Poogate & burping your baby

Because the other thing is during the day he does a lot of burping and quite often, you know, a little bit will come up or sometimes not a little bit, and he obviously does need that whole winding process. But at night I am now doing five minutes of consistent winding and then sit upright for another 15. – Cass

Intro

In today’s chat with Cass, we talk about winding babies, how important it is and how long we need to burp for. This week, Max is waking at around 3 or 4 am and just not resettling. And so we look at how to cope with these early morning wakings. We chat about that much spoken about the topic of poos, diapers or nappies, what’s normal, and what’s not. We also look at the subject of cot death and sleep safety. And finally, we talk about all the phases of dummy and pacifier use. So stay tuned for this one as we explore early health and sleep issues with Cass and her little one, Max.

Welcome to Sense by Meg Faure, the podcast that’s brought to you by Parent Sense, the App that takes guesswork out of parenting. If you’re a new parent, then you are in good company. Your host Meg Faure is a well-known OT, infant specialist and the author of eight parenting books. Each week we’re going to spend time with new moms and dads, just like you, to chat about the week’s wins, the challenges and the questions of the moment. Subscribe to the podcast, download the Parent Sense App and catch Meg here every week to make the most of that first year of your little one’s life. And now meet your host.

Meg: Welcome back I’m Meg Faure, and I am so excited to journey with moms and dads through the highs and lows of each week of parenting. And today we welcome back Cass and a look at the life of a nearly two-month-old. In fact, Max is eight weeks old yesterday. Cass, isn’t he?

 

Cass: Yes, that’s correct. Yeah. He’ll be two months. I think it’s on Saturday. So yeah.

Meg: Oh, my word, time has flown.

Cass: It has, it has actually, a friend of mine visited a couple weeks ago and she said something to me that I keep telling myself, but I thought it was a really good quote. She said “the days are long, the years are short.”

Meg: Yeah.

Cass: And I think that is very much the case at the moment. The days are long but the months are short.

Meg: Yeah. It’s so true. And you know, it’s a funny thing because in the moment of a lot of your parenting conundrums, which I will tell you, and you will know, there will be hundreds of them coming up over the next 18 years. And you kind of wish the moments away, like, especially the two-year-olds where they have been all over the place and they’re throwing temper tantrums or the colicky period. I know that Max doesn’t have colic, but the colicky period, you wish it away or the sleepless nights. But the conundrums of that is, that every time you wish away those pieces, you wishing away the parts that are also, you know, so amazing and the cuddliness and the cuteness. So, it’s a conundrum in parenting, there’s no doubt.

Cass: Absolutely. Alex and I were going to bed the other day and I had the monitor up and I was looking at Max on the monitor and I said, Alex, I was like, oh, I just hurt how much I love him. And then a few hours later, he woke up, he needed a feed, and he was being really being impatient, he just was hungry and I needed to wash my hands and I found myself going, oh, just wait. And I thought, gosh, how I flipped—.

Meg: Oh, my word.

Cass: From being completely googly eyed to just like, oh God, give me a minute.

Meg: I know. It’s so true, because in those painful moments, that can be really painful. So have you had any painful moments this week or have you had any exciting and happy moments that you want to share?

Cass: I mean we have definitely, he is so smiley now. We’re so lucky. He is a joy, but I have to say at the moment, the nights, the early hours I should say, more so than the nights, are a bit of a challenge. And I say this all with a massive caveat that I bumped into a friend of mine the other day. And he was blown away by how well Max was sleeping at night because their little one woke every 90 minutes for the first three months at night.

Meg: Yeah.

Cass: And so I was sort of thinking that we were having a bit of a rough time and I thought, oh, so I do feel awful when I say thing that aren’t great, but it’s different. Max was doing absolutely fantastically at night, and he still does for the first part. But there’s a couple of things, I think we were speaking a couple of weeks ago about how much information there is out there and how often it conflicts with other bits you read. So for example, one of the things I was thinking, which is the right way to go? Okay, so one of the amusing slash not amusing in any way, moments of the week was Max didn’t poo for two days.

Meg: Okay.

Cass: Which is apparently very normal with breastfed babies.

Meg: It is.

