Connecting with Your Newborn – PediaCast 579

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Show Notes

Description

Dr Joanna Parga-Belinkie visits the studio as we consider the important task of connecting with your newborn. There is so much advice, so many products, and an endless stream of opinions. But what matters most? Tune in to find out!

Topics

Connecting with Your Newborn
The Baby Bonding Book

Guest

Dr Joanna Parga-Belinkie
Neonatologist
Children’s Hospital of Philadelphia
Author, The Baby Bonding Book

Links

The Baby Bonding Book: Connecting with Your Newborn
Pediatrics On Call Podcast
Early Relational Health
Zero to Three (Learn Conference: October 8-9, 2025 – Baltimore)
Serve and Return Interactions (Harvard Center on the Developing Child)
Success That Lasts (Harvard Business Review)
Preventing Childhood Toxic Stress: Partnering with Families and Communities
The Power of Play: A Pediatric Role in Enhancing Development in Young Children
Postpartum Depression: What Do Pediatricians Need to Know?

FeedSpot
15 Best Pediatric Podcasts
25 Best Hospital Podcasts

Episode Transcript

[Dr Mike Patrick]
This episode of PediaCast is brought to you by Nationwide Children's Hospital. Hello, everyone, and welcome to PediaCast. We are a pediatric podcast for moms and dads.

This is Dr. Mike coming to you from the campus of Nationwide Children's Hospital. We're in Columbus, Ohio. It's episode 579.

We're calling this one Connecting with Your Newborn. Want to welcome all of you to the program. So, it's no secret that becoming a new parent can be overwhelming.

There's so much advice, so many products, and an endless stream of opinions. But when you strip away all the noise, what matters most? Well, it turns out that building a strong, loving bond with your newborn is the most important thing.

And today we're going to shine a spotlight on that fact. Our guest is the author of The Baby Bonding Book, a thoughtful and practical guide for parents who want to nurture safe, stable, and connected relationships with their babies starting on day one. And that is important because the bond that we have with our infant really informs every next step.

So, it's a building process. And having a strong bond right from the get-go and then building on that as your child becomes a toddler and then a young child, school-age kid, preteen, teenager, and even into young adulthood, it all builds on itself from day one. And so, it is important.

That also puts a lot of pressure on parents. So, we're going to talk about that pressure and, you know, really how to care for yourself while also caring for your baby and connecting with your infant. We're going to discuss relationship-building, brain development, early communication, feeding choices, sleep challenges, and more, all with the goal of supporting parents and empowering those early connections.

In our usual PediaCast fashion, we have a terrific guest joining us. In fact, she is the author of The Baby Bonding Book from the American Academy of Pediatrics. It's Dr. Joanna Parga-Belinkie. She's a neonatologist at the Children's Hospital of Philadelphia. And it will be a conversation packed with insight and encouragement, and it should come in your way very soon here on PediaCast. Before we dive into that, I am proud to say that PediaCast has won a couple of awards here recently from FeedSpot.

We are the number two best pediatric podcast in the country, and we hope to become number one. So please listen and spread the word about PediaCast. But we are the number one best hospital-based podcast, and that's not just pediatric.

It includes adult healthcare systems as well. So, we're really proud of that, and you can check out all of the top pediatric and hospital-based podcasts according to FeedSpot with the links that I'll have in the show notes, so you can find some of the great podcasts on those lists. Also, I want to remind you the information presented in PediaCast is for general educational purposes only.

We do not diagnose medical conditions or formulate treatment plans for specific individuals. If you're concerned about your child's health, be sure to call your healthcare provider. Also, your use of this audio program is subject to the PediaCast Terms of Use Agreement, which you can find at pediacast.org.

So, let's take a quick break. We'll get Dr. Joanna Parga-Belinkie settled into the studio, and then we will be back to talk about connecting with your newborn. It's coming up right after this.

Dr. Joanna Parga-Belinkie is a neonatologist at the Children's Hospital of Philadelphia and an associate professor of pediatrics at the Perlman School of Medicine at the University of Pennsylvania. She has a passion for supporting parents of newborns as they embark on the very important job of bonding with their baby. To help provide that support, she authored a book published by the American Academy of Pediatrics called The Baby Bonding Book, Connecting with Your Newborn.

