When can babies or children be taught bad eating habits?
October 30, 2013 6:35 PM   Subscribe

I am feeding my infant on demand. Said infant gets no sleep whatsoever. Friends are pointing me to various methodologies, many of which schedule discrete eating times (such as feeding all of the calories in a 12 hour period and none in the remaining 12 hour period). I do not wish to do this because I think that this doesn't respect a baby's hunger and worry that, down the road, the child will not be able to recognize hunger/satiety clues. On the other hand, of course I would love to try scheduling like this because it's pretty miserable getting no sleep. All things being equal (the merits of on demand vs. scheduling), is there literature out there in psychology or any other field that has looked to this? Where should I go to find out whether scheduled feedings may have a long-term impact on children?
posted by juliagulia to Food & Drink (28 answers total) 5 users marked this as a favorite
How old is your infant?
posted by nkknkk at 8:01 PM on October 30, 2013

Response by poster: 4 months
posted by juliagulia at 8:02 PM on October 30, 2013

Honestly, I think most parents experiment and figure out what works for their individual kid. You obviously start out feeding on demand, and then as the get older you try to figure out when they NEED to eat versus when they just feel like it.

I think erring on the side of over-scheduling versus over-permissiveness is probably better. It seems easier to adjust an eating schedule if they aren't eating enough, and much more difficult to try and teach a kid self control as they get older.
posted by gjc at 8:10 PM on October 30, 2013 [1 favorite]

FWIW our super great pediatrician that I love (seriously, I was skeptical because he's nearly70 but turns out all that experience is totally a bonus) told us a good rule of thumb for nursing babies is "an hour for every month" until 6 months. So your 4 month old can go 4 hours between feedings and be fine and starting at 6 months they're capable of going a full night without nursing but it will take a week or so to transition. The way we did this was to send my husband in with a bottle of water and after about 3 nights she decided it wasn't worth her while to wake up for just water and slept through the night. At 4 months if she's not sleeping in 4 hour chunks I'd try sending in someone else with maybe an ounce or two of water or milk and see how that goes. Not getting sleep is terrible, I hope that helps.

*Note: The advice my doctor gave me was for nursing babies, I have no idea if formula feeding is different but I don't imagine it would be terribly different.
posted by julie_of_the_jungle at 8:18 PM on October 30, 2013 [1 favorite]

Babies "demand" feeding for a bunch of reasons: they may be hungry and physically want the calories, but they might also be distressed/lonely/bored, and want to suck to soothe. Or they may just be in the habit of feeding at that time, or associate feeding with other activities (like going back to sleep, or like getting to see Mom, yay Mom!). The same is true of adults, if you think about it: we feel inclined to eat when we're hungry, but also when we're bored, stressed out, when it's "lunchtime," when we're at the ballgame with friends, etc. Thus, just because your baby is crying to be fed doesn't mean it's actually hungry (in the sense of needing extra calories RIGHT THEN), and trying to train your baby out of demanding constant feeding won't necessarily mean training it to ignore legitimate hunger pangs. You may have a completely unique tiny-stomached baby, but by four months, most babies can go for a stretch of several hours (5-6, IIRC) without actually physiologically needing to take in more calories.

I'm not aware of hard research on scheduled feedings and subsequent eating behavior, but there is quite a bit of evidence on the necessity of sleep and the deleterious cognitive effects of sleep deprivation. If your baby's eating habits are keeping him/her up, then it might be worthwhile thinking about this as a sleep problem (baby wakes up frequently and eats to cope with the stress, OR baby's been conditioned to associate feeding with going back to sleep). There's lots of great advice out there on unraveling sleep associations and helping babies self-soothe without needing food: that might be a good place to start.
posted by Bardolph at 8:24 PM on October 30, 2013 [5 favorites]

Wow, at first I thought you were talking about hand feeding a 4 month old infant solid food on demand and I thought that was pretty radical. Then I realized you were talking about breast feeding? Yes?

And it seemed like my son didn't sleep, because whenever I ate onions or broccoli, he was cranky as all get out, and then after a while, he did even out. Eventually, it did get better and it did get to a sort of regular feeding schedule.