Cass: But for the whole weekend when daddy was at home, he didn’t poo. And then Monday morning, almost as soon as daddy walked out the door, it was an explosion.   Oh my, I had to take photos. I was so blown away by what he’d been capable of. I went with one wipe and I thought, this is just pointless, this isn’t going to do anything. So I just put him in the bath and sprayed him with the shower.

Meg: Gosh, that is funny.

Cass: Because it was just everywhere. But that meant that, he’s also not pooing at night, which is quite nice because it means that I’m not dealing with that in the dark at night and that sort of thing. But I’m not really sure because I read in places, if they don’t have a dirty nappy, don’t change it because you wake them up to0 much at night and you know, you want to keep it all very calm and that sort of thing. But he often falls asleep on the first boob when I go in to feed him or will go very drowsy and then I’ll go to burp him, which is another area of questioning I have. Then he sort of falls asleep on my shoulder while I’m burping him. So quite often I’ll change his nappy after the first boob, he’ll wake up and he’ll do a decent feed on the second boob. Yes. But as I said, I’ve read quite a few places that if they don’t have a dirty nappy, it’s just wet.

Meg: Don’t change it.

Cass: Don’t change it. And I just don’t know, but I’m worried if I don’t change it, he’s not going to get that extra bit of feeds that he seems to be wanting when I wake him.

Meg: Yeah. So to answer that question just first of all, what time is that first feed of the night generally?

Cass: Between 12 and 1.

Meg: Okay. All right. And then he does another one at about three or four?

Cass: Yeah, exactly.

Meg: Okay. All right. So in that situation and he does he go down quite happily after that midnight feed?

Cass: He does. Yeah.

Meg: Okay. Then I would change the nappy for exactly the reason that you are doing it, which is that you are arousing him sufficiently to get that other side in nicely. We specifically recommend not to change nappies or diapers at night with babies who don’t settle immediately after the feed. So if he was like unsettled after the feed and just not sitting nicely, then it can be that he’s been too aroused by the change of the nappy. And that’ll often happen with our more sensitive and slow to warm up babies. Where he’s a settled baby, so he probably hasn’t even noticed that there’s been a nappy change or that it was dirty in the first place. So my suggestion to other moms is if your baby’s nappy has not been pooed in or soiled, and they’re not settling straight after feed, then don’t change it. But in the event that it’s not soiled and they are settling quite happily after feed, there’s nothing wrong with using it as that cue to wake them up a little bit more and aroused them up after bath so that they can actually do that settling side. So, my suggestion as usual is that your gut is actually correct.

Cass: Yeah. Okay. Because what he’s not doing, and so maybe I don’t change him after the three or four feed. Now in a bit of a nightmare stage where from three o’clock, he is just not settling. And this takes me to the winding question, because the other thing is during the day he does a lot of burping and quite often, you know, a little bit will come up or sometimes not a little bit, you know, so he obviously does need that whole winding process. But at night I am now doing five minutes of consistent winding, and then sitting with him upright for another 15 to make sure that everything…

Meg: No, no, no. You’re doing that until three o’clock, four o’clock feed?

Cass: And all the time, because he’s not burping. And when I’m putting him down, he’s now waking quite quickly afterwards. And he’s just doesn’t seem to be settling from particularly three o’clock. But the night before it was the one o’clock and he’s not crying, but he’s just sounding frustrated, and his knees are going up and he’s kind of going (coughing).

Meg: Yeah. And then if you lift him after, does he do a big burp?

Cass: No. And that’s a strange thing. I mean, last night, Alex and I were taking him in turns where we were going through, because he was not settling. He was making these noises and he just wasn’t interested in going to sleep. And it sounded like he was really frustrated, and we had that the night before, but that was poogate, the night before. And then he did last night, he pooed.

Meg: Okay

Cass: So I thought he was uncomfortable because he was trying to, but now he’s done it the second night, so I’m not really sure how to get the winding done because he just, as soon as you put him on the shoulder, he’s like, oh, I’m settled and happy now.

Meg: Falls asleep.

Cass:  Yeah.

Meg: So I’ve always had a principle of no more than five minutes for winding everyday or night. And the reason for that is that we know the babies. I mean, and they’ve done scans that have shown this, that after five minutes, the windows actually moved through by and large, and it’s going to come out as a fart.

Cass: Okay.

