Is Performing a C-Section Better Than Inducing Labour, when it comes to giving birth, usually the preferred option is to let labour proceed naturally. However, there are times when it is not in the mother or baby’s interest for this to happen. When the health of either is at risk, or if gestation has exceeded [41 weeks duration,](https://nabtahealth.com/articles/doctor-tips-weeks-27-40/) then it is highly probable that an alternative strategy will need to be implemented. There are two options available, [inducing labour](../) or performing a [C-section](../). With an induction, the [uterus](https://nabtahealth.com/glossary/uterus/) is artificially stimulated to contract, and it is then hoped that labour will proceed as per a natural delivery. In contrast, a C-section is a surgical procedure, whereby a cut is made in the abdomen and the baby is removed that way, rather than via the [vagina](https://nabtahealth.com/glossary/vagina/). Sometimes the only safe option is to perform a C-section, for example if the baby is breach, or when an emergency situation arises. However, there are other times when you may be presented with a choice and if this happens, what is the correct answer? Unfortunately there is no definitive right answer. An induction can be at least as safe as spontaneous labour and, if performed in the week prior to the [due date](https://nabtahealth.com/glossary/due-date/), it is thought to reduce [the risk of](https://nabtahealth.com/articles/what-is-preeclampsia/) [preeclampsia](https://nabtahealth.com/glossary/preeclampsia/) in the mother and respiratory distress in the child, possibly as a result of the [placenta](https://nabtahealth.com/glossary/placenta/) remaining fully functional. Unlike C-sections, inductions are not surgical procedures and thus, if all goes to plan, the recovery period is shorter. It is however, a big ‘IF’. [Induced labours](https://nabtahealth.com/articles/induction-of-labour/) are typically more painful, meaning more women will request stronger pain relief including epidurals, and there is a greater likelihood of assisted delivery, such as the use of forceps or ventouse. There is also an increased [risk of hyperstimulation](https://nabtahealth.com/articles/what-is-ovarian-drilling/) of the [uterus](https://nabtahealth.com/glossary/uterus/)., Uterine hyperstimulation causes more frequent, longer [contractions](https://nabtahealth.com/glossary/contraction/), which can [lead](https://nabtahealth.com/glossary/lead/) to complications such as foetal heart rate abnormalities and, in rare cases, uterine rupture. In a significant number of women, induction does not work and a C-section becomes necessary. The advent of the C-section was undoubtedly a medical revolution, instantly saving the lives of millions of women and children. However, C-sections bring with them all the risks of regular surgery, including blood clots, wound infection and bleeding. The recovery period is typically longer after a C-section than after a natural birth, driving restrictions are enforced and a scar remains, although this will fade over time. Whilst current guidelines stipulate that an induction should only be performed when [the risks of continuing the pregnancy](https://nabtahealth.com/articles/complications-during-pregnancy-polyhydramnios/) outweighs the benefits, with more women than ever requesting elective C-sections, the World Health Organisation has highlighted an urgent need for medical assessment efforts to address the risks of induced labour compared to elective C-section. Until such work is undertaken, it becomes a matter of individual circumstance, personal choice and ultimately weighing up what is best for you and your baby. **Sources:** * Grobman, W A, et al. “Labor Induction versus Expectant Management in Low-Risk Nulliparous Women.” _The New England Journal of Medicine_, vol. 379, no. 6, 9 Aug. 2018, pp. 513–523., doi:10.1056/NEJMoa1800566. * WHO Recommendations for Induction of Labour. World Health Organisation, [http://apps.who.int/iris/bitstream/handle/10665/44531/9789241501156\_eng.pdf?sequence=1](http://apps.who.int/iris/bitstream/handle/10665/44531/9789241501156_eng.pdf?sequence=1). Accessed on 23/01/2019. * _Inducing Labour. Clinical Guideline \[CG70\]_. NICE (National Institute for Care and Health Excellence), July 2008, www.nice.org.uk/guidance/cg70/chapter/Introduction. Accessed on 23/01/2019
Sushi is considered a healthy eating option and its popularity is growing in the US. Many parents wonder if it is safe for their young child to eat sushi and when they can safely introduce it in the diet. According to the American Academy of Pediatrics (AAP), there is no need to delay the introduction of fish or shellfish beyond [4-6 months](https://nabtahealth.com/articles/when-can-your-child-eat-sushi-and-raw-fish/) of age in healthy, low food allergy risk children. Specifics about whether the fish is cooked or raw are not made, and the assumption is that this stance reflects cooked fish and shellfish. The Food and Drug Administration ([FDA](https://nabtahealth.com/glossary/fda-2/)) specifies that no raw fish or shellfish should be given to high-risk groups, highlighting very young children as one such group. At what age is a child no longer considered at high-risk? --------------------------------------------------------- A [child’s immune system](https://nabtahealth.com/articles/when-can-your-child-eat-sushi-and-raw-fish/) development