View Full Version : 4-month checkup...ped said what I feared...(long)
03-06-2006, 11:14 AM
We went for our 4-month checkup today. I don't like the pediatrician's advice and need some moral support...
DD has been doing some spotty sleeping through the night (7:30 PM until 6-7 AM) for the past few weeks, but recently started waking up again around 3ish. Sometimes, she'll take the paci and go right back to sleep. Last night, we tried for an hour and finally fed her, at which point she slept soundly again.
My instinct is to try the paci and, if it doesn't work, give her the feeding during the night. For now, especially b/c DH and I take turns, I think I can live with that (as far as a sleep situation that works for everyone in the house...not unrealistic expectations of DD).
Unfortunately, my pediatrician is a little on the conservative/old-fashioned side. She's a big baby (over 100th percentile in height and weight...looks like she's at least 6 months old), so he said "she doesn't need that feeding, let her cry a little bit" and "try starting rice cereal at bedtime." He's also of the put-it-in-the-bottle camp, which I don't want to do. If she's not ready to eat it off a finger/spoon, I don't think she's ready to eat it at all.
As I said above, my gut tells me that, if the paci doesn't work, she's probably either hungry or needing a little comfort feed (even though it's formula). My gut also tells me that she's not quite ready for solid food. I don't think she'll go all the way to 6 months, but she's just not expressing interest in our eating yet. (The ped thought that was a joke..."she won't show interest, either she'll take it or she won't.")
On top of this, DH will support whatever I want to do, but doesn't feel as strongly and doesn't see the problem with following the ped's directions.
I'm feeling rather discouraged and unsupported. I'm also having a little paranoia about a pacifier habit (she used to go down without it...she just started screaming without it the other day), but that's a whole other story.
I'd love to hear the experiences of others and any anecdotal evidence I can show to DH to support my case...
mommy to my beautiful little girl,
Ryan Isabel 11/4/05
03-06-2006, 11:27 AM
The peds advice is quite simply contrary to everything I've read and contrary to everything I believe in my heart. If I were you I couldn't in good conscience follow it. We know that the AAP has said not to do any solids until 6 mo, and studies show that cereal doesn't help them STTN.
I think you've got a fantastic little sleeper on your hands. Many kids don't sleep all the way through the night until they are a year old.
I'd keep doing what you are doing. Trust your gut.
03-06-2006, 11:37 AM
Your 4 month-old sounds like a champion sleeper to me, even with the 3 am feeding. As far as I'm concerned, if your baby is hungry, you feed her, no matter how big she is. I also believe that now is not the time to be worried about a paci issue later on. She's only 4 months-old.
IMHO, you need to give yourself more credit & listen to your gut. I would also try to find a ped that was more supportive & less condescending.
You sound like a really in-tune mama - keep up the good work.
BTW, I *love* your DD's name.
03-06-2006, 11:45 AM
I totally agree with PP's. I don't care how big your baby is, if she's hungry, you feed her. I would hold off on solids until at least 6 months or at least until your little girl shows all signs of readiness. Cereal was meant to go on a spoon and not in a bottle.
Your little girl sounds like a great sleeper and I think it's totally normal for her to need her night feedings. One feeding during the night is pretty great, actually. I think if you read Weissbluth (and talk to my pediatrician) he'll say that it's totally normal for babies to need night feedings until 6-8 months. FWIW, DD self-weaned from her night feedings the day before she turned 10 months. My feeling is that as long as they eat and then go back to sleep, they must be hungry.
Keep up the good work and trust your instincts. I think I would also consider another pediatrician, but that's up to you.
http://www.mothering.com/discussions/images/smilies/candle.gif for Leah
Kaya's a cousin! 10/1/05, 5lb13oz
03-06-2006, 11:46 AM
Trust your Mommy instincts. Your Ped doesn't *know* your child like you do, and is just giving standard advice. Your Ped's advice is just that- advice. From dictionary.com Advice- Opinion about what could or should be done about a situation or problem; counsel.
