Betsy Armentrout, MD visits with the BestHealth team to discuss sleep! Sleep can seem to be this elusive thing for both baby and parents. Dr. Armentrout talks answers questions about best practices for sleeping for mom, dad and baby.
Will I Ever Sleep Again
Host: 00:00 This is the best health podcast brought to you by wake forest Baptist health in partnership with MedCost. Good day everyone. Welcome back to the latest episode of the best health podcast brought to you by wake forest Baptist health, Justin Gomez here. Uh, super excited as we continue to talk, um, with several of our moms slash baby related providers, um, whether it be OBS or pediatricians. Um, with the opening of the new birth center wake forest Baptist medical center. We're talking with the, a lot of, a lot of those type providers and we have a really cool guest, um, to talk with us today. She's one of our pediatricians, Dr Betsy Armentrout. Did I say that right? You sure did. Wow, that's awesome. Um, so welcome, dr. Thanks for coming and hanging out with us today. Thank you for having me. Um, so we're gonna talk about, um, maybe the, the most highly coveted piece of information a little bit today about, um, when you have a new baby and sleep and sleep patterns and sleep training.
Host: 01:11 And please, when will I get back to sleeping normal again for the love of all things holding. Yes. Um, so, uh, this was, um, a high priority topic when, when my two boys were newborns. Um, even more so with, with my, uh, with my wife, I, um, I had really not that much to complain about. Um, she was taking the lion's share of, of the duties in the middle of the night. Um, so doctor, before we get started, um, we're going to have lots of fun talking about this today. Uh, just tell us a little bit about yourself, um, how you got into medicine, why you became a pediatrician.
Mary Armentrout: 01:48 Sure. I think I've just always had a, um, interest in, in science and medicine and I think a heart for children. So it's really what I've always wanted to do. I've been practicing for, um, close to 17 years now. Um, uh, here in town at Fort Simpson, lively in rice and I started my pediatric career there and, um, happily continuing on. Um, I did my residency training at Cincinnati children's hospital. Um, my husband and I have two sons who are 17 and 14. So we've been through the phases of sleep, um, challenges and sleep is just really, really important to the whole family, parents, babies, teens, and um, I think it's really an important priority for, for good health and, and just all aspects of well being.
Host: 02:33 Absolutely. So hopefully the 17 year old and the 14 year old habit down
Mary Armentrout: 02:38 as far as they know, I know they sleep through the night. Yeah.
Host: 02:43 Uh, that's good to know. Um, so, um, there's this, um, you, you know, if with a new baby you just, your world's been turned upside down. It's, it's a fantastic gift. Um, just an a new baby and um, can talk about, uh, in get into, you know, um, multiple babies as well here a little bit later. Um, so you have the baby or you come home from the hospital and there it is. You're at home and, and this little beautiful little baby human need your attention several times throughout the day and the night. Um, so one of the most important things, uh, that, that parents, um, um, stress about think about is, is sleeping. So they want to a, I'm assuming they need to get enough sleep themselves, which is challenging but also, um, for their baby. Um, so when you get home from the hospital and your, how do I, how am I, how does not, what do I, what am I thinking with my baby? It's up every two or three hours. He or she, you know, what is the right amount of sleep? How do I know my baby's getting enough sleep? So I guess just talk to us about that initial phase. Yeah, brand new mom and dad's right when they get home, what that look.
Mary Armentrout: 04:01 So it's a really, really difficult time as a, as a woman has gone through her pregnancy, her sleep has not been good for several months. She's been uncomfortable carrying their pregnancy. She's tired, she goes into labor, she goes through this major event and, and doesn't sleep well there. And then we wrap it up and send you home with a child who's going to keep you awake all night long. And so it's really a perfect storm of, um, really significant sleep disturbance. So I think that the first piece of advice is to recognize that it's going to be rough. It's going gonna be rough for the first, you know, several weeks at least, but it gets better. Um, you know, the advice of sleep when the baby sleeps, there's a lot to that. Um, many babies in their first two weeks or so of life really, they don't have any idea of a difference between day and night.
Mary Armentrout: 04:49 I'm a big fan of sleeping at night and don't care so much during the day. Babies don't care about that and you just can't change it initially. So, you know, my suggestion in the first two weeks is you have to kind of go with the flow and that certainly means if you can get some rest during the day when you have a, a friend or family member who asks you, what can I do? Well you can just kinda keep an eye on the baby for this two hours while I take a nap. So you have to try to, you know, kind of patch it together and get a little sleep as best you can. Um, you can't force it to get the babies to days and nights to flip as they get a little bit older. They have more alertness during the day and we can keep a baby awake a little bit longer. But in those first two weeks you just have to kind of go with it and do the best you can to sleep when the baby does.
Host: 05:31 Gotcha. So I'm following up on that. When should, uh, uh, mom or dad expect their baby to get into a quote unquote regular sleep?
Mary Armentrout: 05:42 Yeah. Um, there's no magic numbers. Sure. Usually by the, after the first couple of weeks, babies are at least are falling into a pattern that nighttime is hopefully becoming more for sleeping than day time. We're a little bit more alert during the day and maybe the feedings are a bit more frequent during the day. Um, I think it's even, even sometimes helpful to wake up maybe every two or three hours during the day time after the first couple of weeks just to encourage, you know, work, not going to sleep long stretches. Um, and then hopefully things start to stretch out a little bit more at night. Um, it's still is, is often unpredictable in the first, in the first month or two, but usually by about two months of age, we've at least fallen into a pattern that there might be one. The initial sleep stretch might be a little bit longer that the baby may be sleeps for four hours instead of two. Often after that when they wake to feed, we're back at that every two to three hour stretches. But we're often having at least one slightly longer stretch at first.
Host: 06:35 Okay. So, um, to take that a step further, the one of the magic questions we have, and it's funny cause you'll talk to different parents and they'll have different answers. Like some parents have icon, my baby slept through the night, eight hours a night when starting at three weeks old. And like some parents maybe or maybe not like us or like months into it and you're like trying to string together like three or four hours. So when I guess talk about maybe what, what can we look look at for expecting a baby quote unquote sleep through that?
Mary Armentrout: 07:08 Yeah, I think that's a great question. And you know, there are, there are a few babies who really do sleep most of the night at a very young age and those families are really, really lucky and they probably ought to, not to brag too much to their friends. Um, in kind of depending on how you define through the night, I would say maybe through the night is that the baby is sleeping a stretch of six to eight hours. Um, and most babies are ready to do that by about six months of age, not 100%, but most. Um, now if your baby goes to bed at, you know, seven or 8:00 PM, which is often a good bedtime for families and their babies and they wake up, you know, six hours later, well that's 2:00 AM and it doesn't feel too the parent like the baby's sleeping through the night, but they are sleeping in a developmentally normal and healthy way that they're sleeping a nice, you know, maybe six to eight hours stretch. Um, and that's a good healthy amount.
