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Children's Health

When to stop giving bottle to 7mo at night?

01/30/2009

Question:

I have a 7mo old baby turning 8 in about a week and he still eats twice a night with a bottle, once at 12am and 3am. Once I feed him, he`ll go right down to sleep but I want him to sleep through the night. It seems like he`s really hungry when I feed him. I know if I stop feeding him, he`ll just cry and it will take awhile to get him to fall back asleep. Should I give him water? But I really don`t know when it`s ok to give them water. Any advice would help.

Answer:

You are not alone in grappling with ending night feedings for older babies. By now you have long expected (and need) an unbroken night's sleep. 

I am assuming that your baby is a full term, healthy little boy without any growth problems. Preterm babies may need night feedings longer than full term babies for good growth, especially if they also have heart, lung, or kidney function problems. Also babies who are not growing well may need the extra calories from night feedings to catch up in their growth.

Healthy, full term babies all experience a drop in growth rate at 5-6 months of age to about half of their growth rate in the first months of life. Normally their appetite drops so that their intake of calories decreases to match the slower rate of growth and they do not become overweight. So you really do not have to worry about depriving a healthy, vigorous baby with a normal growth pattern of their needed nutrition by stopping night feedings.

For most babies, the issue of night feedings is one of having been trained to require night feedings in order to fall back to sleep. It is similar to putting babies to bed fast asleep so that their last memory is being held by a parent. it creates the habit of needing to be held in order to fall asleep.

Needless to say, it is far easier to create a habit than it is to break a habit. You could try several strategies.

The first is to stop night feedings cold turkey and endure the crying, reassuring him every 5 minutes but not feeding him. Sometimes it is more helpful for dad to do this since babies may associate mom with feeding. This may take 5 nights or more to achieve. It is not easy to keep trying to comfort your child. However bear in mind that he really does not need the calories from formula. Both night waking as well as excess food promote excessive weight gain.

The second is to substitute water for formula at night only. This would protect the baby's teeth and decrease the risk for ear infections. However, you are still getting up. The AAP does not recommend that water substitute for formula or breast milk during the day for the first year of life.

The third is to stretch out the time between the 12 and 3 AM feedings so that you give only one night feeding. When that is going well then eliminate the last night feeding. You get more sleep but still have to get to up once. It may prolong the crying at night but feel less cruel to a parent.

The last alternative is to leave things as they are and let him out grow the need for night feedings on his own. This will certainly keep you tired but eliminates the hassle of a crying child in the middle of the night. It may promote cavities in his new teeth and lead to too much weight gain.

Other supportive measures include having and sticking with a simple bedtime routine. If you have not done this already, I highly recommend it. Simple is important so that no matter where you are or if you are on vacation or not, it is easy to replicate the routine to promote sleep. Another comfort measure is to make sure he has a comfort object handy that he associates with you, also called a security object. This can be a blanket, a stuffed animal, or soft doll. If he has not yet become attached to anything in particular, now is the time. Select a soft object and always hold it when you hold him or comfort him to create the association between your loving presence and the object. Eventually the object helps to fill in for you and provide a comforting bridge until you return. It is helpful to have several duplicates so that you have a replacement in case of loss or the need for cleaning.

Penelope Leach's book "Your Baby and Child: Birth to Five Years" offers sound advice for parents on a variety of bumps in the road in caring for a young child. I highly recommend its parent and child friendly advice. Ellyn Satter's book Child of Mine: Feeding with Love and Good Sense" is another gem around feeding issues.  Both are widely available at major book stores or on-line.

Your son is entering the latter part of infancy when effective limit setting becomes an important skill for parents to master. Limit setting is not mean. It is actually truly helpful to the child to learn to manage falling asleep on his own, to accept a variety of foods rather than only 3 favorites, and how to share and empathize, becoming a good best friend. All of these skills need a parent's gentle guidance and limit setting in a kind but firm way.

I hope these thoughts are helpful to you.  

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Response by:

Mary M Gottesman, PhD, RN, CPNP, FAAN Mary M Gottesman, PhD, RN, CPNP, FAAN
Professor of Clinical Nursing
College of Nursing
The Ohio State University