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Announcer: Health tips, medical news, research and more for a happier, healthier life. From University of Utah Health Sciences, this is The Scope.

Dr. Van Hala: Hi, I'm Dr. Sonja Van Hala, and I worked at Sugar House Family Health Center through the University of Utah. I'm a family doctor.

I talk to many parents who are wondering when they'll get a full night's sleep. You know, every baby is different and has their own rhythm. Really early on the baby is in charge, and especially if you're breastfeeding, you're going to want to respond to their rhythm. So when they awake and they start crying, you know, you'll check to make sure their diaper is clean and then you'll most likely be feeding them.

And then oftentimes, they're sleeping in between their feedings. But when the baby is small, their stomach isn't very big and so they need to feed about every two to three hours if they're breastfeeding. With formula, it might be spaced out a little bit more, every three to four hours, and then oftentimes they're sleeping in between.

You can start to expect around two months of age or so some longer stretches of sleeping, five to six hours perhaps at night. But really, we don't start fussing with trying to train them to sleep until closer to four months of age when their stomach is a bit bigger, we know that their growth is going well, and they're able to tolerate longer stretches of sleep.

One thing that I encourage, and I would start doing this early on with your newborn infant, is a bedtime routine, and this can include bathing, singing, reading, just really slowing things down prior to bed and getting the baby in the mood to go to sleep. Once the baby is closer to four months of age, if they start waking in the middle of the night, it's a good idea to just see if they really are fully awake and if they need your attention or if they're just making some noise and you can just let them be and then they'll settle themselves back down.

Certainly, in the middle of the night, it's important to not train them that they're going to have a fun time in the middle of the night. So ways to handle that is if you do need to give them attention in the middle of the night to either feed them or change their diaper, keep the lights down low, don't play, try to not do too much talking and stimulation, try to keep it boring. Do what you need to do and then put the baby back to bed, and then hopefully they'll eventually learn that awaking in the middle of night, you know, really isn't that much fun and so they'll start stringing more hours together.

So I would say if you get some good night's sleep in the first few months of life, that is wonderful and enjoy it. But usually, you're not going to have a full night sleep, meaning five or six hours, until probably around three to four months of life, and around four months is when you can start doing some sleep training with your child and try to extend those hours.

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Interviewer: If you're feeling a little bit overwhelmed with your newborn, it's totally natural because it's hard having a newborn. We're going to find out exactly what that means, and hopefully reassure you coming up next on The Scope.

Announcer: Medical news and research from University of Utah physicians and specialists you can use for a happier and healthier life. You're listening to The Scope.

Interviewer: Dr. Sonia Van Hala is with University of Utah Health Care and one of things she likes to reassure her patients about is when you have a newborn, it's hard. It's difficult. And you find that your patients come in and they think that they are inadequate in some way because it is hard. Tell me a little bit about that.

Dr. Van Hala: Babies are remarkable in so many ways, and especially remarkable in how they really turn your world upside down and you're trying to figure out, how do I right things? The biggest thing that parents are challenged with is when things aren't going according to their expectations. We talk a lot about this as we're approaching the delivery date. I deliver babies as well. Just in being flexible and thinking about what's reality going to look like.

The arenas that I see the big challenges happening are in breastfeeding. When breastfeeding is hard either because of too little milk, too much milk, difficulty with the latch. Just having to work really hard at it, so breastfeeding is a common concern.

Also sleep deprivation. Trying to figure out how to manage with not a full nights worth of sleep. I think one of the big things with that is, just trying to not do too much because if you expect to carry on with your regular life while you're figuring out how to have a newborn, well that's a bit too much at that time. You can postpone those other things until a later time. Focus on your newborn first.

Interviewer: Take it easy on yourself.

Dr. Van Hala: Take it easy on yourself. Then, the third issue would be the fussy baby. There are a lot of really unfussy babies out there. When you see them you think "Oh, that's just lovely" and that's really hard when your baby is not one of them. I know because I had two fussy babies myself. So I really have a lot of heartfelt empathy for those parents who come in concerned about the baby that just cries a lot.

For those parents I say bring your child in as many times as you need, if you are worried about something medical going on. So that your doctor can check your child to make sure your child is well and there is nothing that's being missed.

Also know that babies do cry. The range of temperaments between babies is quite broad and it's very normal. The other really important piece is, it's temporary. So your baby will eventually stop crying and you will eventually have a good relationship with your child.

Interviewer: You said early on that parents come in with expectations about what's it's going to be like having a newborn. What are some of the expectations that they have that aren't quite in tune with reality and I think these answers should be something like, when a parent hears it they're like, "Oh, that's me. I'm expecting too much, maybe I should be more over here."

Dr. Van Hala: I think it falls into some of the arenas I just mentioned regarding feeding, temperament, sleep. Also, your emotional response to that. It's pretty common for parents to, especially moms, who are tired, who are trying to breastfeed, and do all this new stuff, to feel overwhelmed, to maybe not feel so delighted to be with their child all the time and then have guilt surrounding that.

Interviewer: Because what good mother would not want to be around their child all the time? Right? Isn't that the expectation?

Dr. Van Hala: Right, right and then they judge themselves and get down on themselves. You know what? That is totally normal, but I really encourage my moms to just be easy on themselves. Recognize this is a hard job and they will make it through it and they will have a good relationship with their child when they get through it. Sometimes people are worried about the quality of time that they're spending with their child when they are not feeling as positive as they had hoped they would be.

Interviewer: But that time is just the same to the child.

Dr. Van Hala: It is.

Interviewer: All that other stuff is our internal thing.

Dr. Van Hala: Yes, that's exactly right.

Interviewer: What about parents that see other parents on Facebook and think "Their life's is so perfect."

Dr. Van Hala: Yeah, Facebook.

Interviewer: Just judging yourself against other parents and how other parents experience are going and not knowing the whole story. Does that happen a lot?

Dr. Van Hala: Absolutely. Well I think it's common and popular to post the good and fun things in our life. We don't want to be posting all the stuff that's sort of a downer. That can be a disservice to parents with a newborn. If all they're seeing is these positive images, and then they're looking at themselves and saying "That's not me, what's wrong?" When really, there's nothing is wrong. Their experience is normal. It's also temporary

Interviewer: What's that last piece of advice you'd have for a parent that is struggling with these things. Just be sweet to yourselves?

Dr. Van Hala: Yes, absolutely. Be kind to yourself. Gentle, loving, kindness. Right? Also seek a support network, people who can help you out and reach out to them and do ask for help. A lot of people just don't feel comfortable asking for help, do. People want to help and they're not going to know your needs unless you speak up.

Also, important to mention, if you're feeling really down and low, you're just feeling like can't pull out it and you're not having the happiness, do check in with your doctor. Make sure you're not dealing with having postpartum depression. That's a real entity and it does affect your health, and the health of your child, and the health of your relationships. Seek support from your friends your family and also your physician.

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