is slow and steady during the first 2-3 years of life, and by age 4-6 years old, adult levels of immunity are seen. Your [child’s immune](https://nabtahealth.com/articles/can-daycare-build-your-childs-immune-system/) system continues to develop throughout [puberty](https://nabtahealth.com/glossary/puberty/). Given this information, waiting until 5-6 years of age to introduce raw fish and uncooked sushi is the best way. This will ensure your child is defended against potentially harmful substances. Bacterial contamination is a threat to any temperature sensitive food and cannot be seen, smelled or tasted. [Food poisoning](https://nabtahealth.com/articles/how-to-avoid-food-poisoning-during-pregnancy/) symptoms are similar to the stomach flu, so they may be hard to detect. Asking questions about the quality of food and how it is prepared is good. However, taking care to eat at reputable restaurants that you trust can help prevent adverse reactions to contaminated sushi. US restaurants are required to use sushi that has been properly frozen and/or cooked to eliminate parasitic contamination. ##### Food allergies The [Food Allergy](https://nabtahealth.com/articles/4-ways-to-know-if-your-child-has-a-food-allergy/) and Anaphylaxis Network states that about 7 million people in the US have a reported seafood allergy. In addition to seafood allergy risk, Asian cuisine can often contain other allergens such as peanut, egg, tree nut, and soy ingredients. Raw or cooked sushi is typically assembled into a firm, round food. Sashimi is a raw piece of fish set atop a small amount of rice; it has a slippery texture. Both sushi and sashimi may present a choking hazard, especially for young toddlers. A child to eat sushi may also have a sticky texture that may be foreign to the child. Cutting cooked sushi into small pieces before serving it to your toddler can minimize the risk of choking. When it comes to raw sushi or sashimi, it may be best to leave it out of your child’s diet as they are young and building a strong immune system. However, there is no reason why your toddler can’t safely enjoy cooked or vegetarian Asian cuisine, with special attention paid to its ingredients. If you enjoy sushi and other Asian cuisines and want to pass this along to your child, think about alternatives to raw fish such as: Vegetable rolls ##### **Those containing only cooked fish and/or shellfish** * Rice bowls * Tempura * Soups * Salads * Stir-fry * Teriyaki The truth is that while food safety, allergies, and choking hazards should always be considered. There really is no consensus on an exact age that is appropriate to give a young child raw fish. By 5-6 years old, a healthy [child’s immune system](https://nabtahealth.com/articles/can-daycare-build-your-childs-immune-system/) should be strong enough to graduate to raw sushi with the rest of the family. No magical age, grade level, or number of exposures to sushi will prevent the occurrence of an illness from contaminated food. Good judgment and necessary precautions should always be in place. **Sources:** * U.S * Food & Drug Administration * Fresh and Frozen Seafood: Selecting and Serving it Safely. KidsSafe Seafood. Food Allergy and Anaphylactic Network. Powered by Bundoo®
Food-borne illnesses do not discriminate — anyone can become sick. Raw oysters have earned a reputation as a potentially dangerous food. Also, some groups of people have a [greater risk of serious illness](https://nabtahealth.com/articles/is-fish-oil-safe-for-children/) than others, including children. Eating raw oysters comes with the risk of being exposed to Vibrio vulnificus, a potentially life-threatening bacteria. Young children, those under 5 years of age, are more susceptible to food-borne illness because their immunity isn’t fully developed. Here are some facts you should know before you give your young child raw oysters: ##### What will happen if my child eats a contaminated oyster? In reality, allowing your [child to eat](https://nabtahealth.com/articles/is-it-safe-for-toddlers-and-children-to-eat-raw-oysters/) raw oysters might have zero consequences, no matter how many he or she eats. Unlike other bacteria, V. vulnificus cannot be smelled, seen, or tasted. There is no way to determine if the raw oyster is safe to eat. V. vulnificus cannot be killed by a lot of hot sauce, nor are you guaranteed safety by letting your child just try one or two oysters. If your [child eats a raw oyster](https://nabtahealth.com/articles/is-it-safe-for-toddlers-and-children-to-eat-raw-oysters/) that is contaminated with V. vulnificus, it is important to be familiar with the signs and symptoms of food poisoning. In generally healthy people, V. vulnificus can cause vomiting, diarrhea, and abdominal pain. In some cases, it can become worse and infect the blood (invasive septicemia) resulting in fever, chills, and septic shock. V. vulnificus is a serious cause for concern because about half of people who contract the blood infection die. If you are suspicious of food poisoning and/or your child has symptoms, get in touch with your healthcare provider, or even head to the ER. ##### What should I do? To be safe, you may want to hold off on feeding your child raw oysters for a few years, or at least until he or she is five years of age. If oysters are a staple in your household, or a special treat here and there, make sure to thoroughly cook a few for your little one to try. Cooking (prolonged exposure to high heat) is the only way to kill the bacteria and make sure you and your family will be safe. Get yourself a [coach](https://nabtahealth.com/product/conscious-motherhood-coaching-session/) and learn more. **Sources:** * Food & Drug Administration * Raw Oyster Myths. Powered by Bundoo®