Host: 07:57 Okay. Um, well, so you mentioned, um, that's a good by the time around that, that seven or eight time time frame. Um, so I guess following up on that a little bit, um, it's, we're trying to get as much sleep as possible as new parents and trying to get, you know, make sure our babies are being healthy and having a healthy amount of sleep, what, what might be a good bedtime routine to help our babies calm down and relax and get kind of sleep,
Mary Armentrout: 08:24 right. Routine is really important. And I really encourage families to establish some routine by the time of babies, about two months of age. And it doesn't have to be exactly the same thing every night, but it helps a baby a lot and helps them learn if they're getting the cues for, these are the same things we do each night before my parents put me to bed. And so, you know, the kind of the lights are dim. Sometimes there's a bath, maybe we, you know, read some stories, sing a song, quiet music, nothing elaborate, but just kind of the stimulation level is down. We're quiet or quiet voices, you know, maybe rock or do some of that for a little bit and then put the baby down when he or she is still awake, drowsy but still awake. So they're helping to learn to fall asleep on their own bedtime really depends on a family and their schedule and their needs.
Mary Armentrout: 09:09 I think it's often nice for, uh, you know, the, the baby and children to be down and asleep for at least a little while before mom and dad go to bed. Cause I think it's nice and healthy to have some time when your children are asleep that you can, you know, talk to your spouse. Um, or just have a little downtime for yourself. Um, but that's different for every families. Some families are more night owls and the baby's bedtime is going to be a little bit later and it really is just what works best for the family.
Host: 09:34 Gotcha. So, um, once again, it may or may not have personal experience in this. Uh, so the baby wakes up in the middle of the night, you know, let's say the baby's a little older and how three, four, five, six months and um, and little precious baby won't stop crying. Um, and that's their kind of, their main form of communication at that point is crying. Um, they can't tell you what may or may not be bothering them. Um, so when we get in that situation, you know, it's one or two o'clock in the morning and baby's crying, is it, you know, are they sick? Are they uncomfortable? Do they have gas? What are some tips for parents when they're in that situation? Yeah.
Mary Armentrout: 10:13 Right. Yeah. And I think, you know, by the time your baby's a few months old, you've gotten a sense of sort of, there's different types of cries. There's the, I'm not happy in my bed, cry, I'm, you know, uncomfortable cause my, you know, diaper blew out and I'm soaked and dirty in here. And there's different qualities of cry that gets your attention in different ways. And there's the, you know, sometimes I'm awake in my bed and I'm here by myself and I don't like it, cry and, and that one is one that'll often wake us during the night. You know, the first thing I would say is you don't have to run from your bed to the baby. It's okay to, you know, wait a minute or two and see if the baby's going to kind of settle and, um, you know, get, get over there and check on the baby.
Mary Armentrout: 10:53 Sometimes it's a quality, a cry that's different or suggest pain. And of course you're gonna, you know, immediately go and check on the baby. Um, but if, you know, everything seems okay and it seems to kind of cry that I just woke up and I'd like to go to sleep again. It's, it's nice to try to make the intervention as you know, as brief and minimal as you can. Offer some reassurance, settle the baby a little bit, but if you can, again, you know, put the baby down, leave the baby to fall asleep on, on her own or his own, um, that's going to help reinforce that everything's okay. Just needed a little, a little quiet check-in. Um, if the baby's already been going longer stretches without needing to eat during the night, it's good to try to Sue the baby in other ways besides feeding. Um, and sometimes you'll just, that'll finally be that the baby's hungry and you'll do that. But if, if the baby has previously been sleeping longer at night, it's often helpful to try to, um, reassure and calm the crying without immediately going to, to nursing or to a bottle.
Host: 11:48 Um, so I'm gonna, I'm gonna flip it around a little bit and ask this question. Um, and you'll hear parents ask this, uh, every once in awhile you hear kind of the old wives tale, like never wake a sleeping baby. Yeah. Um, but if you're trying to establish some sort of pattern in, let's say the baby is rocking that nap like two in the afternoon and they're just coast in through the afternoon and you're like, man, it's going to be dinner time soon. Should I like this baby up? Cause you don't want them to be up all night long. Right. Um, I guess I'll talk to this a little bit about when, when I should wake my baby up.
Mary Armentrout: 12:21 Yeah. So it kind of depends and I think it's one of those things you learn by experience as a parent of what works for your child. Um, and some, you know, there's certainly some little ones who could sleep from two to 6:00 PM and get up and have some dinner and they are going to go down at 8:00 PM to noon. It's going to be golden and that's great. There are going to be others that if they, they sleep for 30 minutes too long, you're going to be up till midnight with that child and you have to kind of get to know your child and what that's like when you wake a child from the nap. They're like a little bear for like an hour at least. And so it's, it's rough. Um, but you know, you have to just know your child and what works and, and sometimes you're just gonna kind of wing it and parenting has that aspect to it.
Mary Armentrout: 13:04 Absolutely. And there's not in the same, the same, you know, solution is not right for every child, for every family. Um, you know, sometimes your child's taken a really long nap and you are getting some work done and you know, you're going to pay the price for it later, but sometimes you just go with it. Um, if you're, if you're consistently having trouble getting your baby, your child to sleep at night, you know, it probably is gonna make sense to be careful with the nap times that they're not stretching out too long. Cause that can work against you. At night.
Host: 13:30 Sure. So to follow up on nap time, you know, as, as your baby, um, how quickly do nap times change from a newborn once they get up to closer to a year old and you know, what's kind of, as your baby gets a little older, what's a good nap time routine? Do they sleep twice a day for an hour at a time? What, what parents, what should they be shooting for sure
Mary Armentrout: 13:53 or so it again, it's going to be a little bit up to the baby. As parents we provide the opportunity to sleep, but we can't just make it happen. Um, and it, there's a range. Um, some little babies sleep kind of short cat naps throughout the day. They're sleeping 30 or 40 minutes at a time. Others might take a longer. Now they might sleep for a couple hours. Um, everyone likes those longer naps, but you just can't really control it. Um, you can just provide a safe, you know, quiet place for your baby to sleep. Most little ones, um, you know, newborns in their first several months of life, you know, they may sleep, you know, 16 plus hours per day. And so often that's in, in chunks as they get a little bit older, especially to the age where they're, you know, maybe starting to get a little bit mobile crawling or just rolling around on the floor a little bit.
