The Newborn Guide for New Parents

Podcast Transcript

Dr. Richard So:

Welcome to Little Health, a Cleveland Clinic Children's podcast that helps navigate the complexities of child health one chapter at a time. In each session, we'll explore a specific area of pediatric care and feature a new host with specialized expertise. We'll address parental concerns, answer questions, and offer guidance on raising healthy, happy children. Now, let's talk Little Health.

Hi, I'm Dr. Richard So. Welcome to Cleveland Clinic Children's Little Health Podcast. Today, we're gonna be talking to Dr. Hannah Spellman. She is a pediatrician and parent at Cleveland Clinic Children's. Welcome.

Dr. Hannah Spellman:

Thank you so much for having me. It's a joy to be here.

Dr. Richard So:

We're gonna be talking about primary care pediatrics, which is very important, as primary care is often the entry level to our healthcare system. Dr. Spellman, tell us a little bit about yourself.

Dr. Hannah Spellman:

Sure. I am a primary care pediatrician, like you mentioned. Um, I'm originally from Massachusetts, and then trained in undergrad in medical school in the New York area, and then I came to Cleveland for residency. I completed a chief resident year before being a primary care pediatrician, which I started, um, in July, so just a few months ago.

Um, I have two little children. My first, um, is three and a half years old. He was born right after my first year of residency, so sort of just after I started training. And my daughter is one year old right now. Her birthday was just a few weeks ago, um, so she was born during my chief year.

Dr. Richard So:

So being a new parent and being a doctor, uh, that's a big quandary sometimes, you know? Because sometimes, the book answers are different from what you experience in real life. Tell us a little bit about what you went through in your journey through parenthood.

Dr. Hannah Spellman:

Yeah, that's such a good question. Um, so I think when I had my first child, I thought, oh, you know, I know so much, I'm a pediatrician, I should really have all the answers. And that was just not my experience. I think, um, to some extent, my training brought me more questions (laughs) rather than answers. Um, I knew a lot of material and I knew a lot of resources, but having a baby in front of you is just such a different experience, um, especially when you're so emotionally connected to that baby.

I like to say that becoming a mom made me a better pediatrician, because I can understand a parent's experience better, I have a lot more empathy for the experience of the parent and a lot of the challenges that come up with that, especially when it comes to caring for a newborn. And I learned a lot from becoming a parent, things like what sized diaper should my child be wearing, that you really don't learn in medical school, but parents ask the pediatrician those types of questions.

So I think becoming a mom helped me learn a lot more to be a better pediatrician, but to some extent, my pediatrician training made me more of a neurotic parent, I think. (laughs)

Dr. Richard So:

Do you feel like there was like a little bit of imposter syndrome, where it's like, "Okay, I've been giving the book answers for all these years during my training, but then now when I'm a pediatrician, oh my God, it's a little bit different message"?

Dr. Hannah Spellman:

Yeah, definitely. I think sort of the book answers don't always line up with reality, and you're trying to sort of tweak what you know to fit to this real human, like, baby in front of you, um, who's just not following the textbook and things like, does this poop smell normal? Questions that come up for parents in the middle of the night, like, I... It was almost embarrassing to ask my pediatrician, but I also felt like I had to ask because, like, I didn't actually know the answers to those things. (laughs)

Dr. Richard So:

Yeah. Being a new parent, you, yeah, you're, you're very anxious, you're excited, you try to prepare as much as you can. There's a lot of parents who read a lot of different information, whether it's online versus magazines. There's a lot of information out there with regards to, like, what did you wish that you knew now versus what you knew then? You know, what, what could you have told your old self?

Dr. Hannah Spellman:

Yeah, that's such a good question. I think two points. The first is sort of what you mentioned about information. You know, I think social media has really affected the way that mom's taken information. And so just being really mindful about what those sources of information are. If you've been up all night and you're stressed and you see someone's posts on Instagram, that's not necessarily the best form of parenting advice. So just being sensitive to the way that social media affects the information that we take in. It could be a great tool, but also it can also be sort of overwhelming.