As summer brings warmer temperatures and longer days, it’s crucial for moms to prioritize the health and well-being of both themselves and their babies. With a few simple precautions and mindful practices, you can ensure a safe and enjoyable summer season. In this article, we will explore some valuable tips to help moms and babies stay healthy and happy during the summer months. #### **Stay Hydrated:** Proper hydration is vital for both moms and babies, especially during hot summer days. Breastfeeding moms should increase their fluid intake to ensure an adequate milk supply. For babies, consult your pediatrician on appropriate hydration guidelines based on their age. Offer water to older babies and encourage frequent breastfeeding or formula feeding for younger ones. Keep a close eye on dehydration symptoms, such as dry mouth, fewer wet diapers, or lethargy, and seek medical attention if necessary. #### **Protect from the Sun**: Babies have delicate skin that is highly susceptible to sunburns and heat-related illnesses. To safeguard your little one, avoid direct sun exposure during peak hours (10 am to 4 pm). Dress babies in lightweight, loose-fitting clothing that covers their skin, and use wide-brimmed hats and sunglasses for added protection. Apply a broad-spectrum sunscreen with at least SPF 30 to exposed areas, ensuring it is safe for infants and applied 30 minutes before going outdoors. #### **Manage Heat and Humidity:** Extreme heat and humidity can be challenging for babies to tolerate. Keep your baby cool by maintaining a comfortable room temperature, using fans or air conditioning as needed. Dress them in breathable, lightweight clothing made of natural fabrics like cotton. Avoid overdressing or using heavy blankets. Use a cool mist humidifier to prevent dryness and keep the air moist in the nursery. Additionally, never leave your baby unattended in a parked car, even for a few minutes. #### **Be Mindful of Bug Bites:** Summer brings a surge in bug activity, increasing the risk of insect bites and stings. Protect your baby by avoiding areas with heavy insect populations, especially during dusk and dawn when mosquitoes are most active. Dress your baby in long-sleeved shirts and pants, use mosquito netting over strollers and cribs, and consider using child-safe insect repellents recommended by your pediatrician. Regularly check for ticks, and promptly remove them with tweezers if found. #### **Practise Safe Water Activities:** If you plan on enjoying water activities with your baby, take necessary precautions to ensure their safety. Never leave your baby unattended near any body of water, including pools, lakes, or the ocean. Invest in properly fitting swim diapers to prevent accidents, and always stay within arm’s reach of your baby when they are in or around water. If swimming in a pool, make sure it is adequately fenced and secure. By following these essential summer health tips, moms can create a safe and enjoyable environment for themselves and their babies. Stay hydrated, protect against the sun, manage heat and humidity, prevent bug bites, and practice water safety. Always consult with your healthcare provider for personalized advice based on your baby’s age and specific needs. Enjoy the summer season while keeping your baby healthy and happy!
**1\. Bundoo: The AAP recommends exclusive breastfeeding for the first six months and continued breastfeeding up to a year. By this time, many babies are starting on solid foods and some have been eating solid foods for a few months. When does weaning typically begin?** **Answer :** Dr. Jen Lincoln: Weaning, by definition, is when anything other than breast milk — such as formula or solids — is introduced into a baby’s diet. The timing of weaning from breastfeeding certainly varies. Some moms choose to introduce formula when they return to work and thus begin the weaning process at that time, while others wait to wean until they’ve reached a certain time point (6 months, a year — whatever the mother’s goals may be). Still others wait until the child initiates the desire to wean. So there really is no “typical” time. Ideally, if you can stick with it for 12 months, the benefits are huge. Interesting fact: worldwide, the average age of weaning isn’t until age 4 or 5 — very different from what we consider the cultural “norm” here! **2\. What signs might a baby give that he or she is ready to begin weaning?** **Answer :** When babies are left to wean on their own, most do so gradually. Feeding sessions may become shorter, or certain ones may be skipped altogether (though feeds before bed and upon waking tend to be the last to go). Babies who are ready to wean usually show a decent interest in taking solids, too. In general, most babies won’t show signs of being ready to wean if they are less than a year old. If they are younger than this, or they very suddenly want to stop nursing, this may actually be a nursing strike, which is very different than weaning. **3\. Are there are any drawbacks to weaning a baby early if the mom needs to, for example if she’s returning to work?