Mary Armentrout: 14:37 They tire themselves out a little bit more during the day and then they may fall into net patterns are a little bit longer. So often, for example, by say about six months of age, you know, many babies would take perhaps two naps a day or two naps in a short third nap. Um, that's not the same for every baby, but you know, Manny would take a morning nap and then maybe an afternoon nap again of, you know, anywhere between, you know, an hour to three hours depending on, on your baby. But there's going to be those who just take, you know, several shorter naps through the day as well.
Host: 15:05 Sure, sure. This is fantastic information. This is, this is golden right here. Um, so, uh, I have another scenario. I'm kind of, I'm going back and this flashbacks. So the baby is doing well, right? Maybe Jane or baby Johnny. Um, you know, they, maybe they start sleeping through the night. Um, we're rocking it for a month or two, and then all of a sudden, bam, like baby starts waking up in the middle of the night. And again, and it's kinda like, what we've, we've made it past this phase. Why are we going backwards? Right?
Mary Armentrout: 15:36 Pretty much always going to happen. You're going to be good for a while and you're going to feel it. Be feeling so pleased with how things are going and then there'll be a little hurdle. Um, and that happens for many, many reasons, but most of all, it's cause babies are changing developmentally. You know, they're more aware of separation. They're more aware when you've left the room, when they're realizing, Hey, I'm here in my bed and I don't see somebody holding me or right there with me. Um, and so then there's a little, you know, kind of a little bump in the road and we have to help them navigate through that and some, and that usually will come after a period of time when they've maybe been sleeping longer stretches. And that's where we really help make those transitions go a little bit more smoothly.
Mary Armentrout: 16:14 If a baby, if you, if the babies are used to you putting, putting her down awake into her bed. She's drowsy but awake, so she's falling asleep independently. That's helps a lot because then they, when they wake during the night, they're awake, they're in their bed, they're like, it's okay. I know what to do here. I'm in my bed, I'm tired. I can put myself back to sleep if the baby only knows how to fall asleep cause she's always in your arms. She's always feeding or nursing always rocked asleep. Then when she wakes up she's like, okay, come on. We need to do this routine again so I can go back to sleep. So that's where it is. Sometimes it is hard to put your baby down awake, but it really, really helps them be able to put themselves back to sleep at night.
Host: 16:50 That's a good point. And you mentioned bad a couple of times. So I want to touch on this. Um, you know, if you go, if you are searching online or you go to your local, um, your local retail store that sells cribs, um, there's, there's, we can almost be overwhelming. So, um, there's cribs that have all these bells and whistles perhaps. So I guess just talk to us about in an ideal kind of betting crib situation, what that would look like for a baby and what parents need to know.
Mary Armentrout: 17:22 So safety is really the number one priority in terms of the babies sleep space. A baby should sleep on a just affirm mattress. We shouldn't put things in the bed around the baby crib bumpers and soft toys and blankets and things like that. Um, it's just been proven, you know, with a lot of evidence that the safest sleep environment for a baby is on their back on a flat surface. So great examples would be, you know, a regular crib mattress, um, a bassinet that has a firm surface, a pack and play. Um, all of those are good choices. Um, it can be tempting to use some of the little seats and swings and things like that, maybe. Sure do like those they kind of squeeze them in a little bit. They've move, they, you know, they like that snug feeling. Um, but those are just not safe as safe places for baby to sleep as a, um, just a flat from surface.
Host: 18:13 Um, and you that she brought up snuggling so you keep bringing up great things. So is the idea, and my wife was always better at this than, than I was the swaddle swaddling of the blankets and getting the baby snugged in like a little bird.
Mary Armentrout: 18:26 So a lot of babies do really like the swaddle it. I think it kind of recreates the womb that has that really nice stuck feel. And when they're especially brand new, they have all these just kind of fragile nerve endings that are twitchy and their little arms flail out. And so that kind of helps them control that a little bit. Um, and so swaddling is safe. Um, it's good to not swallow the legs too much cause we think that's probably not ideal for their hip development, but you can swaddle their bodies. Um, if when a baby is starting to get close to the point that they're rolling over, then it's time to not swaddle anymore. We don't want the baby to be swaddled and rollover onto their tummy. Um, cause that's not safe. Um, but before a baby's showing any signs that they're getting close to rolling from their back to their bellies, um, then swaddling is safe and you can swaddle the baby and put him or her down on their back.
Host: 19:16 Okay. And as they're getting more mobile, um, they're flipping over, maybe they're, we're into the stage where they're crawling around now. Um, what does that look like as far as getting the baby down for sleep?
Mary Armentrout: 19:28 Yeah. So, you know, we recommend putting a baby down on the back to sleep. Um, at some point in time babies get mobile and they can, they can roll around. Um, when your baby is really active and rolling around and rolling consistently in both ways, if you put the baby down on their back and they immediately flip over onto the stomach, it's okay. Don't panic at that point. It's okay for the baby to sleep on the stomach. Um, you know, whether when that, when they've just done it once, I'd still lay the baby on their back, but if you, you come in and the baby's turned into sleeping on their stomach, don't panic. Um, they're just learning how to do that. So when they're at that stage where they're mobile and they're, they're going to put themselves in the position of most comfort and sometimes that is on the tummy, and that's okay when they're getting into that position themselves.
Host: 20:11 Sure. And then you've heard this story, I'm sure before, correct me if you haven't, but mom and dad put the, the, the kid down. They're a little older now. Um, you know, they're walking and then they're in the living room watching TV or something. And then out of nowhere the baby appears. How did you get out of the career? Um, so, uh, I guess talk to us a little bit. The what do we need to change anything once we find out that they can actually,
Mary Armentrout: 20:38 again, I would say yes probably cause we come back to safety. We need the baby, we need a safe sleep environment and sometimes it's just a onetime thing and um, but it certainly would get my attention and say, okay, this might not be safe cause you'd worry about the child falling out of the crib when they try to crawl out. So if your child is a little bit of a climber and they're climbing out of the crib, it's probably time to transition from the crib into, um, it, you know, a little toddler bed, a bed with a side rail, even just the crib mattress on the floor is just fine. It's perfectly comfortable for the baby and they're not going to hurt themselves. You know, if they rolled that eight inches off the crib, mattress, you know, onto the floor. So that is safe. And so if you need a just a short term fix, like we weren't ready for this, you know, we don't even have a bed.
