A Whole9 guest post from a mother-daughter duo who are passionate about prenatal nutrition. Emily Rydbom CN, LE and Dr. Leslie Stone are founders of GrowBaby®. Read their other Whole9 guest posts here.
It’s an all-too-familiar picture, a tip-toeing parent, holding their breath, willing their child to sleep. The pattern never stops, the child doesn’t sleep, so the parents don’t either. I have to admit, my mother was the one who cheerfully mentioned, “Oh, yes, well as a new mother I didn’t feel normal until you were all 4 years old.” Four! No thanks. I vowed then that I would work toward creating a healthy sleep environment for myself and my son. We both had to survive this and my heart was set on it. I imagine many mothers and fathers have the same grandiose idea of training their child to sleep, but then life happens and they have to adjust. So, in the spirit of adjustment, and sanity, here is GrowBaby’s approach to helping parents work through their sleep challenges.
The recommendations below are for babies over 18 lbs who do not have autism spectrum disorder. In the case of any spectrum disorder, there are more than likely multiple specialists included in their care. Please address the individual needs of the child with all who are involved.
Scenario #1: A child who doesn’t have sleep hygiene mastered
You’ve tried it all; sleep routines, playtime outside, diet changes, and nothing helps. This is where questions arise for us regarding specifics surrounding poor sleep and diet change. In order to make the inhibitory neurotransmitter serotonin and the co-factor to make melatonin (which helps you sleep) you need B vitamins, vitamin C, magnesium, L-tryptophan, and balanced gut health. Why? The largest site of serotonin production happens in your gut, not your brain.
Improve Serotonin Production
You can help to improve serotonin production in your child by addressing their gut health using the 5R approach.¹
- Remove the most commonly problematic foods like wheat, eggs, dairy, soy, shellfish, corn, and refined sugar.
- Replace with naturally occurring digestive enzymes found in fruits like papaya and pineapple, as well as mangoes, watermelon, blueberries, raspberries, and grapefruit, or vegetables like parsley, kale, broccoli, celery, cabbage, beets, and beet greens.²
- Reinoculate with healthy bacteria by choosing fermented foods daily, like yogurt and kefir (if tolerated), bone broth, natto (avoid if Paleo), sauerkraut, kimchi, and miso (avoid if Paleo).
- Repair by choosing nutrients that support gut health like L-glutamine (a non-essential amino acid). You’ll find this in cabbage, beets, beef, chicken, and fish. Butyric Acid (made from fermented fiber in your large intestine) also supports gut health and comes from vegetables, fruit, and butter. Omega-3 fatty acids (essential fats) are found in seafood, flaxseeds, chia seeds, algal oil, walnuts, and almonds.
- Rebalance stress by making sleep learning as much about your child as it is about you. Involve your child, and ask them to choose what relaxes and calms them. It is about observation, but also inquiry. You may be older and wiser, but asking their opinion about what is working will continue to encourage healthy communication. Most babies calm with the quiet humming or soothing tones of their parent’s voice, feeling the beat of the parent’s heartbeat with contact of the chest. When you feel appreciation and gratitude for someone (like your baby) and are close (within 2-4 feet) your heartbeat and their heartbeat will begin to synchronize. So quiet appreciation and gratitude with closeness can calm your child.
Address Protein, Vitamin & Mineral Intake
Protein, vitamin, and mineral intake impact your child’s sleep and by addressing this, you may improve sleep for your child.
L-Tryptophan is an essential amino acid that is a key component of melatonin, which is critical for restorative sleep. Vitamin B6, folate (vitamin B9), vitamin C, and the mineral magnesium work to convert L-tryptophan into melatonin. However, overemphasizing specific nutrients can lead you to overlook other important complementary nutrients.
