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The Tough Stuff: Childhood Sleep & Nutrition

November 8, 2013 10:00 AM with Dr. Lindsay Uzunlar

Are your kids getting enough sleep? Are they eating what they should be eating every day? Are these two things becoming a daily battle? They don’t have to be. Lindsay Uzunlar, MD, Pediatrician at NorthShore, will answer all your “tough stuff” questions, from how much your kids should be sleeping and how to ensure they are getting enough, to crafting a recipe for a lifetime of healthy eating for your children (and the entire family). Submit your questions early.

Brenna (Moderator) - 9:56 AM:
Our chat The Tough Stuff: Childhood Sleep & Nutrition will begin shortly. You can submit questions at any point during the chat.

Dr. Lindsay Uzunlar (NorthShore) - 10:00 AM:
Good Morning everyone. I hope all of you had a great night's sleep and a nutritious breakfast!I am excited to have this opportunity and look forward to helping you with your questions.

  Mandy (Millstadt Il) - 10:00 AM:
My son is 5. He still wears a diaper at night. I was a bed wetter and so was his father. Is there anything that we can do to get him to wake up and go.
Dr. Lindsay Uzunlar (NorthShore)
It is still normal to have nighttime wetting up to the age of 6 especially if there is a family history of this. There are different techniques that you can try. The simplest is just having scheduled wake up times. With this technique, you set your own alarm and wake him up to take him to the bathroom. In a perfect world, you could wake him up before you go to bed (assuming you go to bed later than him) and then not worry about it for the rest of the night.

  Elaine (Chicago, IL) - 10:03 AM:
My 15 month old sleeps very well, and in most cases through the night. He does rely on a pacifier to go to sleep, and on the nights he does wake up in the middle of the night it's because he can't find it. Once he does (by himself or with assistance), he goes right back to sleep. Should we wean him? What are some tips for weaning? Is there an age limit of using one?
Dr. Lindsay Uzunlar (NorthShore)
As you may have realized, he is using his pacifier as a self-soothing object. So the key to helping him transition to good sleeping without it is to replace the pacifier with something else. For instance, this is a great time for a teddy bear or blanket. Put him to sleep with both the pacifier and the new object so that he can associate both with self-soothing. Then you can take away the pacifier and ideally he won't notice it too much. You can work on having the pacifier gone over the next 2-3 months. I would recommend that you just take them all away at once that way when he wants it, you can 100% truthfully say that they are "all gone."

  Tiffany (Freeburg, Il) - 10:09 AM:
My son is 14mo old, generally speaking my son loves to eat but now he's playing with his food, throwing it. I'm having a hard time getting him to eat veggies and meats. He eats everything else just fine. We also have issues with him getting into screaming fits if we don't feed him more even though we gave him a lot of food. He screams and cries if we don't feed him fast enough. We have to avoid letting him in the kitchen because he knows that's where food is at.
Dr. Lindsay Uzunlar (NorthShore)
Don't worry, there are a lot of ups and downs with "toddlerhood" and this is normal. Toddlers tend to want to assert their independence when it comes to feeding. This sounds like you may need a visit with your pediatrician to completely discuss some methods for coping with this.

  Ayanna (Chicago, Illinois) - 10:13 AM:
I have a twelve year old who had from the start rejected peanut butter and meat. Howndoni get him the nutrition that he needs? Also, how many hours does he need to get every night in order to grow and function? He rises at 4:45am each day and goes down at 9pm each night.
Dr. Lindsay Uzunlar (NorthShore)
Two issues: 1. Vegetarianism is kids is fine but I understand your concern about his protein intake. There are other sources of protein besides peanut butter and meat so that is the good news. Some other sources are eggs, milk and soy product and whole grain cereals. Try to make sure that he gets a combination of these at each meal. 2. He should be getting between 8-9 hours of sleep every night.

  Kim (Illinois) - 10:16 AM:
Is dairy and gluten considered a necessary source of food intake for a child's diet? Is it harmful in anyway to one's health? There are many health practitioners who have stated dairy and gluten is actually bad for us and should be avoided. Any strategies to help children learn to explore more food types if they have texture sensitivities?
Dr. Lindsay Uzunlar (NorthShore)
Dairy and gluten-free diets are very popular right now. However they are only necessary for a select number of people and otherwise are part of a healthy diet. Children who experience gastrointestinal symptoms like diarrhea, stomach cramping, vomiting or bloating after eating one or both of these may have a sensitivity. In that case, it is a good idea to see your pediatrician about safely removing these from the diet. If they don't experience these symptoms, then that is a good thing and they can continue eating these things without issue. For texture sensitivities, it is a good idea to "try and try again." It can take kids awhile to get used to new things, tastes and textures alike, so just encourage a single bite each meal and if he or she takes it, consider that a success! If you find that this is taking longer than you think, then speak with your pediatrician.

  sylvia (melrose park il) - 10:23 AM:
My son only like to eat certain things like pizza or mac and cheese. He hates fruits and veggies. What can i do help him get all his nutrition food? thank you
Dr. Lindsay Uzunlar (NorthShore)
This is normal. The solution is also to "try and try again." One easy trick is mixing in vegetables on the pizza (spinach or tomatoes are good) and in the mac and cheese (peas can work).