I think that's the first piece of information. I think the second thing, um, that I would've told myself is that it's going to be really hard, and it's going to be really exhausting, um, in a way that you can't even imagine before you have your first baby. You know, I had come out of a year of, of residency training. I thought I knew what it meant to be exhausted. I'd been having, working long hours, um, staying up all night and, um, nothing really prepares you for having a newborn baby. And I think that it was really challenging and I, I would've just told myself that that's normal, and that that's okay, and that that will get better over time.

Dr. Richard So:

I agree. There's, like, a lot of parents, like, they try and prepare, they're so organized and they even have a birth plan, you know, that how many times I'm gonna push for how many minutes, you know, there's a lot out there on social media like Dr. Google has got all the answers, you know, with zero experience. We say that in the office all the time, but let's get into the nitty-gritty. You know, when we talk about new parents, there's often an excitement and there's anxiety. You know, I think that there's a lot of anxiety for the first baby, and you just want to try to be so perfect with it, you know?

You have your plan of, like, how you're gonna feed, you want to breastfeed, you know? And for me, I think, uh, the difference between anxiety and the first baby and the second baby is that with the first baby, you know, your biggest anxiety is feeding the baby, especially if you're a breast feeder, you know. For example, it's like, I'm the food, oh my gosh, I'm responsible for this baby, but I'm just a big kid at heart, and oh my God, I'm now responsible for this new life. Versus I think with the second baby, I think there's guilty feelings, you know, you already know how to feed the first one, you've been through it already, and then the second one you're actually feel... Your anxiety is more, I think it's more guilt of dividing your time between the first baby and the second baby. What do you think about that, that statement?

Dr. Hannah Spellman:

Yeah, I... That definitely resonates with me. You know, as the first baby, a lot of the time you're just figuring out what it means to take care of a newborn, how do you hold the baby, how do you burp the baby, how do you change diapers, things like that. Um, and with a second baby, um, then you have a lot of that experience already, but now you're trying to parent a toddler and a baby at the same time. And that comes with new challenges, making sure you're really giving dedicated attention to all of your children.

I think aside from that, I also think babies come born, to some extent, with their own personalities. And being aware of that when you have one baby versus two babies is, is really important. So, um, I can say in my experience, my first child, my son, um, he had a hard time breastfeeding at first. We needed to work with breastfeeding medicine a lot. I ended up almost exclusively pumping for the first number of months of his life because he was just had a hard time feeding. He did not like to be put down for sleep, wanted to be held all the time. It was just really for most of his life, and even now into a toddler, he really likes having a parent close to him, likes being held.

And my second child was born, she breastfed right away. She slept great. She... If you swaddled her and put her down, she was, you know, really easy. And I don't think that was anything different that I did. I think a lot of it was just how the baby was born. And babies are sometimes born with their own intricacies and that might be different from baby number one to baby number two or three.

Dr. Richard So:

I'm going along with that. But what I think is, is that I don't think the babies are different. Everyone says like, "Oh, the second baby is so much easier, or the third baby is easier." I think it's more with the parental experience and going along with that anxiety with the first one, you don't know everything. And going on with personalities, I think a lot of babies have their parents personally as well. In my practice, I have, like, two kinds of parents. I have ones that enjoy their babies, their babies are nice and easy, and then you get fussy babies. But then I think that babies, they're like horses.

They know which parents are nervous, you know, just like horses know which riders are riding them and they're nervous and they kick them off. I think babies are the same way. If you have a nervous parent, I think their babies are like, "Oh my God, give me someone who knows what they're doing, and I'm just gonna cry all day." But the most of the anxiety feeding, and most people, I think, new parents are scared. They're scared of hurting their babies, but I think that's 90% of our job is just reassuring them. And the other 10% is interpretation, what they're reading on the internet these days.

Dr. Hannah Spellman:

(laughs) Yeah, definitely.

Dr. Richard So:

With regards to new parents, you know, and going with anxiety, let's go to sleep first, all right. I, I like to go with sleep because I think a lot of parents, you know, newborn parents, there's a lot of keeping up with the Joneses. I want to be able to tell people, "Oh, well my baby sleeps." For example, when I tell my parents, "Your baby's not gonna sleep until four months and that's normal." I think telling parents of newborns that what the normals are and what the normal expectations are, I think that eases their anxiety instead of keeping up with the Joneses. Because I think parents are trying to get the babies, especially the newborns sleep on their schedule, but that's just not the case.

