As I always ask the parents and families of young children who come see me for chronic nasal congestion or runny nose details about their diet and dietary habits, I frequently uncover the truth about middle of the night feedings. I completely understand why parents do not usually volunteer this information. Perhaps we as parents subconsciously know that once our children are no longer infants, it is perhaps a bad habit to feed them at night. As a loving mother, I now understand just how innocent, and natural, it is for anyone to feed a young child when they wake. First, when our babies are truly babies, that means infants from birth to age 12 months, no medical professional would argue about the need to help an infant grow by feeding them pretty much whenever they want to be fed. Mothers can safely assume that middle of the night awakenings and crying are likely representative of the physiologic need to be fed and expression of hunger. Once we feed our babies, whether by nursing or bottle, thank goodness it usually calms them back to sleep and allows us to drag our exhausted bodies back to bed, in complete denial about possibility of repeating this loving ritual again in either 2, 3, or 4 hours, or hopefully not until daylight.
After babies become older than 12 months, they may often still awake at night. Some mothers are blessed with those lovely babies that sleep all night. Then there are those of us who struggled. Claire did pretty well, but until 9 - 10 months of age I nursed her before bedtime at 7:30pm, then fed her at 11pm, and she would wake to nurse again at 2am, and 5am. I am truly amazed how I managed to function as a full time surgeon during all those months when I felt physically and mentally exhausted. Nonetheless, once she was past age 12 months, we did use the "Ferber" method to train her to sleep all night, and I stopped feeding her, even if she woke in the middle of the night and cried. I will save some fun and challenging stories about sleep training for another blog. What I have learned from having conversations and probing about feeding pattern at night is that many toddlers, when they wake in the middle of the night, results in their parents giving them a bottle. It is not unusual that such a baby would then enjoy sucking down 6-8 ounces of whole milk in the dark or dim light, then proceed to be laid back down into their beds, flat, when gravity has no effect and milk can freely "slosh" around and come back up into their throat. Often these babies, despite falling back asleep initially, wake again within the next 2 hours from terrible nasal congestion, cough, and just irritability.
I remind families that once being back asleep, it is truly hazardous to have milk in the tummies of these toddlers and young children. During infancy, that volume consumed was likely only 2 - 3 ounces per feeding. Once a toddler, that volume increases significantly and the stomach can't simply actively pump milk out of it into the intestines. Instead, the warm milk sits around for the next few hours, becoming more sour, and more irritating, and will likely actually decrease quality of the baby's sleep.
If you baby is not malnourished, undernourished, and especially if you have heard plenty of the many cute jokes about your "chubby" toddler or you know that your toddler of solid size and stature, there is truly no need to feed your toddler in the middle of the night. Teach them to self sooth, reassure them, comfort them quickly and lay them back to sleep, without milk. I know that you will be amazed at the likelihood of observing your toddler sleeping even better, and possibly through the night, with less nasal congestion. I have never woken up in the middle of the night hungry, and while I have heard of adults describe that, and even met parents who state they find their school aged children up in the dark eating or snacking, this is quite rare and should be discouraged. Why do we not talk about this more openly? maybe it is because I remember, even as Claire is now 6 years old, those moments in the dark, when I held my baby close, and nursed her, the world was perfect and I had no worries, not about tomorrow, not about my busy day, not about the future. I was able to completely enjoy being a mother because nothing feels so right as feeding your child and providing them comfort. There is no wrong in loving your child, but love effectively and help them sleep better, and yourself too. Let those who wake contemplate the meaning of life and go back to sleep without waking the digestive track. There will be breakfast in just a few hours.