03-06-2006, 11:47 AM
Jessica, I would absolutely follow your mama instincts! If you feel like she needs you, do what feels right. My ped gave similar advice about sleeping at our 4-month appointment, and I nodded, smiled, then did what I wanted. At 5 1/2 months, Becca is still waking twice a night to nurse.
We also have a ped who is over-anxious to start solids IMO, and I've ignored that too this time around. We started too early with Gwen and boy did we pay for it. Our feeding struggles lasted for months and were traumatic for all of us.
On the pacifier front, if it makes you feel any better, recent studies have link pacifier use to a decreased risk of SIDS.
Missy, mom to Gwen 03/03 and Rebecca 09/05
Want a penpal for your BBB kiddo? Send an email to:
03-06-2006, 11:54 AM
Your pediatrician should take a refresher course or something. Both scientific studies and anecdotal evidence show that rice cereal doesn't help sleep for most babies -- there may be some it works for, but on average in makes sleep WORSE not better (how well do you sleep with a tummy-ache?)
The AAP says (http://aappolicy.aappublications.org/cgi/content/full/pediatrics%3b100/6/1035)
Exclusive breastfeeding is ideal nutrition and sufficient to support optimal growth and development for approximately the first 6 months after birth. ... In the first 6 months, water, juice, and other foods are generally unnecessary for breastfed infants.
Here's Kellymom with links to piles of references on why you shouldn't start solids early, and particularly not in a bottle: http://www.kellymom.com/nutrition/solids/solids-sleep.html
And just for your amusement:
03-06-2006, 12:10 PM
My DS is nearly 5 months. When we were in for our 4 month check up, he was up every couple hours to eat - and he weighs 19 lbs! My ped. didn't say anything about sleeping/eating (maybe because I'm on kid no. 3). At the time though, DS had an ear infection and the ped. said if he's sick you just do what you have to. Well, the nighttime feedings continued and I thought I had a trained nightfeeder. I don't want to jinx myslef, but the past two nights he has been up only once to feed.
My ped. said it was up to me as to when I wanted to start solids. She said if I don't want to add anything to my plate, then wait until 6 months. Nutritionally, they don't need anything else until then.
I say do what's right for you. If you don't mind getting up in the night and feeding, then do it. If it gets to be a problem for *you* then you can think about doing something else.
Don't worry about the pacifier. She will not have it in her mouth when she graduates high school LOL. If she likes it and it helps her sleep - use it! My middle child uses (yes, have to work on that one of these days!) a paci and she is my best sleeper! My first DD didn't use on and of course I was one of those moms that looked at other kids with pacis and wondered why they had that thing - now I understand.
It sounds like you are doing a GREAT job! If it works for you don't worry about what others think - even your ped. It's such a short time that they are young and all these things will pass.
Keep up the great mommying! :)
03-06-2006, 12:33 PM
Just reinforcing what the PPs said. I don't even discuss sleeping with my ped. Actually, I think it's because their practice is accepting of all children and their differences, so they don't make an issue out of it.
Your DD is a great sleeper! I would have given anything for DD to wake up only once at night at 4 months old. If your DD needs to eat, feed her. I wouldn't even let her cry if you know that's what she needs. At her age, it's not uncommon for babies to need a night feeding.
FWIW, my DD didn't sleep through the night until she was almost 12 months old! She woke twice a night for a loooong time for feedings, then down to once a night for a looooong time for a feeding.
You're doing a fantastic job and just go with how you feel instead of what your ped is saying. I also agree with other PPs who suggested that you look for another ped, but that is your choice to make.
BTW, I did try rice cereal in her bottle at about 7 months (out of desperation and probably partly to prove to my Mom that it wouldn't work). It made no difference whatsoever - it's empty calories!
03-06-2006, 12:37 PM
Love your daughter's name! ;) My daughter is exactly your daughter's age and we have our 4 month ped appt in 1 hour, so I will post back what I hear because I'm planning on asking about sleep, too. However, I KNOW that my ped doesn't recommend dropping night feeding til at least 6 months. My DD is not sleeping nearly as long between feedings as yours - your DD sounds great! Try not to worry and go with what you think will work best for your DD. My DD is co-sleeping, but still gets up several times every night to eat. I'm working on getting her to sleep at night in her crib but not worrying too much about the night feeding. They are growing so fast at this stage, KWIM? Anyway, just wanted to say Hang in there Mama! Remember, smile and nod. :) I'll post back what my ped says.