Mary Armentrout: 21:20 We have a crib and they're climbing out. Just take the crib, mattress out, put it on the floor. That's completely fine. It's a whole different ball game. Now when you have a mobile baby and a mobile child. And so that's, you know, again, coming back to safety, you want to make sure that, that the room where the child is sleeping is, you know, is safe and they can't climb a bookshelf or pull the dresser down on them, that there's not chords they're going to pull down because there's a good chance this child's going to be up to something unattended while you know, you think he or she is sleeping. Um, keeping the door closed often helps so you can hear it. If the baby comes out, you don't want the child to come out of the room and fall down the stairs. Sometimes he's in a baby gate at the door, although good climbers can get over those too. So, um, that takes a little more creativity sometimes. But just really making sure the environment is safe. Um, S just in anticipation that your little one is going to be moving around when you can't see.
Host: 22:10 Um, so speaking of safe, um, we have the crib situation, but a lot of times where babies fall asleep is in the car seat. Right? Um, so I guess first of all, when a baby, it is always, it always seems to happen. Like you're, the baby's not, doesn't appear tired at all. So you're going to run a couple of errands, five minutes into the car ride that baby falls asleep. Yeah. So what do you do? You do, I mean, you see these pictures. One of my friends just posted one recently on, on social media, or it's like just hanging out in the parking lot because the baby's sleeping in the car seat in the back. So is it, I mean, do you recommend that? Is it okay to wake the baby up out of the car seat?
Mary Armentrout: 22:46 Right. So it's going to happen and that's life and the car seat, they love to sleep in those little seats and you're moving and there's a low vibration. They're just happy as can be. So, um, you know, that's going to happen and you need to, you know, go to the store and things like that. So your is going to fall asleep in the car seat. It's not a, it's not the safest place for your baby to sleep like at night. Um, I wouldn't recommend that for asleep space or necessarily be napping during the day if you're not keeping an eye on the baby. If you're shopping and the baby's falling asleep in the, in the carrier and you know, you're, you've got the carrier in the stroller and you can see the baby. You know, I don't think that you have to wake the baby up, but you're keeping an eye on the baby. Um, if it is a nap time, it, you know, we, it is probably a good idea if you can take the baby out of the car seat, um, and lay, lay him down in his, in his bassinet. I realize that usually wakes the baby up, but it's just not quite as safe of a space. But if you're watching the baby and he's asleep in his car seat, um, if you're just keeping an eye on them, that's usually okay.
Host: 23:42 Sure. And I'm, I want to throw in a shameless safety disclaimer here with car seats. Um, so we have the safe kids program. [inaudible] um, and um, you, you're probably familiar with it as well being at a pediatrician's office, but, um, we offer, um, car seat checks monthly, um, through wake forest Baptist health and the safe kids program. So if people just go to wake health that EDU, they can, they can check the schedule on our calendar for the latest car seat checks. Cause, um, I know that can be a source of stress sometimes as well. Tricky to get in just right. Yeah. Tell me about, yeah. Um, so that's, that's uh, glad to let people know that we have that service. Um, so we're wrapping up here in a second. Dr Arman trout. Um, so as the baby, um, gets a little older and we have the bedtime routine down, um, and there may be getting into toddler hood. Um, I know one thing that can, um, pop back up is maybe, um, uh, nightmares or the baby kind of wakes up. He can kinda tell when your baby's dreaming sometimes what their little movements or sound they make. Um, but if you notice maybe the baby start these kind of jolted awake crying, um, is there any advice for, for that situation if they may be, it looks like they're having a nightmare,
Mary Armentrout: 24:59 right? Yeah. That certainly is going to happen. It's very also very normal. Developmentally. They're just learning a lot of new things. I'm seeing just a lot of different things that they're trying to figure out. They don't really have a clear grasp between fantasy and reality. Um, and maybe they've seen a picture, you know, at the store that was Elian and it looked a little bit scary. Even if a parent's been super vigilant that they've never seen a cartoon that was scary or anything else, which most kids do and they're okay, things will still scare them sometimes. And so it's normal. Yeah. I think the most important thing is just to offer a little reassurance. There's two different kind of night Mayer situations that parents will encounter. There's a nightmare, which is a bad dream, just like we've all experienced. And you know, usually the child, often they can describe it to you, a little bit of what they saw.
Mary Armentrout: 25:43 They're awake, they're, um, just really kind of distressed and needs some soothing and go back to sleep. And, and I think it's important just to recognize that that felt really scary. You know, I know you were upset, you know, but it wasn't real and everything's okay. But just acknowledging yet that did feel really scary. Um, there's also something called night terrors, which is a little bit different. Night terrors are sort of asleep phase disruption. Um, often in the earlier part of the night, sometimes within the first hour or two of a child, I'm going to sleep and they may cry out, maybe screaming, really upset and will look awake, maybe eyes open, but you can tell like not quite with you. Um, and it's because it's actually still part of a sleep phase. Um, and those can be distressing to see. And if, and sometimes they'll come in patterns and can sometimes run in families, the people who sleep walk or sleep talk.
Mary Armentrout: 26:31 Sometimes those night terrors go along with that. And in that situation you actually want to try to not wake your child up because if you do get them fully awake, they can feel more distressed as to like, why is my heart pounding? And I'm afraid and I don't know what's on, but just to try to help them kind of kind of ride the storm essentially and settle back down. And they'll often go in phases where they might do it, you know, several times over, but you know, a month or two and then kind of ease out of it again for a little bit.
Host: 26:55 Sure. And um, so one, one last question and where people might, there's probably changes with, with your first child as opposed to your second, third, or fourth child, but, um, you know, when, when should a mom or dad, um, think about calling the doctor's office Collin or on the on call nurse about if there's some situation whenever they can't get the baby to sleep. Um, what do you here at the office about that?
Mary Armentrout: 27:19 Well, I mean, I think my advice on that is anytime you feel really unsure and uncomfortable, call us. You know, and I'm more than happy to talk to you and say, you know what, it sounds like everything's okay. I'm not upset for there not to be a bad problem. So if you're uneasy, if you're uncomfortable, if you feel unsure, definitely call your doctor's office and you'll be able to get some information as to whether, yeah, why don't we come in and talk about this or whether it sounds like it's okay. Um, and, and I think that's just the most important thing. I think if something in your gut feels like, I'm not sure if this is okay, then then call to get some information or to maybe get checked out.
Host: 27:54 Gotcha. Well, doc, this has been so helpful and I hope the listeners find this helpful. I know it's, it's one that parents stress out about a lot, but, um, hopefully if they're listening to you, they're, they're reassured that it's gonna be okay and that, you know, each kid is different. And, um, sometimes you are winging it or just trying to get through for a little bit. Um, and that everything's going to be okay. So this has been asleep again. Yes. You doing surely asleep again. Uh, this has been super helpful, so I appreciate everyone listening to this episode. Um, if you have any questions or maybe you're looking for a pediatrician, um, you can look up Dr. Armentrout's information on our website, wake health. EDU or any of our other pediatricians as well. We have plenty, plenty of pediatricians listed on our staff and you can read up on, on different information or you can call seven one six week in. Um, they'll connect you to the correct people. So, um, hope everyone is enjoying this episode and um, we'll talk to you again soon. Thank you.