Dr. Hannah Spellman:

Yeah, I definitely see that. And I, you know, that resonates in my experience to some extent as well. Newborn babies are not intended to sleep for long periods of time. They need to wake frequently to feed, especially if they're breastfeeding, both because the baby needs to feed frequently and mom needs that for her milk supply to be established. Um, so it's normal for babies to wake up every two to three hours and we want them to wake up to feed every two to three hours.

And that leads to very exhausted moms and very exhausted parents. And you really... It's, it's important to have family members and friends who can rely on to help you out with that because you're going to be so exhausted. But I definitely agree, you know. I think there might be some babies who, primarily babies who aren't necessarily breastfed, but who are able to establish sleep schedules and sleep for longer stretches of time if they, um, have, you know, good weight gain, they're not having reflex issues. Maybe there are some babies who can sleep for long stretches overnight, but that's not the norm. And I think that sets an unrealistic standard.

And yet, when you're an exhausted parent who's been up for so many nights in a row, it's, it can be challenging to hear that and to, I think it can be helpful to know that it's not gonna last forever. Like, eventually your baby will sleep longer stretches through the night, but it is exhausting while you're going through that. And it is still normal, exactly like you're saying.

Dr. Richard So:

Yeah, that's the big quandary is that for the first two weeks of life, your goal is to get that baby to regain their birth weight, and you're still a new breast feeder or you're feeding your baby. And I think for the first two months, I think the goal should be just learn how to feed your baby to learn your routine. Versus there's other parents who are trying to, "Oh my God, I want this baby to sleep. I can't sleep at night. I'm back to work. My paternity is over. I need this baby to get to sleep." And then you have parents trying to feed, and then they're coming back weekly to my office for a weight check after weight check or for weight check because they're wrapping their baby so tight, they're buying everything on the market to position their baby to get their baby to sleep.

And what I think is happening, sometimes, when we get these weight checks over and over again, sometimes it's not the baby. I think it's the parent trying to get to sleep and they're missing feeds, trying to get longer sleeps where you get a parent say, "Oh, I got my baby to sleep for eight hours." Yeah, but you missed two feeds and now you gotta come visit me in the office.

Dr. Hannah Spellman:

Yeah, I, I definitely do think some babies are born having an easier time sleeping, and some babies don't wanna be put down, do wanna be held. And I think sometimes parents feel like, "Oh, I'm doing something wrong because my baby won't sleep on their back in their bassinet." Um, and I think it's important to reassure parents, you're not necessarily doing anything wrong. It's normal for babies to wanna be held. Babies often don't wanna be put down, and that's, that's actually protective for them in many ways. And yet it leads to very exhausted parents.

Dr. Richard So:

Yeah. I think a keynote note, like, about this podcast and talking about sleep is that if you've ever been to Las Vegas, I think that's what ba- newborn babies are like. They're like from Las Vegas, they're in casino mommy for 37 to 40 weeks. They're in the dark, there's no clocks, they're partying, they're kicking you every night, and they're up at night and they're partying, there's no clocks and it's dark. And then all of a sudden comes birth, they come outta a casino vagina. It's like coming out the casino like at 6:30 in the morning, there's bright lights. All right. And what do we do when we have bright lights? What all the babies do? They shut their eyes.

So I think what newborn parents need to understand is that when I say babies are from Vegas, all right, it means that it's gonna take them a good six weeks to figure out what's day and night because they've been in the casino for 38 weeks, all right, that means they're gonna party all night, all the babies are gonna stay awake and they're gonna sleep all day. And what we know about the circadian rhythm of the hormones is that it takes six weeks for them to flip-flop and figure out what daytime and nighttime is. I think if parents understood that, I think things would be a little bit easier.

Dr. Hannah Spellman:

Yeah, I think it's really important to normalize, um, the sleep patterns of babies. And so moms and parents don't feel like they're doing anything wrong if that's how the, the pattern is going.