That is our topic today, Connecting with Your Newborn. But before we dive into our topic, let's offer a warm PediaCast welcome to our guest, Dr. Joanna Parga-Belinkie. Thank you so much for stopping by the studio today.

[Dr Joanna Parga-Belinkie]
Thank you so much for having me.

[Dr Mike Patrick]
Yes, we are very excited that you're here. And some of our listeners may recognize your voice because you are a fellow podcaster and co-host the Pediatrics On Call podcast from the American Academy of Pediatrics. And we'll put a podcast in the show notes so folks can find it easier.

But we're really excited that you are here and going to talk about your book. So, thank you.

[Dr Joanna Parga-Belinkie]
Yeah, I was so excited to be on this podcast because it was the first one that I listened to when I was training in pediatrics. So, this is going to be really fun.

[Dr Mike Patrick]
Yes, yes, it is definitely going to be fun. So, first, let me ask you, you know, you are a neonatologist, you're a podcaster, and now you are a book author. What motivated you to write The Baby Bonding Book and how do you hope that it helps parents?

[Dr Joanna Parga-Belinkie]
You know, there is just so much noise out there about infant care. And there's a lot of information. There's good information, there's misinformation and disinformation, which I consider to be bad information on how to care for your newborn.

So, I wanted families to have a resource and allow them to kind of disconnect from all the chatter. Newborn care, give them really good information and allow them to focus on their baby and building a relationship with their baby, because safe, stable, nurturing relationships are really what makes babies grow and thrive and develop their brain. And so newborn parenting can be really demanding.

And I want to give parents permission to just take a time out and enjoy, find the joy in parenting these really small humans.

[Dr Mike Patrick]
Yeah, yeah, it is so very important. And of course, we'll put a link to the book itself in the show notes as well. This is episode 579 over at pediacast.org.

You know, there's so much out there now in terms of like technology, and I feel like those things are growing day by day. And as kind of a tech person myself, it's really cool. Like, oh, there's a crib that will alert you if their oxygen levels are going low.

And I mean, there's just all kinds of tech stuff, some of it safety related, some of it convenience related. But you really encourage parents to focus less on gear and really relationship building. What does that shift in mindset look like?

[Dr Joanna Parga-Belinkie]
You know, I'm so glad, Mike, that you mentioned gear, though, because I think the reason why there's so much baby gear for babies is that this is a pain point for parents. It's a difficult time to parent a newborn. And so, you know, I like to come at things with people who are trying their best, right?

So, I think all of these product makers, consumers want to try to make this period of time easier, right? And they see it as a point of stress for parents as they develop kind of, you know, becoming parents and this new relationship with a newborn. But what I see is that a lot of families will then focus on kind of making a nursery, getting all this gear for their nursery, making a baby registry, and maybe they'll make a birth plan, right, for the delivery.

And the delivery is this extremely important moment, right? And it could go a number of ways, right? It can go the way you hoped or not.

So, it's a very emotional moment, too. But what I don't really see a lot of families prepare for is the after baby's born, hey, like, how am I going to connect with this baby, you know, and what's that going to be like? And what kind of relationship do I want to have with them?

And what are the values that I want them to have as they grow? And I think that reframing can be really important for families because it can help you realize, you know, how short the newborn period is and how the goal is not, you know, that moment of delivery, having that all go well, and, you know, you're done. The goal is like, hey, this is a lifelong relationship.

And I think that's the frame shift, right? Like kind of coming out of that consumerism and that focus on delivery and thinking about what is this, what do I want this lifetime to look like with my child? And how do I prepare myself as a parent for that and how things are going to change and what values I want my child to have as they grow?

So that's what I really encourage families to take time out to do. And this took me time as a parent, too. I have three kids.

And it wasn't until my third baby that I made a vision board for really how I wanted our relationship to be. And I broke it into different categories. And I used a Harvard Business Review article on success and happiness when I did this.

And so, you know, I thought about happiness, you know, like how am I going to be happy with baby? What does happiness mean for me in this relationship? I thought about achievements as a parent, about the legacy that I wanted to have for my kids, and also about significance, what really mattered to me and what I wanted to pass down to my kid.