ETA: My ped visit went great - she said to ignore the books and just love my baby. She said DC still need to eat until at least 6 months at night because they are growing so rapidly - if you look at a growth chart the curve is very steep til 6 months, then it gets a little more rounded, then more rounded again at 12 months. It was nice, she pretty much told me to relax about sleep because they are still just babies and will grow up all too fast as it is. Did I mention that I love my ped? :)
Bottom line: Do what works for your baby - she is still very young and if she needs her mama, she needs her mama!
03-06-2006, 12:56 PM
You are the expert on YOUR child. Your pediatrician's advice isn't gospel, and is in fact scientifically inaccurate.
As the PPs mentioned, there are several studies saying rice cereal does NOT improve sleeping. Your child sounds like a fabulous sleeper, even with waking one time per night!! The current recommendation is no solids before 6 months, and regardless, it doesn't sound like your DD is at all ready to start them.
Nothing new to add, but you are a great mama for questioning your ped's advice.
If something isn't a problem, it isn't a problem, kwim? You know your child and if you think your baby is hungry, you feed her. Your ped's advice is making you question your instincts because you are considering that person the expert, but your ped is definitely out of date...your ped should be questioning her own advice, not leaving you wondering if *you* are wrong.
There is nothing saying you EVER have to follow something your ped tells you to do if it doesn't gel with your instincts. If she asks about it in the future, either skirt around the topic (none of her business really as long as you are okay with how things are going on the sleep front) or flatly say "As her mother, I know she's not ready for solids and I'm fine with her sleep patterns. Thanks." and move onto another topic.
She could be starting early teething, she could be going through a growth spurt, or she just may need comfort/feeding in the middle of the night...all of those things are 100% normal. Your ped's one-size-fits-all recommendation is not in your child's best interest.
03-06-2006, 12:57 PM
What she said!
Follow those wonderful mommy instincts!!
03-06-2006, 01:15 PM
My DD is also 4 months old and she gets up once or twice through the night to feed. This is totally normal for their age (my dd is also a chunk-a-monk) My ped did say if I wanted to I could start her on baby food but if I wanted to wait that would be fine.
The rice cereal whether it be in a bottle (which I don't think should be done but thats just totally my opinion) or on a spoon is not going to make her sleep anymore than she does now.
Go with your gut feeling your the mommy and you know whats best for your baby.
Mom to Jillian 10/20/05
03-06-2006, 01:31 PM
Trust your gut! You are right on there.
My 10 month old was only up once last night and I considered that a great night! Just last week he was up 2-3 times every night. :-)
Food won't help them sleep, and would probably do more harm than good at this point. They don't need solids because they are 'big' - how do you think they get 'big'? Milk of course!
03-06-2006, 01:46 PM
i think you need a new ped. really.
my 13 month old eats at night. i have tried everything to stop him, but he still eats at night.
03-06-2006, 01:54 PM
IMHO, you're the mommy. You do what you think is right. The ped's advice is just that, advice. It's not an order, and you don't have to follow it. You've obviously done your homework, so go with what your gut and your careful research have told you.
mom to Emma, stillborn 11/04/04
and Max, 01/05/06
03-06-2006, 02:08 PM
My DD was also very big- 16.5 lbs at 4 months- but at that age she was still waking every 3-4 hours to eat. My ped also said she didn't *need* to eat overnight, but I ignored that. I just couldn't let her cry if she was hungry. I thought she would never sleep through the night, but she finally did at almost 9 months.
As for the rice cereal- I couldn't wait to start it at 6 months, believing it would help DD sleep. Not so- she still continued to wake to eat at night. Not only that, it made her really constipated and she ended up NOT sleeping for a few days until we straightened that out.
As for pacifiers, I may get flamed for this, but my DD, at 19 months, still takes a binky at night. She only needs it to fall asleep and then spits it out. They have to stay in the crib and she has never wanted one unless she's going to bed.