** **Answer :** Yes. We know that the longer babies receive breast milk, the greater the multiple benefits are. However, if a mother finds she absolutely must wean before the desired 12 months of breastfeeding, any breast milk is better than none. Also, weaning a baby before he or she wants to can [lead](https://nabtahealth.com/glossary/lead/) to a more stressful process for everyone involved, though it doesn’t need to be insurmountable. **4\. What’s the biggest mistake you see parents making when it comes to weaning?** **Answer :** The biggest mistake I’ve seen is when moms think they need to wean when they don’t actually have to. Many are told they have to wean if they need to take a certain medication or have a certain study (like a CT scan, for example). Rarely is this the case, but many are given incorrect information! If you are told this, always ask a [lactation](https://nabtahealth.com/glossary/lactation/) consultant to be sure before you start the weaning process! Also, many moms think pumping at work will be too hard before even starting, and so they wean because of this. Good preparation and having a good support system can go a long way in making a working mom successful so she doesn’t have to throw in the towel before she wants to! Powered by Bundoo®
Baby-led weaning is a child-centered approach to feeding and [transitioning from breastfeeding](https://nabtahealth.com/articles/9-ways-to-make-night-weaning-work-for-you/) to a solid food diet. Allowing baby to set the pace — eat when hungry and stop when full — is a responsive feeding approach, one that has been positively associated with [healthy eating](https://nabtahealth.com/articles/5-nutrients-for-baby-led-weaning/) and body weight. If you choose to use a BLW approach to feeding your baby, follow these tips to ensure safety and success: * Exclusively breast-feed your baby for the first six months. * Continue breast milk (preferable) or formula for at least the second six months of life. No regular cow’s milk or milk alternatives until after a year of age, and then whole fat sources should be used until age two. * Make sure baby [shows developmental-readiness](https://nabtahealth.com/articles/qa-with-dr-jen-lincoln-what-about-weaning/) for solid food by sitting upright without props or assistance, reaching for food, or showing other signs of interest. * Feed your baby the food your family eats (soft-cooked, well-cooked or cut into graspable pieces). * Offer a variety of foods from all the food groups. Don’t rely on starchy foods like crackers, breads and cereals. * Understand the unique and [important nutrient needs of your baby](https://nabtahealth.com/articles/5-nutrients-for-baby-led-weaning/), including [iron](https://nabtahealth.com/glossary/iron/), [zinc](https://nabtahealth.com/glossary/zinc/), [vitamin D](https://nabtahealth.com/glossary/vitamin-d/), total fat, and DHA. * Let baby regulate his or her eating. * Watch for signs of choking. Reviewed by Dr. Sara Connolly, December 2018 **Sources:** * Brown A, Lee M, Maternal control of child feeding during the weaning period: differences between mothers following a baby-led or standard weaning approach. Maternal & Child Health, 2011; 8: 1265-71. * Brown A, Lee M, An exploration of experiences of mothers following a baby-led weaning style: Developmental readiness for complementary foods. Maternal & Child Nutr, 2013; 2: 233-43. * Townsend E and Pitchford N, Baby knows best? The impact of weaning style on food preferences and body mass index in early childhood in a case-controlled sample. BMJ Open, 2012; 2: e000298. * American Academy of Pediatrics Section on Breastfeeding, 2012 Policy statement: Breastfeeding and the use of human milk. Pediatrics, 129, e827-e841. * Dietary Reference Intakes. Food and Nutrition Board, Institute of Medicine, National Academies. * Rapley G and Murkett T, Baby-Led Weaning: Helping Your Baby Love Good Food. Vermillion: London, UK, 2008. * Castle J and Jacobsen M, Fearless Feeding: How to Raise Healthy Eaters from High Chair to High School. Jossey-Bass: San Francisco, CA, 2013. Powered by Bundoo®
Baby-led weaning is one way to start solids with your baby. It involves skipping the spoon and allowing your baby to self-feed solids that are prepared in graspable and dissolvable forms, such as sticks of cooked meat or ripe fruit cut into wedges or sticks. While research suggests that baby-led weaning encourages self-regulation, [development of feeding skills](https://nabtahealth.com/articles/9-ways-to-make-night-weaning-work-for-you/), and leaner babies, there isn’t much research to assess its nutrient adequacy. Some research suggests that lower calorie foods such as fruit and vegetables are more common in this feeding approach, which may be associated with baby’s weight status. More recent research points to inadequacies of [iron](https://nabtahealth.com/glossary/iron/) in the diet of baby-led weaners and their spoon-fed counterparts. More research on nutrient intake is needed to help guide optimal food selection to support normal growth and development. #### In the meantime, here are [five nutrients parents](https://nabtahealth.com/articles/qa-with-dr-jen-lincoln-what-about-weaning/) of baby-led weaners should pay attention to, and why: [Iron](https://nabtahealth.com/glossary/iron/)—[Iron](https://nabtahealth.com/glossary/iron/) requirements are particularly important during the first year of life when baby’s brain is developing, his body is