What if you could listen to a wise pediatrician coach you through the first year of your baby’s life? What if he had information that could help you and your baby sleep through the night sooner. Would you be interested?
Dr. Tom Hines has been a pediatrician for over 30 years and seen lots of babies. In addition, he and his wife, Mary Jo had four children of their own. He came to talk with me about his best advice that he would give for baby’s first year.
If you are about to have a child listen closely for some great wisdom. If you know someone that is about to have a child, forward the link to them. Believe me, they will thank you when the parents are sleeping through the night again.
Chap: I’m Chap Bettis, and you’re listening to The Disciple-Making Parent, a podcast of The Apollos Project, where we seek to equip parents and churches to pass the gospel to their children.
What if you could listen to a wise pediatrician coach you through the first year of your baby’s life? What if he had information that could help you and your baby sleep through the night sooner? Would you be interested? Hi, my name is Chap Bettis and I’m the author of The Disciple-Making Parent. And in today’s conversation, I sat down with my friend Dr. Tom Hines to talk about the important issues of a baby’s first year. Tom has been a pediatrician for over 30 years, and therefore he’s seen lots and lots of babies. In addition, he and his wife Mary Jo have four children of their own. But I asked him to come talk with me about his best advice that he would give parents who are about to have a baby or whose baby is in the first year.
Now, listen, don’t write this off. I can just see you moms smiling. Don’t write this off because we have two guys talking about babies. First of all, I enjoyed the conversation, but he was doing 99% of the talking, which is exactly the way I wanted it to be. I was feeding him questions and learning from him. But additionally, the reason that this is so important is we want to set good patterns. I see families exhausted and struggling because they don’t understand these principles. And so rather than families being out for a few months, they’re just out for, like, a year because they don’t understand this. The children are running running them ragged. Children are meant to be a blessing, not a burden. And so understanding some of these principles will move you more quickly in that direction.
So if you’re about to have a child listen closely for some great wisdom, or if you know someone that is about to have a child or is in their first year, forward the link to them as well. Believe me, they will thank you when they are actually getting sleep through the night.
Again, before we start, I want to remind you though, that I’d love to hear from you at email@example.com. Let me know how the Lord is using the book, The Disciple-Making Parent, in your life or in the church. Or if you have suggestions for other topics that you’d like to hear about, I’d love to hear from you. Just simply shoot me an email at firstname.lastname@example.org. But now let’s listen in on a conversation with Dr. Tom Hines.
Well, today we’re talking with a good friend of mine. Tom Hines is on my board, a pediatrician for 30 years, and just a great friend and lots of wisdom. And I asked him to come back and have a discussion on issues that parents will face and should think about in the first year of their baby’s life. And how does this relate to being a disciple-making parent? Well, you are actually changing and shaping their body and shaping them even in that first year. I’m not sure what we’re going to talk about is found in scripture and verse, but I definitely think it’s wisdom that comes out. So Tom, thanks for having this conversation with me.
Dr. Hines: Thanks for inviting me.
Chap: So let’s just walk through the timeline of a child here. So I’m a new parent who just had a baby. My wife and I bring this baby home and what should we be thinking about?
Dr. Hines: Well, the first thing I share with a parent is life is different. And you have this little bundle of joy that you brought home. And often parents are feeling very overwhelmed when I see them in the office for that first visit. So part of my goal in that first visit is just to reassure them to hang in there and everything will be fine, and to just try to get them through the first one to two weeks. The first one to two weeks, you know, the main thing to encourage is bonding with the baby. And what parents are struggling with is from day one, they want to be the perfect parent. And since there are no perfect parents, I reassure them that they shouldn’t be worrying about that.
And also, there are many voices out there that parents are listening to. They’re reading the blogs, they’re reading the magazines, they’re listening to grandma. And in the midst of it all, the first thing I tell parents in the very beginning- and it may sound strange. I tell them to relax and just enjoy being a parent, enjoy your baby, turn the voices off and just enjoy your child and get some restless first weeks or first week or two. The first week or two is just kind of crazy. Anything I say will go in one ear and out the other; they’re in kind of survival mode. They’re not getting a lot of sleep. And really the goal in the first few weeks is just to establish feeding and weight gain, whether they’re breastfed or bottle fed, and to make sure that the baby is growing properly, gaining weight and that the parents are kind of settling into a little bit of a routine with the baby.