Meg: And very often what happens is that we kind of sit there juggling and burping and they’re actually gulping air while we are doing that. And then they make a big burp and we think, oh, that was the burp that we’ve been waiting for all along. But actually it wasn’t, it was the burp that they’ve created while they’ve been sitting there waiting for it to come up. And so the rule for them is only five minutes of burping. And then after that, they go down. If he’s then niggly, so I’ve got two things to say about the niggly things. Sometimes it’s just as much as just picking him up. So you put him down after five minutes, you then five minutes later starts with lifting and pulling up his legs, picking him up and do one little burp and see whether or not it’ll come up again then. And in the situation that it doesn’t come up again, settle him back down again, because the other reason why they, and probably the more likely reason why he’s having this niggly patch is that babies of eight weeks classically have one niggly patch in 24 hours. And for most babies for nine out of 10 babies, it happens between five and eight in the evening. But you do get the babies that happens in the early hours of the morning. And in actual fact, my third child had that as well. So I would find myself pacing with her at that time. It’s just a niggly time. Almost all babies have a period in 24 hours where they’re classically, that becomes their little prickly patch. And it’s possible that his is that early hours in the morning because he is not prickly at any other time of day really, is he, not in the evenings?

Cass: No. I mean we are trying to work out when and how to feed him in the evening. So that’s more us trying to get that right for him because we are trying to, so I think we spoke last week and we now I’m feeding him when he does seem really hungry at about five and then we’re doing bath and that sort of thing. And then, I mean, last night I fed him at five. He went for a bath at half-five, I think half-fiveish and then he did a bottle and he honestly drank about 160 ml after doing a feed. So then I was worried, well, then, first of all, fool that I am, I thought, oh my God, he’s going to sleep forever because he’s had so much food. No, he did not. But I thought then when he was really niggly in the early hours morning, I thought, oh my gosh, is it because he had just too much in the night, but from what you’re saying, no, it’s probably.

Meg: Probably, it’s just that niggly patch. And you know, a couple of things around that niggly patch, one is to listen, you don’t have to respond, because they often will actually sort themselves. The second thing is to actually just go in and put your hands on him and pat him and kind of stroke his forehead and soothe him that way, lying down. And then as I’ve mentioned, I think this is the third time I mentioned that or that heavy little product that you can put on him as well. Also helps him to stay in a bit of a deeper state of sleep. So you can try all of those. Also, you know, that I wouldn’t change the nappy for that feed. Definitely not. So I would do one side and if he’s too sleepy to take in the second side, he’s going to wake up for a feed at six anyway, and then you’re going to give him the second side. And that’s what resets your day between five and six you’ll have a full feed that will then reset his day. But I think, you know it’s not helpful to moms to hear this, but this does pass.

Typically your height of the irritable patch is six weeks. And then each week from six weeks to 12 weeks, it just diminishes, diminishes, diminishes. So I think you will find that early hours of the morning he will actually settle down.

Cass: Yeah. Because what he does love, if we give in, which invariably we do is going on to daddy’s chest because by this time we’re probably, I’m certainly really tired. And at about 5:00 am, he goes on to Alex’s chest and he will sleep for three hours if he could like that. And I sort of, in my head, I keep saying, I know they can’t form habits right now, but he will just sleep forever if he can. And so then last night I started thinking, he just want to be on the chest and so he’s not going down because he knows it’s the time that we’ll give in.

Meg: No, he’s definitely not manipulating you, babies at that age can’t do that.

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Meg: I mean, actually interestingly, I always say, and this goes for all the way through, into the toddler years that anything after 4:00 am you break all the rules. And the reason for that is that usually babies who sleep pretty well at night, which by the way, one night waking, which is what you’re getting one and a half, two, you’ve kind of got another one at three, but between one- and two-night wakings when eight weeks old is typical. Anyway, that’s totally normal. So he’s sleeping well. So to break the rules at that time in the morning is probably exactly what I would say do. I wouldn’t worry about that at all. The only thing, and I think it’s worth talking about this because we haven’t discussed it on a previous podcast is around sleep safety. It is very important to mention what sleep safety looks like. It’s one of our contentious parenting topics. And depending on which country you are in; you will have different advice. So if you were in America, the American Association of Pediatrics is very specific about no co-sleeping, no babies in the bed at all. And, in fact they believe that co-sleeping is a massive risk. Now what we know about SIDS, which is otherwise known as cot deaths, Sudden Infant Death Syndrome is that there are specific risk factors that increase the baby’s chance of having a cot death and obviously a cot death is absolutely everybody’s worst nightmare. One of them. And the biggest one is tummy sleeping, which is why when the American Association of Pediatrics brought in the Back-to-Sleep campaign at the end of the last century, towards the end of the 1900s that was the biggest single impact on SID rates because they dropped off dramatically. But obviously the research keeps going and they’ve looked into the dummies impact on SIDS. You know, what else? The risk factors and your big risk factors, the next big risk factor is co-sleeping.