Speaker 3: 28:58 Thanks for listening to this episode of the best health podcast brought to you by wake forest Baptist health. For more wellness info, check out wakehealth.edu and follow us on social media, wake forest Baptist hell, the gold standard of healthcare.
Host: 01:11 And please, when will I get back to sleeping normal again for the love of all things holding. Yes. Um, so, uh, this was, um, a high priority topic when, when my two boys were newborns. Um, even more so with, with my, uh, with my wife, I, um, I had really not that much to complain about. Um, she was taking the lion's share of, of the duties in the middle of the night. Um, so doctor, before we get started, um, we're going to have lots of fun talking about this today. Uh, just tell us a little bit about yourself, um, how you got into medicine, why you became a pediatrician.
Mary Armentrout: 01:48 Sure. I think I've just always had a, um, interest in, in science and medicine and I think a heart for children. So it's really what I've always wanted to do. I've been practicing for, um, close to 17 years now. Um, uh, here in town at Fort Simpson, lively in rice and I started my pediatric career there and, um, happily continuing on. Um, I did my residency training at Cincinnati children's hospital. Um, my husband and I have two sons who are 17 and 14. So we've been through the phases of sleep, um, challenges and sleep is just really, really important to the whole family, parents, babies, teens, and um, I think it's really an important priority for, for good health and, and just all aspects of well being.
Host: 02:33 Absolutely. So hopefully the 17 year old and the 14 year old habit down
Mary Armentrout: 02:38 as far as they know, I know they sleep through the night. Yeah.
Host: 02:43 Uh, that's good to know. Um, so, um, there's this, um, you, you know, if with a new baby you just, your world's been turned upside down. It's, it's a fantastic gift. Um, just an a new baby and um, can talk about, uh, in get into, you know, um, multiple babies as well here a little bit later. Um, so you have the baby or you come home from the hospital and there it is. You're at home and, and this little beautiful little baby human need your attention several times throughout the day and the night. Um, so one of the most important things, uh, that, that parents, um, um, stress about think about is, is sleeping. So they want to a, I'm assuming they need to get enough sleep themselves, which is challenging but also, um, for their baby. Um, so when you get home from the hospital and your, how do I, how am I, how does not, what do I, what am I thinking with my baby? It's up every two or three hours. He or she, you know, what is the right amount of sleep? How do I know my baby's getting enough sleep? So I guess just talk to us about that initial phase. Yeah, brand new mom and dad's right when they get home, what that look.
Mary Armentrout: 04:01 So it's a really, really difficult time as a, as a woman has gone through her pregnancy, her sleep has not been good for several months. She's been uncomfortable carrying their pregnancy. She's tired, she goes into labor, she goes through this major event and, and doesn't sleep well there. And then we wrap it up and send you home with a child who's going to keep you awake all night long. And so it's really a perfect storm of, um, really significant sleep disturbance. So I think that the first piece of advice is to recognize that it's going to be rough. It's going gonna be rough for the first, you know, several weeks at least, but it gets better. Um, you know, the advice of sleep when the baby sleeps, there's a lot to that. Um, many babies in their first two weeks or so of life really, they don't have any idea of a difference between day and night.
Mary Armentrout: 04:49 I'm a big fan of sleeping at night and don't care so much during the day. Babies don't care about that and you just can't change it initially. So, you know, my suggestion in the first two weeks is you have to kind of go with the flow and that certainly means if you can get some rest during the day when you have a, a friend or family member who asks you, what can I do? Well you can just kinda keep an eye on the baby for this two hours while I take a nap. So you have to try to, you know, kind of patch it together and get a little sleep as best you can. Um, you can't force it to get the babies to days and nights to flip as they get a little bit older. They have more alertness during the day and we can keep a baby awake a little bit longer. But in those first two weeks you just have to kind of go with it and do the best you can to sleep when the baby does.
Host: 05:31 Gotcha. So I'm following up on that. When should, uh, uh, mom or dad expect their baby to get into a quote unquote regular sleep?
Mary Armentrout: 05:42 Yeah. Um, there's no magic numbers. Sure. Usually by the, after the first couple of weeks, babies are at least are falling into a pattern that nighttime is hopefully becoming more for sleeping than day time. We're a little bit more alert during the day and maybe the feedings are a bit more frequent during the day. Um, I think it's even, even sometimes helpful to wake up maybe every two or three hours during the day time after the first couple of weeks just to encourage, you know, work, not going to sleep long stretches. Um, and then hopefully things start to stretch out a little bit more at night. Um, it's still is, is often unpredictable in the first, in the first month or two, but usually by about two months of age, we've at least fallen into a pattern that there might be one. The initial sleep stretch might be a little bit longer that the baby may be sleeps for four hours instead of two. Often after that when they wake to feed, we're back at that every two to three hour stretches. But we're often having at least one slightly longer stretch at first.
Host: 06:35 Okay. So, um, to take that a step further, the one of the magic questions we have, and it's funny cause you'll talk to different parents and they'll have different answers. Like some parents have icon, my baby slept through the night, eight hours a night when starting at three weeks old. And like some parents maybe or maybe not like us or like months into it and you're like trying to string together like three or four hours. So when I guess talk about maybe what, what can we look look at for expecting a baby quote unquote sleep through that?
Mary Armentrout: 07:08 Yeah, I think that's a great question. And you know, there are, there are a few babies who really do sleep most of the night at a very young age and those families are really, really lucky and they probably ought to, not to brag too much to their friends. Um, in kind of depending on how you define through the night, I would say maybe through the night is that the baby is sleeping a stretch of six to eight hours. Um, and most babies are ready to do that by about six months of age, not 100%, but most. Um, now if your baby goes to bed at, you know, seven or 8:00 PM, which is often a good bedtime for families and their babies and they wake up, you know, six hours later, well that's 2:00 AM and it doesn't feel too the parent like the baby's sleeping through the night, but they are sleeping in a developmentally normal and healthy way that they're sleeping a nice, you know, maybe six to eight hours stretch. Um, and that's a good healthy amount.