But one of the things I like to help parents with once weight gain is established, feeding is established, and we’ve kind of gotten through that crazy first one to two weeks is to really get them to start thinking about putting that baby on a routine or a schedule of some sort, both for their good and also for the good of the baby. There’s been a lot of controversy through the years about you can’t spoil a baby or you can’t get a baby on a routine. You’re going to hear a lot of things, really do a lot of different things, but by the end of the first month, you can definitely have a baby on some semblance of a routine or schedule. It may not be perfect, but what I try to help parents do in that first month is to know what to aim for and how to get there.
And it’s not difficult, and like anything with children when you’re trying to establish a good pattern or good habit, it’s always best to start off on the right foot in the right way, then to go back and to try to correct a habit that you don’t want that’s already kind of become ingrained in a way, even for premature babies, I once had a mother who was a neonatal intensive care unit nurse who was having all kinds of trouble getting a baby on a schedule. Wasn’t even sure if you could do it. And I pointed out to her, I said, “Well, when a baby is premature and in the NICU, what do you do in the NICU?” She says, “Well, we put them on an every-three-hour feeding schedule.” I said, “Hmm. And what do you think happens with a full-term baby?”
And she had never connected the dots that day in and day out at her work, these babies are routinely, no matter how young they are, put on an every two-and-a-half to three-hour schedule in terms of feeding. She’d never connected the thought with a full term baby can be put on a schedule. It was revolutionary to her.
So what kinds of things do I tell a parent? Well, it’s not rocket science, but if you want the baby to be in bed by eight or nine o’clock, you got to start their day by eight or nine o’clock. It’s not rocket science. So you pick a time and you say, “Gee, I would like this to be the start of the day for this baby.” And then going forward, there’s things that I share with them in terms of a schedule. I’m not sure how much detail we’d want to go into it. But I would just say it’s understanding that babies can be put on a schedule and just letting that sink into a parent. But you start the day the same. It’s what you do between those two points in time- from the time they get up to the time they go to bed- that’s key. But the importance of a schedule just brings the home back to some sense of normalcy by the first couple of months. Because again, having a baby disrupts everything, disrupt schedule, sleep for both the parents and everybody else involved. And that’s why a schedule is important too, to do that in the beginning, we could spend an hour how to do that.
Chap: Let’s talk more about this. One of the reasons I’m concerned about this is because I see parents who in 5, 6, 7 months, their child’s still not sleeping through the night. Sharon and I are blessed. We’re blessed all four of our kids slept through the night at eight weeks. And so one of the things is we had some good teaching on that. And I’m wondering if you would address that. Talk about the routine there of the eating and being awake and asleep.
Dr. Hines: So again, I mentioned before, parents are listening to many voices. And it is true that in the first week or two, you demand feed a baby, you’re establishing feeding, you’re establishing weight gain. So again, everything I’m saying is in regard to a baby that’s feeding well, growing normally, there’s no other real health issues to be concerned about. It’s a normal, healthy baby. How do you get that baby on a routine or schedule? So again, the beginning of the day is determined by when you want that child in bed by. So if you start the day with a feeding at seven o’clock that day is going to end roughly with a feeding around seven o’clock. So let’s say you get the baby up at seven o’clock. And sometimes just the hardest part in the beginning is waking the baby up.
You may have to do a diaper change. And if that doesn’t do it, you may have to undress the baby down to the diaper and play with them a little bit. And if you still can’t get that baby awake, you may have to begin the day with a sponge bath just to get the baby awake enough to feed the baby. Cause that’s one of the things that parents really struggle with. They say, “I can’t get the baby awake.” So once the baby’s awake and you feed the baby and you’re done burping a lot of times, the baby’s already drifted off back to sleep, but that’s not the time of the day you want the baby to sleep. So I tell the parents when you’re done feeding, if the baby’s dozed off, wake them back up because I’m defining the start of the day as the first feed of the morning that you want the baby to eat and stay up for a little bit.
If the baby eats and just goes right back to sleep, that day has not begun yet. You know, it’s like the teenager that gets up and has breakfast and goes back to bed and sleeps till noon. He has not started his day. So you wake them and you feed them. And then it’s important to keep them awake for some period of time. My rough rule of thumb is about 15 minutes awake time per week of age. So that by the end of the first month, during the day, that baby should be up as much as an hour or so give or take 10 or 15 minutes after a feeding. And then when that baby has been up for some period of time, they should be showing you some signs of fussiness or tiredness.