With my daughter, what happened is that I was trying to keep her to a schedule and everyone was telling me to keep her to a schedule, so I listened to them and guess what? The pediatrician told me she wasn't getting enough and I had to supplement her breast feedings with formula. There was no one to tell me that it's pretty normal for babies to go through a supply and demand phase. And trying to keep them on a schedule is hard when you're breast feeding.

I'm not sure about the research, but I am sure about not listening to other people about your baby. Feed your baby when s/he's hungry. If you want to be sure, weigh the baby before and after feedings, keep track of the diaper output. But it will get better, I assure you. Make sure you switch sides. And stop listening to other people tell you how to feed your baby. It's okay, you're doing fine.
posted by Marie Mon Dieu at 8:55 PM on October 30, 2013 [5 favorites]

I do not wish to do this because I think that this doesn't respect a baby's hunger and worry that, down the road, the child will not be able to recognize hunger/satiety clues

I am unaware of any empirical basis for this concern and wonder how it would even be tested. There is considerable evidence that we cannot form declarative memories from before when could speak, and four months old is well within the window of time from which nothing is remembered.

My experience is that the time to feed an infant is when he is hungry. What I take from your question is that your infant is hungry and what he's getting now isn't cutting it. I am assuming that you are feeding by breast exclusively. By four months, both of my kids were getting cereal mixed in with their bottles. Without it, they were just too hungry. My little sister was born at 10.5 lbs and was drinking cereal within the first month because breast milk just wasn't keeping her full at all.

I know there is a lot of political charge around breast feeding among mothers, but a lot of infants are just too hungry to be comfortably sustained on breast milk alone. Don't feel bad if that is the case with your baby. You may just need to supplement with formula or perhaps even formula with a bit of cereal added.
posted by Tanizaki at 9:08 PM on October 30, 2013 [1 favorite]

What does the baby's sleep actually look like? Short cat naps? Is the baby unhappy when he's awake? If he's unhappy more often than not, you can start looking at things like reflux or food intolerances. He's barely a person at this point and only knows that he needs food and mom. Also, solids are not recommended before 6 months of age, and if your supply is adequate and you're feeding on demand, you can sustain a baby on breastmilk for quite a long time. (and cereal in a bottle is a choking hazard for very young infants!)

Some reading on scheduling here and sleep here.
posted by chiababe at 9:16 PM on October 30, 2013 [3 favorites]

I'll also add that 4 months is a known age for a pretty awful sleep regression that you basically just have to power through.
posted by chiababe at 9:25 PM on October 30, 2013 [4 favorites]

Premature babies in the special care nursery, of which my child was one, are fed on a three hour schedule. I wouldn't know where to start looking but I assume that there is a huge amount of medical research and experience behind that decision. My daughter thrived on it and we kept it up, slowly dropping night feeds and adding the occasional day feed on demand.
posted by Wantok at 9:33 PM on October 30, 2013

4 months is pretty young. There is no way you should be trying to load the baby's calories into 12 hours so he won't want to eat for the other 12 hours. My baby is 5 months and eats every 2 hours or so when he is awake, and wakes every 3-4 hours at night to eat. I'm writing as he nurses!

Chiababe gave you the links I was going to recommend. Kellymom is a great resource, with links to peer reviewed studies.

Is the baby at daycare? He might be reverse cycling, which you can read about on Kellymom. This is also a great question for your pedi.
posted by apricot at 9:50 PM on October 30, 2013

I don't have any scientific studies for you, but I am strongly of the opinion that you will not harm your child by feeding during the night, a 4 month old is just requesting what he/she needs rather than wants. At this point eating and sleep are so closely tied together that as Bardolph says, its not just about calories. My first slept through the night pretty well until separation anxiety (10 months-ish), whereas my second was such a stubborn reverse-cycler that I ended up co-sleeping so that both of us would get some sleep (and he some milk). I feel like while ostensibly your question is about eating, really its about sleeping, because neither of you is getting any. My advice would be to stop listening to what everyone says you should do, and find the strategy that works for you both, even if its something you swore you wouldn't do.
posted by Joh at 10:10 PM on October 30, 2013 [4 favorites]