growing, and [iron](https://nabtahealth.com/glossary/iron/) stores are being built up. Around the time of introducing solid food (6 months), [iron](https://nabtahealth.com/glossary/iron/) requirements shoot up to 11 mg/day (from 0.27 mg/day), making [iron](https://nabtahealth.com/glossary/iron/) an important consideration when choosing foods to feed your baby. If you are breastfeeding your baby, [iron](https://nabtahealth.com/glossary/iron/)\-rich foods will play a central role to your baby’s overall growth and development. Try to offer two servings of [iron](https://nabtahealth.com/glossary/iron/)\-containing foods each day; if offering plant-based [iron](https://nabtahealth.com/glossary/iron/) sources, give a source of vitamin C (orange juice, tomato sauce, etc) at the same time to maximize [iron](https://nabtahealth.com/glossary/iron/) absorption. Good sources of heme [iron](https://nabtahealth.com/glossary/iron/) (animal-based and naturally well-absorbed in the body) are: chicken liver, oysters, beef liver, beef cuts and ground beef, turkey (dark meat), tuna canned in water, turkey (light meat), chicken (light and dark meat), fresh tuna, crab, pork, shrimp, and halibut. Good sources of non-heme [iron](https://nabtahealth.com/glossary/iron/) (increase absorption by adding a source of vitamin C): ready-to-eat cereals, oatmeal, soybeans, lentils, beans (kidney, lima, black-eyed peas, navy, black, pinto), tofu, spinach, raisins, molasses, and commercially prepared white and wheat bread. [Zinc](https://nabtahealth.com/glossary/zinc/)—[Zinc](https://nabtahealth.com/glossary/zinc/) is a key nutrient for growth and appetite. Children with poor [zinc](https://nabtahealth.com/glossary/zinc/) intake may grow slowly, and have a poor appetite causing inadequate food intake. [Zinc](https://nabtahealth.com/glossary/zinc/) is also tied to immunity and plays a role in keeping your baby healthy. Include [zinc](https://nabtahealth.com/glossary/zinc/)\-rich foods as your baby transitions to solid food, such as red meat like beef and lamb, poultry like chicken or turkey, crabmeat, lobster, fortified ready-to-eat breakfast cereals, a variety of beans, different nuts (when older), whole grains and foods made with whole grains, and dairy products. Fat—Babies need quite a bit of fat in their diets to sustain their rapid growth in the first year of life, especially when considering how easily their tummies fill up. Every calorie counts! In fact, babies need about 50 percent of their total calories from fat, which is an amount naturally found in breast milk and infant formula. However, when babies start solid food, their fluid intake naturally decreases over time, making fat sources from solid food an important inclusion. Fat sources include plant oils, avocado, nut butter, butter, whole milk (wait until a year old) and yogurt [Vitamin D](https://nabtahealth.com/glossary/vitamin-d/)—If you’re breastfeeding, your baby should already be getting a [vitamin D](https://nabtahealth.com/glossary/vitamin-d/) supplement; [vitamin D](https://nabtahealth.com/glossary/vitamin-d/) is included in the panel of nutrients in infant formula. As your baby transitions to solids, keep an eye out for foods that include [vitamin D](https://nabtahealth.com/glossary/vitamin-d/), either naturally (fatty fish such as salmon, cooked mushrooms, or eggs) or fortified with [vitamin D](https://nabtahealth.com/glossary/vitamin-d/) (milk or [vitamin D](https://nabtahealth.com/glossary/vitamin-d/)\-fortified orange juice). As you reach the one year milestone, milk or milk alternatives fortified with [vitamin D](https://nabtahealth.com/glossary/vitamin-d/) will help your baby reach his requirements, though you may still need supplementation to assure your baby is getting enough. DHA—Docosahexaenoic Acid (DHA) is an omega-3 fatty acid essential for the development of the retina and the brain. Breastfed babies will receive DHA through mother’s milk, provided that mom has a good diet including DHA food sources (found below); many infant formulas include DHA. By 9 months, start offering solid foods that are [good sources of DHA](https://nabtahealth.com/articles/qa-with-dr-jen-lincoln-what-about-weaning/), including 1-2 servings of low-[mercury](https://nabtahealth.com/glossary/mercury/) fish each week, including salmon, trout, shrimp, tilapia, pollock, and canned light tuna. Other sources of DHA include fortified eggs, DHA-fortified milk, and DHA-fortified orange juice. Consider a DHA supplement if your toddler won’t eat fish or other sources of DHA. **Sources:** * A Review of Studies on the Effect of [Iron](https://nabtahealth.com/glossary/iron/) Deficiency * The Journal of Nutrition. Castle JL and Jacobsen MT * Fearless Feeding: How to Raise Healthy Eaters from High Chair to High School * Jossey-Bass, 2013. Development and pilot testing of baby-led introduction to solids * BMC Pediatrics. Zeigler et al * Dry cereals fortified with electrolytic [iron](https://nabtahealth.com/glossary/iron/) or ferrous fumarate are equally effective in breast-fed infants * J Nutr * 2011; 141: 243-248. Powered by Bundoo®