And even if they’re kind of chewing on their hands, the biggest mistake a parent can make at that point is to interpret that as the baby is hungry and it’s very easy and natural to think that. And so they feed the baby, but the baby doesn’t take a full meal because they really were not that hungry, the baby drifts off, but only for 20 or 30 minutes. And then lo and behold, the baby wakes back up is crying again and is fed again. And so now you’ve kind of started down that that pathway of feeding the baby every couple hours. You’re never sure what the baby wants. And so the goal after you wake the baby and feed the baby and keep the baby up is to interpret that fussiness at that point as I’m tired, what I really need is a nap, and what mom needs is a nap too. So you have this common goal that you share.
And if you start this in the first few weeks, it really is not that difficult. The baby is primed to go to sleep. Their little tummy is full, they’ve been up and they’re ready to go to sleep. And so a lot of times you can rock them till they’re drowsy, and then you want to start laying them down in the places that you want them to fall asleep, be it a bassinet, could be a mat on the floor if it’s a safe place, it could be the crib. But the point is to give them a chance at that point to put themselves to sleep. And so if they start crying, it is reasonable to allow that baby to cry for up to five minutes or so to give them an opportunity to see if they will self-soothe and kind of doze off. Now, if a baby is not used to doing that, then you might have to pick them up and maybe for that one nap just kind of rock them until they’re asleep and then lay them down.
And then your goal from that point is to get a good one to two hours of nap out of them and to get them ideally to about the three hour mark before that baby is stirring and getting up and ready to eat again. And when I say three hour mark, I’m referring to the start of one feeding to the start of the next. So if they’re fed at seven in the morning, at least in that first month, if they were sleeping and now it’s 10 o’clock, I would advise the parent to go ahead and wake the baby and then repeat the cycle. So the baby gets up, the baby eats, the baby’s kept up for a period of time. The baby gets tired and our goal is to get that baby asleep by not rocking them all the way to sleep, ideally by not feeding them to go to sleep, but by taking care of their needs, holding them until they’re drowsy, and start laying them down while they’re just a little bit awake and letting them finish the process.
If you start that from the very beginning, even from the first week or two, again, you’ll make the project much easier for yourself. And by the end of the first month, you’re going to have a baby that is starting to actually nap in a very routine and predictable fashion for you. When the baby is awake, you don’t want them to get a lot of power naps yet. So when the baby is supposed to be awake, your goal is to keep the baby awake, alright? And if you let them take lots of power naps, you’re really sabotaging your effort to get them into a good routine.
The other thing that’s helpful in the beginning is if you need to run an errand, plan it around nap time, because 9 out of 10 babies, as soon as they’re put in their car seat and the car takes off, will fall asleep. And the beauty of that is they’ll sleep the whole time you’re shopping. And then when you come home, you wake them up and their schedule has not been interrupted. You’ve actually planned your schedule around their schedule. And that’s often very helpful by the end of the first month, that little cycle of waking, feeding, keeping awake, going down for a nap, waking up, eating, and so on, is going to be repeated three times during the course of the day. After they get up from that third nap, your goal is to keep them awake until bedtime so that when you feed them at bedtime, they’ll really just be ready to crash. And from the get-go, they’ll start giving you at least three to four hours of sleep through the night time. Again, it’s not hard to do that when they’re sleeping during the day.
The other thing I tell parents is get them used to normal noise levels of the home. You know, have the dog bark, different shades of degrees of light, just normal household activity noises and so on. And get them to sleep in different places. Often by the end of the first month that baby is sleeping on their own during the day. But during the night, which is the more important at the very most, they should only be getting up twice through the night. And I’m defining that as over a 12 hour period. So that to get up at seven with a feeding, they go to bed around seven with a feeding. That means they’re really only getting up at 11:00 and 3:00, and then again at 7:00.
By the end of the second month at the very most, they should be getting up once through the night. And by the second to third month, they should be sleeping through the night. Things that can sabotage that are, again, the baby has to be growing normally. So sometimes with a breastfeeding mom, milk supply might be an issue, or the parents are mistaken around some of the cues that a baby is giving. But if the baby continues to grow fine, then putting them on a schedule is a very doable thing with them sleeping through the night, often by the second or third month.
