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!
Gastroschisis is a rare birth defect that affects 2-5 per 10,000 newborns (0.02-0.05%). It occurs when the baby’s intestines are found outside the body because of a 2-5cm opening on the right side of the belly button. The defect arises during the first trimester of pregnancy, when the primordial [umbilical ring](https://nabtahealth.com/glossary/umbilical-ring/) is forming. In some cases it is diagnosed by ultrasound at 18-20 weeks of pregnancy, otherwise it is diagnosed at delivery. Standard treatment for gastroschisis is surgical repair of the defect, once the protruding organs have been slowly returned to the abdominal cavity. This technique is known as silo repair. **What are the health implications?** ------------------------------------- Babies who are born with gastroschisis have a smaller than normal abdominal cavity. The organs that are displaced (most frequently the intestines, but sometimes the stomach and liver too) are not encased in a membranous sac, meaning they are exposed to the [amniotic fluid](https://nabtahealth.com/glossary/amniotic-fluid/) that surrounds the baby in utero. This fluid is an irritant to the delicate developing organs and can cause them to become swollen, inflamed and thickened; they may also develop an overlying fibrous peel. The intestine may be short, or twisted, and as a result blood flow to the bowel can be disrupted. 10% of infants born with the condition will have gastrointestinal tract abnormalities and many experience delays in their bowel function due to poor absorption and deficient movement of food through the digestive system. Even after surgery to repair the defect, [babies](https://nabtahealth.com/articles/treating-fevers-in-babies-over-6-months/) with this condition often struggle with eating and digesting, with many continuing to gain most of their nutrition via an IV line. They are also at increased risk of infections, dehydration and hypothermia. **What are Risk Factors for Gastroschisis?** -------------------------------------------- The biggest risks for having a baby with gastroschisis are being a young mother and being a smoker. Expectant mothers who have been diagnosed with a [genitourinary tract infection](https://nabtahealth.com/urinary-tract-infections-and-pregnancy/) (GUI) and/or given medication for herpes ([antiherpetics](https://nabtahealth.com/glossary/antiherpetics/)) are also at greater risk. One study found that women who were under 20 years of age, smoked and had been diagnosed with a GUI have a risk of developing gastroschisis that is 25 times higher than women who are over 20, do not smoke and have not had a GUI. If the GUI is present at the time of conception it can cause cell destruction and [inflammation](https://nabtahealth.com/glossary/inflammation/) at the site of the [umbilical cord](https://nabtahealth.com/glossary/umbilical-cord/) attachment, giving one possible mechanism for this type of defect. It remains unclear why younger women have a greater risk of developing gastroschisis. One explanation is that women who are under 20 are statistically more likely to develop a GUI or STI, both of which increase the risk of this birth defect. The increased prevalence of GUIs in younger women is, in part, due to their cervical histology making this type of infection more likely. Thus, alternative environmental risk factors possibly exacerbate the risk of gastroschisis in a group that is already considered to be higher risk. Herpes infections during pregnancy can have detrimental effects on the developing foetus. To reduce the likelihood of [pregnancy complications](https://nabtahealth.com/articles/pregnancy-complications-and-your-midwife/), including [premature labour](https://nabtahealth.com/glossary/premature-labour/), low birth weight and foetal anomalies, a mother-to-be with clinically diagnosed herpes will routinely be prescribed antiherpetic medications. Herpes infection during [pregnancy](https://nabtahealth.com/articles/pregnancy-after-miscarriage/) is not common and it is thought that fewer than 5% of pregnant women require any sort of antiviral medication during their pregnancy; however, antiherpetic use is associated with a four-fold increased risk of gastroschisis. **The Pathogenesis of Gastroschisis** ------------------------------------- It is not fully understood what causes gastroschisis. The rarity of the condition makes it difficult to study real-life examples. One theory is that in the very early days of pregnancy, perhaps as soon as 35 days after conception, there is a defect in the formation of the amnio-ectodermal junction (the primitive [umbilical ring](https://nabtahealth.com/glossary/umbilical-ring/)). During a normal pregnancy, the ring forms in the first few weeks