wants right then. At those times, it can be tempting to do everything possible to stop the crying and make the distress go away.

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 her 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 and take a quick break.

Dr. Ayelet Talmi, clinical psychologist

Babies learn by exploring their environment, through seeing, hearing, touching and (sometimes kind of grossly) tasting. They learn from exposure to new things, but they also learn from repeated exposure to things they can expect will happen next or in the same way they’ve happened before.

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, clinical psychologist

First of all, let’s acknowledge something important: you’re probably doing OK. For reasons both numerous and obvious, there’s a lot of 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 a while for babies to learn night is night and day is day, and that we sleep at night. The best thing parents can do to help that process along is to develop a routine and schedule that gets them used to sleeping at the desired times. Having dinner, taking a bath, reading a story, 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.

Until then, the best thing you can do is plan to be very tired. Having to get 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 few months. Ask the grandparents to come over and take a shift. Ask a friend to come watch the baby while you take a nap. You can always pay it forward for someone else.

And remember, babies do cry, and that can be very frustrating and very discouraging. If you want to put the baby in a safe place like a bassinet or crib, it is perfectly OK to leave the room, take a breather and calm down.

Dr. Stephen Hawkins, sleep medicine specialist

By the time babies are about 4 to 6 months of age, they can learn the skill of putting themselves to sleep. Parents can start to teach it even earlier than that by developing a routine (see above) that helps them anticipate going to sleep, and then putting them down when they’re drowsy but awake, which helps them learn to fall asleep quickly without a caregiver holding or rocking them. Babies who learn to fall asleep on their own will not only go down more easily at bedtime, they’ll also learn to fall back asleep on their own if they wake in the middle of the night. Conversely, babies who don’t learn this skill early on may have a much harder time as toddlers — so it’s good to teach them early.

The “cry it out” method involves urging this process along by letting the baby cry until she falls asleep. Some babies will be less resistant to falling asleep — some may not cry at all — and others may express their displeasure at this new development (ahem) very loudly.

This can be hard to hear. For most families, the first night will be rough and the second night will be rougher, but by the third or fourth night the baby will settle in and learn she can put herself to sleep.

“Cry it out” is not for everyone, and there are lots of ways to modify it to fit your family’s needs. It’s perfectly OK to do it or not to do it. Whether you decide to try this method or not, the most effective way to teach her the skill of falling asleep on her own is to develop a routine and put the baby down while she’s drowsy but awake, which you can start from the beginning.

 —Dr. Stephen Hawkins, sleep medicine specialist

Doctors don’t always know the exact cause of a crib death, which is often called 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.

In that same vein, while the conventional wisdom once held that placing an infant to sleep on her 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 her back is far safer than placing her on her stomach.

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

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. There’s not much worse than trying to soothe a baby without success.

The most important things in those moments is to remember you’re doing alright, and that it’s OK if you need to just to set the baby down in a safe place like a crib or bassinet, leave the room, 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.

Dr. Ayelet Talmi, clinical psychologist

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 she hungry, or just gassy? It can be hard to tell.

The upshot: the vast majority of women — about 95% — make enough milk, and most babies only need to eat 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, and 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 she’s getting enough.

Dr. Maya Bunik, Child Health Clinic, medical director

There’s not a whole lot of research on the subject of marijuana and breastfeeding, but we do know a few things about it. We know that marijuana is a lipophilic — or fat-loving — substance, and that it’s capable of attaching to fat in the breast milk and also getting to the baby’s brain that way.

One study in 2009 estimated that 0.8% of mother’s dose of THC (the psychoactive component in marijuana) is ingested by the baby. Older research from the 1980s showed that THC can be concentrated in breastmilk up to eight times compared to metabolites shown in the infant’s stool. Because marijuana has long been illegal, more recent research has been scarce.

That’s beginning to change. Currently Children’s Hospital Colorado is planning a study with the Centers for Disease Control and the Colorado Department of Public Health and Environment to determine how long marijuana lasts in breast milk, and it’s possible that soon we’ll know more. For now, though, we don’t know if there’s any safe level, and so it is best to refrain from using any marijuana when breastfeeding.

Dr. Maya Bunik, Child Health Clinic, medical director

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, as well, but that’s no reason to change the maternal diet.

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

Dr. Maya Bunik, Child Health Clinic, medical director

The most important thing is also the simplest: to be there and available. The simple, daily tasks of parenting — picking a baby up when she wakes, changing diapers, playing, feeding, soothing — happen hundreds of times over the first years, and they 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 they’re 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. Literally speaking, the daily tasks of interacting with an infant are creating the brain architecture that will set the stage for the rest of their lives. It teaches them the fundamentals of how to self-regulate, how to calm down when they’re upset, and how to engage and respond to the world.

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

Dr. Ayelet Talmi, clinical psychologist

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