Now, around the one-month visit, one question I always ask is, “Is the baby making so much noise at night that it interrupts either your sleep or the sleep of the father?” Because what surprises parents are, babies are very noisy sleepers. They make all kinds of noise, and often one or both the parents are light sleepers. And at that point, if the baby is routinely interrupting one of the parents’ sleep, I will suggest at least that they consider moving the baby into the baby’s own room. They have to feel comfortable with doing that, but I find that that’s helpful because then both parents get a good night’s sleep. They begin to major on the majors, which is if the baby’s hungry, the baby’s going to cry. And if the baby cries, you’re going to hear them because your ears are fine-tuned for that. And what I tell them to do is turn off the monitor because the purpose of moving them into the other room is that you don’t want to hear all the minor stuff. If the baby’s across the hallway and the baby cries, believe me, you will hear that cry and respond accordingly. Keep in mind that a baby monitor was originally designed for when you are in a part of the house where you could not hear a baby cry. And so the baby was upstairs, you were downstairs, and you couldn’t hear the baby cry. That’s where the usefulness of a monitor would come in. The modern parent uses the monitor 24/7 at all times to hear every breath of the baby. And you’re going to drive yourself crazy doing that.
Chap: What I love about what you were saying and why I think it’s just so important is that we’re on a schedule as well. So we get up and we eat, and then we stay awake and then we eat the last meal. We go to bed and then we’re hungry at 2:00 AM, but we don’t wake up. So we’re able to extend that time. And so whether you’re talking about children in the NICU, or you’re talking about adults, we’re extending that feeding time just by sleep. So I just thank you for that rather lengthy explanation, but I just think it’s so vital to restore the sanity of the home. And probably moms are listening to us. Hopefully there’s some dads who also go, “Honey, you need to do this because it’ll restore some sanity to the home.” So let’s go on to month two, three, four. What are you starting to say to parents there? What are some good habits to pick up?
Dr. Hines: Well, again, going back all along, I emphasize enjoy your baby. Talk to your baby, play with your baby. All those things are important. But it’s also important not to hold your baby 24/7. So often at the one- or two-month visit, I’ll hear something like this: “Every time I put my baby down, they scream. So I ended up holding my baby all day long.” And what I try to help them to see is, it’s kind of this vicious cycle. The more they hold the baby, the more the baby wants to be held. And so they kind of box themselves into this cycle of holding the baby all the time and it drives them crazy.
And so, you know, it’s definitely important to hug the baby, hold the baby, kiss the baby, talk to the baby, play with the baby. There’s also a time for a parent to practice what I call “benign neglect.” And that is put the baby down once in a while. It could could be tummy time, a mat on the floor. It could be just a little infant seat. They’ve got too many contraptions. I can’t even begin to name them anymore. The Bumbo chair, all this stuff. So I keep it as simple as I can. And it’s okay to ignore your baby so you can at least go to the bathroom or take care of a personal need or have breakfast or something. And if the baby cries for five or 10 minutes here or there, eventually what you will find if you continue to practice benign neglect, is that the baby will begin to actually entertain themselves. They’ll cry for a little bit, and then they’ll just settle down and start looking around. This happened with my daughter-in-law: I had to say, “You need to practice benign neglect. You’re holding the baby too much.”
And again, it’s balance. It’s not all of one or all the other. But I want parents understand that they’re not being a bad parent by putting the baby down and taking care of things. You’re actually doing the baby a favor because that baby is an independent little person and you have to help them develop that all along from the time they were born to the time they leave your home for college. And so from day one, you’re working yourself out of a job. Now may sound like something simple, but benign neglect is helpful. And you’ll find that now you can just put them down for 10 minutes here, 20 minutes there, and they’re perfectly fine. And that’s tremendously freeing for a mother because many times, you know, the mothers will tell me, and I’ll hear this story not uncommonly, that the only time they can ever get anything done all day long is when the baby is sleeping, and it doesn’t have to be that way. But a lot of times they kind of box themselves into this corner that they find themselves in. And so again, within the first month or two, that baby should be perfectly content to be put down and left for short periods of time throughout the day, as well as defined times of mommy time, play time, daddy time, all that kind of stuff, which is important.
And it may sound funny, but I just tell parents, talk to your baby. Talk to them like they understand every word you’re saying. But that facial interaction, that’s human speech that, uh, that’s very important to a baby’s development. So one to two months is a time of transition where babies are starting to develop social reciprocity. You talk to them, they’ll coo back at you. You’ll smile at them, they’ll smile at you. It’s a very gratifying time as a parent, but if you don’t see that, then that’s a cause sometimes of concern in terms of the development of that baby. Before that it’s more random, you know, the baby smiles because they pass gas or the baby makes a noise. But by two months there’s this reciprocity and communication and it’s a very cute age.