post-[implantation](https://nabtahealth.com/glossary/implantation/) and a number of the early embryonic structures pass through it, enabling the embryonic cavity to enlarge and the [umbilical cord](https://nabtahealth.com/glossary/umbilical-cord/) to start forming. These early structures give rise to loops of the developing bowel, which, by week 10 of pregnancy, still protrudes through the [umbilical ring](https://nabtahealth.com/glossary/umbilical-ring/). Towards the end of the third month of pregnancy the protruding bowel retracts back into the developing abdominal cavity. It is thought that in cases of gastroschisis, this process is disrupted, possibly through non-closure of the ring, or a rupture to the delicate membrane surrounding the ring, localised to the right hand side, preventing the bowel from fully retracting into the abdominal cavity. Identification of the condition in sets of siblings and distantly related family members has suggested a genetic component. However, to date, no consistent genetic abnormalities have been identified across patients. It is therefore more likely that multiple genes are involved, rendering a female more susceptible to the environmental risk factors associated with gastroschisis. The specific gene mutations that have been identified to date, require further investigation to support or disprove a causative role. Another proposed mechanism is some sort of vascular compromise as a result of the right umbilical vein failing to develop properly. This would create a possible site for thrombosis, weakening the area and leading to the problems associated with gastroschisis. The association between gastroschisis and smoking is thought to occur as a result of genetic variations, known as [](https://medlineplus.gov/genetics/understanding/genomicresearch/snp/)[SNPs](https://nabtahealth.com/glossary/snps/) (Single Nucleotide Polymorphisms), which are more frequently observed in maternal smokers than nonsmokers. The most likely explanation is that gastroschisis is [multifactorial](https://nabtahealth.com/glossary/multifactorial/) in origin; possibly caused by a genetic susceptibility, in combination with environmental factors, such as young age, smoking and GUI/STI exposure. These environmental factors may then make developmental defects more likely. Nabta is reshaping [women’s healthcare](https://nabtahealth.com/). We support women with their personal health journeys, from everyday wellbeing to the uniquely female experiences of fertility, pregnancy, and [menopause](https://nabtahealth.com/glossary/menopause/). Get in [touch](/cdn-cgi/l/email-protection#bac3dbd6d6dbfad4dbd8cedbd2dfdbd6ced294d9d5d7) if you have any questions about this article or any aspect of women’s health. We’re here for you. **Sources:** * Ahrens, K A, et al. “Antiherpetic Medication Use and the Risk of Gastroschisis: Findings from the National Birth Defects Prevention Study, 1997-2007.” _Paediatric and [Perinatal](https://nabtahealth.com/glossary/perinatal/) Epidemiology_, vol. 27, no. 4, July 2013, pp. 340–345., doi:10.1111/ppe.12064. * “Facts about Gastroschisis.” _Centers for Disease Control and Prevention_, [www.cdc.gov/ncbddd/birthdefects/gastroschisis.html](https://www.cdc.gov/ncbddd/birthdefects/gastroschisis.html). * Feldkamp, M L, et al. “Risk of Gastroschisis with Maternal Genitourinary Infections: the US National Birth Defects Prevention Study 1997–2011.” _BMJ Open_, vol. 9, no. 3, 30 Mar. 2019, p. e026297., doi:10.1136/bmjopen-2018-026297. * “Gastroschisis.” _National Organization for Rare Disorders_, 2019, [rarediseases.org/rare-diseases/gastroschisis/](http://rarediseases.org/rare-diseases/gastroschisis/). * Kliman, H J. “The [Umbilical Cord](https://nabtahealth.com/glossary/umbilical-cord/).” The Encyclopaedia of Reproduction, _Yale University School of Medicine_, 29 Oct. 2006, [medicine.yale.edu/obgyn/kliman/](http://medicine.yale.edu/obgyn/kliman/placenta/research/Umbilical%20Cord%20EOR_163162_284_18220_v1.pdf)[placenta](https://nabtahealth.com/glossary/placenta/)/research/[Umbilical Cord](https://nabtahealth.com/glossary/umbilical-cord/) EOR\_163162\_284\_18220\_v1.pdf. * Lubinsky, M. “A Vascular and Thrombotic Model of Gastroschisis.” _American Journal of Medical Genetics_. Part A, vol. 164A, no. 4, Apr. 2014, pp. 915–917., doi:10.1002/ajmg.a.36370. * Opitz, J M, et al. “An Evolutionary and Developmental Biology Approach to Gastroschisis.” _Birth Defects Research_, vol. 111, no. 6, 1 Apr. 2019, pp. 294–311., doi:10.1002/bdr2.1481. * Torfs, Claudine P., et al. “Selected Gene Polymorphisms and Their Interaction with Maternal Smoking, as Risk Factors for Gastroschisis.” _Birth Defects Research Part A: Clinical and Molecular Teratology_, vol. 76, no. 10, Oct. 2006, pp. 723–730., doi:10.1002/bdra.20310.