Wantok, I never found a research reason behind the 3-hour feeding for kids in the NICU, when I asked and looked, although I didn't look that hard. The nurses sometimes fed kids a little earlier if they were crying. The big thing seemed to be the amount fed over 24 hours which was calculated from the weight of the infant, and was altered by if the baby was getting breastmilk and/or formula, plus calorie supplementation (we had that added to the breastmilk), and also things like surgery, digestion and kidney issues (e.g. ours was given less feed when she had kidney problems for a few days). Once the babies started latching on to nurse directly, they kept to the amount fed by bottle when not nursed, counting a breastfeeding session as a standard bottlefeed. They weighed every damn diaper though right up to discharge!

Daily calorie requirements for infants which links to a calculator will give you an idea.

I was pushed by my doctors to breastfeed exclusively longer than I should have in hindsight, but my kid had lots of medical complications. Supplementing with formula made everyone happier, and she is still nursing at two years old.

Another trick is to pump and weigh the milk, calculate the calories and see if you're producing enough. That's how I figured that I was not able to provide enough milk, even nursing around the clock and on medication, for my baby.

At four months, babies vary hugely. I have friends who have sworn by the scheduled feeds, and they definitely make life easier. We just rolled with whatever, feeding on demand, because of weight gain issues, and my kid has the widest and easiest appetite. Seriously, other toddlers stop to watch her eat - she strips meat from bones and devours anything put before her on a plate. She eats durian. But she has days when she will eat very little and days when she seems to be constantly eating, usually around a growth spurt.

You might have luck searching for the impact of institutional feeding schedules, but those are going to be depressing reports and don't relate to at-home feeding.

Try a schedule for a week and see if it makes your life easier. Your baby will very clearly let you know if the schedule works or not for her.

I think the hunger cues thing is more likely to kick in later at the toddler stage. I was schedule-fed rigidly as a kid, and have to this day no real sense of appropriate hunger, and big food issues, but it can be traced to mealtimes as a child with my parents, not earlier when a nanny looked after me.
posted by viggorlijah at 10:50 PM on October 30, 2013

Pick up a copy of Child of Mine by Ellyn Satter. It is a fantastic resource for feeding kids and it starts with infancy.
posted by sutel at 1:45 AM on October 31, 2013

Please don't let

what he's getting now isn't cutting it...breast milk just wasn't keeping her full at all
...a lot of infants are just too hungry to be comfortably sustained on breast milk alone

worry you; that is absolute nonsense. Apart from the now really well advertised reasons to not add things to bottles, not add solids before 6mo, and not bother with the heavily processed "baby cereal," this particular idea -- babies are ravenous and milk is somehow insufficiently caloric -- does not hold water because adding cereal doesn't add many calories at all anyway.

And Different types of food take longer to digest. Starch, which is what rice cereal is, is really easily digested. Starches are used as quick sources of energy. If we stayed asleep for however long our bellies are full (which I don't believe either or we would never sleep for 6-8 hours a night) then starch would be a poor choice. We would need to load our kids up with a Big Mac or something to get them to sleep longer since fat is the slowest food type to be digested. via


Another trick is to pump and weigh the milk, calculate the calories and see if you're producing enough

is also very outdated advice. Is My Baby Getting Enough Milk? is a great quick reference...

The following are NOT good ways of judging

"I can express only half an ounce of milk". This means nothing and should not influence you. Therefore, you should not pump your breasts "just to know".

What one can pump has no relation to what one can make; it just doesn't work like that.

Notice in the first link that formula actually has slightly fewer calories than breast milk; pediatricians are not great at feeding advice. I enjoyed Mothers and Medicine: A Social History of Infant Feeding enormously; it is a pleasant read that catalogues a lot of truly appalling advice dished out to mothers in relatively recent history. Which does a lot to dispel the idea that one might be doing something wrong. Also a lot to undermine any confidence you might have in 'professional' advice, and through that I mean to address your question: this field is swamped with bullshit and I don't have a good source to suggest for authoritative research.