You definitely want to give them plenty of floor time. It’s easy. There’s so many contraptions out there that parents have been given by well-meaning friends at the shower and everything else, but a baby develops their upper body strength by being on the floor and being on their tummy. And that’s how they, they push off and they lift up and they develop neck strength and they learn to roll over and eventually develop truncal tone and strength so they can sit. All that takes place in the course of that baby being allowed to develop that on the floor, in a safe place, a pack and play. So many times we have them in devices all day long and the devices restrict their movements. One very popular sleeping thing is called a Rock and Play. And it’s not necessarily true for every brand out there, but it’s restrictive to the baby’s movement. So they can’t roll one way or the other, and often by the time they’re three or four months old, the baby starts developing a flat spot on the back of their head because they’ve not been able to move normally.
The other thing that I’ve become aware of, and again, if there’s a need, somebody is going to create it. And even if there’s not a need somebody going to create it, so I’m just going to buy it and give it to a parent. But in the old-fashioned days, we would just swaddle a baby by manually wrapping a baby tightly in a blanket. But now a lot of these blankets have Velcro. And, and it’s like you’re putting the baby not just in a tightly wrapped blanket. You’re putting them in a straightjacket and it’s great. And the babies love that tight swaddle. But the normal infant by one to two months of age in a normally swaddled blanket can escape like Houdini. They can work their way out of it. And it’s a very gradual and natural process. With these Velcro devices, babies can’t do it. And so again, it keeps them very tightly. And eventually when the parents try to get rid of it, the baby’s own movements startle them awake all the time because it hasn’t been this gradual process. It’s like this sudden freedom and the babies actually start waking themselves up. And so then the parents put them back in the Velcro, which again, restricts every movement possible. They can’t move their arms or legs. They can’t start rolling over and all these things.
So these are things that I talk to parents about early on that seem like little things. But what our goal is, is to get a baby on a nice routine and a nice sleep schedule so that the home begins to kind of fall back into a normal and somewhat predictable pattern, not that it is ever predictable with a baby, but a somewhat more predictable pattern where the parents are getting a decent night’s sleep. And when the baby cries, they can with confidence say, “Oh, yeah, it’s nap time.” Or, “It’s time to feed the baby.” There’s a certain satisfaction that parents have, knowing with some confidence now they can predict what’s happening, what’s going on with the baby. Often problems develop because they were misinterpreting the baby’s cues. They were winging it and actually feeding into the cycle of craziness, and that’s often what happens. It’s an innocent thing, but it happens nonetheless.
Chap: Well, talk just a little bit. Where are we at? Have I got a four-month-old at this point?
Dr. Hines: We’re getting there, we’re getting there. So the thing that’s different about a four-month-old is now they’re starting to roll over. I mean, they’ve done this randomly. Now they’re doing it a little bit more purposefully. They’re getting more social, they’re getting just more active in terms of grabbing and they’re drooling and everything is going in the mouth. But by four months, if the baby’s not sleeping through the night, then I try to really hone down as to why that may be happening. By that time the schedule keeps adjusting. So what I shared before is really apropos for that first month of life in particular, but the things that begin to change after the first month as the amount of feedings increases, the feeding interval increases. So it becomes more of a three to four hour range during the day, and the sleep through the night begins to extend. And that baby really should be sleeping by around the third month and at the latest the fourth month.
But at the fourth month, there’s getting more mobile now. They’re still very interactive. They’re babbling, they’re watching you walk across the room. So again, that play and interaction with the baby is still important. But one of the principles I like to share with parents is that as a baby develops and grows, you want to anticipate things before you get there. So, you know, someday that baby’s going to be crawling, someday that baby’s going to be walking. Is there anything you can do to kind of head off some of the possible issues that you’re going to face going forward? And one of those things that between four to six months, where the baby is just kind of rolling around happy as a camper and doesn’t know any better, is to think about introducing a pack and play or a little play pen and just start doing some of the baby’s wake time in that enclosed environment.
Now, it’s a safe place. So if you have a pet, the baby is safe. If you baby has a sibling, he’s generally safe. And again, you don’t have to worry really about anything going on and you can leave the baby there for 10, 15, 20 minutes and so on. And between four and six months, if you start regularly using the playpen during wake time and building up the baby’s capacity for the play pen to stay in there and to be happy. And one of the ways you do that is not rescuing them right away. So if the baby gets fussy, sometimes if you ignore them for a few minutes, they’ll just go back to play. So I would say sometimes you need to be a little bit slow in your response to their crying. And if the baby really needs you, the crying is going to persist or amplify over time. But a lot of times they’re just fussy and maybe they just need a diaper change, and then you can put them right back in. But you want to build up their capacity in that four- to six-month period.