Host: 07:57 Okay. Um, well, so you mentioned, um, that's a good by the time around that, that seven or eight time time frame. Um, so I guess following up on that a little bit, um, it's, we're trying to get as much sleep as possible as new parents and trying to get, you know, make sure our babies are being healthy and having a healthy amount of sleep, what, what might be a good bedtime routine to help our babies calm down and relax and get kind of sleep,
Mary Armentrout: 08:24 right. Routine is really important. And I really encourage families to establish some routine by the time of babies, about two months of age. And it doesn't have to be exactly the same thing every night, but it helps a baby a lot and helps them learn if they're getting the cues for, these are the same things we do each night before my parents put me to bed. And so, you know, the kind of the lights are dim. Sometimes there's a bath, maybe we, you know, read some stories, sing a song, quiet music, nothing elaborate, but just kind of the stimulation level is down. We're quiet or quiet voices, you know, maybe rock or do some of that for a little bit and then put the baby down when he or she is still awake, drowsy but still awake. So they're helping to learn to fall asleep on their own bedtime really depends on a family and their schedule and their needs.
Mary Armentrout: 09:09 I think it's often nice for, uh, you know, the, the baby and children to be down and asleep for at least a little while before mom and dad go to bed. Cause I think it's nice and healthy to have some time when your children are asleep that you can, you know, talk to your spouse. Um, or just have a little downtime for yourself. Um, but that's different for every families. Some families are more night owls and the baby's bedtime is going to be a little bit later and it really is just what works best for the family.
Host: 09:34 Gotcha. So, um, once again, it may or may not have personal experience in this. Uh, so the baby wakes up in the middle of the night, you know, let's say the baby's a little older and how three, four, five, six months and um, and little precious baby won't stop crying. Um, and that's their kind of, their main form of communication at that point is crying. Um, they can't tell you what may or may not be bothering them. Um, so when we get in that situation, you know, it's one or two o'clock in the morning and baby's crying, is it, you know, are they sick? Are they uncomfortable? Do they have gas? What are some tips for parents when they're in that situation? Yeah.
Mary Armentrout: 10:13 Right. Yeah. And I think, you know, by the time your baby's a few months old, you've gotten a sense of sort of, there's different types of cries. There's the, I'm not happy in my bed, cry, I'm, you know, uncomfortable cause my, you know, diaper blew out and I'm soaked and dirty in here. And there's different qualities of cry that gets your attention in different ways. And there's the, you know, sometimes I'm awake in my bed and I'm here by myself and I don't like it, cry and, and that one is one that'll often wake us during the night. You know, the first thing I would say is you don't have to run from your bed to the baby. It's okay to, you know, wait a minute or two and see if the baby's going to kind of settle and, um, you know, get, get over there and check on the baby.
Mary Armentrout: 10:53 Sometimes it's a quality, a cry that's different or suggest pain. And of course you're gonna, you know, immediately go and check on the baby. Um, but if, you know, everything seems okay and it seems to kind of cry that I just woke up and I'd like to go to sleep again. It's, it's nice to try to make the intervention as you know, as brief and minimal as you can. Offer some reassurance, settle the baby a little bit, but if you can, again, you know, put the baby down, leave the baby to fall asleep on, on her own or his own, um, that's going to help reinforce that everything's okay. Just needed a little, a little quiet check-in. Um, if the baby's already been going longer stretches without needing to eat during the night, it's good to try to Sue the baby in other ways besides feeding. Um, and sometimes you'll just, that'll finally be that the baby's hungry and you'll do that. But if, if the baby has previously been sleeping longer at night, it's often helpful to try to, um, reassure and calm the crying without immediately going to, to nursing or to a bottle.
Host: 11:48 Um, so I'm gonna, I'm gonna flip it around a little bit and ask this question. Um, and you'll hear parents ask this, uh, every once in awhile you hear kind of the old wives tale, like never wake a sleeping baby. Yeah. Um, but if you're trying to establish some sort of pattern in, let's say the baby is rocking that nap like two in the afternoon and they're just coast in through the afternoon and you're like, man, it's going to be dinner time soon. Should I like this baby up? Cause you don't want them to be up all night long. Right. Um, I guess I'll talk to this a little bit about when, when I should wake my baby up.
Mary Armentrout: 12:21 Yeah. So it kind of depends and I think it's one of those things you learn by experience as a parent of what works for your child. Um, and some, you know, there's certainly some little ones who could sleep from two to 6:00 PM and get up and have some dinner and they are going to go down at 8:00 PM to noon. It's going to be golden and that's great. There are going to be others that if they, they sleep for 30 minutes too long, you're going to be up till midnight with that child and you have to kind of get to know your child and what that's like when you wake a child from the nap. They're like a little bear for like an hour at least. And so it's, it's rough. Um, but you know, you have to just know your child and what works and, and sometimes you're just gonna kind of wing it and parenting has that aspect to it.
Mary Armentrout: 13:04 Absolutely. And there's not in the same, the same, you know, solution is not right for every child, for every family. Um, you know, sometimes your child's taken a really long nap and you are getting some work done and you know, you're going to pay the price for it later, but sometimes you just go with it. Um, if you're, if you're consistently having trouble getting your baby, your child to sleep at night, you know, it probably is gonna make sense to be careful with the nap times that they're not stretching out too long. Cause that can work against you. At night.
Host: 13:30 Sure. So to follow up on nap time, you know, as, as your baby, um, how quickly do nap times change from a newborn once they get up to closer to a year old and you know, what's kind of, as your baby gets a little older, what's a good nap time routine? Do they sleep twice a day for an hour at a time? What, what parents, what should they be shooting for sure
Mary Armentrout: 13:53 or so it again, it's going to be a little bit up to the baby. As parents we provide the opportunity to sleep, but we can't just make it happen. Um, and it, there's a range. Um, some little babies sleep kind of short cat naps throughout the day. They're sleeping 30 or 40 minutes at a time. Others might take a longer. Now they might sleep for a couple hours. Um, everyone likes those longer naps, but you just can't really control it. Um, you can just provide a safe, you know, quiet place for your baby to sleep. Most little ones, um, you know, newborns in their first several months of life, you know, they may sleep, you know, 16 plus hours per day. And so often that's in, in chunks as they get a little bit older, especially to the age where they're, you know, maybe starting to get a little bit mobile crawling or just rolling around on the floor a little bit.
Mary Armentrout: 14:37 They tire themselves out a little bit more during the day and then they may fall into net patterns are a little bit longer. So often, for example, by say about six months of age, you know, many babies would take perhaps two naps a day or two naps in a short third nap. Um, that's not the same for every baby, but you know, Manny would take a morning nap and then maybe an afternoon nap again of, you know, anywhere between, you know, an hour to three hours depending on, on your baby. But there's going to be those who just take, you know, several shorter naps through the day as well.