Dr. Richard So:

Yeah. And as we move through, as we get to, like, your journey through parenthood, learning to feed your baby is another important point. And learning all the different cries, you know. When, when you first have that baby, everybody only knows one cry. Cry, cry, cry, feed, feed, feed. But as pediatricians and as parents, uh, we know that that's not always the case. I think it takes two months to figure out all different cries in your baby. It... I usually talk about it at the one- month visit where I'll say, "Okay, now that you've learned how to feed your baby, your baby should have gained about one pound at the one-month visit where you visit your pediatrician."

And that's when I talk about learning the different cries in your baby. So we know cry, cry, cries, feed, feed, feed, normal gastric emptying time or normal stomach emptying time is every two, three hours, but in a one-month baby it may be a little bit quicker. So we always say, "Okay," I always tell my parents, "Feed the baby at every one and a half to two and a half hours and look at the clock," you know. But then parents are always worried about what they heard from before is like, "Oh, but I was told I can't let my baby sleep for four hours." But I think once your baby regains birth weight, then you don't have to wake up your baby from sleep anymore.

Dr. Hannah Spellman:

Yeah, I mean, I see the same thing in practice. You know, I think those, that first one to two weeks, um, is really focused on gaining the weight back and babies need to feed frequently, both for their weight gain and for mom's milk supply to be established. Um, and that might be every one to two hours. It could sometimes babies cluster feed, and they're feeding on and off every half hour for a stretch of time. And again, that's challenging, but that's normal. That's a physiologic way for babies to be feeding.

And then once they get back up to that birth weight, then you usually can trust them to wake to feed a little bit more. Obviously, there's exceptions to every rule, but that's generally what we see.

Dr. Richard So:

You told me that it was hard to feed your first one. Tell me how hard it is to pump breast milk and, like your, your sleep habits.

Dr. Hannah Spellman:

Yeah, that's a great question. So I would say feeding was such a big part of my journey with my first child. Breastfeeding is really important to me. I think for, for health reasons, I think there's a lot of evidence that breastfeeding is the best sort of healthy source of nutrition for infants and there's a lot of health benefits to moms. So for a variety of reasons, I really wanted to breastfeed and I felt like I sort of had been trained. I had read the books, I knew what I was doing, I'd watched videos online, done all the modules.

And um, when my son was born, he had a very difficult time latching, and we worked with lactation, and still wasn't really making a lot of progress. Um, he would get stressed out trying to come to breast. I would get stressed out trying to feed him. After about 10 days or so, he still was losing weight and hadn't really started gaining weight back, so I started pumping. Um, probably looking back with what I know now, I probably should have started pumping a little bit sooner. But again, you know, hindsight, is 2020, I just didn't know that at the time.

Um, so I started pumping to try putting him to breast and then supplement with some, um, expressed breast milk. Um, and I did work with breastfeeding medicine to, to sort of troubleshoot that. It turns out he had a little bit of torticollis, so a little bit of muscle tightness that made latching more, um, uncomfortable for him. And I think we really tried everything we could. We went to a baby chiropractor, we tried some stretching-

Dr. Richard So:

Wow.

Dr. Hannah Spellman:

... exercises, um, and he really just never latched effectively for, for months. Um, I tried to put him to breast every so often, but by that point, um, his primary nutrition was just, um, expressed breast milk. I would say pumping, um, to feed a newborn baby is very time-consuming. I, I was pumping about eight times a day, so about every three hours, including through the night, my husband and I had a whole routine of like packing up our pump parts and coolers overnight before going to sleep. And he was doing all the feeding overnight while I was doing all the pumping, so that was definitely challenging and it was really a two person effort.

To some extent, it took a big strain off because I, I knew how much milk the baby was getting. I wasn't worried about his weight gain. I went back to work to residency at about eight weeks, and I was confident that he was going to be fed. Like, I knew how to pump, I knew how much milk he was getting, and I do think it allowed me to feed him breast milk even though it was challenging.

Um, and I kept trying to put him to breast every so often and around, you know, four to six months he actually kind of figured it out. Um, and he eventually started breastfeeding, and I'll be honest, he breastfed, um, up until I had my second child. So I stopped pumping when he was about a year, between 12 and 15 months old. But he kept breastfeeding, um, directly for a period of time after that. So, um, breastfeeding journeys can be weird. Um, it was very difficult, and, um, I put a lot of work into it, and I had a lot of support at home which allowed me to do that.