On the plus side, at least as far as this goes, infancy is pretty fleeting.
posted by kmennie at 4:02 AM on October 31, 2013 [11 favorites]

Your baby will not be this little forever. Feed her in your bed, sleep with her next to you and give her access to your breast when she needs it. If you sleep with her you'll be able to sleep yourself. As she gets older you'll be able to adjust accordingly.
posted by h00py at 4:34 AM on October 31, 2013 [3 favorites]

Generally speaking, if a baby or a child is hungry, feeding him or her is usually a good idea. All the nonsense about scheduling vs not scheduling --- do what works for your baby and what works for you.

My kids are 2 and 4. I still feed them on demand.They demand to be fed by saying such things as, "I'm hungry!" or "I need a snack!" or "Can I have [insert food stuff of choice.]" They were both fed on demand as babies --- one by formula in a bottle and one primarily by the breast. They seem to know when they're hungry definitely. And my son will look at me and say, "My belly is saying, 'Hey, I'm all full! No more food in here!'" The "belly" has its own voice, even, so I'm guessing he's ok on knowing when he's done being hungry, too.

Learning about food and food choices is part of being a parent, but it's absolutely nothing to worry about for a four month old unless there are allergies or medical issues that directly affect feeding. The way you handle food issues as kids get older? Talk to them about food and listening to their bodies and what healthy eating is and why it's healthy.

So, feed your four month old when your four month old is hungry and worry about the rest when your babe turns into a three or four year old who can start to understand small decisions.
posted by zizzle at 6:01 AM on October 31, 2013 [3 favorites]

@kmennie, I agree that pumping is not the equivalent of breastfeeding because babies are generally way more effective at getting milk out, but in my case, the amount from expressive pumping was an important clue to figuring out how underfed my kid was. This was due to unusual issues - reflux, breast scars, prematurity etc, but we had a failure to thrive infant who did not get formula supplemented for too long because of the breastfeeding-only pressure. For 95-99% of kids, that's appropriate, but I wish badly someone had told me that formula wasn't failure.

Also, breastmilk and formula, the calories are slightly off but even more, breastmilk is perfect for babies and is digested faster and much more efficiently, thus the different poop and more frequent feeds.
posted by viggorlijah at 6:44 AM on October 31, 2013 [1 favorite]

I agree with snickerdoodle and other commenters that your baby may not actually be hungry when she wants to nurse. I think it would be worth trying to pinpoint what she wants before you try to put her on a schedule. My three-month-old often wakes up at night and wants to nurse, but at least half the time he really just wants to comfort suck, not actually eat. At those times I just give him a pacifier and we both go back to sleep. Figuring this out saved my sanity (and my nipples). Four months is old enough that your supply should be established, and your baby should be gaining weight well enough that you have some room to experiment.

Regarding the literature, here is an study (albeit from 2008) that says that breastfeeding can lead babies "to develop their own internal cues to signal when they feel full". And here is another one that says that babies fed on demand do better in school. Also, I second that Kellymom is an excellent resource for well-cited information.
posted by lollymccatburglar at 6:54 AM on October 31, 2013

I found this study a bit interesting: The only difference they could find between babies randomly assigned sleep training at 8 months and those not was that the mothers were less likely to be depressed. http://pediatrics.aappublications.org/content/early/2012/09/04/peds.2011-3467 Here's a pdf

But I have a 7-month-old and haven't done any "sleep training" yet, she's a pretty decent sleeper though, sometimes sleeping through the night.

With my first, she was more on the 2-3-4 hour schedule every night, which was rough. I night-weaned after a year and she did sleep better after that. She is still tough to get to bed and she's 4.
posted by mgogol at 7:18 AM on October 31, 2013

I'm not going to wade into the schedule/don't-schedule feeding debate, though I do have pretty firm personal opinions on this topic. It can be bewildering to be beset on all sides by such firm opinions, especially when you are sleep-deprived and overwhelmed and desperately looking for a solution. And you didn't ask for opinions, you asked for research. However, I did feel the need to second chiababe's comment regarding the 4-month sleep regression, as it is extremely important and should not be lost in this discussion about people's feelings on feeding. The 4-month sleep regression is no damn joke, and will take any mild progress you may have made so far towards sanity and toss it up in the air and jump on it when it falls down. I distinctly remember feeling somewhat...insane during that time, for about a month and a half. With a few blessed exceptions, the baby was waking up nearly every hour or two for weeks, and the cumulative effect on my mental state was horrifying. I just want to tell you that this is a thing, and that it ends.