In this case, L-tryptophan needs help from specific nutrients. Choose foods that are high in B vitamins like dark leafy greens, brewer’s yeast, squashes, cruciferous vegetables, bell peppers, and protein. Choose foods that are high in vitamin C like citrus, bell peppers, romaine lettuce, pineapple, melon, strawberries, and kiwi. And finally, choose foods that are high in magnesium. This not only improves cellular energy, but encourages relaxation. Some magnesium-rich foods include: spinach, squashes, sesame/flax/pumpkin/sunflower seeds, cruciferous veggies, and green beans.
Scenario #2: Parental fear of sleep learning/sleep hygiene
The first thing that we need to address with all parents is this: stress is a crucial part of life. Focus should be on allowing your children to experience positive stress response (brief and intermittent and mild-moderate in magnitude) vs. toxic stress response, (strong, frequent, or prolonged activation of the body’s stress response systems in the absence of the buffering protection of a supportive, adult relationship).³ Helping your child learn how to sleep is a positive stress response and one that has a lifelong impact for their sleep hygiene. It also allows their natural stress response to occur.
The American Academy of Pediatrics says this: “when buffered by an environment of stable and supportive relationships, positive stress responses are a growth-promoting element of normal development. As such, they provide important opportunities to observe, learn, and practice healthy, adaptive responses to adverse experiences.”
Some parents choose to co-sleep with their child or cry-it-out method with their child. It is not our job to judge which methods of sleep training are the right ones for you and your child, and we want to move past the quick judgments that all parents can make, and put the stress of sleep learning in context. What can you do to support and respect your child as they learn to sleep through a positive-not a toxic – experience?
Instead of listing out ways to teach your child to sleep, our encouragement is this: you will not ruin your child. Stress and crying is not always accompanied by increased cortisol⁴, especially when paired with the comfort that you bring as a parent. That means that the transition that you make with your child from co-sleeping or crying it out to independent sleeping will bring challenges; however, it will not bring lifelong damage. Remember that you are providing a safe opportunity to let your child experience stress in a healthy way – tears and all.
Scenario #3: A child who sleeps, but a parent who doesn’t
Despite your best effort to trust that all is well with your sleeping child, there may still be some worry in the back of your mind. This is such a common problem for parents. The adrenal (stress) response that results from worrying and stress can sabotage good sleep. “I slept fine until my baby was born and now I have insomnia. I can get to sleep, but I can’t stay asleep.”
This is the classic “tired but wired” phenomenon. How do you solve it? After all your hard work to get your child to sleep, it’s time for you to relearn to sleep. You come by insomnia honestly. After only 10 minutes of stress, your gut barrier can be compromised, leaving you susceptible to immune suppression and low serotonin production. (The more severe the stress the more stress hormones affect your intestinal environment, and the harder it is to maintain healthy bacterial balance and gut integrity).
Colicky babies have altered bacteria in their gut – an imbalanced system. Just like we addressed foods to improve gut health for your child, we encourage you to do the same for yourself. Addressing your B vitamin intake, vitamin C, magnesium, and L-tryptophan intake will improve your sleep as well, helping you to stay in a deep slumber.
There are certain foods that help you make inhibitory neurotransmitters. Choose foods that help you make serotonin and GABA (made from glutamic acid), whose primary roles are to reduce excitatory neurotransmitters (like dopamine) from over-stimulating your body. We’ve covered tryptophan-rich foods, but foods that supply precursors for GABA are abundant in a healthy diet as well. Some foods rich in glutamic acid include tomatoes, almonds, walnuts, and animal protein sources.
Why is it not important to emphasize GABA precursors for children? Because in the mature brain, GABA is an inhibitory neurotransmitter, but in the developing brain it is an excitatory neurotransmitter.5 This does not mean avoid all rich foods for your child, but it does mean, pay close attention to dinner and pre-sleep snack choices.
Herbal therapies have known associations with the promotion of sleep. We suggest implementing herbs into your sleep hygiene, as long as you are not breastfeeding. If you are interested in using herbs while breastfeeding, check with your healthcare provider. The following are the herbs most commonly known to promote sleep and decrease anxiety: hops, lavender, chamomile, lemon balm, motherwort, passion flower, kava kava, skullcap, and valerian root.6 You can find individual or combinations of these herbs in teas that are praised for sleep promotion.
