How My 3-Year-Old’s Sleep Fell Apart

A couple of weeks ago, I wrote that after I finished my book, I needed a sort of parenting reset with Cee. One of the big areas that we needed to work on was sleep. Bedtime had become a battle, and it was taking Cee a long time to fall asleep. This was leaving us all frustrated at the end of the day, and Cee was waking up grumpy in the mornings. I didn’t have the energy and attention to work on it while I was trying to finish my book, although in hindsight I’m not sure why we waited this long. Over the last couple of weeks, we’ve made some big changes to get us back to happy bedtimes.

Let me back up and tell you how we got into trouble with sleep in the first place. Last August, we moved to a new house. By this time, Cee had been in a toddler bed for almost a year, but she had no problem staying in it at bedtime or through the night. We had a sweet bedtime routine that ended with kisses goodnight, turning off the light, and then good sleep for Cee. After we moved, Cee started talking about being afraid of things like the deer and turkeys that wandered through the yard of our new house. We talked about these fears, got her a night light, and spent a little more time with her before saying goodnight, singing a couple of rounds of Twinkle, Twinkle and rubbing her back for a few minutes. All of that was fine.

Then Cee started getting out of her bed after we left her room for the night. She’d pad into the living room or my office to find me. I’d walk her back to bed and tuck her in again, but some nights this happened over and over. I would be shocked to see her in my office door at 9:00 or 9:30 PM, long after her 8:00 bedtime. She was also waking up during the night, coming into our room, and patting my shoulder until I woke up. I would walk her back to her room, often lying down next to her until she went back to sleep. Alternatively, I’d pull her into bed with me, but neither of us slept very well this way. All of this was adding up to fewer hours and less restful sleep for both of us.

When did the sweetness of a good nap become something to resist?

When did the sweetness of a good nap become something to resist?

Things seemed to get worse around the holidays. Cee was getting out of bed more and more after bedtime, and she was having a hard time separating when we tucked her back in. She started asking us to sit with her while she fell asleep, and this actually seemed like a reasonable solution. At least if we sat in her room we could make sure that she stayed in her bed, and maybe she would fall asleep easier and get more rest this way. I reminded myself that she was just 3, and if she was asking for more support in her transition to sleep, why shouldn’t we give that to her? (Never mind that she had been falling asleep on her own since she was a baby.)

There was something else going on at this time, too. I thought that maybe Cee’s struggles with sleep were because I wasn’t there enough for her in the day. I was going through a really tough period, approaching the 1-year anniversary of our first miscarriage and beginning some fertility testing. Continue reading

Amylase in Infancy: Can Babies Digest Starch?

Several readers have emailed me to ask about babies’ ability to digest starch. Here’s one:

“I have noticed you recommending cereals for babies several times.  I am sure that you are aware that many people look at feeding a baby grains before the age of one or even two as if you have offered your child strychnine. One of the reasons cited is that they supposedly do not have amylase to digest grains before that time. I have often wondered what exactly is happening to the cereal if it is not being digested, but the only statement I could find is something about it “rotting” in the gut.

I would love to get information from a scientific point of view on this topic.  Everything I have been able to find thus far has been very biased towards one point of view or another. Either “cereal is the perfect first food. Easy to digest and enriched with iron” from the infant cereal companies or “Cereal is junk.  No infant should ever eat grains. It is not natural or traditional and they can’t digest it” from online parenting sites.

I need a little clarity and common sense.”

~Hope

I love the skepticism in Hope’s email, and I can also empathize with her frustration about how difficult it is to find good information about a seemingly simple question: Can babies digest starch? If you search for the answer to this question online, you will run into dire warnings of the dangers of giving starch to babies. But these sites might set off your woo detector – as they should. So, after receiving multiple emails about this question as well as seeing it mentioned in discussions on the Science of Mom Facebook page, I figured it was time to put some evidence-based information about babies and starch digestion on the Internet.

Researching this question has given me an excuse to read some classic nutrition physiology papers harkening back to the 1960’s and 1970’s, and it’s brought back memories of years in the lab, exploring nutrient digestion and metabolism. And starch digestion in infancy, it turns out, is a really neat story.

Let’s start with some basics about carbohydrate digestion.

What is starch? How is it digested?