You are not a bad mother if your baby is waking up frequently, and not everything about this process is in your control and can simply be "fixed" if you can just do the right thing. Your baby is not necessarily like your friend's baby, and your friend's baby isn't like your other friend's baby, and there is no one magic bullet that will create the perfect textbook sleeper through perfect parenting. No matter what you do, know this is just a bad stage, and it gets better.
posted by tigerbelly at 8:35 AM on October 31, 2013 [4 favorites]

Maybe [re?]reading Jean Liedloff's writings about the "Continuum concept" would help you. Here's a start.
posted by Namlit at 9:27 AM on October 31, 2013

This may not be what you want to hear, but 4 months is really still very young. Some kids seem to come out of the womb with internal clocks, but many have virtually no natural schedule and wake, eat, sleep, and cry intermittantly until easily a year. You need to separate out these things:

1) baby's need to eat. On-demand is far and away the widest recommendation, for the reasons you note and because their cries are the best guideline to their speed of using up what they've eaten (which will vary with nutrition, growth spurts, activity, and all the rest). There was an "every four hours is plenty" regime in the 1940s-50s and Dr. Spock was one of the first to advocate for free feeding and trusting biology -- he never stopped.

2) your need to sleep (and/or desire to get baby to have a sleep schedule). baby won't sleep nicely at 4 months -- very few do. Six months is the earliest that anybody really recommends thinking about "sleep training" methods of any sort (although becoming aware of your baby's sleepy signals so you can put them down while still drowsy is valuable at any age) and many babies are crummy sleepers well past 12 months. However, surviving sleep deprivation is a valuable goal/skill long before that. Here are some thoughts:
a) You say "doesn't sleep at all" -- are you starting to make clear distinctions between night and day? Often it takes babies a while to get those sorted out, and things like keeping real bed time very dark (and any feedings very quiet and dim, low interaction) while keeping it lighter at nap times and being more animated during day activities can make a big difference.
b) Is this all-night crying, or are you just getting up every two hours? The former could be a sign of day-night reversal or could indicate digestive unhappiness (or colic, a catch-all for difficult baby behavior). It's possible that putting a lift under one end of the crib mattress or letting him sleep in a swing for some stretches could help. The latter could indicate restlessness, lonesomeness, or real hunger -- at least it allows for cat naps!
c) Even if you're breastfeeding, it's probably worth pumping some bottles that Dad can feed at night, so that you get at least one stretch of sleep guaranteed. Use earplugs if they do the job, or sleep that stretch in the basement, or whatever it takes to keep you functional (turn off the monitor!). Having a young baby is hard work, and you are completely right to look after yourself to make it possible.
d) Even if you were certain you would never co-sleep, nobody will blame you if you change your mind because that's the only solution that gets you all through the night sane. Or sleep upright in a chair with the baby in a carrier. There are no end of not-particularly-recommended solutions that people find because they NEED TO SURVIVE AND THIS WORKS. Experiment, find one, survive.
e) This Too Shall Pass. His stomach will get bigger, his schedule will settle down, you'll stop twitching alert every time he rolls over, whatever. About the time you recover, it will Be Something Else.

Hang in there!! You're tired, it's hard, but you're doing a great job!
posted by acm at 11:40 AM on October 31, 2013 [2 favorites]

My baby is 3 months old and we co-sleep. I'm not sure if you've tried that - we usually sleep and nurse like this at night. That way, when he starts waking a bit at night due to hunger, the boob is already close to him and it hardly takes a minute for him to start nursing again and me to fall asleep again. He was waking every 2 hours or so up to last week when I had to go back to work. Now it is more frequent, but I'm still getting a good chunk of rest by co-sleeping.