And I had um, support at work as well. My colleagues and co-residents were really supportive of me pumping at work, which made a huge difference. But it was challenging. Um, and it didn't go the way I expected it.

Dr. Richard So:

It's really hard. It has to be because if I, if I tell you to feed your baby every one and a half, two and a half hours, number one, you have to pump, then you have to feed, then you have to clean everything. That takes a lot of time when you have to sterilize. There's so many different sterilized out there and then you gotta feed again. That gives you like roughly 25 minutes to sleep if it's every one and a half hours, 'cause it takes a long time to feed your baby.

Dr. Hannah Spellman:

Yeah, exactly. And I think it's hard to hold your baby while pumping. So to some extent, it can create a, a distance and a barrier between the mom who's pumping and not really being able to connect with her baby during that same time.

Dr. Richard So:

I think it's really good that you told our audience that you did pump it first and then the baby was eventually gonna latch and it gives, I hope it gives a lot of our new mothers out there a lot of hope that you have to stick with it, and it's gonna take some time. But I wanna talk a little bit about getting that visual satisfaction of knowing the amount. Because in my practice, all right, I think that it's the parent where you don't need that visual satisfaction of how much the amounts you get it because the baby will do it once you regain birth weight. I think the only visual satisfaction that you get, you're not gonna get the volume, but I think you need to trust your weight of your baby.

If your baby's gaining weight in your pediatrician scale, you don't need that visual satisfaction of the amount or the volume that your baby is getting. But I... Parents just need to know that sometimes. And it's confusing to me your baby's gaining weight, you don't need to know that much.

Dr. Hannah Spellman:

Yeah, with my second child, um, she was great at breastfeeding, and I... Because of my experience, my first child, I was very nervous. I was very nervous about her weight gain. I wanted to come back for weight checks, um, beyond what my pediatrician felt the need for because I was so nervous about that weight gain. And the reality is, if I followed her cues, and I fed her when she was hungry, um, she did it. And I think lots of babies actually are great at breastfeeding and once again, once they get back to that birth weight, if you follow their cues and you don't try to disrupt their schedule, so if you just let them feed when they feed without trying to do any sleep training or any other things, then they pretty much figure it out, and they can get onto their own growth curves and have great breastfeeding experiences.

I think to some extent the society that we live in, um, damages breastfeeding more than we realize. So I think moms need to have, you know, a good amount of paid maternity leave and ideally having some parental leave for another parent too to help support because it's so exhausting to really help support the mom who's breastfeeding. Um, I think that's a really important part of it because once you start pumping and start changing sleep schedules and going back to work, that in of itself can sometimes disrupt breastfeeding.

But, you know, when allowed uninterrupted, then sometimes you do really have to trust the process, which can be hard for, you know, type A moms like me who are, who are used to controlling our environments.

Dr. Richard So:

What, what I hear about is a lot about trust and like, "Oh this is a good baby." But I think that the trust is internally, and I don't think has anything to do with the baby. I think it has to do with the mother, where you have to, like, trust that the baby's getting it where you don't need that visual satisfaction on that part. And it's the same thing with crying, all right. Let's go down that road a little bit where it takes two months to learn all the cries. And the moms always think, "I'm not... My baby's not getting enough, my baby's not getting enough." Or, "I need my baby to sleep. I need my baby to sleep." Those are some things where okay, I need to feed, feed, feed.

And then I think a lot of moms don't know the difference between feeding and suckling and it, oh it... 'Cause they're worried about the volume, they're worried about the weight. And I think learning how to feed versus suckling where all of a sudden, now we're overfeeding and my baby's spitting up and refluxing. Let's talk about reflux. With regards to reflux, to me, the only abnormal reflux is anything with blood in it. Anything with bile which is dark green, you know, which means to some kind of intestinal obstruction or anything projectile.