Now, when you look at the actual research, the co-sleeping that they’re talking about is co-sleeping on couches. So that’s kind of falling asleep when weren’t intending to fall asleep with a baby on you and specifically in the context of alcohol and drugs. So, you know, that kind of situation where you – maybe a parent has had two glasses of wine and falls asleep on the couch to two o’clock in the morning because they were dead tired, pacing the floor with the baby and then actually smothers the baby. And that’s your biggest risk factor. Yeah, but having said that American Association of Pediatric has ruled out co-sleeping as a possibility entirely.

In Britain and the UK, it’s slightly different because you do have different theories on it. Like for instance, there’s a very big argument to be made. Or this research that has been put forward that says co-sleeping increases attachment and increases breastfeeding rates, which it definitely does increase breastfeeding rates, but there’s also an argument that it increases attachment. When you look at the science behind those particular articles, they’re not entirely true. And this very interesting research that’s actually been put out around that where it doesn’t impact attachment. So for that reason, I wouldn’t be advocating co-sleeping for attachment reasons. Co-sleeping most parents do for convenience reasons, which is exactly what you’re doing. That’s pretty much why parents do it. So if you are going to co-sleep and even if it’s five o’clock in the morning, you would need to do it very safely and safe co-sleeping means that baby has their own space. They’re not actually on your chest. So they’ve got their own sleep space in between the two of you with no duvets near them, with no pillows near their head. You know, it’s a very clinical sleep space, even though it’s with you. And this starts all the way through until the year of age, although the risk of SIDS decreases substantially as you get close to a year. So I guess in terms of the habits, it’s not a major thing with him having that little cuddle time in the morning. In terms of the sleep risks and the sleep safety risks, you know, you would have to make sure that Alex was actually pretty much awake, which is always difficult to guarantee that at that hour of the morning.

Cass: Yeah. Alex actually props himself up on pillow, so he is not lying down, he’s put up and he goes on his phone so that he doesn’t fall asleep, but the other thing is he of course hasn’t been awake all night.

Meg: Well, you’ll remember that I think in our second episode I spoke about splitting up. And in terms of you split up your nights, you do till five, four or five and anything after that is his responsibility. And if it means that he’s got him on his chest, so you can get a few more hours, and then that’s fine. But I think it’s good that Alex isn’t actually falling asleep.

Cass: Yeah, no, I mean, we’re both terrified of that.

Meg:  Yeah.

Cass: But yeah I mean sometimes we can lie there just two of us chatting and you know, because we’ve woken up and Max is still absolutely zonked. And I suppose really what I was worried about was that because he was so uncomfortable when we put him down on his back. But so all of those things were contributing to me wondering if it’s because I’m not winding properly at night because he’s fallen asleep.

Meg: No, I think he’s going in for the sensory and that’s very often the sensory, whether it has been carried in a sling, being pushed in a pram, being given a little massage, swaddling, part of those as things are things are reuse for that unsettled patch. And so what he’s using for that unsettled patch is human engagement and love and paddles, I think.

Cass: Yeah, he is. But no, I mean, that’s been the kind of the challenging bit, and then as I say, funny, but not so funny that moment, there was the first time we’d had one of those. I was actually speaking to my friend the other day and I showed her a picture and she was like, is that your first one? We’ve had loads of those.

Meg: Those explosive poos. So those actually, and it was interesting what you said at the beginning. You know, it’s true that breast fed babies can do seven poos in a day or one poo in seven days. I mean, and that’s how completely opposite into the continuing a poo routine can be for babies. What’s interesting is because he’s such a highly regulated baby, which is a good thing. He actually has ended up already stopping poos at night. And it’s one of the things your hormones actually dictate that and start to, you know, limit the amount of poo that you do in the middle of the night. And we need each as about two or three years old, it’ll do the same for his urine production at night. So then he’ll sleep through without needing a nappy anymore.