But I think just this exercise of listing your parenting goals and your hopes for the future kind of allows you to take some of the focus off the whirlwind of pregnancy and delivery and allow you to really think about how am I going to connect with this new human being who's now living in my house?

[Dr Mike Patrick]
Yeah, no, absolutely. And I think that you have, especially if it's your first baby, you kind of have a romanticized vision of what those first months are going to be like. And then when it hits you, it's way more difficult than you ever thought it would be.

And, you know, baby's crying, you're not getting enough sleep, you're not sure if they're getting enough to eat, you have so many questions. And, you know, and then we're asking you to bond with this, you know, this infant who's cute, but also is, you know, has upended your life. And that can be difficult.

And I think that then when you focus in on gear and tech, it's like that might get the dopamine going a little bit when otherwise it's not there. But it's just so important. And in fact, you write in the book that this bonding experience is really key to infant brain development.

Can you talk a little bit more about that? So, I mean, this is really important for baby's brain growth.

[Dr Joanna Parga-Belinkie]
Yeah, I mean, if the first year of life is when the brain is forming, and you really have this incredible amount of brain growth in your first year of life, you've got different connections, neurons that are firing, you know, parts of the brain that are starting to speak to each other. And when I'm when I'm teaching medical students, right, I always say that babies develop from the top down and from the inside out. Right.

So, if you if you go to the if you go look at developmental milestones, you'll see babies start to develop skills from the top down, you know, head control. And then they get to walking right for gross motor. And then, you know, they get trunk stability.

And then they start like really focusing on how they're moving their arms and moving their fingers, you know. So, it's like an incredible thing to watch because there's just this explosion of growth. Right.

In this first year. And it doesn't seem like it when you have that little newborn who's sleeping most of the time. But in sleep, they're building so much.

And the brain is really picking up on cues and shaping itself. And the shaping of that brain is based on reactions that the baby is having with trusted caregivers. Right.

And this is occurring from the moment that a baby is born. So, I think it's really important to think about how are you going to help your baby respond to your baby and help them build emotions and intelligence and skills? Because that's actually what you're doing.

Right. So, I feel like that the world of newborn parenting can feel really small. But the impact of how you interact with your baby in that first year is lifelong.

You know, it's setting up the brain for how it's going to be wired and how that that child is going to respond to their environment. Yeah.

[Dr Mike Patrick]
Yeah. When newborns are really young, of course, we want to take care of them 24-7 and meet all of their needs when they have those needs, regardless of if it's convenient for us or not. At what point is it OK to let them cry?

You know, there's the whole Ferber, you know, cry it out. And there's a lot of controversy, especially from the lens of parents that may feel like they're abusing or neglecting their child if they just let them cry. What are your feelings as a neonatologist and baby brain growth expert on that?

[Dr Joanna Parga-Belinkie]
Yeah, this gets to how babies communicate with us. Right. And babies don't talk, obviously.

So, but they do make sounds. Right. And crying is one of those sounds that they make in order to tell you that something's going on.

Right. But what I tell new parents is crying is not you're doing something wrong and you're a capable of that complex thought. Right.

Crying can be a number of things. So, to answer your question, like, I think it's always OK for a baby to cry. In fact, as a neonatologist, when I'm in a delivery room and a baby comes out, I want to hear them crying because I want to hear them opening up their lungs, taking their first breaths, not relying on the placenta.

That's important to me. Right. And babies cry, you know.

And of course, you know, we could get into a whole discussion about your fussier babies and your colicky babies. Right. And what to do with those kinds of babies.

But I think for any baby that's crying, really, they're trying to tell you they're trying to communicate a need. Right. And so, what you're doing as a parent is you're kind of learning a new language for how you're talking to this baby.

[Dr Mike Patrick]
Yeah.

[Dr Joanna Parga-Belinkie]
Right. But that need could be I'm cold. My diaper's wet.

I'm hungry. You know, oh, I'm on you know, I'm on the floor and there's something under my back. I don't like it.

You know, like it's usually not a condemnation of your parenting. It is a let's I'm trying to talk to you and tell you my needs. And crying is one of those ways that I can communicate with you.