By six months, they’re really rolling. Usually from front to back, back to front, they’re starting to roll across the floor. Their mobility is increased. Now there’s increasing safety issues. And when you’re there in the room, it’s fine. You can watch the baby and let them roll all over the place. But now you want to start getting dinner going. What do you do? Well, you can just put the baby in the Pack and Play in the kitchen and the baby sees you and you can see the baby and you can get your stuff done and you can cook dinner or do whatever you need to do, because nine months is going to roll around faster than you wanted it to. And all of a sudden that baby is crawling all over the place. So not only are they usually starting to crawl, many babies are pulling up to a stand, babies are starting to walk along furniture. And so again, childproofing, the home becomes a whole separate conversation, but they’re mobile. And so safety does become an issue. And so, because you’ve used that Pack and Play or play pen all along, when you put them in there, it’s not a big deal. It’s their home away from home. They’re used to it. They like it, it’s actually kind of a comforting thing to them.
But if you wait until the baby is crawling all over the place and you decide, Boy, this is not good. I need a break, often when you start using the Pack and Play or play pen at that point, the baby interprets that as You just threw me in jail. Why am I in jail? Get me out of here!, you know? And the baby is not going to be happy. Now, could you still train him to use it? I think so. It’s just going to involve more crying, that’s the problem. And parents don’t like to hear crying for the most part. But you could have avoided a lot of that crying in the beginning if you had just introduced it at a pre-walking stage or a crawling stage. And so a lot of times I see the bigger picture. I know where that baby is heading. I see where those parents are going. I try to head it off at the pass before it becomes a problem and before they’re screaming for help. It’s much easier to solve these things at the early stages than at the later stages. It can be done, but it’s just more complicated and they’re fussier about it.
Chap: So now we’ve got a nine-month-old leading up to our first year. So what are other issues that I’m going to face, and what mistakes do you see, or what things do you want to head off at the pass up until that first year?
Dr. Hines: So between six and nine months, their mobility increases at nine months. Most babies are pretty mobile. What do you want to start doing at that six- to nine-month interval? Let me just kind of back up. One of the things that is going to take place maybe even as early as four to six months is the introduction of food. And so with the introduction of food comes the introduction of the high chair, and with the introduction of the high chair comes dinner time, meal time. So in that four- to nine-month period, you are starting to train the baby in terms of mealtime behavior. It doesn’t just happen in a vacuum. It happens sequentially from the day you start putting a spoon in that baby’s mouth. So in the beginning, when you first start feeding a baby, you are going to prop them up in a high chair, and you’re going to move that highchair ideally up to the dinner table. And initially you’re probably going to feed that baby a little bit separate from the family. When you’re first establishing feeding, the idea is just to get them to learn how to swallow properly. The tongue movement is a little different than when they nurse or take a bottle. They have to kind of figure it out, but once they figure it out, it’s like full speed ahead.
So four to six months, you’re generally introducing food six to nine months. You’re starting introduced table food. Now it may sound a little bit silly or funny. I don’t know what the word would be, but babies actually learn how to eat by watching us. And yet often the baby is excluded from the dinner table. And I often find that those babies are less receptive to the food that we eat because they don’t see us eating it. So I try to encourage parents to include and eat with the baby for breakfast, for lunch and for dinner, at least as often as because in that six- to nine-month period, we’re often introducing just regular table foods. And I give them guidelines on that. And it becomes this very natural flowing process. You know, they see Dad eating his broccoli. Hey, I’d like some broccoli. They see what the parents are eating. And so when you offer them the food, it’s this very natural transition. And a lot of times, if you wait too long to introduce some of these foods, or if they never see you eating them and you never include them at the dinner table, I find that the whole process of getting a baby to take food becomes more difficult. But the other part of the process I want to kind of zero in on is they’re also learning to sit at the table.
And so over that four to nine month period, and even up through the first year, you want to work on their capacity to sit at the table to be a welcome participant. And I’m going to say the hard part is not to make them the center of attention. I know they’re cute. It’s fun to watch them eat and make a mess and rub it in their hair. Make them a welcome part of meal time, but try really hard not to just continually make them the center of mealtime. The other thing is they’re all going to get fussy at the dinner table at times, and don’t let them escape too easily. In other words, try to increase their capacity to sit at mealtime so they can sit for 10 minutes and then 20 minutes, and then they can sit through most or all of the meal because you want them to be able to sit and be a part of meal time and the family time.
