PROTEINS IN A BABY’S DIET

NEW YORK TIMES COLUMN: FAMILIES TODAY:
PROTEINS IN A BABY’S DIET
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. Is there any risk in not feeding beef or pork to our nearly 8-month-old son as he gets older? He is still on vegetables, fruits and oatmeal, but one of these days, we need to introduce proteins.

A. You started proteins almost eight months ago! Breast milk and formula, mainstays of a baby’s first-year diet, both contain lots of protein. Fish, dairy products and eggs will eventually also be good sources. Egg whites should not be given to children under age 1 since they may cause allergies.

Proteins come from plants, too. Important sources include soy foods, (for example, tofu and tempeh – staples of many Asian diets), soy milk, legumes (peas, beans, lentils, peanuts), nuts and seeds.

Cooked and strained peas and beans are early solids with protein. They can be mixed with blander-tasting foods like soupy corn or rice cereals for children who initially resist the taste.

To reduce allergy risk and to prevent choking, children under 2 should not be given peanut butter. In children or families with lots of allergies, it’s better to wait until 3. Whole peanuts, which can block small airways, should not be fed to children under 3.

As children grow, their nutritional needs change, varying with gender and activity level. Children also absorb, digest and metabolize nutrients differently.

All of us need certain amino acids – the building blocks of proteins – to survive and thrive. Essential amino acids are those that we can’t make on our own and that our diet must provide. Two additional amino acids – cystine and tyrosine – are essential for young babies, whose ability to make them doesn’t mature until later in the first year.

Breast milk contains the amino acids required in the first year. But when babies start eating solids and drinking less milk, the balance can be tricky.

Dairy products, eggs, fish, poultry and meat contain a wide range of essential amino acids, as do legumes and soy foods and milks. Other sources are foods made from quinoa, an ancient South American grain-like food, or from hemp seeds (hemp milk and even ice cream are now available).

Corn, rice, wheat and other grains also contain proteins but with fewer of the necessary amino acids. If animal protein is not part of a child’s diet, a variety of different plant-derived foods is important. With all these options, omitting red meat needn’t interfere with adequate protein intake.

The daily protein requirement should be spread out in feedings over the course of the day since babies’ bodies can’t store extra protein. They break down the proteins into amino acids that stimulate tissue growth. Spreading out protein across the day will stimulate growth several times daily.

Nutrients other than protein need special attention, too: iron and vitamin D and, for babies and children who are not given any milk or animal-based foods, vitamin B-12. Vitamin D supplements are recommended for all infants who are breast-fed (baby formula is fortified with vitamin D). Iron is found in plant foods as well as in meats, but is not as readily absorbed, so the daily requirements are higher for children and adults who eat no meat.

Check with your pediatrician about iron supplementation, since too much iron is not healthy. Vitamin B-12 is found only in animal-based foods and foods contaminated with B-12-producing microorganisms. Poultry, fish and eggs contain plenty of B-12 – so, again, red meat isn’t essential.


Responses to questions are not intended to constitute or to take the place of medical or psychiatric evaluation, diagnosis or treatment. If you have a question about your child’s health or well-being, consult your child’s health-care provider.

Dr. Brazelton, prior to his passing, was the founder and head of the Brazelton Touchpoints Center, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is currently the Director of the Brazelton Touchpoints Center. Learn more about the Center at www.touchpoints.org.

Reprinted with permission from the authors.

LEARNING TO BE A ‘BIG BROTHER’

NEW YORK TIMES COLUMN: FAMILIES TODAY:
LEARNING TO BE A `BIG BROTHER’
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D

The new baby has come home and suddenly the older sibling doesn’t get the same attention as before. The newcomer is ever more demanding of their mother, whose energy may not yet have returned.

The older brother’s demands increase, too. It’s almost as if he must test to be sure that his mother will recover and that she can still care for him. Teasing and testing, refusing bedtime and waking up each time the baby does – all are to be expected.

Sometimes an older child will take on the helping role of “big brother” or “big sister,” but don’t be fooled. Along with pride in helping, and his discovery that he is more “grown-up,” he’ll still resent the baby and feel sad about losing you.

You can make it clear that there are times when he can help, and times when he can be a baby, too. He’s telling you, “Why did you need her? I can do anything she can. I can still be your baby and please you.” He is facing one of life’s crises and learning how to cope with it in the safety of your loving care.

Expect the older child to lose ground again at some point. Usually it’s in the developmental area he’s just mastered. If he has begun speaking, he may resort to baby talk. If he’s feeding himself, sleeping through the night, becoming toilet-trained or conquering fears of strangers – count on a slide backward. This is what we call a touchpoint, a temporary falling apart that anticipates a new step ahead. He is learning how to be a big brother.

Think what it means to the older child when a 2-month-old baby fusses every afternoon and parents rush to attend to her. You can help him understand his feelings. He’s working so hard to understand the new baby, and to imitate her. “Of course you want to talk like the baby: Everyone pays so much attention to her right now.” Or, “Don’t worry about wetting the bed. Once you get used to having a baby sister, it’ll stop.”