Following childbirth, many women that wish to breastfeed [worry about their milk supply](../breastfeeding-am-i-producing-sufficient-milk). Milk production is regulated by the hormones [prolactin](https://nabtahealth.com/glossary/prolactin/) and oxytocin, which start working mid-way through pregnancy; however, once the baby is born, on-going production comes from consistent and regular removal of the _milk from the breasts_. Therefore, the single best way of _improving milk supply_ is to feed, or express, often. The first few days after delivery are critical for establishing milk secretion and this is the time at which many women who are struggling with [breastfeeding](https://nabtahealth.com/articles/is-breastfeeding-overrated/) decide to switch to [formula feeding](https://nabtahealth.com/articles/correct-position-for-formula-feeding-babies/). There are options for increasing milk supply and for those women who are struggling with [breastfeeding](https://nabtahealth.com/articles/is-breastfeeding-overrated/), it may be worth trying these before switching to an entirely formula-based diet. **1\. Seek professional help** ------------------------------ Prior to attempting pharmacological methods or herbal remedies try speaking to an expert. Your [gynaecologist](https://nabtahealth.com/glossary/gynaecologist/) or midwife should be able to put you in touch with a [local](https://nabtahealth.com/product/at-home-lactation-consultation/) [lactation](https://nabtahealth.com/glossary/lactation/) specialist. These women are trained to offer advice and counselling. They can evaluate whether your breastfeeding challenges are physical (for example, poor positioning, latching difficulties, baby tongue tie) or emotional (usually due to fluctuating hormone levels after giving birth). Their role is to support and encourage, and it is essential that if they do not do this, you find somebody else, who does. **2\. Pharmacological galactogogues** ------------------------------------- A galactogogue is a substance administered to enhance milk supply. To date, there have been no drugs approved [solely to enhance](https://nabtahealth.com/articles/when-should-you-see-a-lactation-consultant/) [lactation](https://nabtahealth.com/glossary/lactation/). The medications that are prescribed are usually licensed for other purposes and used ‘off label’. That does not mean they are unsafe; as licensed drugs, they will have undergone extensive safety testing and, when prescribed to [assist with](https://nabtahealth.com/product/at-home-lactation-consultation/) [lactation](https://nabtahealth.com/glossary/lactation/), they are given at a significantly lower dose than that normally recommended. Domperidone is an antiemetic, sometimes given to infants with severe gastrointestinal reflux. Domperidone stimulates the release of [prolactin](https://nabtahealth.com/glossary/prolactin/), which is one of the hormones that regulate milk production. When given at a dose of 10 mg, three times a day, there is a modest _increase in milk_ production; generally of between 80 and 100 mL a day. There is an association between domperidone and cardiac arrhythmias and, in very rare cases, [sudden cardiac death](https://nabtahealth.com/articles/9-common-cardiac-defects-in-children/). Therefore, women with a history of heart complications should be advised against the use of this drug. It does not cross the blood-brain barrier, meaning there is no risk of neurological side effects, and the dose that passes into [breast milk](https://nabtahealth.com/articles/low-milk-supply-we-can-help/) is extremely low. Given for the first few weeks post delivery, it is moderately successful at enhancing milk supply, but longer term studies on its efficacy are lacking. Metoclopromide is an alternative medication sometimes used to stimulate milk production. Like domperidone, it’s primary usage is to prevent nausea and vomiting, but it also increases [prolactin](https://nabtahealth.com/glossary/prolactin/) levels. Unlike domperidone, it crosses the blood-brain barrier and can cause quite severe neurological side effects, such as tremor and bradykinesia (slowness of movement). Most studies on this drug have failed to find a significant _increase in milk production_. More of the drug passes into the breast milk, although levels are still well below those given therapeutically to infants with stomach complaints. The side effects and lower efficacy mean that, generally, domperidone is preferred over metoclopromide for improving [lactation](https://nabtahealth.com/glossary/lactation/). It is recommended that when medication is prescribed, women continue to feed and _pump milk regularly_ to further enhance their supply. **3\. Herbal galactogogues** ---------------------------- Perhaps the best known non-pharmacological method of _boosting