  Tiffany (Freeburg, Il) - 10:26 AM:
When does a child's bed time start to change. I always put my son to sleep when he shows signs of being tired, it's usually around 7:15-7:30p.m. he will sleep until 6:30-7a.m. As he gets older will he naturally stay up any later?
Dr. Lindsay Uzunlar (NorthShore)
The key to remember is that you are in charge of bedtime: from infancy through the time that they leave your house. Setting bedtimes is really important. The times that kids go to bed can really range depending on age. They will naturally start going to bed later as they need less sleep. A newborn needs up to 15-17 hours of sleep; a 6 month old needs 13-14 hours of sleep; 9-24 mos need about 12 hours of sleep; school age between 9-10 hours and adolesence 8-9 hours.

Dr. Lindsay Uzunlar (NorthShore) - 10:31 AM:
For new questions, please remember to tell me how old your child is so that I can tailor the answer to you.

  Renee (Wilmette, IL) - 10:32 AM:
I have an 11 month old and would love if he slept longer at night. I would like to get him to bed earlier, but am afraid he will also wake up sooner. Right now he goes down for bed between 8 and 9pm and typically up by 5 or 5:30am. He does take 2 naps during the day and wakes up from the last one still a little tired. Is there anything I can do to help him sleep longer at night?
Dr. Lindsay Uzunlar (NorthShore)
A lot of babies need help learning when and how to sleep so this is where you can make a big difference. I would start by observing him and when he naturally seems sleepy. It may be that he starts to be more fussy earlier than 8 or 9 in which case you can try putting him to bed earlier (always putting him to bed drowsy but not sleeping). If that isn't the case, then you can help him by making sure that he doesn't nap past 4pm and start your bedtime routine earlier than 8-9pm to encourage an earlier sleep time. If you are having difficulties, then you can check in with your pediatrician about sleep training techniques that are best for him and you.

  Jessica (IL) - 10:39 AM:
It is a constant struggle to get 4 year old son to eat much at lunch or dinner. He eats next to nothing for those two meals. Seems to have a fairly hearty appetite in the morning but only wants to eat the SAME thing at lunch and at night - apples, carrots with ranch dressing, and occasionally yogurt. He refuses proteins like meat. Says he is a vegetarian - no one else in the family is. How do we get him to try more foods? How can we ensure he's getting enough protein?
Dr. Lindsay Uzunlar (NorthShore)
This is a normal time for children to be very picky with their eating. Lots of kids also choose to be vegetarians at this stage because they don't want to eat animals. There are many different ways to get in protein. If he particularly likes breakfast, then eggs, milk and whole grain toast are good sources of protein. To help him eat more at other meals, make sure that he takes a "no thank you" bite of the food you have made for the other meals. He should be eating what you make for the family at both lunch and dinner, even if it isn't his favorite.

  Anonymous - 10:45 AM:
Hello Dr.Uzunlar. Is it normal still for 3 year old to still be thumb sucking. tried many differnt things but can not seem to make it stop, even is sleep. Also is normal for 3 year old to wet their bed? Thank you.
Dr. Lindsay Uzunlar (NorthShore)
Yes these are both normal things for a 3 year old to do. To help him with the thumb sucking, you need to find something that can substitute for the calming feeling he gets from thumb sucking. For instance, you can try introducing a teddy bear at night. Remember always use positive reinforcement when trying to bring about change. So if you find times when he is not thumb sucking, be sure to praise him. For help with bed wetting, please see the previous answer regarding this issue.

  Ana (glenview, Il) - 10:50 AM:
Good Morning Dr Uzunlar, My healthy son will be 3y/old next week, how much milk does he really need to drink a day? He also eats solid food. He will usually have 4 glasses per day.
Dr. Lindsay Uzunlar (NorthShore)
Morning. He should be taking about 16-18 oz of milk a day.

Brenna (Moderator) - 10:51 AM:
There are 10 minutes left in this chat. It has been a very popular topic. We won't be able to get to every question today, but a transcript of the chat will be made available after this chat.

  Erin (Chicago, il) - 10:52 AM:
My almost 13 month daughter was exclusively breast fed. At 6 months, we had minimal success with solids. I don't think she holds out on food to nurse. She plays with food, tries a variety of food but chews it & spits it out. I don't think it's a texture issue. The only food I can get her to consistently eat is pizza. I make smoothies almost daily with varying success. I don't know if I should wean cuz I'm worried she's not getting good nutrition. Not sure what else to do. Also juggling 3y/o twin
Dr. Lindsay Uzunlar (NorthShore)
This can be tricky especially with having the twins around. However I wouldn't worry about her not taking enough if you start to wean. She should naturally start to increase her food intake as you do so. If/when you transition to cow's milk, she should be taking less than 20oz a day.

  Jess (Indianapolis) - 10:57 AM:
When can I try my baby on animal milk? Do you have recommendations re cow vs goat?
Dr. Lindsay Uzunlar (NorthShore)
To help with brain growth, babies should remain on breast milk or formula until 12 months old. After that, trying cow's milk is best as it has a more complete set of nutrients. Goat's milk is an option if you feel that he may not be tolerating the cow's milk but in that case he should be taking a multivitamin with it.

Dr. Lindsay Uzunlar (NorthShore) - 11:01 AM:
Thanks for all your great questions. Happy eating and sleeping!

Brenna (Moderator) - 11:01 AM:
Thank you everyone for your participation today. Thank you Dr. Uzunlar for tackling the "tough stuff" this morning. Have a wonderful weekend, everyone.

Dr. Lindsay Uzunlar (NorthShore) - 11:03 AM:
For further questions about nutrition, Dr Leslie Deitch will be giving a lecture at our Wilmette office this Monday 5:30pm

This chat has ended.

Thank you very much for your participation.