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If there is one topic that we receive many questions about, it is bedtime. Bedtime struggles are a common challenge for many families. While some parents choose to stay with their child until they fall asleep, many parents want their children to learn how to go to sleep on their own. No matter which option you choose as a parent, it is never advisable for children to fall asleep in front of the television.

The reasons why the transition of learning to fall asleep on their own can be difficult range from developmental reasons, (such as common childhood fears,) to environmental reasons (such as changes to routines), and everything in between. No matter what the underlying causes are for the difficulties you are experiencing, the recommended strategies are often the same.

The following is a list of some tried and true strategies:

• Preparing your child
  Before starting any new plan in your home, it is important that your child understands what is going to happen and why. Take some time to sit down with her during the day when you are both rested and focused and let your child know the reasons why it is important for her to learn how to go to sleep on her own and not in front of the television.
• Make your child's bedroom fun!
  It is important to make this new change as easy as possible for your child. Get your child involved in making his or her bedroom more appealing. Encourage your child to prepare his or her room with enjoyable and fun things (e.g., pictures, posters, a nightlight, wind chimes, a dream catcher, and/or a bedspread in a favourite color!). Focusing your child's attention on the positives will reduce anxiety when he or she first starts sleeping alone.
• Establish a bedtime routine
  As a parent, you probably already have a bedtime routine with your child which might involve reading a story and goodnight kisses. This entire routine should take place in your child's bedroom. Even if your child is not ready to sleep alone right away, it will be easier if your child is used to getting ready for bed in his or her own bedroom, rather than in your bedroom or in front of the television.
• Gradually facing fears
  It may be unrealistic to expect your child to be able to sleep alone immediately. Instead, you can make a gradual plan with your child, with the goal being to "sleep in my own bed for the entire night". It is important to progress at your child's pace. For example, you can start by staying with your child until she is almost asleep and gradually work your way to leaving right after story time is over, helping her adjust slowly over a period of time.
• Consistency is the key
  If your child leaves her room after you leave, you will need to walk her back to her room and again give her reassurance. You can expect, realistically, that the first week of this method is going to be the hardest, but it's also the most important in terms of consistency and following through on the limit you've set
• Give lots of praise
  No matter what fear your child is facing, it is difficult. Therefore, it is important to give your child lots of praise and reward. Every time your child is successful, be sure to praise this success!
• Patience
  Changing routines like bedtime require a lot of patience and perseverance. Know that with time and reassurance, your child will be able to manage this transition and it is a good foundation for managing other transitions in her life.

If you have tried all of these strategies over a period of time and you are still experiencing difficulty with the new routine, you may consult your paediatrician or other professional regarding further ideas or information.

ManitobaParentZone.ca acknowledges the assistance of Healthy Child Manitoba in responding to this question.

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Many women express concern about having enough milk to satisfy their infant. It is important that breast feeding women maintain good nutrition as this will have an impact on milk production. This includes eating well-balanced meals and being well-hydrated. In well-nourished women, milk production is controlled by infant demand – the more the infant feeds, the more milk is produced.

Indications that the infant is receiving adequate milk for continued growth include feedings that are frequent and long enough; contentment lasting one and a half to two hours after feedings; baby has six to eight wet diapers per day; and baby is gaining at least four to eight ounces per week.

The infant should have two or more stools in 24 hours the first four days of life; three or more stools in 24 hours through weeks four to six; and after that stools may range from five in 24 hours to one every five to six days.

Other indications of adequate breast milk intake include: breasts that are full before and softer after feeding; milk leaking from the opposite breast during nursing; the mother feeling milk ejection, such as a tingling sensation; the mother becoming relaxed and sleepy during the feeding; and the absence of nipple pain or trauma. If a mother has concerns about baby's elimination or weight gain, a health care provider should be consulted.

Growth spurts usually occur at two weeks, six weeks, two to three months, and five to six months. The infant will want to feed more frequently during these times, which will stimulate increased milk production.

There is no evidence that particular foods can increase your milk supply. Supplements and ingredients such as brewer's yeast found in lactation cookies, muffins, etc., have not been studied thoroughly on lactating women. It is not recommended that women take these supplements without consulting with their care provider first.

ManitobaParentZone.ca acknowledges the assistance of Manitoba's Health Links in responding to this question.

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You are confused about how to feed your baby. You've been told to breastfeed and you're considering that. You also wonder how much better could it be than formula?

While you're "nesting" getting your home ready for a new baby, your body is preparing for the birth. You've got a built in nest, your arms and your breasts. It's the way you're designed, to have milk ready for your baby, whether it's early, on-time or a bit late.

There's no formula that even comes close to the milk your body creates. Babies are born with immature immune systems. This is why they can get sick easily. When you breastfeed the antibodies and cells in your milk that help prevent infections and later disease get transferred to your baby. Infant formula has none of these. A baby who has little or no breastfeeding is at higher risk of ear infections, intestinal upsets, and respiratory problems.

Your milk has every vitamin, mineral and nutrient your baby's body needs. Science has not yet discovered all of the elements in human milk, or how to make artificial milk change through a meal, from day to day and month to month. My baby went easily from the breast to table food around the middle of his first year; he'd already had tastes through my milk.

I didn't realize until I took training to become a volunteer breastfeeding helper with La Leche League Canada how breastfeeding protects my health. With a family history of heart disease and diabetes, I'm glad that by breastfeeding my three kids, I've helped reduce my chances of developing both of those conditions.

One thing I learned is how much easier breastfeeding is for me as the baby gets a little bit older – a little newborn will want to take their time whereas a 3 month old is very happy with a quick nurse. It's actually a nice way to sit down and reconnect for a few quiet minutes. It's also a time when I can think of the hundreds of bottles I didn't have to wash!

I'm happy I breastfed because it's important for the baby's health and for mine, it's convenient and once I got the hang of it, it was easy. Most of all, though, the memories of nursing a little one were what kept me breastfeeding, feeling so in tune with the baby's needs and remembering smiles and giggles at my breast, seeing the light in my baby's eyes after she'd been out with her dad. That's what kept me going.

ManitobaParentZone.ca thanks Linda Romphf and La Leche League Canada in responding to this question. Linda Romphf is a La Leche League Leader with La Leche League Canada (LLLC). LLLC Leaders offer information and support by phone, email or through a local group get-together.

Linda Romphf,
La Leche League Canada Leader
Winnipeg West Group
For breastfeeding support and information, please go to www.LLLC.ca.

LLLC Manitoba Phone Helping Line: 1-204-257-3509

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Breast milk is produced on a supply and demand basis. It is suggested that in order to maintain milk supply while you are away for 8 hours, you should be expressing milk every 3 hours. The effectiveness of your method of expressing milk will affect your ability to meet your goal of maintaining your milk supply. Also, if you are tense, upset or uncomfortable, the success of expressing your milk may be impacted.

There are breastfeeding support groups and clinics available to support mothers. You may contact the Breastfeeding Hotline for more information at 204-788-8667.

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