Baby 411 & Toddler 411 Blog

Q of the day: When to ditch the binkie?

Q. My baby loves his pacifier. I'm afraid to take it away from him. When it is the ideal time to pull the "plug"?

Pacifier, binkie, plug...call it what you whatever you like. After working with families for 15 years, I think the ideal time to ditch the paci is 6 months. Research shows that pacifiers offer some protection against Sudden Infant Death Syndrome, and 90% of SIDS cases occur in babies under 6 months of age. In fact, the American Academy of Pediatrics actually encourages pacifier use in babies for SIDS prevention.

However, pacifiers are meant to soothe a newborn or young infant whose only strategy to soothe himself is his natural instinct to suck. Babies over 6 months of age are much more capable of settling down and they can be consoled in a variety of other ways.

In older babies, the pacifier becomes a crutch (or a mute-button!) and often causes more of a sleep disruption than a binkie-free life. You see, babies form sleep habits and if falling asleep with a pacifier is one of them, they wake up unhappy when it has fallen out. Then, they wake you up and you are unhappy too. Do you really want to be the binkie retriever every 90 minutes throughout the night?

Taking the paci away only becomes more difficult as a child gets older, and remember they have no good reason to continue having it. So, I suggest getting rid of it when there is no longer a need for it and it is easy to do so. It's much harder to take it away from a 1 year old, 2 year old, or a preschooler!

Just do it. I promise it will be easier than you think.

Reader Email: How do we give up swaddling?

Reader Joshua S. writes today:

I do have a question though that was not in the book, unless I missed it.  We have been swaddling our two month old son with one of those halo swaddles - the one that you put the baby in, zip it up, then there are wings that swaddle around the baby.  The baby sleeps really well in this.  We are trying to not swaddle him, but, it's not working (at all).  People say that I will know when he does not like to be swaddled anymore when he busts out of the swaddle.  The problem is that this swaddle zips and velcroes. It is impossible to bust out of.  Do you have any suggestions as to how to transition our son out of the swaddle and to sleep without it.  Obviously, he will grow out of the swaddle at some point, but I wanted to start doing the transition now.   If I unzip it, he constantly moves and then cries.  When I put him to sleep in the swaddle, he initially moves a lot in the swaddle, kicking his legs, and moving his hands (inside the swaddle).  Any suggestions are appreciated.  Thank you.

Happy to help. This is your homework assignment, due in the
next four weeks: get rid of it. Two reasons: 1. you want him to develop
sleep associations that you want to live with for a long time--so any sleep
crutches should be out of his world by three or four months of life. 2. if
he isn't moving around at night, the back of his head will become pretty
flat. So, while it is okay to continue it for a few more weeks, the
swaddler's days are numbered. Your son will be older in a few weeks and more
capable of soothing himself with fewer immature newborn reflexes.

The take home message: I would suggest quitting, cold turkey, by 3 months of age. Most babies like to move around at that point and have fewer of those newborn startle reflexes that wake them up when they move around. Your goal is to have the sleep habits you want to keep by 4 months, so transitioning to that goal is the plan. That will also help reduce the dreaded flat spot on the back of the head (plagiocephaly) that babies get when they are constantly sleeping in one position.

Question of the day: Is it ok to mix formula with cow's milk

Reader Amy F writes in today with question about mixing formula and cow's milk:

My daughter is 10 months old and breast fed. We started trying out cow's milk just recently. Knowing that it does not have all the needed nutrients as breast milk, I was wondering if I can add formula to milk for added nutrients? She will not take formula any other way.

Hi Amy,

Thanks for writing in. The American Academy of
Pediatrics nutrition committee does not recommend
replacing breast milk or formula with cow's milk under
one year of age---period.

The reason? Not only does cow's milk lack the proper
nutrients that breast/formula have but babies under
one year have difficulty digesting cow's milk in large
volumes. It's ok to use milk in prepared foods, or
offer yogurt or cheese under a year, but drinking 8oz
or more of cow's milk a day can result in severe
anemia. The milk irritates the gut, and causes the
baby's intestinal lining to break down.