Starch is a type of complex carbohydrate. Made from lots of glucose molecules bonded together in long, branching chains, it is a plant’s way of storing glucose – product of photosynthesis and source of energy – in a stable form. We find starch in grains, root vegetables, winter squashes, beans, and some fruits, like bananas. Starch is an important storage depot for the plant, and it also makes for tasty staple foods for cultures around the world.

One little section of starch, containing 3 glucose molecules. Wikimedia Commons, public domain.

A chain of 3 glucose molecules, like a tiny section of starch.

Glucose is the major fuel for the cells of the body. When we eat starch, we have to break the bonds in those chains of glucose molecules, liberating them to be absorbed from the small intestine into our blood. Starch digestion begins in the mouth, where salivary amylase starts chopping up those large glucose chains. When this partially digested starch gets to the small intestine, amylase made and secreted by the pancreas jumps in to do more bond-breaking and is responsible for most of starch digestion in adults. A suite of enzymes produced by the cells lining the small intestine, including sucrase, isomaltase, maltase, and glucoamylase, work on the remaining short chains, finishing up the job and making glucose available for absorption.

Starch Digestion in Infants

Infants go through some incredible nutritional transitions in the first months of life. Prior to birth, their growth and development is fueled almost entirely by glucose from mom, absorbed across the placenta. After birth, they have to abruptly transition to an exclusive milk diet, which is high in fat and lactose, still a relatively simple sugar. As they start solid foods, babies have to adapt to a much more complex and varied diet. Around the world, starch is a major source of energy in the diets of children and adults alike. But when infants are first introduced to starchy foods – often in the form of cereals and porridges – starch is a novel nutrient to their digestive tract. They need to turn it into glucose, but are they equipped to do this? Continue reading

Traveling with Kids: It Isn’t All Bad (plus 7 tips to keep it that way)

I apologize for my long absence from the blog. It’s been a busy couple of months. We finally bought a house, and with the help of many friends, got moved to our new home. Then the projects began – and continue. Summer school term wrapped up, and I’m prepping for fall term to begin in a couple of weeks. My book is coming along slowly what with all of the above. The blog has been completely neglected.

But I need to get back here. It’s like running and yoga for me; once I get out of the habit of lacing up my shoes or rolling out my mat or actually hitting “publish” on a blog post, these things I love seem to get a bit harder to do. So today,  I thought I’d share my latest installment of Things I’ve Learned About Traveling with Children. (Follow the links to previous installments on traveling with babies and toddlers).

Last week, Cee and I traveled together to Kentucky, where I grew up. It was a last-minute trip, tickets booked just days before our flight. Husband was working and couldn’t leave on such short notice. The reason for our trip was bittersweet. A dear friend died unexpectedly, and we went to mourn her loss and celebrate her life. Despite the sadness, it was a special trip with Cee. It was her first visit to Kentucky, so she met (and vice versa) lots of old friends, many of whom now have kids of their own. (I no longer have immediate family in Kentucky, so we don’t visit there often.) Together, we explored the little house where I grew up, touched the grave of my father, and splashed in the creek where I spent the summers. My mom and my brother also came, so it was full reunion of family and friends.apple tree kids

Something else made this trip special: Cee was an absolute joy as a travel companion. Until this trip, travel always felt like a scary limbo – so long as we were in airports or on planes, until we had a bed and a home base, I carried the knowledge that everything might fall apart at any moment. There could be a poop explosion on the plane or projectile vomit upon landing. My bare boobs might fly out of my shirt as my nursing baby squirmed, the two of us wedged in the middle seat between two strange men.There could be two hours of inconsolable crying on a fully booked red eye from Oregon to New York. I say this because all of these things have happened over the last few years of traveling with Cee. We’re experienced travelers, we know the tricks, and we roll with the punches when things get messy. And they usually do, so I don’t much look forward to traveling.

But now… Cee is potty trained, so no poop explosions (although she did wear a pull-up while we were flying, just in case). She can now tell me when she feels nauseous, so we had plenty of time to get out the little complimentary motion sickness bag. And she’s weaned, so no need to lift my shirt. She sleeps when she’s tired, avoiding that dangerous over-tired state. sleepy headCee is two, but when people ask how old she is, I now feel the need to add that she’ll be three in November. Especially after this trip, she doesn’t feel like a toddler anymore. Continue reading

What’s Your Feeding Style? (Fearless Feeding Review and Giveaway)

Do you have a feeding philosophy? What’s your feeding style?