You worked hard to make breastfeeding work and you are on a roll. Your baby is thriving and your confidence in nursing is solid. But now you’re tired! Your baby is still waking up several times at night, and you can’t get back to sleep. Many families in this position decide it’s time to wean, if only to get better sleep. But there is a middle ground. Breastfeeding is not an all-or-nothing proposition. If you are struggling with frequent night-waking, you may want to consider night weaning as [opposed to full weaning](https://nabtahealth.com/articles/qa-with-dr-jen-lincoln-what-about-weaning/). This way, your baby still gets all the benefits of breastmilk and you can hopefully get some much-needed sleep. There is a right time and a wrong right time to wean: babies under the age of 6 months are too young to wean from nursing at night because they still need the calories. Sucking at the breast also has proven protections against SIDS. But if your baby is more than 6 months old and you want to try night weaning, here are some good tips. #### [Strategies for Successful](https://nabtahealth.com/articles/tips-for-baby-led-weaning/) Night Weaning Whatever the age of your baby, there are a few things to keep in mind when night weaning: Make sure your baby is nursing plenty during the day. It can be easy to get distracted and forget to nurse as often as it takes to satisfy your baby’s caloric needs. Your milk is calorie-dense and very hydrating. Prepare your baby by telling her that she is not going to nurse until the sun shines. Teach her about day and night. Even if your baby isn’t speaking yet, she may still understand you. Routine and consistency are important. Have a set bed time and bedtime ritual. This could be bath time, baby massage, reading or telling a story, and nursing. Be sure your baby is eating nutritious solids. If your baby is already eating solids, make sure to provide as much nourishing and filling food as possible during the day. Plan to cluster nurse just before bedtime. Your [milk is fattier](https://nabtahealth.com/articles/5-nutrients-for-baby-led-weaning/) if you nurse in clusters. In the evening, your milk has more melatonin to help your baby sleep more. Avoid night weaning when your baby is sick or teething. This is a time when your baby needs attention twenty-four hours a day, and sleep disturbance comes with the territory. It is also best not to wean during a big change such as a move, a parent returning to work, or during holidays and vacations. Many babies who once slept through the night will wake more when routines change, when mom returns to work, during travel, or when there are visitors. #### Offer lots of skin-to-skin contact while night weaning. Have a sippy cup with water available. You may be surprised to know how thirst-quenching your milk is, so your baby may actually be thirsty. Avoid pumping at night to relieve fullness. This will encourage your body to continue making milk at night, so you’ll just be pumping instead of nursing. This negates your plan to be able to sleep more. Hand-expressing can help to relieve fullness without over-stimulating your breasts. **Sources:** * Cohen Engler A, Hadash A, Shehadeh N, Pillar G * Breastfeeding may improve nocturnal sleep and reduce infantile colic: potential role of breast milk melatonin * Eur J Pediatr * 2012 Apr;171(4):729-32.Does Breastfeeding Reduce the Risk of Sudden Infant Death Syndrome? Powered by Bundoo®
By 13-18 months of age, children are recommended to have an average of 11.25 hours of uninterrupted nighttime sleep and up to 2.5 hours of daytime sleep. Babies at the younger end of this age group usually take two naps, but will transition to one afternoon nap by 18 months old. Developmental changes. [Developmental milestones](https://nabtahealth.com/articles/physical-development-milestones-in-infants-between-2-4-months/) for these early toddlers include learning to walk and transitioning from two naps to one. Toddlers this age also commonly experience separation anxiety as well as emotional attachments to objects such as pacifiers and bottles. Although it can be difficult, avoid reverting back to old bedtime sleep habits—instead continue to incorporate positive bedtime activities. Giving verbal reassurance can help let them know you are nearby at bedtime. It’s also a good idea to continue phasing out sleep crutches such as rocking to sleep or associating milk with sleep so your child won’t wake up during the night needing to be rocked or fed back to sleep. Not to mention you want to protect those budding teeth. Transitioning from two naps to one. At 15–18 months, toddlers usually transition from two naps a day to one single afternoon nap after lunch. This can be tricky and result in overtiredness and difficult nighttime sleep, so be sure to look for signs that your child is ready for this transition. Shoot for the one nap to begin around 12:30 or 1 p.m., and try getting your toddler to bed a bit earlier than usual during this transition. Sample Schedule. The predictability of a good sleep schedule helps children feel secure, especially when dealing with emotional and behavioral sleep problems. This is a flexible outline to help you create your child’s own sleep schedule. Be sure to always watch for your child’s behavior to determine their sleep cues. 7-7:30 a.m.: Wake-up and breakfast. 9-9:30 a.m.: Start of one-hour morning nap if still taking one—still will probably want a snack right before or after the nap. 11:30 a.m. – 12:30 p.m.: Lunch (depending on morning-nap timing). 12:30-1:30 p.m.: Start of afternoon nap. About 90 minutes if it’s a second nap, about 2-2.5 hours if it’s the only nap of the day. Snack after nap. 5-5:30 p.m.: Dinner. 7-7:30 p.m.: Start bath/bedtime routine. This schedule applies to generally healthy children with no growth or developmental concerns. Sleep schedules are based on recommendations from the [American Academy of Pediatri](https://www.aap.org/)cs. Remember, you should always consult with your child’s pediatrician. **Sources:** * Kim West, LCSW-C. The Sleep Lady’s Good Night Sleep Tight. Powered by Bundoo®