That being said, how is your diapering situation for night-time? Are his/her pants uncomfortably wet? We cloth diaper and he pees so frequently that I was changing him every hour or two at night for a while there until we got better nighttime diapers. He was just so uncomfortable when he wet himself because it would get cold or leak or both and he'd wake up unhappy which would wake me up unhappy and it took us much longer to get back to sleep. I only bring this up because this might be why your baby is not sleeping so well.
posted by jillithd at 12:30 PM on October 31, 2013

Six months is the earliest that anybody really recommends thinking about "sleep training" methods of any sort

Simply not true. Plenty of reasonable, educated people recommend scheduling babies younger than that. Our pediatrician recommended sleep training at 8-10 weeks; while we did not do this, we did sleep train at 16 weeks and he has slept through the night (~10-12 hours) pretty much since then. I wouldn't say that anyone should feel obligated to do this, or that every child is easy to do this with (no idea, I only know my kid), but sleep training at 3-4 months is not at all uncommon or unhealthy.

I'm just gonna nth the "sounds like a sleep problem" advice. It's not healthy for you or the baby not to get any sleep, at 4 months, the baby should be able to sleep for at least 4 hour stretches even without sleep training. And you deserve to get some sleep. You're not going to mess up the baby's hunger cues by not feeding him during the night. He needs to be gaining weight and making appropriate wet/dirty diapers, as long as those two things are happening he's getting enough to eat; and it is totally possible to do that without constant feedings all night.
posted by ch1x0r at 7:00 PM on October 31, 2013 [1 favorite]

If you are breastfeeding, and this is going on, from my experience, and the experience of my daughter who also breastfed-I recommend ONE bottle of formula at night. This gives your boobs a chance to catch up and gives your child a full tummy and breaks a cycle...of whatever is going on.

Easy to try, and if it works, yay! If not, I agree it might be a sleep problem.
posted by St. Alia of the Bunnies at 7:44 AM on November 1, 2013

With all due respect, this is not true of all babies and all moms and dads. Some parents are hyper aware when baby is in the bed and can't get into deep sleep; some babies want to party instead of sleep if the parents are nearby. If your baby is not getting enough sleep, you'll both be miserable. The effects of sleep deprivation are well-documented. And if your baby is very overtired, it will be harder for her to outgrow it. If your baby hasn't reached the point where her longest stretch of sleep is at night, then please read up on sleep training. Not all methods require crying it out, and the earlier you start the gentle ones, the more likely it is to work.

Yes. Sleep training (done correctly) isn't some brutal piece of torture. It's about teaching self soothing and self control. The same way you don't let the kid eat candy before dinner or color on the walls.

I know a family where the older two are cuddlers and love climbing into bed with mom and dad and sleeping. The third kid loves it too, but she wants to play. Practically from birth, she needed to sleep in her own quiet room or else she would be overstimulated. She will wake up in the middle of the might, cry a little and go back to sleep. Not distress crying, just "I'm alone and want to be playing and I'm sad" crying. So mom or dad pops in, reassures her that they haven't abandoned her, and right back to sleep she goes.
posted by gjc at 9:26 AM on November 3, 2013

I just wanted to add that I'm reading "Bringing Up Bebe" right now, and the book suggests that most babies in the country of France are fed on a schedule rather than on demand after the first couple of months. The book also discusses briefly the fact that the French seem to be better than Americans at self control when it comes to eating. I doubt that there is any very solid research to back up the associations/outcomes here, but the fact that this is the culture of an entire industrialized nation is certainly suggestive at least that feeding on a schedule doesn't screw you up completely - and especially not as a 4 month old.

That being said, I would agree with the above comments about nighttime and sleep. From what I can tell of anecdotal evidence, it seems quite common that babies will wake up every 2 hours or so at that age if they have not been sleep trained. I sleep trained my daughter at that age and she went from waking up every 2 hours and eating each time to sleeping for 12 hours straight within a week or two, with one dream feed late at night. To me, this strongly supports the idea put forward by other posters that the wake ups are not necessarily due to hunger. Doesn't mean you need to ever sleep train your baby but it might influence your thoughts about what causes babies to wake so frequently when they are not sleep trained, and how to address that.
posted by treehorn+bunny at 5:15 PM on November 29, 2013

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