If your baby isn’t sleeping well, nutrition could be part of the puzzle. Good feeding habits are the foundation for healthy growth, development, and sleep. This article includes general guidelines appropriate for most healthy infants. Discuss any recommendations with your baby’s pediatrician or healthcare provider to make sure they are right for your baby.
Is your baby getting enough to eat during the day to sleep through the night?
Some babies are not eating enough and this can affect sleep. While it is difficult to track total ounces for breastfeeding babies, consider keeping a 24 hour food diary for babies who drink pumped breast milk or formula. This can be helpful in determining if your baby is generally taking in the recommended ounces for his age. Your pediatrician can also compare your baby’s growth chart with his previous height and weight data and determine if your baby is following his growth trends.
Take a look at the Nutrition Guidelines for Infants adapted from John Hopkins Feeding Guide for the First Year. You can see how breast milk or formula intake typically changes during your baby’s first year.
Nutrition Guidelines for Infants
|Age||Amount of Formula or Breast Milk per Feeding||Number of Feedings per 24 Hours||Total Ounces per 24 Hours|
|1 month||2 to 4 ounces||6 to 8 times||16 to 24 ounces|
|2 months||5 to 6 ounces||5 to 6 times||24 to 32 ounces|
|3 to 4 months||6 to 7 ounces||5 to 6 times||28 to 32 ounces|
|5 to 6 months||6 to 8 ounces||4 to 6 times||28 to 32 ounces|
|7 months||6 to 8 ounces||3 to 5 times||30 to 32 ounces|
|8 months||6 to 8 ounces||3 to 5 times||30 to 32 ounces|
|9 months||7 to 8 ounces||3 to 5 times||30 to 32 ounces|
|10-12 months||7 to 8 ounces||3 to 4 times||24 to 32 ounces|
Follow your baby’s lead on feeding. A baby’s intake will vary from feeding to feeding. It is normal for some babies to have smaller, more frequent feedings. If you force feed your baby, you are more likely to get a fussy baby who spits up. Formula-fed babies often go longer between feedings due to the digestion process of formula versus breast milk. There are no absolutes on ounces and feedings, so make sure you are paying attention to your baby’s cues.
Evaluate the bottle and nipple size. Switch to a larger bottle and nipple when developmentally appropriate. Most babies over six months need an 8-ounce bottle. Older babies who are still on a size one nipple (the smallest one) may become frustrated or exhausted and limit their intake during feeding times due to the extra work of sucking from the small nipple. Older infants usually need a size two, three or larger nipple. Keep in mind that if the nipple hole is too large, however, it is possible for the breast milk or formula to come out too quickly and this can be a choking hazard. There are many bottle and nipple choices available for consumers, so if your baby seems unhappy or overly fussy, there are options out there that mimic nursing, have an ergonomic design, or have venting systems that decrease air bubble intake.
Hold your baby during feeding times. Parents and caregivers are often multi-tasking during feeding and may either prop a bottle or put their baby to sleep with a bottle. Going to bed with a bottle increases the likelihood of ear infections and tooth decay. Some babies are fussy and have reflux-type symptoms. Holding your baby upright during bottle feeding may improve these symptoms and that equates to better sleep.
Switching formulas. If your baby has recurring gastrointestinal problems, sometimes switching formulas can help with digestive issues and improve infant sleep patterns. There are a lot of formula options, so it is good idea to discuss formula changes with your baby’s healthcare provider. Breast-feeding moms can also look at their diet to determine if eliminating certain allergens or food/beverages help your baby have improved digestion. Babies sleep better when they don’t have tummy pain.
Introducing solids. It is an exciting time to begin solid foods with your baby! Generally you want to introduce solids around four to six months of age, or when your baby has at least doubled their birth weight and weighs about 13 pounds or more. Other ways to assess readiness for solids is ensuring that your baby can sit up independently, can open her mouth when food comes her way, and can move food from the spoon to the back of her mouth (it is normal for this step to take some time).
It is best to start with a rice or other single-grain cereal mixed with formula or breast milk, and then move onto pureed vegetables, fruits, and then meats. Most babies show a preference for sweet foods, so you may want to offer grains and vegetables first to ensure variety. Remember that during the first year, babies will still get the majority of their nutrition from breast milk or formula. Continue offering breast milk or formula before solids at most meal times, especially if you are working on sleep.
It is recommended that you start with one new food at a time and try the same food for three or four days before introducing the next new food. This is helpful if your baby has an allergy or intolerance to a certain food item. Remember that infants ONLY need breast milk or formula for the first four to six months. It might be tempting to give pureed foods to young infants under four months, but most babies are not developed enough to sit in a high chair and have good head control until at least four to six months. There is also evidence that introducing solid food too early can cause allergies and eczema.
Calorie-rich foods. Each ounce of breast milk or formula has about 20 calories. If your baby is taking four to six ounces, this is easily 80-120 calories per feeding. Babies who fill up on baby food may have to eat several servings to get this many calories, and likely the baby food will not provide the necessary fat or protein that is found in breast milk and formula. For babies with growth or sleep issues, offering formula or breast milk first during feeding time will keep your infant well-nourished and may help with sleep habits. After the bottle is finished or your baby cues you to move on, then you can then work on developmental milestones (and the joy and sometimes frustration of introducing a new food to your baby) with pureed or mashed foods and a spoon.
Homemade baby food. It is convenient to purchase baby food, but you can make your own baby food that could be more nutritious (again, a well fed baby will hopefully sleep better for you). Making your own baby food saves money, can have fewer added fillers or extra ingredients and can be nutrient-rich. With commercial baby food, check the food label to ensure that it does not contain starches to thicken, added preservatives, or sweeteners. The trend now is to offer simple baby foods with fewer ingredients, so you can easily find healthy choices in the grocery store. Just make sure you are well-informed and reading food labels and ingredient lists.
If you want to make foods at home, one of my favorite baby foods to recommend is a simple fork mashed avocado. It is a great source of healthy fat, vitamins and minerals. Just peel a ripe avocado (no cooking required), remove the pit and mash or puree until the desired consistency. You can also make homemade fruit or vegetable purees from cooked fresh fruit or vegetables with no added salt or seasoning. Prepare purees in a food processor or blender by mixing with breast milk, formula, or water. You can make baby food ahead and refrigerate for three days or freeze in ice cube trays for longer storage.
Ensuring that your baby is healthy and well-nourished can be the key to great sleep in infancy and beyond. Making nutrition a priority early in life can help your child have the right foundation for optimal growth, development and happy sleep.
Guest author Amy Tramm is a Registered Dietitian, Registered Nurse, and Mom of three teenagers who love to sleep in on the weekends.
This information should not be used as a substitute for medical care and advice of your pediatrician. Discuss any health or nutrition concerns with your healthcare provider. This article contains nutrition guidelines that may not be appropriate for your baby’s specific needs.