And babies communicate in different ways, too. But and so, you know, I always tell new parents crying is not a failure. Crying is a form of communication.

But you but I think you also touched on a point, Mike, that this is not something that's easy to do alone. You know, like I always had a visceral reaction to my baby when they were crying. You know, each of the babies, you know, I was I think I was almost programmed as a parent to have that, you know.

And so, I think this gets the point of, you know, safe, stable, nurturing relationships are key for baby's growth and development. But it can be, you know, and what they need is just really one loving, trusting caregiver. But having those different loving, trusting caregivers that can be there for your baby helps offset the stress of parenting a newborn.

Right. That can't communicate with you in the way that other adults can.

[Dr Mike Patrick]
Yeah. And I would advocate for finding a trusted person in your life. If you're a single parent, it is much more difficult.

And I think if you have someone, you know, that can be there, especially in the early months, you know, a trusted relative or something can be helpful. But also, I think it's important to spend some time on self-care as well and still go out on date night, you know, with your significant other and have someone else watch the baby and just get out there and also sort of live your life, too. Right.

[Dr Joanna Parga-Belinkie]
Yeah, because I mean, I think this can't be an individual act, you know, raising a child. It really requires that that you have relationships as the caregiver that are also safe, stable, and nurturing so that you can kind of have support for, you know, the difficulties and demandingness again of having that newborn baby. And the needs of baby are very different than needs of parent.

Right. And I think that that's one of the difficulties of parenting a newborn, too, because like what is going to be really stimulating and exciting for a baby whose brain is just everything's new for them, you know, is not the same. So, it's stimulating for the caregiver.

And so that's why you really need caregivers for the caregivers, too, you know, because this is a team sport raising a baby.

[Dr Mike Patrick]
Yeah, absolutely. The environment that the baby is in, even though we want to take a focus off of technology and off of the gear and really put the spotlight on that, you know, nurturing a relationship, what sort of environment helps that happen?

[Dr Joanna Parga-Belinkie]
Yeah, I mean, I think this gets back to when I'm talking about safe, stable, and nurturing relationships. Right. So, I mean, we'll talk about safety first.

Right. Because when we think about safety, that might bring up thoughts of the physical environment that the baby's in. Right.

And that's important, you know, making sure, especially as your baby becomes more mobile, that you have the things you need to baby proof your house and to make sure your baby's not going to kind of get into trouble. Right. And but even from the very time they're a newborn, you want to be thinking about things like a safe sleep surface for a baby.

Right. Creating an environment where there's, you know, they can be alone on their back with no blankets or other things around them in a space that's separate from your sleep space, you know, and that will provide them with physical safety. And when I think of physical safety, too, I think about finding a pediatrician that you trust and getting your growth checks and all your recommended vaccines, too.

Right. Because that's going to help the body stay healthy and help, you know, you be able to, like, have someone you trust to help you with the medical side of things so you could focus on relationship building. Right.

And all of these things are going to help your baby grow and thrive so that, you know, you can then think about their psychological safety. Right. Because this gets into them trusting you and trusting that they have somebody who's looking out for them, which a baby really needs.

Right. They want someone they can rely on who's going to care for them. And that doesn't mean that person's not going to make mistakes.

Like, you know, I'm sure you could talk to this, too, Mike. Like, we're both parents. I've made mistakes.

You know, things I'm like, oh, maybe I shouldn't have said that to my kid. Or, you know, maybe I shouldn't have let you play with that toy. And that's OK.

Because to be human is to learn from mistakes that grow. Right. So, like, you're going to be teaching that to your baby as they as they grow.

So. So I think there's the physical environment, there's the psychological environment. And as a part of that, too, this is where we get to, like, the stable part of relationships.

Right. They want people they can count on. And that doesn't mean, hey, you're on call 24-7.

Right. We talked about making sure you have other people that come in to help you because caregivers need help, too. And, you know, and I've been on 24-7 calls.

Not 24-7, but like I've been on 24-hour calls. Right. And it's really hard to be on for 24 hours straight.