These are not the most common topics in parenting discussions. We’re often too busy talking breast and bottle, baby led weaning or purees, organic or conventional, and how to get our kids to eat more vegetables. But the question of feeding style, I believe, matters more to children than any of these oft-discussed topics.

I am really pleased to have a new book on my shelf that covers the HOW and WHY of feeding children just as well as it covers WHAT to feed: Fearless Feeding: How to Raise Healthy Eaters from High Chair to High School, by Jill Castle and Maryann Jacobsen. Both authors are registered dieticians, mothers, and bloggers. They take a long-term view on feeding – that we shouldn’t just be concerned with what our kids are eating today, but also about teaching kids to eat well for a lifetime.

9781118308592_Castle.inddFeeding style is one of the first topics in Fearless Feeding, so if you’re not sure how to describe your own feeding style, here’s your chance to give it some thought. Castle and Jacobsen discuss 4 feeding styles, analogous to parenting styles that may be familiar to you: Continue reading

Potty Training: 7 Lessons Learned

Cee has been wearing undies for six months, and I think I’ve drafted a potty post for each of those months. Each time, before I had a chance to edit and publish it, something would change, and the post would seem irrelevant. Potty training is truly one of the hardest things I’ve done as a parent, but not in any of the ways that I expected. I thought I’d finally share some of the lessons I’ve learned so far. In other words, this post is mainly about my missteps and mistakes.

I write this knowing that your process, and the challenges that you face along the way, might be very different. Every kid is different, as is every parent. Like any two-year-old, Cee really wants to do things herself, but she is also a really sensitive kid. And as she’s been learning to use the potty, I’ve been learning more and more about her and how she ticks.

1. Begin when your child is ready.

Okay, I actually think that we got this part right. Cee started showing some interest in using the potty around 18 months. When she started daycare last fall, she jumped into the potty rotation with the bigger kids. By January, she was coming home at lunchtime in the same diaper (dry!) as when I dropped her off in the morning. And in February, after admiring her friends’ underwear, Cee told me that she wanted some too.

Cee was around 27 months when we made the switch to undies. Some would say that’s late, and some would say that’s early. I don’t think there’s a magic age, but I can’t imagine starting this process if Cee wasn’t interested in it. It’s been challenging enough as it is.

Of course, I did dig into the scientific literature to see if I could find some guidance on optimal timing and “methods.” But I think this is an area where the science is just not that helpful. Melinda Wenner Moyer recently wrote a review of scientific support for different methods of potty training at Slate, and she concluded that there’s decent support for parent-led and child-led and quick and gradual methods. This is true, but I also think that the potty training research is limited by the bias of the authors. Potty training is a culturally diverse practice, and a study conducted in a given place at a given time is always going to be framed by the norms of that place and time. Lacking good science, and considering that Cee is not interested in doing things just because I want her to, I waited until it was her bright idea to try going diaper-free. I began with the simple strategy of following her lead, praising her successes, and responding to accidents in a neutral way. Easy, right?

2. Ultimatums don’t work.

Here’s where I made my first mistake. Continue reading

Preparing Your Child for a Big Move (Book Giveaway!)

So, we’re moving this summer. At least, we think we are. The deal isn’t done yet, and we’re not even sure of our exact closing date, which is maddening. But probably, by the end of the summer, our little family will move to our first-ever, very-own home, just about a mile away from our current rental.

Talking about a move with Cee has been interesting. She’s been coming to look at houses with us from the beginning, starting in February. We struggled to explain to her why we were spending so much time dragging her through empty houses. We talked about moving to a new house, and she just looked confused. “Why, Mama?” Why, indeed, would we want to leave the only home she likely remembers? (We moved from Arizona to Oregon when she was 7 months.) What could be better than this house, the place of warm memories and celebrated milestones?

Cee thrives on the familiar. Even though we’ll still be living in the same neighborhood and not much else about her life will change, I know this move will be stressful for her. Heck, moving is stressful for everyone. So what can we do to ease the transition? I’ve had this question at the back of my head all summer.

