Crying baby? Don't make feeding your first response

Parents, we've all been there in the dark of night. Staggering half-asleep into the wailing baby's bedroom and quickly administering a bottle or breast so everyone can collapse back into bed.

Don't do it, say Pennsylvania State University researchers. If you can resist the habit of making feeding your first response, your baby likely will sleep better and may weigh less as a result.

This recommendation is one of a list of good-parenting guidelines that the Penn State team distributed to more than 130 families in the Harrisburg area.

Other tactics included putting babies to bed before 8 p.m., allowing them to "self-soothe," and, if needed, playing recorded white noise to help them sleep. Parents were also counseled on how to soothe fussy babies during daylight hours. One tip: Look for cues that the child is truly hungry before feeding, such as grabbing for mom's shirt front.

Collectively, the guidelines had a positive effect on sleep duration and weight gain, the researchers reported in a pair of new studies. In families that were taught the guidelines, 5.5 percent of children were overweight at age 1, compared with 12.7 percent of children whose parents did not receive the instruction.

The goal was to develop new strategies in the fight against obesity, as numerous studies have linked rapid weight gain in infancy with a higher chance of being overweight later in childhood and beyond.

Pediatrician Ian M. Paul, one of the studies' authors, realizes that a few of the guidelines will prompt incredulity in some sleep-deprived quarters. The one about nighttime feedings, in particular. How else do you get some peace and quiet?

If the infant is truly hungry, by all means, feed away. But parents need to try other strategies first, he said. Patting babies on the back, consoling them with gentle words or a song, or changing a diaper if needed.

"Food is for hunger," said Paul, a professor of pediatrics at Penn State College of Medicine. "It is not to soothe a fussy baby. It is not to get them to sleep. It is important for babies to learn this early on."

The reason? If a person learns to eat for reasons other than hunger, that pattern may persist into adulthood, he said.

"There is some evidence that the brain's rewards systems get programmed very early," Paul said.

Parents who participated in the studies were not told that a prime goal was to prevent excessive weight gain, only that the guidelines would help them establish good sleep habits and raise a healthy baby.

Study participant Maria Russ, 31, of Harrisburg, said the instructions were a key reason that her firstborn daughter, Gabriella, now 2½, was a great sleeper.

"It's been wonderful," Russ said. "It puts the parents at ease."

That type of reaction is a sign that parents are likely to adhere to the guidelines, said Sarah E. Anderson, an obesity and parenting researcher at Ohio State University, who was not involved with the studies.

"It was likely to have positive impacts on the children's health and the family," said Anderson, an associate professor of epidemiology. "Those things are going to help the family function more smoothly and with less potential for distress in the parents and children."

Penn State's findings on weight gain in the study participants were published last month in JAMA Pediatrics. In the second study, published in the July issue of the journal Pediatrics, children whose parents received the best-practices instructions slept longer, on average.

That makes sense, said Ohio State's Anderson, as other research has found a link between inadequate sleep and obesity.

Both studies involved the same families, who were randomly divided into the group that received the instruction and the group that did not. The researchers plan to publish results when the children reach 3 years of age.

During the first year, all parents received educational materials and four home nurse visits. One group was taught the best practices for good sleep habits and obesity prevention - though again, the word obesity was not mentioned. The other group received more general safety education, such as how to prevent sudden infant death syndrome.

Paul, who has three children, ages 8, 6, and 20 months, concedes that strict adherence to the guidelines is a challenge.

He said he blew it with his oldest child, always rushing in the moment she started to cry. He did not feed her, but generally rocked her until she got back to sleep. Not a good idea.

The result was that she was a poor sleeper until age 3, he said.

"I picked her up and rocked her to sleep because I was a sucker," the pediatrician said. "My personal experience has definitely helped my research."