We don’t want parents to expect utter sleep deprivation with each new family member. With consistency and balance, you will be able to find the right answer for you and your family.
Remember that sleep is a nutrient. We have to choose and nourish it, just like we choose and gain nourishment from whole, real, and healthy food. Be willing to adjust and then be consistent. You will find what is right for your child.
Have a happy and healthy day,
Emily Rydbom & Dr. Leslie Stone
Connect with GrowBaby® on Facebook, Twitter, and Vimeo.
Emily Rydbom is a Certified Nutritionist and Lifestyle Educator who works with Dr. Leslie Stone in a functional family practice clinic. Emily specializes in facilitating lasting healthy lifestyle behavior change for all ages. She has received training in functional medicine, functional nutrition, first-line therapies, food as medicine, and holistic nutrition. Her passion is empowering and equipping expectant mothers with proper nutrition and nutrients during preconception, gestation, and postpartum/breastfeeding to help decrease the risk of chronic disease for generations.
Dr. 
Leslie Stone, Family Practice, OB is a specialist with 30 years of experienced practice in obstetrics, women’s health, and family medicine. She specializes in the area of women’s health and healthy childhood development. Over the years, she has developed functionally unique practices, providing high-quality healthcare to women.
Dr. Stone works on early recognition of health issues with early intervention to correct imbalances that can lead to chronic illness. She has helped women of many nationalities and cultures deliver babies. Leslie has delivered well over 4000 babies since 1982.
REFERENCES:
1: Institute For Functional Medicine, 5-R GI Support Program, www.functionalmedicine.org, Federal Way, Washington, USA.
2: Bowden, Jonny, 150 Healthiest Foods On Earth, Fair Winds Press; Pap/Com edition, January 1, 2007.
3: American Academy of Pediatrics, http://pediatrics.aappublications.org/content/129/1/e232.full.
4: Gunnar, M.R., J. Connors, and J. Isensee. Lack of stability in neonatal adrenocortical reactivity because of rapid habituation of the adrenocortical response. Dev Psychobiol. 22(3): p. 221-33. 1989.
5:Excitatory Actions of GABA during development: the nature of nuture http://www.nature.com/nrn/journal/v3/n9/full/nrn920.html.
6: Romm, Aviva, Botanical Medicine For Women’s Health, pg 491, Table 19-9, Churchill Livingstone: St. Louis, MI.
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Under improving serotonin production, you didn’t mention kombucha in your list for reinoculating with healthy bacteria. Thoughts?
“There is no denying that kombucha is a potent source of probiotics and a top fermented food. However, the reason that we did not list it in food sources to improve serotonin production is because we are cautious to list it for mothers who are pregnant or breastfeeding. Because kombucha is made from fermented teas that are frequently cultured with bacteria and fungus, it is seemingly a safe drink. However, there is a lack of published studies about whether the drink actually delivers on its health claims without causing harm. This asks us to remain cautious when generalizing it as a universally accepted fermented food source. It is a great food source for anyone who is not pregnant, or breastfeeding.”
Many thanks for your thoughtful and prompt reply that my husband posted. We brew our own kombucha and we are expecting our first child so the insight in very useful for both us as the well as the expecting moms and breastfeeding mom’s that I treat in my functional medicine practice. We both greatly enjoyed your post on sleep hygiene and look forward to more information to come. Cheers!
Thank you Amy. We look forward to anymore questions that you or your husband may have. Awesome work making your own fermented foods. You are doing wonders for your health. Have a happy and healthy day!
Thanks for the quick reply. So, now you’ve got me curious about sauerkraut. It was my understanding that the bacteria in sauerkraut is essentially the same as kombucha, with the exception that kombucha has a relatively higher yeast count, all things equal. Is that your understanding as well and should we stick to store bought brands? As a reference, we ferment both kombucha and sauerkraut at home, because it’s so inexpensive, tasty, and good for our guts.