So, again, it's more focused on most of the time. You know, I'm going to be giving you attention and helping care for you. And I'm going to show you and model for you, you know, how I want our relationship to be.

And then you want other trusted people who can also model relationships to offer stability to your growing family. Right. Because babies need someone there for them.

And then the nurturing comes in with just being, you know, practicing positive parenting. Right. And that doesn't mean not disciplining your child or anything like that.

It's hard to discipline a baby, to be clear. You know, when they become a toddler, that's when you have to start thinking about that. But really, it means like meeting them, meeting their needs and showing them love and kindness and empathy.

Right. And again, this is not you always getting it right. And because I think it's also important for babies and young kids to see when we get it wrong, you know, because they learn too.

But it's the trying and it's the engaging and it's the responding and it's the learning how they're talking and communicating with you. And actually, if you start to like learn their temperament and how they are when they're little, that's going to help you when they get older, when they're a toddler and when they're a school age kid, because you're going to be like, oh, we've been through a lot of this. I know some of the nonverbal signs of like when you're upset or what you need.

And it's just going to strengthen your relationship.

[Dr Mike Patrick]
Yeah. You know, as a parent, it's amazing to me. I just have two kids, and they are so different.

But you could tell, you know, in those first few months, as I look back, that that personality of they were very different and that tracks even now into young adulthood, you know, one's more laid back and really didn't cry much. And one is and I won't say which is which and one's more high maintenance and was back then and might be a little higher maintenance today. I don't think she listens to my podcast, so I'm safe.

Oh, I said she. Oops. I just gave that away.

But anyway, you know, in all of this, as adults and even as adults with school age kids and even toddlers, a lot of our relationship is based on language. You know, like we are talking back and forth and we're having a conversation, and those conversations build on each other. And that also kind of deepens our relationship.

But babies, of course, don't use words. And so, us using words to them, of course, it's important as they start to learn language. But in those in those early months, they don't understand what we're saying.

So how can we bond with a baby that we can't really have a conversation with?

[Dr Joanna Parga-Belinkie]
Yeah. Language is so much based on like hearing right and deciphering words and using parts of the brain baby hasn't fully developed yet. Right.

So, I think there are other ways, though, of active listening and picking up on nonverbal cues and using your other senses to get you know, to watch and see how your baby responds to things. I'll mention this when I was a fellow. I trained in Los Angeles, and I got involved in a little bit of research on cry deciphering, actually.

And so, there are some studies out there that say parents get learn, you know, by actively listening what pitch cry means different things from their baby. They get to start to get a sense of with that cry, you know, as a form of communication, what their baby needs. So, I think that's really interesting.

Right. And you can you know, you can see like I was just at the doctor with my 15 month old and I can see when another person comes in that she doesn't know just from her body language, how she gets closer to me, how she holds me, like how she's starting to feel, you know, about having someone else come in the room or doctor that she does see pretty regularly, but I think probably forgets, you know. So, there's other nonverbal cues.

But one of my favorite communication techniques is serve and return. I always like imagine it when you have a baby is like being a tennis match with them. Right.

And of course, as the adult, you're going to be the better player. So, you're hitting the ball over the net and you're seeing what comes back. Right.

So I always tell parents like talk to your baby, you know, start reading them books really early, you know, so that, you know, they're starting to understand your cadence, you know, your voice, you know, point at things and see how baby responds, because what's going to start to happen is they're going to start to return kind of those gestures and those sounds to you. Right. And so, there's really cute videos online of like a baby doing a goo or a ga and the parent doing it back and them seemingly having this conversation.

Right. Which you're talking about when you get older is so important for how we communicate. Right.

And that is, again, building that baby's brain, that back and forth and what it shows. Right. Because you're not like teaching a six-month-old a bunch of vocabulary.

Right. They're just not ready for that. But it shows that you have an interest, that you're there to nurture them and that you're interested in connecting with them.

And that for a baby is huge because they want to know that you're a trusted caregiver, that they can have that back and forth with. So as so they can make those mistakes, start to pick up on things, practice language. This is all really important for a baby.