Cass: Okay. Cause actually, it’s not a question from me, but the same friend message today, because her other one is the same age as Max had slept from nine until 6:45 in the morning.

Meg: Wow. That’s good.

Cass: But had woke up with the dry nappy.

Meg: That’s very interesting. That’s highly, highly unusual. So your hormone that actually turns off your urine production, shouldn’t be turning off urine production at that age. It’s very unusual. You know, you do want to make sure that you’re having nine wet nappies in 24hours, you know, seven to nine waking nappies in 24 hours. So, you know, I would wonder whether or not he did sleep well, which he wouldn’t be if he was dehydrated, but yeah, you don’t want babies switching off their urine at this age. It’s not normal.

Cass: No. I mean, and interestingly, I was chatting to her yesterday and I said, you know, you’ve got these amazing nights. And she said, I’d almost rather have amazing days because that’s when I’m awake with her. And so she has trickier days with her little one, but with these amazing nights, so, and then I have these wonderful days with Max and still very good nights, but at the moment they don’t, they don’t feel so good when you are sort of up feeling like you’re up constantly from one or three in the morning.

Meg: Yeah, for sure.

Cass: It is the nights. I think you become a bit, I found as a mom, I become a little bit obsessive about the nights, sort of how do I do it?

Meg: Yeah, for sure. I think the nights, I mean, in terms of sleep norms, what happens between birth and 17 weeks is that you end up moving that one night feed out later and later. So it was a 10, it becomes 11 and it becomes 12. Now yours is between 12 and 1 and then increasingly that through to the morning. And then you can imagine if you’re having that night feed at two, then the next feed is five. So that means you’re on one night feed. And that’s actually what the typical baby does on each end of the continuum. You’ve got the baby, like your friend’s baby who’s actually sleeping basically from nine until six, which is sleeping through the night essentially. So she’s doing that very long stretch. And then you’ve got other ones who on the other end of the continuum are still waking up at 10, 11 1, you know, and going through all that through the night.

So Max has actually slap bang where, what we expect for this age, what then usually happens is at 17 weeks, we have what has now been termed this 17 week sleep progression that everybody dreads.

Cass: I am starting it.

Meg: Yeah. And it just does happen. They start to wake, you know, instead of stretching till two or three, which he’ll be doing probably by then, he’ll wake up at 12 or maybe even 11. And it feels like hell, because like you just getting them in the right direction and they go backwards. And so when we talk about that, there can be two possible reasons for that sleep progression, which we’ll go into in much more detail when we get there, the one is nutrition and the other one is self- soothing. And then the next stage comes about, and particularly for those who actually start to piece it together between four months and six months they become quite good sleepers. And then at six months they then sleep through for 8 to 10 hours at night. And that could be going down kind of at six in the evening and waking at four for your first feed. And that will eventually by eight months disappear altogether. So that’s the way that these sleeps move or the progression that babies take through sleeps.

Cass: It is amazing how your body does adjust and how little sleep I am actually surviving on because it’s broken. The other night he did seven hours, I think it was last week. Oh, no, actually it was, had he done it yet the day of the vaccinations, the day after he did a seven-hour stretch, that night.

Meg: That was the night we last spoke then.

Cass: Yes, it was the night. In fact, I nearly messaged you in the morning because I woke up after four or five hours. And I was sitting there counting 11, 12, 1, trying to work out my hours. Is he actually doing this long? I don’t understand. I couldn’t get back to sleep. Cause I was so excited. So I missed out on the long stretch, but I’d had four and a half hours. And I said to Alex, next morning, I actually, haven’t had four and a half hours of a solid period of sleep since he was born. And it suddenly hit me how amazing our bodies are that, you know, before, if I hadn’t had that for seven, eight weeks, I think I’d have just caved, I wouldn’t have been able to go. But you just keep going now and everything adjusts. It’s amazing.

Meg: Yeah, no, you certainly do. Although, it is torture, for me I think that’s why I ended up working as a sleep therapist because for me it was at a torture, you know, I could not bear it. And with my first born, I did have to do some quite serious sleep training by about seven months because we had managed to get ourselves into a 45 minute, wake up for the dummy, we call it dummy patrol and you know, every 45 minutes he’d wake up with his dummy and that was hell. So I know like that sleep deprivation is absolutely nothing I could do, it’s really is awful.