Projectile vomiting, everyone thinks their kids projectile vomiting, but it means like you're typing on your laptop, it doesn't hit your lap, lap, it actually hits the screen like the exorcist, you know, but everyone's always afraid that reflux is like a big problem in their baby. We're overfeeding our baby 'cause we're trying to get them sleep more, you know, but they're refluxing and then they're not sleeping 'cause we're overfeeding and it just becomes a bad cycle.

So I think to learn the difference between feeding and suckling could be a, a big part where I had a mother who I need that third ounce so I can sleep more. And I think there's a big anxiety part where your parent is worried about growth, so I'm trying to get more in there because I'm worried about the weight, but then we're overfeeding and we're causing problems.

Dr. Hannah Spellman:

Yeah, it's interesting. I think it, I think about it a little bit differently with babies who are primarily feeding at the breast or feeding from bottles. I think in terms of reflux, you know, all babies spit up some, you don't even notice it and some it's, it looks like a huge amount. If you took a teaspoon of milk and spilled that on the floor, it would also look like a huge amount. So you... It's hard to get to sort of know from the visual. If the baby's gaining weight, well usually they're keeping enough milk down and that's, that's a good enough sign.

Babies who, you know, who are feeding directly at the breast, um, sometimes they wanna go to breast to feet and sometimes they just wanna go to breast for comfort and for bonding and, you know, you don't always know. Um, I still think it's important and valuable to listen to those cues and listen to those signals. But sometimes if baby's just been at the breast the entire day and mom needs a break, it's okay to take the baby off, use a pacifier, have someone you know, have dad put his finger in the baby's mouth to suck for a little bit so mom can go take a shower. Like, that's as healthy and normal and important.

Babies who are bottle feeding, you know, because they have that sucking instinct, sometimes they'll seem like they wanna keep sucking and sucking and sucking and you could put a bottle in their mouth and they'll just keep sucking at it all day because that's a natural instinct and that feels good, but it doesn't always mean that they need that amount of milk. Um, so I agree sort of listening to the baby's cues, trying to do some sort of responsive bottle feeding where you slow them down and see like are they really hungry or do they just really wanna suck?

That, that's an important pattern to sort of learn to figure out. And it's not always clear at first and it changes over time. Sometimes babies can take more milk over time, and so you have to kind of watch that adjustment. You also mentioned crying. You know, learning to hear those babies cries. I think that that's another thing. Some babies cry a lot and I think that can be really stressful for parents. Sometimes crying means they're hungrier, wet or uncomfortable and sometimes they just cry and we don't always know why. And that can be really overwhelming and challenging for parents.

And so if that's your experience with your baby, you know, you have my deepest empathies, and that, to some extent, can be normal too. Um, there's a idea that, you know, people have written about called purple crying. I don't know if you talk about purple crying, but um, it's that baby sometimes cry until they're purple in the face with no reasons. And there's all these strategies you can use, holding, rocking, bouncing. I think a baby carrier holding the baby in a baby carrier can be really helpful for that because then mom can be hands free and baby's still getting that, that direct skin to skin contact.

But it can be really overwhelming, and yet it doesn't mean that there's something wrong with the baby as long as the baby's gaining weight, you know, always come to the pediatrician. We're happy to do a weight check and make sure there's nothing else going on. But some babies just cry a lot, um, until they cut and grow out of that phase.

Dr. Richard So:

Yeah, I think a lot of parents, they think every time the baby cries it's like an adult where they think their baby's in pain. But you and I know that's not the case is that, because adults, when we cry, there's different kinds of cries. For example, when someone dies in your family or the Browns win the Super Bowl, those are different cries, and I think it takes a while for the parent to figure out all the different cries. I basically tell parents, "There's no way your baby cries every three hours 'cause there's no way your baby's in pain every three hours. You just haven't figured out the different kinds of cries where it takes at least two months in my world to be comfortable and not be afraid of the baby."

For example, at the one-month visit, I think the three cries are, number one, you're hungry. Everybody knows that from day one. Cry, cry, cry, feed, feed, feed. But then you learn over time that the second cry, it's dirty diaper, you know. 20 minutes after a feed, you gotta go take a poop, all right. So I think the second cry, those first two, like, I'm hungry and I'm dirty every parent goes. But I think parents, they takes a while for to figure out the, "I'm sleepy cry." Babies cry when they're sleepy. And then as you get to about six to eight weeks, I think there's a rhythm where the baby, we talk about when you're out of Vegas at six weeks when you learn that your baby has figured out daytime from nighttime, you'll start to see a rhythm where every baby cries at 9:30 to 10:30, 'cause there's a mid-morning nap.