Hey Drew!
Although sauerkraut and kombucha share a lactic acid makeup, they do not share all of the yeast spectrum that is found kombucha. The yeast spectrum is currently in question and is not confirmed (at this point in time) to be considered totally safe for pregnancy and breastfeeding, or harmful. There is also the kombucha alcohol content in question. Even though minuscule, it is still not determined if it a safe food for pregnancy and breastfeeding. Following the discovery that store bought brands contained more alcohol (because they fermented longer than a home brew) steps were taken to decrease further fermentation in the bottle in the grocery store. Home brewing is still considered to be safer for alcohol content, as the brewer has more control over the fermentation process. There are two articles that I will point you toward regarding sauerkraut and komchucha make-up. We hope they are useful! Sauerkraut: “Identification of lactic acid bacterial strains with high conjugated linoleic acid-producing ability from natural sauerkraut fermentations.” Kombucha: “The yeast spectrum of the ‘tea fungus Kombucha.” We do promote sauerkraut as a top fermented food for serotonin production, pregnancy, gut health, and breastfeeding. Hopefully, one day, we can do the same for kombucha. Thanks! Let us know if you have anymore questions.
Thank you for that answer! We are enjoying your posts and insights. Cheers!
I must say I am really really disappointed in this article. The statement that “you will not ruin your child” in relation to cry it out clearly shows you have not done your homework. Research has actually found that cortisol levels in babies who are subjected to CIO remains very high even when they have stopped crying and is perceived to have “self soothed” when they have simply given up trying to communicate. Babies who are upset but have responsive parents who attempt to soothe them (ie crying in arms) do not show this increase in cortisol levels. Who are we to say what constitutes high level and long term stress for babies? It is probably true that every baby subjected to CIO will not be “ruined”, just as every solider going to war will not get PTSD but to me the risk is just too high. Especially when the research also shows that sleep training for most people is unsuccessful and has to be repeated over and over when normal events like teething, being sick and developmental leaps causes increased wakings/crying. You are using the argument from the AAP as if you can make up for being unresponsive through the night by being there for them in the day, but this is also not supported by research. What children learn from being left in the dark alone without a parent is that there is no point asking for help, promoting learned helplessness. To learn how to regulate their emotions children need parents to model such behaviour this simply cannot be done when they aren’t even in the room or just sitting next to their cot while they scream. I think this section of the article is a massive cop out and intentionally left vague to avoid offending anyone. Paleo peeps (and I am one) have no problem laying down the law and stating their opinions when it comes to most other things. Yes – parenting is hard (I have a 1 year old) but that doesn’t allow us to get soft on what the research says. If people were educated and had realistic expectations about what normal child sleep looks like (night wakings is the biological norm and actually has a protective effect) and given ideas on how to cope (co-sleeping, (breast)feeding to sleep,family support, going to bed early when baby sleeps etc – and yes I now everyone cannot or do not have the opportunity to do all these things!) I think children would be a lot better off rather than parents being shocked that their baby isn’t sleeping and being convinced by sleep trainers that there is something wrong and that they risk giving their bub a slew of “bad habits and sleep crutches”. Have a read of http://www.evolutionaryparenting.com for more interesting reading with great reviews of the research in this area.
In terms of serotonin, I think you left out a few/ brushed over the most important ones like exposure to sunlight (could be included in outside playtime I guess) particularly first thing in the morning and massage for both mum and bub. Research shows babies massaged before bed sleep better, and it makes for a beautiful bedtime ritual. Especially if dad can then give mum a massage while mum feeds bub to sleep.