If I have learned anything in the past 19 months, it's that you do what YOU believe is best for your baby, not what anyone else thinks. So if you think she's hungry, feed her! As everyone else said, listen to your instincts on this one!
Mom to Madeline
03-06-2006, 02:39 PM
I can't thank you all enough for your wonderful outpouring of support and sharing of your own experiences. I'm usually at work during the day, but am home with DD today b/c of the doctor and have been reading your replies periodically.
I LOVE posting here...everyone is so helpful and supportive. I'm naturally a person who's very unsure and doesn't trust her instincts. Mommyhood has only made this worse, unfortunately. I'm working on it though!
Just to follow up...I appreciate the advice of those who suggesting changing doctors. I don't think changing peds is right for us at the moment. This is actually our 2nd one...he's better than the 1st! Outside of this one-size advice, I actually think he's a great pediatrician. He's very warm and personable and I feel like we can build a relationship with him. I think I'm going to go for the nod-and-smile approach for now...but you're right, I do want to trust him as the "expert." It's very difficult...there are so many opinions out there!
Well...DH and I have a lot to talk about tonight!
03-06-2006, 04:35 PM
No offense, but your ped sounds a little whacko, at least in regards to this issue. She definitely WILL show signs of interest when she's ready for food. I was so excited to start solids (why?) that I did it a little early (5.5 months) and it totally backfired on me. It's a long story but basically DS ate some avacado and his system wasn't able to handle it, so we ended up at the ER (and he's not actually allergic to it). She'll let you know when she's good and ready. Just follow her lead and trust your instincts.
Oh and fwiw, my DS has been near/at/over the 100th percentile since about 2 weeks old and I still give him a nighttime nursing several times a week if he wakes up and wants one. I have no idea what the 'experts' say about this and really couldn't care less. I figure my DS is only going to be little for a short while and if he needs/wants me to help him in this capacity, then so be it. He sleeps 12 hours straight some nights, so I don't feel like it's a crutch for him. And frankly, I'm going to miss the middle-of-the-night feedings when they're gone so I don't really mind it. He's so active during the day that I relish the cuddling we get to do at night.
03-06-2006, 04:42 PM
My DD is 5 months old, and sometimes she sleeps through the night (7-7), and sometimes she doesn't. I just feed her if I know she's hungry and not just flipping over on her tummy and readjusting. We haven't started cereal yet, and she's only in the 50% of growth rate, so I figure why not. I would go ahead and feed your daughter if she's hungry, and give her the paci if she's not. I'm suprised that your ped is still recommending feeding cereal before bedtime and in a bottle even! Isn't that outdated advice? Anyway, do what settles everyone, and I'm sure your baby will eventually settle back. Who knows? Maybe she's having a growth spurt. DD had plenty of those :-)
03-06-2006, 05:00 PM
Find a different pediatrician if you can. That one's not using up-to-date information, and it's better to have a pediatrician who both uses current information and is supportive of your parenting.
FWIW, my son was also a very big baby (99th percentile on both weight and height at that age) and he fed a minimum of once per night until he was a good bit older than your daughter. The fact is, he was growing so fast he needed the food that often.
As for the change in sleeping pattern you're experiencing, that's normal at 4 months. Most babies' sleep patterns change, for better or worse, at around 4 months.
03-06-2006, 05:48 PM
Just wanted to chime in. I know how you are feeling! DD has been OC in height and weight since she was 2 months old. She has always gotten up at least once a night to eat. Currently, she gets up 2-3 times at night to eat. (All our ped has ever said is "Breastmilk obviously agrees with her!" I have often thought, maybe she isn't hungry, but whenever she crys and I get her and she eats, I feel better.
You are right, she is hungry or she needs you! This is really a time for her to be moving and shaking and learning so there is no doubt that she needs to eat or just get some quiet time with you. Keep up the good work.
03-06-2006, 06:41 PM
If you like the pediatrician and you can filter through his information things will be fine. My ds was so big at his 4 month appointment that they had to plot him off the chart because he was so high above the 100% mark. He is a very slim 5 year old now. I fed him every 2 hours until he was at least one, once a night is nothing. It sounds like you are doing a great job.