**1\. Bundoo: What do the terms “organic” and “natural” actually mean when it comes to [skin, hair, and healthcare products](https://nabtahealth.com/articles/getting-started-with-nabta-health-your-101-guide-to-skin-and-hair/)? Are these terms regulated so parents know what they’re getting?** **Answer :** Dr. Rachel Shnider: “Organic” and “natural” have to do with the sourcing of ingredients in various products. “Organic” products are supposed to be regulated by the [FDA](https://nabtahealth.com/glossary/fda-2/) in order to be labeled this way. I do not believe that the same applies to “natural” products. Regardless, it is important to remember that the words “organic” and “natural” do not necessarily mean “healthy,” as these words only have to do with where the ingredient comes from, not its safety profile. For example, many “natural” or “organic” plants are still highly toxic or potentially allergenic. **2\. Are there any ingredients in natural products that you really like and recommend to your own patients? For example, do you find that lavender and chamomile are soothing, or that baby skin really responds to organic aloe vera?** **Answer :** Actually, I recommend against a lot of these products. Just because they are “organic” or “natural” does not mean they are best for your [baby’s skin](https://nabtahealth.com/articles/baby-skin-care/). Many babies have very sensitive skin that is easily irritated by fragrance and flower/herb extracts, so I usually recommend products that are completely fragrance-free. I do not think that they need to be “natural” or “organic.” In fact, my favorite skincare products for babies are: Dove sensitive skin soap, Cetaphil, CeraVe, and Aquaphor to name a few. Some parents prefer to use oils such as olive oil or coconut oil — these oils tend to work well, too, and offer a more “natural” option. **3\. On the other side, are there are any of these products that you don’t recommend or consider a waste of money?** **Answer :** I absolutely do not recommend “all natural” insect repellents, for one. Some can actually be harmful to small children, and overall, they have been proven to not work as well as traditional DEET and Picaridin-based products (which I do recommend for children, including infants). **4\. It’s not hard to find websites with parents worrying about potentially toxic ingredients in conventional shampoos, soaps, and lotions. These might include fragrances, preservatives, texture enhancers, and ingredients like benzoic acid, cetearyl alcohol, and others. What do you recommend parents do if they are worried about this?** **Answer :** The Environmental Working Group has a great website for consumers that ranks different products in terms of safety (ewg.org), and I often recommend it if parents have concerns. Overall, I tend to tell parents to not worry too much about these products. Exposure to these chemicals is related to amount used and the time it spends on the body. So for most items (such as shampoos, soaps, etc.), the amount used is fairly small, and the products are washed off rapidly. Powered by Bundoo®
A study recently published in the journal Social Science & Medicine reignited the debate over the benefits of breastfeeding (or breast milk feeding) versus formula feeding when it seemed to find that the benefits of breastfeeding are “overstated.” Dr. Cynthia Colen, an assistant professor of sociology at Ohio State University and [lead](https://nabtahealth.com/glossary/lead/) author of the study, attempted to find out whether previous studies showing benefits of breastfeeding weren’t reliable because of flaws in their design. When comparing all children in Colen’s study, those who were breastfed showed superiority in all outcomes measured except asthma (which is surprising considering several other studies have shown breastfeeding protects against asthma). However, when excluding extraneous factors (such as race and [socioeconomic](https://nabtahealth.com/glossary/socioeconomic/) status) by looking at individual families where one [infant was breastfed](https://nabtahealth.com/product/the-breastfeeding-box-2/) and the sibling was formula-fed, she concluded that breastfeeding might be no more beneficial than formula feeding for 10 of the 11 long-term health and well-being outcomes studied in children age 4-14. In her study, Colen used data from the 1979 cohort of the National Longitudinal Survey of Youth (NLSY), a nationally representative sample of young men and women who were between ages 14 and 22 in 1979, as well as results from NLSY surveys between 1986 and 2010 of children born to women in the 1979 cohort. The outcomes measured included asthma, body mass index, behavioral compliance, hyperactivity, math ability, memory based intelligence, obesity, parental attachment, reading comprehension, scholastic competence, and vocabulary recognition. Although the results of this study are interesting, the preference toward [breast milk for infant nutrition](https://nabtahealth.com/articles/covid-19-vaccine/) is unchanged. Several news media outlets ran stories