I know I’m a bit harsh (and long winded) but I expected more from a page that promotes wellbeing and building a foundation of long term sustainable health without gimmicks and quick fixed (which CIO is!). Wouldn’t it be wonderful if children were nurtured with this mindset from the get go? Yes its hard, but its also worth it. And if parents choose to sleep train, they need to be properly educated about the potential implications for their bubs and OWN THEIR CHOICES.
Stina,
Thank you for your response. We always appreciate any perspective, recognizing that we are all individual and unique. The intention with our post was not to convey that overwhelming stressors were advocated, but rather agreeably, they can have a detrimental effect emotional effect. But, small stressors under the context of unconditional love, do have an emotional intelligence benefit for our children. You want your child to be able to be empowered and have choices, and we as parents do have to institute great sleep beginnings. The terminology sleep training is controversial. We recognize that. As an error and an oversight, we used the word train. We did not state that we advocated CIO, or co-sleeping, quite the contrary, we were simply trying to state that no matter what you chose as a parent, that judgement toward yourself, could be checked at the door, because we are all learning what is best for our individual child. We look at sleep as a lifestyle, and teaching a healthy and balanced lifestyle is absolutely appropriate. Your child needs to know that there is a world beyond themselves. We have to work toward an overall healthy picture, recognizing that in all things–teaching and learning is achieved in the context of love and support. Healthy sleep may not be a method or a training, but we do need to have conscious tools that help create a sleep environment that is healthy and balanced.
In response to your comment regarding serotonin, massage, and sun. You are right. Those are great ways promote serotonin production. We omitted them and chose not to be exhaustive, as we wanted to focus on nutrition for serotonin production for this post.
I must also note Stina, from one parent to another (I also have a 17 month old), that lack of sleep for both mom and baby can cause anyone to try a multitude of ways to help their child learn to sleep. The heart behind the post was not to advocate for CIO or co-sleeping, but to say that no matter the way you choose, you will find the right decision for you and your family.
Again, thank you for your time.
Have a happy and healthy day,
Emily
GrowBaby Health
http://www.growbabyhealth.com
Thank you for your reply. I think we’ll have to agree to disagree that CIO is a small stressor (if that is what you’re saying – I still find it a bit vague). I do agree that providing an environment promoting healthy sleep is important, but I strongly disagree that CIO (or controlled crying or camping out or any of these methods) teaches children anything positive, but on the contrary is damaging to their emotional intelligence. Children soon enough learn that there is a world outside themselves, its our job to make them feel loved, safe and listened to and scaffold them so they can develop a healthy brain and body – who else is going to do that? I’m just worried that someone will read this and use it as a justification for being unresponsive to their children’s needs even if that is not what you intend maybe? It’s just too vague – sorry. Parenting does not end at 7pm and start at 7am. It’s a round the clock job. Being responsive is key in developing emotional intelligence in children full stop. Please have a read of: http://evolutionaryparenting.com/the-myth-of-warmth/ for someone who can formulate themselves much better than rambling old me!
And trust me I know about being so sleep deprived that I hardly know what day, year or country I’m in. CIO has never ever been a consideration – other coping strategies exist that aren’t damaging to my child’s long term emotional wellbeing. And I guess that’s what I wish was advocated more so that people didn’t think they have to sleep train their child if they are unhappy with their sleep situation. Children sleep trough the night in their own time, just as they learn to walk, talk and use the toilet in their own time. Of course there are strategies twe can use to help facilitate it but please please please stop normalising CIO/CC! The no-cry sleep solution by Elizabeth Pantley is a great book, so is the Discontented Little Baby Book by Dr Pamela Douglas for the early days. For helping mums who are struggling or pregnant women who want to prepare the book Becoming Mum by Dr Koa Whittingham is AMAZING.
Thank you again for your reply – and thank you for the clarification that you don’t support CIO but sadly I think you come across as condoning it. And co-sleeping is totally paleo btw – and when done safely an amazing sleep and sanity saver, not to mention protective of breastfeeding!:)
Lots of love to all the sleep deprived parents out there! I’ve heard it gets better:)
Stina