Now, it’s easier said than done. Some kids can be real stinkers when it comes to meal time. But you know, if, if you want to see this happen, again, start young and build up their capacity in that four- to nine-month period. By nine months, they’re pretty much going to start transitioning to table food and be part of meals and so on. So, you want them to have learned to sit, eat, and not be the center of attention and not be totally distracting and not be screaming and crying and kicking and fussing the whole time. Because if you’re not training them in this way in the home, then when you go to a restaurant, or you go to somebody else’s house, or you go to church, that baby is going to be an unhappy camper, and they’re going to kick and cry and fuss. Because you have inadvertently trained them between four to nine months that when they kick and cry and fuss and scream, they get relief from a situation they don’t like. They don’t like sitting, it gets them on the floor. They don’t like sleeping. It gets them in your bed. They don’t like eating. It gets them to eat junk. So babies, that’s all they can do. They kick and cry and fuss and scream, but parents often then respond like a knee-jerk to that without ever letting the baby experiencing a minimal or small degree of discomfort at times and see if they can kind of stop fussing or distract them a little bit, or get them to work through it so that they learn to, like I said, sit at a mealtime because this has implications then outside of the home.
Chap: Yes. So that’s great, I mean, just this idea that one of our goals is to have our children sit with us at dinner and participate. I love what you said. I never really thought about it, but I love what you said of they learn by watching us eat. And then, of course we don’t want to be child-centered parents. So yes, you are welcome to join us. And we as a family have a meal and we’re not going to constantly stare and laugh at you.
Well, talk about, talk about how you advise parents concerning routine. So we have a, we have a mom perhaps who’s not working, and, loves her child, loves her children, wants them to give them the best, but her mind is thinking, Well, then that means I need to provide for them all day, stimulate them all day, and then be at their every whim. So talk about, do you advise routines, for parents? Structure?
Dr. Hines: So, yes. And kind of getting back to it, the reason in the first couple of months that I spent a lot of time in the office talking to them about schedule and sleep routine is it allows parents then to get back into their routine because they were a family before the baby came along. The baby is now a welcome member of the family, and the goal is to get the baby to fit into the family, not to fit the family into the baby. It’s just a different mindset. So somehow the modern mother feels like they need to devote their entire waking hour to every care and whim of this child. And you’re not dealing doing yourself or the baby a favor. So in getting a baby on a routine or schedule, it allows you to get back into your routine and schedule so that by six to nine months, the baby’s basically taking two naps during the day, sleeping through the night.
That gives you a tremendous amount of freedom. You can actually get together with friends. You can actually go on a date and have regular times together as husband and wife. So that part of that routine is just waking, feeding, napping, but the predictability of it, and also the fact that the baby is not constantly demanding you all the time is tremendously freeing too, to a mother. So that you know, at one point we had four children six and under in our home. If we did not have routine and schedule and predictability, I would be at the loony farm, right? With my wife. But that helped us tremendously so that we could actually go out to eat as a family because they we’re trained at home how to eat at the dinner table. It allows you to just get back to the normalcy of life: going on a date without the kids, going on a short trip together as spouses without the children, because whoever cares for the child, you can write out the schedule and say, This is when they get up, and this is when they take a nap and this is when they eat. And so you’re not only helping yourself, you’re helping any caregiver that’s going to help you out along the way from a babysitter to a grandparent. Everybody’s on board.
And by having that information, it’s just tremendously freeing. I just keep kind of repeating that phrase because I find that mothers’ lives become- and I would say, I’m not picking on the mother, but it’s often the mother because she’s the one that bears the brunt of this, becomes so entwined with the child. She no longer has an individual life. It’s like her life is the baby and that’s not healthy and that’s not right. And I would say, that’s not what God wants for you or for your husband or for the family. So that in that 6- to 9-month period and all the way up through a year, things should be increasingly on a normal pattern where the parents are regularly getting away. The mom can do her shopping. They can go out to eat. Although that foundation was laid in the first one to four months for that freedom of the rest of that first year of life to occur.
So by 12 months, you know that baby’s going to be walking pretty soon, the mobility is getting greater. They’re going to start saying a few words. Their understanding is way ahead of their vocabulary and their language, but things should be going pretty smoothly. Now, the one other thing that I failed to mention, and it’s a simple thing, and again, it’s anticipating future problems, but by nine months of age, a baby understands the word No. Most parents are not convinced of that, but developmental experts will say that a baby cognitively understands the word No. And so if from the get-go you reinforce no to a child in terms of backing up your word, you are creating a much happier environment for your family and for your child down the road.