following the release of Colen’s article, stating that breastfeeding’s benefits have been dramatically “overstated.” However, an enormous amount of research points toward the benefits of breastfeeding for both the mother and infant. For the infant, breastfeeding is associated with a reduced risk of acute otitis media (ear infection), [atopic dermatitis](https://nabtahealth.com/glossary/atopic-dermatitis/) (eczema), gastrointestinal infections, lower respiratory tract diseases, asthma, obesity, childhood leukemia, and sudden infant death syndrome (SIDS). For the breastfeeding mother, breast and ovarian cancer risk is reduced. In terms of cost, breastfeeding is free. Breastfeeding promotes a growing bond between mother and infant. Regarding Dr. Colen’s study, only a few pediatric medical outcomes (asthma, body mass index, and obesity) were explored. The rest were neurobehavioral in nature. Still, the study highlights the notion that choice of nutrition is not the only factor involved in child health and development. While the benefits of breast milk are undeniable, other variables in a [child’s environment](https://nabtahealth.com/articles/involving-dad-with-breastfeeding/) are also important. This should come as good news to mothers who are unable to breastfeed. Reviewed by Dr. Sara Connolly, December 2018 **Sources:** * Colen CG, Ramey DM * Is Breast Truly Best? Estimating the Effects of Breastfeeding on Long-term Child Health and Wellbeing in the United States Using Sibling Comparisons. Social Science & Medicine * January 2014. Ip S, Chung M, Raman G, Chew P, Magula N, DeVine D, Trikalinos T, Lau J * Breastfeeding and Maternal and Infant Health Outcomes in Developed Countries * Evidence Report/Technology Assessment No * 153 (Prepared by Tufts-New England Medical Center Evidence-based Practice Center, under Contract No * 290-02-0022) * AHRQ Publication No * 07-E007 * Rockville, MD: Agency for Healthcare Research and Quality * April 2007. New Mother’s Guide to Breastfeeding, 2nd Edition * American Academy of Pediatrics * 2011. Section on Breastfeeding, American Academy of Pediatrics * Breastfeeding and the use of human milk * Pediatrics * 2012: 129(3): e827. Powered by Bundoo®
#### To spank or not to spank? There are no denying children can test parents’ patience, and finding ways to effectively discipline them can be a challenge. Studies have shown that up to 90 percent of parents have spanked their children at least once. But before you settle on spanking as a disciplinary tactic, you should know that research shows that spanking is detrimental to a child. “It’s a very controversial area even though the research is extremely telling and very clear and consistent about the negative effects on children,” says Sandra Graham-Bermann, PhD, a psychology professor and principal investigator for the Child Violence and Trauma Laboratory at the University of Michigan. “People get frustrated and hit their kids. Maybe they don’t see there are other options.” The American Academy of Pediatrics (AAP), the American Psychological Association (APA) and the National Education Association (NEA) all strongly oppose spanking, which is a form of corporal punishment. #### The negative impact of spanking It increases the chance of mood disorders. Researchers found 2-7 percent of mental disorders were attributable to physical punishment. Spanking also increases the chances of a child developing anxiety disorders, alcohol and drug abuse problems, and several [personality disorders in the future](https://nabtahealth.com/product/conscious-parenting-coaching-course/). It promotes aggressive behavior. Research shows that frequent spanking at age 3 increased the odds of higher levels of aggression at age 5. It can lower IQ. A study found that children who were spanked had lower IQs four years later than those who were not spanked. In addition to being detrimental to the child’s overall well-being, research shows that spanking does little to reduce a [child’s behavioral problems](https://nabtahealth.com/articles/7-parenting-donts-during-a-divorce/). #### Alternate forms of discipline Time out: Experts recommend the one-minute-per-year rule, meaning if your child is 3 years old he will be put in time out for three minutes. Positive Reinforcement: Instead of just focusing on when they misbehave, remember to put a spotlight on when they do the right thing. [Parents](https://nabtahealth.com/articles/7-parenting-donts-during-a-divorce/) want their children to seek out positive attention instead of negative. Distraction: When misbehaving, infants and toddlers can usually be redirected or distracted with a favorable activity. Reasonable consequences: Taking away privileges or items (a favorite toy, video games, etc.) is an appropriate form of punishment for older kids. **Sources:** * American Academy of Pediatrics * Physical Punishment and Mental Disorders: Results From a Nationally Represenative US Sample. American Academy of Pediatrics * Mothers’ Spanking of 3-year-old Children and Subsequent Risk Of Children’s Aggressive Behavior. University of New Hampshire * Children Who Are Spanked Have Lower IQs, New Research Finds. University of New Hamphsire * Spanking by Parents and Subsequent Antisocial Behavior of Children. University of Michigan * Spanking sparks aggression, does little to reduce behavior problems. American Psychological Association * The Case Against Spanking. Powered by Bundoo®