milk supply_ is via the consumption of [lactation](https://nabtahealth.com/glossary/lactation/) cookies (or brownies, or lemonade, depending on personal preference). These can be homemade or shop-bought; however, the latter often come with a high price tag and indiscriminate ingredients, meaning their effectiveness may be questionable. It is the individual ingredients within [lactation](https://nabtahealth.com/glossary/lactation/) products that give them their proposed galactogogue properties. The most widely known herbal remedy for enhancing milk [supply is fenugreek](https://nabtahealth.com/articles/natural-methods-to-alleviate-period-pain/) seeds. As well as being a key ingredient in [lactation](https://nabtahealth.com/glossary/lactation/) cookies, these seeds can be consumed in capsule form or dissolved to make a tea. [Fenugreek](https://nabtahealth.com/articles/natural-methods-to-alleviate-period-pain/) seeds have been used extensively as a cooking spice across India and the Middle East for many years. They stimulate sweat production and, as the mammary gland is a modified sweat gland, it is proposed that they stimulate this gland to produce milk. The evidence for their efficacy is inconclusive and mainly anecdotal, although they do seem to have a mild galactagogue effect and many _[lactation](https://nabtahealth.com/glossary/lactation/) consultants_ will recommend them. A dosage of 1 – 6 grams a day is recommended and side effects are generally minor, [](https://nabtahealth.com/articles/diarrhoea-during-your-period-when-to-see-a-doctor/)[diarrhoea](https://nabtahealth.com/glossary/diarrhoea/) and flatulence being amongst the most common. At high doses, fenugreek can lower blood sugar levels, so it is suggested that women with diabetes mellitus do not use it. There are other herbal options which include shatavari root, malunggay leaves and silymarin (65-80% milk thistle extract). Malunggay is widely used as a galactogogue in the Philippines and thistle extract is another common ingredient in [lactation](https://nabtahealth.com/glossary/lactation/) cookies. However, the scientific evidence for their beneficial qualities is lacking. There are very few studies, and the results are variable and inconclusive. Herbal products do not need to undergo the same rigorous testing as other food and drink products. This means they are not regulated by government bodies and do not need to be tested on humans prior to being sold. The safety profiles of herbal products may not be as well established as conventional medication, however, many, including fenugreek seeds, have a long history of use in cooking and medicine, and therefore, are generally considered to be very safe and well tolerated. In conclusion, adequate support, on both an emotional and practical level as well as frequent feeding (or expressing) are the best ways of _boosting milk supply_. Medical and herbal products seem to show some beneficial effects, however, the scientific evidence for their usage is limited and often restricted to short-term studies. Nabta is reshaping women’s healthcare. We support women with their personal health journeys, from everyday wellbeing to the uniquely female experiences of [fertility](https://nabtahealth.com/articles/causes-of-female-infertility-environmental-lifestyle-factors/), [pregnancy](https://nabtahealth.com/articles/dos-and-donts-in-early-pregnancy/), and [](https://nabtahealth.com/articles/effects-of-menopause-on-the-body/)[menopause](https://nabtahealth.com/glossary/menopause/). Get in [touch](/cdn-cgi/l/email-protection#ea938b86868baa848b889e8b828f8b869e82c4898587) if you have any questions about this article or any aspect of women’s health. We’re here for you. Seek more advice from [at-home](https://nabtahealth.com/product/at-home-lactation-consultation/) [lactation](https://nabtahealth.com/glossary/lactation/) consultation and get to learn more **Sources:** * Asztalos, E V. “Supporting Mothers of Very Preterm Infants and Breast Milk Production: A Review of the Role of Galactogogues.” _Nutrients_, vol. 10, no. 5, 12 May 2018, doi:10.3390/nu10050600. * Bazzano, A N, et al. “A Review of Herbal and Pharmaceutical Galactagogues for Breast-Feeding.” _The Ochsner Journal_, vol. 16, no. 4, 2016, pp. 511–524. * Drugs and [Lactation](https://nabtahealth.com/glossary/lactation/) Database (LactMed) \[Internet\]. Bethesda (MD): _National Library of Medicine (US)_; 2006-. Fenugreek. \[Updated 2019 May 1\]. Available from: [https://www.ncbi.nlm.nih.gov/books/NBK501779/](https://www.ncbi.nlm.nih.gov/books/NBK501779/). * Grzeskowiak, L E, et al. “Domperidone for Increasing Breast Milk Volume in Mothers Expressing Breast Milk for Their Preterm Infants: a Systematic Review and Meta‐Analysis.” _BJOG_, vol. 125, no. 11, Oct. 2018, pp. 1371–1378., doi:10.1111/1471-0528.15177.