Cass: Yeah. I’m quite that. I don’t know how we’ve done it, but actually much only has a dummy in the day. He doesn’t need the dummy at night, which, I don’t know how I’ve done that. I would love to know, I haven’t done a thing, Max has done it, but he just doesn’t need a dummy at night. So because initially we were on dummy patrol. Yeah. And somehow he’s managed to change that to self sooth, and so now he only has a dummy when he’s going to sleep in the day.

Meg: That’s great. No, that’s really excellent. Yeah. Look, I think the dummy is such a debate. You know, I always get asked about dummies should we use them? How do we get rid of them? What age they need to get rid of? And you know, I think each age band there’s advice around dummies. For the first 12 weeks I do like dummies because specifically of during the day, like you say, because little ones are classically a little bit more niggly. You might actually find, Cass if you use a dummy during his niggly patch after 3:00 am that he might reset, like might be worth putting that into place.

Cass: Yeah. I might try that.

 

Meg: Because that’s where a dummy is useful. And then between four and seven months of age, dummies classically, we go into what’s called dummy patrol, where at varying levels, you are required to put the dummy in because babies need them, and they can’t do them independently. And then seven to eight months you can actually teach little ones to use the dummy on their own, which changes everything because then they just find the dummy. And I always say to moms, once we’ve taught them how to I’ll help you with that if we get there at that age. But once you’ve taught them, you kind of throw five dummies in the cot and just pray their find one, that’s the strategy there. And then going into toddler years, there’re two principles around, around dummies, one is that they actually shouldn’t have dummies while they are walking around, as soon as they’re walking. And the reason for that is not so much that it looks ugly or it’s unhygienic or anything else. It’s actually just for language reasons that once little ones are walking, they need to learn to talk. And so if they’ve got the dummy in their mouth, it does impact on language. We know that less kind of language explosion, but also when they do start to speak, they lateralize the sounds on the side of their mouth, around the dummy and so can cause a little bit of a speech impediment in some ways. And so dummies then only become for sleep. And then you can get rid of a dummy between three and four years old because at that age, there’s a story you can tell and you can take, you know –

Cass: Make up a reason.

Meg: Exactly. Exactly. We had hyenas that stole the dummies. So cause we’d actually been in the African bush and we’d had been, had our house surrounded by hyenas when James was two and half and they make a hell of a noise at night. And so every night he’d go to bed and he’d go “Where are hyenas?,” he called them the “myheanas,” “Where is the myhenas, where the myhenas?,” and they were just making such a racket, and on about the third night, I said, you know what, we’re going to throw away the dummy. We just going to tell him that the myhenas took it. And he bought into it. I said, you know, those myhena babies were crying so much we had to give them to the myhena mummies – the dummy for the myhena babies.

Cass: That was so sweet.

Meg: Yeah. So those the kind of different stages with dummies and pacifiers that babies go through. Well, if he goes again between from three, definitely we’ll try and avoid. I won’t worry too much about the winding and we’ll try and just pat him and put the, the weighted toy on his tummy and then possibly if it still continues, try the dummy.

 

Cass: Yeah.

 

Meg: Yeah. No, it is worth trying at that time because those niggly patches for other moms they might be between five and eight. For you, and also for my third, it always kind of three to five in the morning, and that’s very common that they just have one patch that is just their niggly patch.

 

Cass: Yeah. Well, hopefully as I tell myself when I’m having a really good day and that it doesn’t or good night, and it doesn’t last, I’d say, okay, what is this phrase, but so is the bad time. That’s just a phase.

 

Meg: Well, I love that you say that because it is how you have to frame early motherhood that, you know, everything is there just for a period of time. Even the gorgeous stuff is there only for a period of time, but certainly the bad stuff passes.

 

Cass: Yeah.

 

Meg: Cass, thank you so much. As always it’s awesome to chat.

 

Cass: Thank you.

 

Meg: Thank you very much. And we will chat again next week.

 

Cass: Absolutely. Thanks so much, Meg.

 

Meg: Thanks, Cass. Cheers

Cass: Bye

Meg: Bye.

Thanks to everyone who joined us. We will see you the same time next week until then download Parent Sense and take the guesswork out of parenting.