For your baby with the discriminating palette, I'd
rather see you add a teaspoon or two of prune juice or
pear juice to the formula to sweeten it up or mix a
little expressed breast milk in it if you've got it.

Hope that helps explain the rationale here~
Best,
Dr B

Question of the day: Dark circles under the eyes-

Reader Janine C. writes in today:

Hi!

my 7 month old daughter used to get dark circles under her
eyes when she was tired. now she's waking up with them and
has them all day. rubbing her eyes often, too. it's troubling me.

i asked my pediatrician and her reply was 'could be allergies.' so, what
do i do? how can i receive a better diagnosis? we have 4
indoor/outdoor cats. baby411 states early exposure to animals
can be good. could this be seasonal allergies? could this be
a sign of something more serious? thanks for any feedback and
consideration to add a little more on this in the next
edition.

best, janine

Janine,

Thanks for writing in. Dark circles under a child's
eyes are relatively uncommon in an infant unless it's
a hereditary thing. However, your pediatrician is
correct that "allergic shiners" can occur due to a
response to allergens--in an infant, that is not
seasonal allergies but environmental ones. The tops on
that list are carpet molds and dust mites. These
indoor allergens occur not matter how clean you keep
your home, but obviously can be more prevalent in
homes with wall to wall carpeting than those with tile
or wood floors.

If your baby is rubbing her eyes AND has those
shiners, it may be wroth talking to your doctor about
ways to limit these allergens in your home (or
discussing it with an allergist). Allergy testing,
other than for food allergies, are not really done in
kids under 4-5 years of age. It's probably not the
pets.

Dr. Brown
author, BABY 411 * TODDLER 411

Question of the day: Is Finger Sucking Bad for Baby?

Reader Charlotte S. writes today:

Dear Dr. Brown and Denise:

What are your thougths on finger sucking?  My 6.5 month-old son has been breastfeed since birth and continues to be breastfed in addtion to starting solids at 5.5 months.  I introduced a bottle when I went back to work when he was 9 weeks.  He's never had a pacifier.

However, at at 3 months of age, he began sucking the middle and ring fingers of his right hand.  My husband feels this is wrong.  I counter that children have a strong desire to suck up to 2 years of age; he does it mainly to soothe himself to sleep and sometimes during his sleep.  My husband asks "what's the difference between finger sucking and a pacifier?"

I am of the understanding that finger sucking is OK before the permanent teeth arrive (at 5-7 years of age) and that one can reason with a child before that to stop sucking his fingers.  My husband feels that it's easier to break a 4 month habit than a 4 year habit, but I don't think our son's finger sucking will last that long.

You talk a lot about a pacifier and to get rid of it by 4 months in Baby 411 but don't say much on the subject of finger sucking.  Please advise.

Hi Charlotte,

Hope you are finding Baby 411 helpful. We do actually discuss thumbsucking in the discipline chapter--which is essentially the same issue you are dealing with, only different fingers!

It's okay for a baby/child to suck their thumb/fingers. Sucking is very soothing, and infants have very few reliable strategies to soothe themselves when they are very young. Like the pacifier, after 4-6 months of age, babies begin to have many other ways to console themselves or be consoled by others--distraction, music, changing the scenery, comfort objects (blanket, doll, etc)--are just a few suggestions. And toddlers really do not need to suck to find comfort at all.
 
While you can take away the pacifier, you can't take away a digit. And you are correct that neither will cause permanent tooth damage unless these behaviors continue when the permanent teeth start to erupt (age 5-7)--although some data suggests these kids are more prone to crossbites if they continue into toddlerhood. No harm done right now with a 6 month old.

If your child is still sucking his fingers as a toddler, I would suggest discouraging the behavior in public to limit the risk of crossbite and limit germs going into his mouth! You can tell him it;s okay to do it in his room (which he may do to settle down and sleep).