I received the following guest post a couple of weeks back from the folks at Twigtale, a small parent-owned company that makes custom photo books to help kids with transitions. The Twigtale books are really cool, and I encourage you to check them out. Putting together a custom photo book for a big event is the kind of thing I might intend to do for Cee but never get around to, but Twigtale makes it easy with with a template and text written by child development experts. (Cee loves looking at our photo albums, but you know how long those take to put together. I’m still working on our 2012 family photo book!) So, I’m posting this article for those of you who, like us, might be approaching a move and as a sort of shout-out to Twigtale. They’ve also kindly offered to give away any custom photo book (about moving or any other topic they cover) to one Science of Mom reader. See the end of the post for more details!

Moving Guide – Preparing Your Child for a Big Move

By Allison LaTona, MFT

Summer is here, and with the warm weather and sunshine comes a lot of change for families.  The structure of the year gives way to more down time and loose fun.

Kids may be anticipating a new school year, with new teachers and classrooms, or perhaps starting school for the very first time.  Some parents decide to work on potty learning in the summer, as they can take advantage of the warmth outside providing more “naked time” for their children to better listen to their bodies.  And perhaps most stressful of all, you may be moving this summer.

So the burning question is, how to best prepare your young children for the move? Continue reading

My Favorite Parenting Strategy

A few weeks ago, I blogged about Cee’s long, drawn-out process of getting ready in the morning. She was maddeningly slow at changing from pajamas to her clothes for the day, but she also insisted on doing it herself. If I tried to help, the pace of progress slowed even more. If I tried to take over, it became a physical battle, and I was sure that wasn’t worth it. I tried a few strategies to keep our mornings moving, and readers offered more great ideas in comments on my post.

One of my more brilliant ideas, I thought, was a hand-drawn morning schedule for Cee. I drew a step-by-step diagram of what she needed to do each morning – get dressed, go potty, brush teeth – and then I showed that we could have a few minutes to read a book or play together before leaving the house, assuming she could move through her schedule at a reasonable pace. We drew out the schedule and discussed it the night before, and she was really into it. She showed it to Daddy and carried it around for her bedtime routine, then carefully placed it by her bed before she went to sleep. In the morning, she was excited to follow the schedule and get to book time, and she did it! I thought it was quite a success story. But, by the next morning, Cee was bored with the schedule idea. In fact, I’m pretty sure she saw right through it as one more pressure tactic from me. Cee doesn’t respond well to pressure, thinly disguised or not.

So. I settled on my favorite parenting strategy: patience. Honestly, I can’t think of a more important asset to the parent of a toddler.

I did a lot of little things to ease our morning crunch. I got as much ready the night before as I could; I went to bed and got up earlier to get some work done before Cee woke; and I asked Husband to take over on mornings when he could squeeze it in his schedule, just to ease my nerves. And then, I tried to summon more patience and relax. I trusted that this was a phase that wouldn’t last forever.

dressed and ready

Dressed and ready to go

I’m happy to report that I was right. For the last few mornings, I have woken to the sound of little feet running down the hall. Cee has been waking early, dressing herself, and then coming to wake me up with bed head and a big smile. That whole dressing fiasco? It’s gone. She’s getting dressed on her own, while I’m still snoozing.

Why the change? It isn’t anything I did. Me telling her that she needed to get dressed faster had zero impact, I can assure you. It’s more likely that it prolonged the process. Maybe she’s discovered that it’s more pleasant to get dressed without me breathing down her neck. Maybe she herself got bored with the snail-paced process and figured she’d rather get on with more interesting things in her day. But whatever it is, she is very proud of herself, and I am too. We’re both relishing her autonomy.

But now Cee has moved on to other time-consuming projects. Lately, she’s been wanting to buckle her own car seat. She can do this, but it takes long minutes of sitting in the car waiting for her. Sometimes we’re in a hurry, and I tell her that I have to do it this time, and sometimes that causes a meltdown. But if I can, I try to find my patience and let her do it herself. Just like the dressing process, the learning part takes time – much longer than if I did it myself. But I trust that at some point she’ll get really good at buckling her own seatbelt (always followed by my check). And then she’ll feel proud and independent, and ultimately that means that she does more things for herself. So again, patience.

Patience tells a toddler: You don’t have to be more than you are right now. And when I choose the patience strategy, I’m telling myself the same thing: You don’t have to fix this. You don’t have to have an answer. Staying calm is enough.