What do I mean by that? Within the home environment I tell parents, because of safety, you’ve got a mobile child, he’s crawling, he’s pulling to stand. He’s getting into everything. No is a good word for that child to know and understand. Anything you really don’t want broken, I tell parents remove. Anything that child could get hurt on, I tell them to also remove. Everything else is for testing. So the TV remote is the most famous one. So your little child is kind of walking along and all of a sudden this remote, cause they see Dad with the remote all the time. So they want that remote. And they’re gonna start going for that remote or the pick up the remote. And you would just say, “No, no, don’t play with the remote and you need to put that down now.”
They’re not going to do what you say, right? So if in that moment, you just very quietly calm, cool, you just kind of walk over and you just take the little remote out of their hands and put it in a safe place. And you get down in their cute little face. And you just say, “Mom or Daddy said No, you can’t play with that.” And if they fuss you just to kind of ignore them and walk away. It’s not a big deal. So if starting around nine months, you begin to just gently but consistently reinforce the word No: You tell them once, you take action, you reinforce it, for their little mild upsetness you just walk away. It’s not a big deal. You will save yourself so much grief down the road. If you wait to start this till they’re 12 months old, 15 months old or 18 months old, you have a real battle on your hands.
Think about an 18 month old who doesn’t know the word No versus a nine month old that you’re teaching the word No. Nine months, you’re the boss. You’re in control. 18 months old, you’ve got a battle on your hands. Now within the first month, if you’re doing this consistently, you can even tell them No with your eyes. They’ll start going over to the remote. They’ll start looking at you. You’ll start looking at them. You can see the balance that they’re weighing out in their little minds. And they just said, this is a bad idea. And they just walk away from it. And then you smile and you say, “Good boy, good girl.” And once you are at that point, it’s like, Wow, all right, but how did you get it? You start. Now, what do you do if they consistently go back to it, go back to it, go back to it?
Well, after about the third time, you just pick them up and you walk them to a little Pack and Play or a crib. You put them in there and you just say, “Mommy/Daddy said no. You’re in time out.” and just walk away and ignore them for a few minutes. Just that brief moment of isolation and time out to reinforce the fact that you’re not going to argue with them about saying no, we’ll conquer that behavior usually within a week. And then you’re back to where you were. I also would recommend that for any kind of physical aggression. I especially don’t like children hitting or kicking or throwing things. And so once you establish that that is unacceptable, that’s like automatic time out. And again, if it’s done consistently, usually within a week of just repeated isolation and time out, it will eliminate those kinds of behaviors.
So if your goal is by the end of the first year, you have a child that is sleeping through the night and on a good routine and schedule, sits at the dinner table without a tremendous amount of fuss, and understands the word No, you are light years ahead of where the average, at least American modern, parent is at. They’re often at a place where that kid is not sleeping through the night has never heard the word No, can’t sit for five minutes at the dinner table and ais the center of attention and runs the home. And from that point forward the parent finds themselves in that place, they have a tremendous amount of catching up to do. It can be done, but it’s done with a lot more conflict and grief and stress on the parents’ part.
Now, other things just briefly, I mean, you can read to your child, you can sing to your child, you can introduce good Christian music. You can do all these things as you know, and all of those things are important in terms of the development of your child. So reading and singing and good music and all these kinds of things, but a child that has the ability to sit and focus and listen and gets a good night’s sleep is going to absorb all that to a much, much greater degree. It’s going to be more effective and transforming. And now you’ve laid a very solid foundation so that, that you can begin to build on from year one to year two. It is a myth that the terrible twos are inevitable. The terrible twos are the result of kids who have not been trained in the first two years. And it just comes to a head around 18 months to two years of age where their will is beginning to be expressed and all the little tricks that parents use such as a distraction or redirection no longer work because the child has you figured out. And once they have you figured out and you have no other game plan, that’s where the terrible twos come from and it causes real grief and havoc. And I could tell you too many stories of where that can take you. So I’ll spare you.
Chap: Well, that sounds like a whole other conversation to talk about. Yes. Godly discipleship in the second year. But this has been great in terms of- I know you don’t mean it to be exhaustive, but as you mentioned, those things at the end, just about reading and singing and et cetera, there’s so much more we could talk about. But the foundational things that you’ve given us, which are just a routine sleeping, sitting at the dinner table. Those are foundational. And I think the listeners are going to see why I wanted to have you on a little episode here, because there’s so much wisdom. So thank you, Tom, for taking the time out. I think this is going to be a very popular episode and be passed around to lots of young parents. So thank you for your time.
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