Your understanding will be far more effective than getting annoyed or pressuring him to be a “big boy.” These responses are bound to backfire into even more dramatic bids for you to let him be your baby again.

Some children seem to sail through these first months. They are compliant, even helpful. But this interlude won’t last. The price of such a challenging new role for a child may have to be paid at a later touchpoint, or in reaction to one of the baby’s own touchpoints.

Each of his steps backward is an opportunity for you and the child to learn together to master the next stage of development.

An older sibling who is 5 or 6 years old may not express his resentment and frustration through tantrums or meltdowns; instead, he may devise ways to attract your attention by spilling things, falling, or needing your help with homework. Or he may come to your side as if to help, only to drag around and get sassy with you. But he needs the same understanding as a younger child. He will be better able to tell you how he feels than his sibling, and more able to help in a useful way once he feels understood.

DISCIPLINING THE OLDER CHILD

  • Stop him firmly but quietly.
  • Hold him, or use a time-out if he’s ready to comply.
  • Pick him up to hug and love him. “It’s tough having a baby sister, isn’t it? But I can’t let you do that and you know it. I must be here to stop you until you can stop yourself.” Watch his face and his eyes take it in and soften.
  • After you’ve made contact with him and are feeling close again, let him help you with the baby. In that way, he’ll begin to sense the goal of discipline and to feel like a “big brother.”

(This article is adapted from “Understanding Sibling Rivalry,” by T. Berry Brazelton, M.D., and Joshua D. Sparrow, M.D., published by Da Capo Press, a member of The Perseus Books Group.)


Responses to questions are not intended to constitute or to take the place of medical or psychiatric evaluation, diagnosis or treatment. If you have a question about your child’s health or well-being, consult your child’s health-care provider.

Dr. Brazelton, prior to his passing, was the founder and head of the Brazelton Touchpoints Center, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is currently the Director of the Brazelton Touchpoints Center.  Learn more about the Center at www.touchpoints.org.

Reprinted with permission from the authors.

9 MONTH OLD AND NAPTIME RESISTANCE

NEW YORK TIMES COLUMN: FAMILIES TODAY:
9 MONTH OLD AND NAPTIME RESISTANCE
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. Our healthy 9-month-old son has started to resist going down for his naps. We have tried every method in the book (quiet time, reading, rocking, dark room) but he still cries/wails before each nap.

On good days, he takes two one-hour naps; on bad days (more often lately), one or two 45-minute naps. He goes to sleep easily at night without nursing and sleeps through for about 10 hours.

A. Most 9-months-olds require about 12 hours of sleep during each 24-hour period – including nighttime sleep and naps. Sleep needs vary among babies. The range for 9-month-olds is from 11 to 13 hours per day, according to pediatric sleep specialist Richard Ferber, M.D. So on “good days” your son is within the average.

Many children resist naps, even when they need them. Up until 6 months, most babies take three naps a day – one in the morning, one midday or early afternoon and one later in the afternoon.

At around 6 months, one nap is dropped. At around 12 months, babies often drop one of the two remaining naps. A little ahead of schedule, your baby may be getting ready to switch from two naps to one.

When a baby is on the verge of dropping a nap, a period of back-and-forth may follow for a few weeks. This transition is typical of what we call a touchpoint, when an area of development such as sleep becomes briefly disorganized to reorganize into a more mature pattern.

One day, your baby may take one nap and skip the other, or he may have trouble falling asleep before both. He’ll also be cranky and tired when he has had fewer or shorter naps. Falling asleep at night may be harder, also.

When one nap replaces two, naptime also shifts – between the old morning and afternoon naps. The remaining nap’s length may be longer, or the baby may sleep a little longer at night. At 12 months, the sleep total is only about 30-45 minutes less than at 9 months, so the single remaining nap may be longer than before.

Can a parent help this transition? Try to be sure that the baby is getting enough sleep over each 24-hour period. Inadequate sleep can interfere with falling asleep and sleeping restfully.

Help your baby consolidate his two naps into one by putting him down for his morning nap a little later. Put him to bed later, too, which might lead him to sleep longer – thus easing the shift to consolidate morning and afternoon naps.

The transition will happen anyway in a few months, if not sooner. You may be just as glad for him to keep napping twice a day for a while longer, even if he struggles to get himself to sleep and the naps are shorter.

If he gets tired and cranky, encourage quiet time for cuddling and reading together so that he can get a little rest and comfort even if he can’t sleep then.

(For more information, see “Solve Your Child’s Sleep Problems,” by Richard Ferber, M.D. published by Simon & Schuster.)


Responses to questions are not intended to constitute or to take the place of medical or psychiatric evaluation, diagnosis or treatment. If you have a question about your child’s health or well-being, consult your child’s health-care provider.

Dr. Brazelton, prior to his passing, was the founder and head of the Brazelton Touchpoints Center, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is currently the Director of the Brazelton Touchpoints Center. Learn more about the Center at www.touchpoints.org.

Reprinted with permission from the authors.