It’s tempting to try to fix the little challenges of every stage, but so much of childhood we really can’t control. We can try to prevent meltdowns with attention to sleep, food, daily rhythms, and choices, but when it comes right down to it, the meltdowns are bound to happen at some point. We can do everything right (whatever that means) in the transition from diapers to undies, but we’re probably still going to have some accidents and setbacks along the way.  We can cosleep or sleep train or something in between, and we’re still going to have days when we’re dead tired. So much of parenting is riding out the stages, focusing on the parts of each that we love and then coping with the tough parts as best we can. And then waiting, with patience, trusting that we’ll come out the other side with our kids, who will be moving on to new challenges before we know it.

What are your kids working on that is requiring your patience? And maybe more importantly, where do you find more patience when you’re running low?

Do-Nothing Day

Last weekend, a friend asked if Cee and I would like to go for a hike with her on Sunday morning. I would have loved to go. It was perfect Oregon summer weather, and this friend is one of my favorite people in the world. But, I said no.

I said no because Cee needed a Do-Nothing Day – or at least Do-Nothing Morning. Five days per week, she goes to daycare for the morning. She has a great time there, and I get my work time in. It’s a nearly perfect arrangement. The only thing that’s hard about it is actually getting there.

Cee likes to do things herself, and she likes to do them at her own pace. She does not do well under pressure, and she does not like deadlines and ultimatums.

It is vitally important to her to choose the right underwear for her day. And sometimes she can’t decide on the right pair, so she settles on two pairs instead. (And once, six pairs at a time, which made potty time quite a production.) And then the right pants, sometimes two pairs of those, too (or one pants, one shorts, since we’re on the verge of shorts season). And then a shirt. Maybe it is one particular favorite shirt that she really needs, and if it’s in the dirty laundry, we have to talk about how we wear clean clothes to school. Sometimes we don’t make it to socks – I just carry her to the car barefoot with a pair of socks in my pocket.

Cee enjoys this process, and she sees right through my efforts to shorten it. If I put two pairs of pants in front of her and ask her to choose the blue ones or the grey ones, she thinks about it for what feels like a long time and then says, “Hmmm, where are my red pants?” and starts digging through her drawer. For now, I have accepted that getting dressed just takes some time. But usually, around the time that she has her undies on and one leg in her pants, one leg out, I glance at the clock and realize that we running late. I end up rushing her (with mixed success), and we’re often both a little frazzled by the time we get in the car.

This snail-paced getting-dressed routine is annoying to me, but lately I’ve also been noticing just how stressful it can be to Cee. She doesn’t like to be rushed, and I don’t think she likes seeing me get impatient either. She slows down, shuts down, and falls apart, and that’s a rough way to start the day. Continue reading

Sleep Deprivation: The Dark Side of Parenting

Sleep deprivation is an inevitable part of having a baby, and surely that’s been true throughout the history of our species. But we also live in a culture that seems to take some amount of pride in getting by on little sleep. We think of sleep as time wasted, as lost productivity. We forget – or ignore – the biological necessity of sleep.

Becoming a parent only further stretches our already-too-thin sleep allotments. Newborn babies wake frequently to feed or for comfort during the night. We try to “sleep when the baby sleeps” and piece it together to come up with a reasonable amount, but it often doesn’t feel sufficient. And now more than ever, new parents are really isolated as they make this transition; they don’t have much in the way of backup resources to help with the 24/7 job of caring for a baby.

This month, the theme of our Carnival of Evidence-Based Parenting is Transition to Parenthood. (See the bottom of this post for links to other Carnival posts and here for summaries of them all.) Sleep deprivation is a universal part of that transition. What does the sleep deprivation of early parenthood really look like? How does it affect us? And what can we do to mitigate it?

Just How Bad Is It?

For many moms, sleep debt actually begins in pregnancy, when sleep needs may increase but discomfort and frequent trips to the bathroom interfere with a full night’s sleep. But by far, the biggest change happens in the immediate postpartum period. One study found that in the first week of the baby’s life (compared with late pregnancy), moms got 1.5 hours less sleep, fragmented into three times more sleep episodes per day. The early postpartum period is also characterized by lots of day-to-day variability in sleep. Sleeping with a new baby means unpredictability, with little to no control over whether tonight will be a good night or a bad one.