Host: 15:05 Sure, sure. This is fantastic information. This is, this is golden right here. Um, so, uh, I have another scenario. I'm kind of, I'm going back and this flashbacks. So the baby is doing well, right? Maybe Jane or baby Johnny. Um, you know, they, maybe they start sleeping through the night. Um, we're rocking it for a month or two, and then all of a sudden, bam, like baby starts waking up in the middle of the night. And again, and it's kinda like, what we've, we've made it past this phase. Why are we going backwards? Right?
Mary Armentrout: 15:36 Pretty much always going to happen. You're going to be good for a while and you're going to feel it. Be feeling so pleased with how things are going and then there'll be a little hurdle. Um, and that happens for many, many reasons, but most of all, it's cause babies are changing developmentally. You know, they're more aware of separation. They're more aware when you've left the room, when they're realizing, Hey, I'm here in my bed and I don't see somebody holding me or right there with me. Um, and so then there's a little, you know, kind of a little bump in the road and we have to help them navigate through that and some, and that usually will come after a period of time when they've maybe been sleeping longer stretches. And that's where we really help make those transitions go a little bit more smoothly.
Mary Armentrout: 16:14 If a baby, if you, if the babies are used to you putting, putting her down awake into her bed. She's drowsy but awake, so she's falling asleep independently. That's helps a lot because then they, when they wake during the night, they're awake, they're in their bed, they're like, it's okay. I know what to do here. I'm in my bed, I'm tired. I can put myself back to sleep if the baby only knows how to fall asleep cause she's always in your arms. She's always feeding or nursing always rocked asleep. Then when she wakes up she's like, okay, come on. We need to do this routine again so I can go back to sleep. So that's where it is. Sometimes it is hard to put your baby down awake, but it really, really helps them be able to put themselves back to sleep at night.
Host: 16:50 That's a good point. And you mentioned bad a couple of times. So I want to touch on this. Um, you know, if you go, if you are searching online or you go to your local, um, your local retail store that sells cribs, um, there's, there's, we can almost be overwhelming. So, um, there's cribs that have all these bells and whistles perhaps. So I guess just talk to us about in an ideal kind of betting crib situation, what that would look like for a baby and what parents need to know.
Mary Armentrout: 17:22 So safety is really the number one priority in terms of the babies sleep space. A baby should sleep on a just affirm mattress. We shouldn't put things in the bed around the baby crib bumpers and soft toys and blankets and things like that. Um, it's just been proven, you know, with a lot of evidence that the safest sleep environment for a baby is on their back on a flat surface. So great examples would be, you know, a regular crib mattress, um, a bassinet that has a firm surface, a pack and play. Um, all of those are good choices. Um, it can be tempting to use some of the little seats and swings and things like that, maybe. Sure do like those they kind of squeeze them in a little bit. They've move, they, you know, they like that snug feeling. Um, but those are just not safe as safe places for baby to sleep as a, um, just a flat from surface.
Host: 18:13 Um, and you that she brought up snuggling so you keep bringing up great things. So is the idea, and my wife was always better at this than, than I was the swaddle swaddling of the blankets and getting the baby snugged in like a little bird.
Mary Armentrout: 18:26 So a lot of babies do really like the swaddle it. I think it kind of recreates the womb that has that really nice stuck feel. And when they're especially brand new, they have all these just kind of fragile nerve endings that are twitchy and their little arms flail out. And so that kind of helps them control that a little bit. Um, and so swaddling is safe. Um, it's good to not swallow the legs too much cause we think that's probably not ideal for their hip development, but you can swaddle their bodies. Um, if when a baby is starting to get close to the point that they're rolling over, then it's time to not swaddle anymore. We don't want the baby to be swaddled and rollover onto their tummy. Um, cause that's not safe. Um, but before a baby's showing any signs that they're getting close to rolling from their back to their bellies, um, then swaddling is safe and you can swaddle the baby and put him or her down on their back.
Host: 19:16 Okay. And as they're getting more mobile, um, they're flipping over, maybe they're, we're into the stage where they're crawling around now. Um, what does that look like as far as getting the baby down for sleep?
Mary Armentrout: 19:28 Yeah. So, you know, we recommend putting a baby down on the back to sleep. Um, at some point in time babies get mobile and they can, they can roll around. Um, when your baby is really active and rolling around and rolling consistently in both ways, if you put the baby down on their back and they immediately flip over onto the stomach, it's okay. Don't panic at that point. It's okay for the baby to sleep on the stomach. Um, you know, whether when that, when they've just done it once, I'd still lay the baby on their back, but if you, you come in and the baby's turned into sleeping on their stomach, don't panic. Um, they're just learning how to do that. So when they're at that stage where they're mobile and they're, they're going to put themselves in the position of most comfort and sometimes that is on the tummy, and that's okay when they're getting into that position themselves.
Host: 20:11 Sure. And then you've heard this story, I'm sure before, correct me if you haven't, but mom and dad put the, the, the kid down. They're a little older now. Um, you know, they're walking and then they're in the living room watching TV or something. And then out of nowhere the baby appears. How did you get out of the career? Um, so, uh, I guess talk to us a little bit. The what do we need to change anything once we find out that they can actually,
Mary Armentrout: 20:38 again, I would say yes probably cause we come back to safety. We need the baby, we need a safe sleep environment and sometimes it's just a onetime thing and um, but it certainly would get my attention and say, okay, this might not be safe cause you'd worry about the child falling out of the crib when they try to crawl out. So if your child is a little bit of a climber and they're climbing out of the crib, it's probably time to transition from the crib into, um, it, you know, a little toddler bed, a bed with a side rail, even just the crib mattress on the floor is just fine. It's perfectly comfortable for the baby and they're not going to hurt themselves. You know, if they rolled that eight inches off the crib, mattress, you know, onto the floor. So that is safe. And so if you need a just a short term fix, like we weren't ready for this, you know, we don't even have a bed.
Mary Armentrout: 21:20 We have a crib and they're climbing out. Just take the crib, mattress out, put it on the floor. That's completely fine. It's a whole different ball game. Now when you have a mobile baby and a mobile child. And so that's, you know, again, coming back to safety, you want to make sure that, that the room where the child is sleeping is, you know, is safe and they can't climb a bookshelf or pull the dresser down on them, that there's not chords they're going to pull down because there's a good chance this child's going to be up to something unattended while you know, you think he or she is sleeping. Um, keeping the door closed often helps so you can hear it. If the baby comes out, you don't want the child to come out of the room and fall down the stairs. Sometimes he's in a baby gate at the door, although good climbers can get over those too. So, um, that takes a little more creativity sometimes. But just really making sure the environment is safe. Um, S just in anticipation that your little one is going to be moving around when you can't see.