**1\. Low milk supply** ----------------------- Some women find themselves unable to produce an adequate [breast milk supply](https://nabtahealth.com/articles/low-milk-supply-we-can-help/) to meet their babies’ needs, but fortunately, there are some evidence-based options to help them increase their production. It’s important to note, however, that truly low milk supply is actually pretty rare among breastfeeding women, so before you try every tip on our list, be sure that it is really an issue for you. **2\. Focus on nursing** ------------------------ A great place to start trying to increase your milk supply is by setting aside a weekend (or a time when you have a partner or friend around to help) to take a “[nursing vacation](https://www.leadinglady.com/blogs/our-moms/what-is-a-nursing-vacation).” This means that instead of focusing on your to-do list, you focus entirely on your baby. Get as much skin-to-skin time as you can, and let your baby feed as much as he or she wants. This contact can not only increase your supply, it also gives moms much-needed rest and bonding time with baby. **3\. Feed more frequently** ---------------------------- The more you feed your baby (and empty your breasts), the more milk your body will produce. If your milk supply is low, you should consider letting go of plans to get your baby on a schedule or reduce nighttime feedings, in favor of [feeding your baby](https://nabtahealth.com/articles/3-rules-for-feeding-your-baby-solids/) whenever he or she is hungry. By doing so, your body should react by producing more milk. **4\. Pump** ------------ Again, removing more milk from your breasts is the goal here. Pumping or hand expression may be a good way to encourage breast milk production, but it’s also important to know what you need to do with the milk you are removing in this case. You should check with your [](https://nabtahealth.com/articles/when-should-you-see-a-lactation-consultant/)[lactation](https://nabtahealth.com/glossary/lactation/) consultant to see if your baby needs the pumped milk on a regular basis as a supplement (if there are any issues, like weight gain) or if it’s okay to store the milk for later use. While supplementing your baby’s diet is recommended in some cases, it’s important not to do so if it isn’t necessary because it can decrease your baby’s interest in nursing (because he or she may feel full from the supplement instead). **5\. Massage before feeding** ------------------------------ Unlike hand expression or pumping, massaging your breasts before feedings isn’t intended to remove any milk at that time. Instead, a pre-feed massage can increase the amount of [milk your baby](https://nabtahealth.com/articles/3-ways-to-boost-milk-supply/) is able to remove during a feeding. Again, if your baby takes in more milk, your body will likely try to keep pace by producing more. One massage method worth trying is the “massage-stroke-shake” approach. **6\. Herbal remedies** ----------------------- Herbs and medications, also called galactagogues, may also help you increase your milk supply. There isn’t much data to support whether or not these supplements work well, but that’s likely because there aren’t many good studies about them. If you choose to go this route, it’s important to be careful which ones you choose because all options are not of the same quality and some may have side effects. You should talk to your doctor or [](https://nabtahealth.com/product/at-home-lactation-consultation/)[lactation](https://nabtahealth.com/glossary/lactation/) consultant to help you decide. **7\. The bare necessities** ---------------------------- Cut back on pacifiers, bottles, and supplements that your baby can suck on and that replace the breast. These can all be distractions that can interfere with your milk supply. If you’ve been supplementing your baby’s diet with something like formula, be sure to [consult a pediatrician](https://nabtahealth.com/articles/when-should-your-pediatrician-send-your-child-to-an-ent/) to see if your baby really needs it. **8\. Relax!** -------------- It’s difficult to let go of stress and to focus on taking care of yourself when there is so much to do and think about. However, stress can keep your milk from letting down normally, so it’s important to try to relax. Even if your biggest stressor is the very fact that you have low milk supply, it’s important to remind yourself that any milk you produce is better than no milk at all. Take some time for yourself so that you can be your best self for your baby. **9\. Get checked out** ----------------------- As you navigate low milk supply, you may find that nothing is working to increase your _breast milk production_. If that’s the case, and you haven’t already discussed these issues with your doctor, it may be time to see if there are any underlying medical conditions. Conditions like undiagnosed [thyroid](https://nabtahealth.com/articles/how-thyroid-disease-can-affect-your-pregnancy/) disorders, [diabetes](https://nabtahealth.com/product/diabetes-nutrition-session/), and [polycystic ovarian syndrome](https://nabtahealth.com/articles/does-polycystic-ovary-syndrome-cause-infertility/) can all cause low milk supply. **10\. Cut out hormonal meds** ------------------------------ Did your milk supply start getting low after you started taking birth control again? Certain types of birth control can interfere with your milk supply, so if this is true for you, consider choosing another birth control method and cutting out hormonal medications. **Sources:** * Riordan and K * Wambach. Breastfeeding and Human [Lactation](https://nabtahealth.com/glossary/lactation/), 4th edition. Powered by Bundoo®
**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®