Every baby cries at 1:30 to 3:30 'cause they all take a mid-afternoon nap, and then every baby cries from 7:00 to 10 o'clock at night, and they all call it the witching hour. But as pediatricians, you know, that's a different meaning of what we say. So I think learning the different cries when you're a baby, "I'm hungry, I'm dirty and I'm sleepy." I think that confidence in a parent takes about two months.

Dr. Hannah Spellman:

Yeah. And I, and I think that, I'll say in my experience, I don't know that I ever really always figured out exactly what every crime means. I, I feel like my kids never really cried when they were, when they had a wet diaper. Like, that was just not part of my experience. My, my son, I feel like 90% of the time he was crying 'cause he wanted to be picked up. If we put him down, he just wanted to be picked up, didn't necessarily mean he was hungry, or tired, or when he was tired he wanted to be picked up.

Um, and my daughter, 90% of the time, her crying meant she wanted to go to breast. Sometimes it was 'cause she was tired and wanted to nurse to sleep. Sometimes she was hungry. Sometimes she just wanted the cuddles, but she just always cried 'cause she wanted to go to breast. So I, I think to some extent babies have the things that they want and they often cry for that.

Dr. Richard So:

I think parents get a little bit, probably the most nervous when they cry at night because the officers are closed. They don't know who to call. But what I always tell parents is, is that I have the four Bs, and it's called Dr. So's bedtime routine. I, I'm big in giving a bath every night. I don't think that babies dry out because you and I take a shower every day and we don't, we don't dry out. There's a lot of medical urban legends. Don't give your baby a bath every night. But I like clean butts. I like clean necks, I like clean armpits. I like the babies to smell good. So I always tell my parents between 7:30 and 8:30, you, you give your baby a bath.

The baby should love the bath. You know, if your baby is not, does not love the bath, you probably got the wrong temperature water, 'cause baby was inside for 38 weeks, and they've only been out for, like, two or three. And if they don't sink into that water and just relax, I go, "I think you don't have the right temperature water." So I always say it's bath, boob or bottle, read a book and then go to bed. If you do that probably about six to eight weeks, then you'll have that baby about four months, 'cause I think that's when babies can sleep like all night if you're the lucky parent.

Dr. Hannah Spellman:

Yeah, I, I agree with, I think those, those can be really helpful steps of the bedtime routine. My first son, um, he didn't love the bath at first and I think part of it was just he just wanted to be skin to skin all the time. And anytime we separated him from that, he just got upset and eventually we figured it out. My daughter loved the bath right away. I enjoy bathing my kids from, from infancy as part of their bedtime routine, 'cause I think it's nice soothing and bonding.

I think for families that don't feel like they have the time or the head space to do that, it's not necessary, but doing something that's kind of that soothing contact that's like a calming ritual routine is important. I think reading before bed is such, such good bonding activity, and I think it's important to build those sleep patterns.

I think some babies will respond really well and go to sleep right away with that. And I think there are gonna be some babies that just wake up through the night and they're not great sleepers. And again, it doesn't mean you're doing anything wrong as parents. I'm sure kind of in a future episode, you'll get to talking about sleep training and the pros and cons of, of that. Um, and you know, we're not even gonna touch that today. But, um, I think building and sleep routines is helpful. I think it's important for the baby and for the mom, and sometimes babies are still gonna wake up and it's gonna be challenging.

Dr. Richard So:

Well, Dr. Hannah Spellman, it's been such a pleasure talking to you on our first ever Little Health podcast. We appreciate your expertise as a pediatrician and a mother.

Dr. Hannah Spellman:

Yeah, thank you so much for having me.

Dr. Richard So:

Thanks for listening to Little Health. We hope you enjoyed this episode. To keep the Little Health tips coming, subscribe wherever you get your podcasts, or visit clevelandclinicchildrens.org/littlehealth.