Host: 22:10 Um, so speaking of safe, um, we have the crib situation, but a lot of times where babies fall asleep is in the car seat. Right? Um, so I guess first of all, when a baby, it is always, it always seems to happen. Like you're, the baby's not, doesn't appear tired at all. So you're going to run a couple of errands, five minutes into the car ride that baby falls asleep. Yeah. So what do you do? You do, I mean, you see these pictures. One of my friends just posted one recently on, on social media, or it's like just hanging out in the parking lot because the baby's sleeping in the car seat in the back. So is it, I mean, do you recommend that? Is it okay to wake the baby up out of the car seat?
Mary Armentrout: 22:46 Right. So it's going to happen and that's life and the car seat, they love to sleep in those little seats and you're moving and there's a low vibration. They're just happy as can be. So, um, you know, that's going to happen and you need to, you know, go to the store and things like that. So your is going to fall asleep in the car seat. It's not a, it's not the safest place for your baby to sleep like at night. Um, I wouldn't recommend that for asleep space or necessarily be napping during the day if you're not keeping an eye on the baby. If you're shopping and the baby's falling asleep in the, in the carrier and you know, you're, you've got the carrier in the stroller and you can see the baby. You know, I don't think that you have to wake the baby up, but you're keeping an eye on the baby. Um, if it is a nap time, it, you know, we, it is probably a good idea if you can take the baby out of the car seat, um, and lay, lay him down in his, in his bassinet. I realize that usually wakes the baby up, but it's just not quite as safe of a space. But if you're watching the baby and he's asleep in his car seat, um, if you're just keeping an eye on them, that's usually okay.
Host: 23:42 Sure. And I'm, I want to throw in a shameless safety disclaimer here with car seats. Um, so we have the safe kids program. [inaudible] um, and um, you, you're probably familiar with it as well being at a pediatrician's office, but, um, we offer, um, car seat checks monthly, um, through wake forest Baptist health and the safe kids program. So if people just go to wake health that EDU, they can, they can check the schedule on our calendar for the latest car seat checks. Cause, um, I know that can be a source of stress sometimes as well. Tricky to get in just right. Yeah. Tell me about, yeah. Um, so that's, that's uh, glad to let people know that we have that service. Um, so we're wrapping up here in a second. Dr Arman trout. Um, so as the baby, um, gets a little older and we have the bedtime routine down, um, and there may be getting into toddler hood. Um, I know one thing that can, um, pop back up is maybe, um, uh, nightmares or the baby kind of wakes up. He can kinda tell when your baby's dreaming sometimes what their little movements or sound they make. Um, but if you notice maybe the baby start these kind of jolted awake crying, um, is there any advice for, for that situation if they may be, it looks like they're having a nightmare,
Mary Armentrout: 24:59 right? Yeah. That certainly is going to happen. It's very also very normal. Developmentally. They're just learning a lot of new things. I'm seeing just a lot of different things that they're trying to figure out. They don't really have a clear grasp between fantasy and reality. Um, and maybe they've seen a picture, you know, at the store that was Elian and it looked a little bit scary. Even if a parent's been super vigilant that they've never seen a cartoon that was scary or anything else, which most kids do and they're okay, things will still scare them sometimes. And so it's normal. Yeah. I think the most important thing is just to offer a little reassurance. There's two different kind of night Mayer situations that parents will encounter. There's a nightmare, which is a bad dream, just like we've all experienced. And you know, usually the child, often they can describe it to you, a little bit of what they saw.
Mary Armentrout: 25:43 They're awake, they're, um, just really kind of distressed and needs some soothing and go back to sleep. And, and I think it's important just to recognize that that felt really scary. You know, I know you were upset, you know, but it wasn't real and everything's okay. But just acknowledging yet that did feel really scary. Um, there's also something called night terrors, which is a little bit different. Night terrors are sort of asleep phase disruption. Um, often in the earlier part of the night, sometimes within the first hour or two of a child, I'm going to sleep and they may cry out, maybe screaming, really upset and will look awake, maybe eyes open, but you can tell like not quite with you. Um, and it's because it's actually still part of a sleep phase. Um, and those can be distressing to see. And if, and sometimes they'll come in patterns and can sometimes run in families, the people who sleep walk or sleep talk.
Mary Armentrout: 26:31 Sometimes those night terrors go along with that. And in that situation you actually want to try to not wake your child up because if you do get them fully awake, they can feel more distressed as to like, why is my heart pounding? And I'm afraid and I don't know what's on, but just to try to help them kind of kind of ride the storm essentially and settle back down. And they'll often go in phases where they might do it, you know, several times over, but you know, a month or two and then kind of ease out of it again for a little bit.
Host: 26:55 Sure. And um, so one, one last question and where people might, there's probably changes with, with your first child as opposed to your second, third, or fourth child, but, um, you know, when, when should a mom or dad, um, think about calling the doctor's office Collin or on the on call nurse about if there's some situation whenever they can't get the baby to sleep. Um, what do you here at the office about that?
Mary Armentrout: 27:19 Well, I mean, I think my advice on that is anytime you feel really unsure and uncomfortable, call us. You know, and I'm more than happy to talk to you and say, you know what, it sounds like everything's okay. I'm not upset for there not to be a bad problem. So if you're uneasy, if you're uncomfortable, if you feel unsure, definitely call your doctor's office and you'll be able to get some information as to whether, yeah, why don't we come in and talk about this or whether it sounds like it's okay. Um, and, and I think that's just the most important thing. I think if something in your gut feels like, I'm not sure if this is okay, then then call to get some information or to maybe get checked out.
Host: 27:54 Gotcha. Well, doc, this has been so helpful and I hope the listeners find this helpful. I know it's, it's one that parents stress out about a lot, but, um, hopefully if they're listening to you, they're, they're reassured that it's gonna be okay and that, you know, each kid is different. And, um, sometimes you are winging it or just trying to get through for a little bit. Um, and that everything's going to be okay. So this has been asleep again. Yes. You doing surely asleep again. Uh, this has been super helpful, so I appreciate everyone listening to this episode. Um, if you have any questions or maybe you're looking for a pediatrician, um, you can look up Dr. Armentrout's information on our website, wake health. EDU or any of our other pediatricians as well. We have plenty, plenty of pediatricians listed on our staff and you can read up on, on different information or you can call seven one six week in. Um, they'll connect you to the correct people. So, um, hope everyone is enjoying this episode and um, we'll talk to you again soon. Thank you.
Speaker 3: 28:58 Thanks for listening to this episode of the best health podcast brought to you by wake forest Baptist health. For more wellness info, check out wakehealth.edu and follow us on social media, wake forest Baptist hell, the gold standard of healthcare.