03-06-2006, 06:51 PM
I would get a new pediatrician immediately. I am not kidding. Your ped isn't just old fashioned, but totally out of line with current recommendations. Your baby is just an infant, only four months old. It is totally normal to wake-up to eat, even at 100%. My son was in the 95th percentile and woke-up, nursed and went back to sleep. And the rice cereal recommendation is totally unsupported by any scientific evidence, it is something my MIL would spout off with. Aaahhh! I hope you can find a new ped and the support you deserve. Trust your instincts mama! Your instincts are correct, your ped is out of line. Take care.
03-06-2006, 08:33 PM
I don't know how to help, but I think you're right about waiting on cereal until she's older.
Maybe you want to try soothing her by rocking? I don't think that a small feeding would hurt. Four months seems early still, so you can work towards dropping a nighttime feeding a few months down the road.
We started letting Alek cry around 9 months or so, and we did it using the Ferber, or modified Ferber method, along with establishing bedtime routines. But 4 months is still very young. I think that even sitting with her for a while until she gets tired again might be worth trying.
03-06-2006, 08:45 PM
Your instincts are right and your ped is wrong!!!!!
Your dd is doing splendidly!!!! Having one feed through the night at her age is great. And she has plenty of time to give up the paci and thin out, she's doing exactly what she's supposed to.
I say keep doing what you're doing. Btw, we found that when dd woke up drowsy, sometimes all she needed was a hug and back down she went. When she woke up wide eyed, we knew she needed a bottle. She's now a wonderful sleeper and all around happy child.
03-06-2006, 09:06 PM
Tell your PD you don't believe in starving babies. That's what I told mine....when DD wakes up at night hungry, she gets fed, and when I wake up at night hungry, I go right to the fridge and grab that comfort pizza ;)
Seriously, though, the poor kiddo is 4 months old!!! She's entitled to all the middle of the night food/cuddles/hugs/kisses that her little heart desires.
03-06-2006, 10:02 PM
This is indeed a smile and nod situation with your ped. You know better; you're better educated about it and you have a good, strong instinct that will protect your baby. So the answer to "How is she sleeping?" is "Great, thanks." How you parent your baby is none of his business. You're the mother. You don't have to have his permission to do what you know is best for your child, nor his forgiveness for ignoring his advice. He knows a lot about medicine, but this is about parenting your particular child, and YOU are the expert on that.
Mama to Abigail Rose
Nursed for three years!
and Ethan James
"When you know better, you do better."
03-06-2006, 10:39 PM
My DD gave up her paci at 4 months too. I nursed her back to sleep when she woke up. I don't think she was hungry so much as she liked nursing and rocking in the chair. DH couldn't get her back to sleep just rocking and she never took bottles. If your DD will take a bottle in the middle of the night, you're so lucky! :)
03-06-2006, 11:03 PM
Go with your gut. Feed your baby! My daughter is having some sleeping issues right now (we're not sure if it's because she's sick or what) but my ped said NOT to let her cry for more than a minute or so (to see if she'll settle herself) -- and she's almost 7 months.
ETA: Every childcare book tells you NOT to add cereal to the bottle. Also, we've been feeding oatmeal before bed and she's still waking wanting to eat. Are you wedded to this doctor?
03-07-2006, 12:12 AM
i second all the previous posts. I just also wanted to say that my dd was always large and i think sometimes that means that need to eat MORE not LESS!!! I mean..think about it....if you were growing that quickly you would eat more, too! DD was only 6 lbs and 20" when she was born and now she is 23 1/2lbs. and 32". That's a lot of growing in 10 months and she has always been a big eater. As long as DD is tall and heavy...you're good. Feed the baby when she's hungry. We went through a similar problem when Maddie was about 4 months, but DH was the one with the bad advice. He read on some website that babies that age didn't need a nighttime feeding...but he didn't understand that our baby was OUR baby...not ALL THE BABIES IN THE WORLD. Individual children require individual treatment. Trust your instincts and remember you ARE the expert on YOUR child! Not your PED!!!!
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