Mothers usually get the majority of our sympathy when it comes to postpartum sleep deprivation, but the research shows that fathers’ sleep takes a hit, too. A study of 72 San Francisco couples welcoming their first baby compared sleep in the last month of pregnancy to sleep in the first month postpartum (around 20 days of life).  Across this time span, mothers lost an average of 41 minutes of nighttime sleep, while dads lost just 18 minutes. Moms, however, gained 30 minutes per day in daytime napping; dads didn’t get a nap bump at all. In fact, in this study, dads actually slept less than moms – both in late pregnancy and in the postpartum period. Moms still had it harder; they were waking more during the night and had more sleep fragmentation than dads (and it’s quite possible that moms need more sleep, what with recovery from childbirth and the demands of breastfeeding). But regardless, in this and other studies, moms and dads both reported a similar level of fatigue during the day.

There’s some good news to come out of this research, however. It seems that experienced moms are better at handling sleep in the postpartum period. Despite juggling more responsibility at home, studies show that moms who had given birth at least once before tended to get more sleep at all stages of pregnancy and in the postpartum period. Their sleep was also more efficient, meaning that of the time they spend in bed, they spend most of it sleeping rather than tossing and turning – or laying awake listening to the grunts and sighs of new baby sleep. Somehow, experienced moms seem to prioritize sleep more, or they’re just so tired that they crash hard at every opportunity.

How does sleep deprivation affect new parents?

We know a lot about the effects of sleep deprivation but actually very little about the specific type of crap sleep experienced by new parents. Most sleep deprivation studies have been conducted in residential labs, where participants (often young, probably resilient, undergrads) are generally paid to live for a few nights or maybe weeks so that their sleep habits can be controlled and monitored. In a review paper entitled “Sleep Disruption and Decline in Marital Satisfaction Across the Transition to Parenthood,” Gonzaga professor Anna Marie Medina and colleagues make an important point: Lab study participants know that they’ll be subjected to sleep deprivation for a finite amount of time, and they know they can even drop out if it becomes too much for them.

“Understanding that one can end a study, and being certain of the temporal parameters of potential sleep deprivation, imbues the experience of sleep loss with a level of controllability that new parents seldom have. That is, (most) new parents realize they cannot opt out of the sleep disruption experience, and they have no certainty about when they may have an opportunity for sufficient sleep. The stress literature has suggested that such uncontrollability could amplify the mood and physiological consequences of sleep deprivation.”

In other words, most of what we know about the effects of lost sleep may be even worse in new parents. On that happy note, there are a few major areas of concern… Continue reading

Breastfeeding a Toddler? Should You Be Concerned About Iron Deficiency?

You may have heard about a study published in Pediatrics last week (Maguire et al. 2013) showing an association between iron deficiency and breastfeeding beyond a year. If you’re breastfeeding a toddler, or considering it, you might be wondering if you should be worried about iron deficiency. There is very little research on breastfeeding beyond a year in developed countries, so this study is worth a closer look. (If you’re interested, I’ve written before about some of that research, my own reasons for choosing to breastfeed beyond a year, and my experience of weaning my two-year-old.)

What This Study Shows

This was a cross-sectional study of children ages 1-6 in Toronto, Canada. Blood samples were taken from 1647 children, and their mothers were asked, “How long has your child been breastfed?” We always have to be cautious about studies based on parental recall. However, research shows that mothers actually answer this question with good accuracy (Li et al. 2005). Of the children in this study, 93% had been breastfed at all, and median breastfeeding duration was 10 months. Twenty-seven percent of children were breastfed for more than one year, and 4% breastfed for more than two years.

The children’s blood samples were analyzed for serum ferritin and hemoglobin. Serum ferritin reflects the amount of iron stores available for use by the body, so it can be used to assess iron deficiency. If an iron deficient child also had low hemoglobin, he was diagnosed as having iron deficiency anemia. In this study, the prevalence of iron deficiency was about 9%, and 1.5% had iron deficiency anemia, findings similar to other studies in developed countries (Baker et al. 2010, full text here).

This study showed that kids that were breastfed for longer were more likely to be iron-deficient. Each month of breastfeeding beyond baby’s first birthday increased the risk of iron deficiency by about 5%. Children who were breastfed for longer than a year were estimated to have 1.7 times the odds of being iron deficient than those breastfed for less than a year. Continue reading