[Dr Mike Patrick]
Yeah. And I think kind of important for parents, too, because, you know, that serve and return, it really does, even though you're not communicating with words necessarily, it does allow you to see, hey, there's a reaction, we're forming a connection. And by the way, there is a link that we're going to put in the show notes from the Harvard Center on the Developing Child on serve and return interactions.

But I think having those in mind can really help because a lot of parents feel disconnected from their babies in those early days, especially if you're not aware that this sort of thing can happen. How do you encourage parents to practice serve and return?

[Dr Joanna Parga-Belinkie]
Yeah. I mean, I think it's just inviting a baby to be a part of your daily activities. Right.

I think a lot of parents feel like they have to be doing all these special things for a baby, this special like, you know, baby music class, baby like story time. Got to go to baby group. Got to do.

I think you don't have you know, it's fun to do those things because sometimes that is community building, you know, and you're getting out in your community and you're meeting other parents and you're starting to like make friends that have kids the same age as you. That's all really important. Right.

Because we talked about the importance of community and other relationships. But like to stimulate your baby, just involving them in your daily activities, narrating it for them, showing them how you're doing things like I used to just unload and reload the dishwasher with son when he was a really little baby, and he used to watch me do it. And I used to tell him I'm really bad at loading the dishwasher.

So, we used to talk about that, you know, and again, I wasn't expecting he was going to respond. But it's those simple acts of involving them in your daily routine. That's going to be really brain altering for them.

[Dr Mike Patrick]
Yeah. Yeah, absolutely. And, you know, depression and anxiety, especially for new parents and when it's your first baby in particular, can be a real issue.

And I would imagine that doing, you know, as you mentioned, you know, just having them be with you as you're doing your daily things and kind of narrating it and, you know, make modulating your voice and, you know, just really engaging them as you're going about your regular day to day stuff might be able to help with the anxiety and depression that can go along with those early days. So, it's not only great for the baby, but in that sense, great for the parent as well. Do you do you see a lot of those the newborn baby blues?

Is that really still an issue for parents these days?

[Dr Joanna Parga-Belinkie]
I mean, it's such an issue. I think up to 80 percent of parents experience some form of baby blues. Right.

And there's been studies in, you know, parents who identify as mothers, parents who identify as fathers also having this. Right. Because, again, we talked about how having a baby just alters your life, you know, the cadence of your life and the things that you used to do.

Right. And of course, I work in the NICU. So, I also see babies, you know, who have to be hospitalized.

And you can imagine how that influences how parents see themselves and how they might bond with their baby. Right. Because it's generally unexpected when you wind up in the NICU with me.

So, I think baby blues and even things like postpartum depression are pretty prevalent. Right. And so, I think we have to take focus off just like this moment of delivery and immediately surrounding it and think more about giving yourself the time and space to build your love for a lifelong relationship.

Right. Because love at first sight is really something for the movies, strong relationships. If you think about the strong relationships you have as an adult, too, you know, sometimes that takes work and time to build them, but it's worth it.

You know, and being a parent is, you know, a different form of work kind of. Right. So, I think it's I want families to know you don't have to feel this incredible connection immediately on day one.

It's a connection you're building over time. Yeah. And give yourself that space and that grace to build a relationship.

[Dr Mike Patrick]
Yeah, that is so important. And it's really the cumulative of all those interactions that really make the difference. So, you're going to have good days and you're going to have bad days.

You just really want there to be hopefully more good days than bad days. And, you know, and as you said earlier, it's really about growing and learning each step along the way. And I guess that does make it a little bit easier with subsequent kids.

Although at the same time, you know, when you have a fussy baby who's crying and you're not you don't have enough sleep and even the most experienced parent can start to have some anxiety and depression around that. So, it's and that's not a sign of weakness. Right.

I mean, I think that that's really important. You mentioned it's so common, but it's OK to seek help because it's going to make you a better parent. And really, we all need help.

I am a firm believer that we that everybody needs some therapy.

[Dr Joanna Parga-Belinkie]
I think it's so important. Right. You can't do this alone.

We already we were already mentioning that this is a team sport, you know, so think about and a therapist can be one of your team members.

[Dr Mike Patrick]
Yes. You know, if that's something that you need after delivery. Let's pivot to feeding, because that is something else that really takes up a lot of time and effort and energy with the newborn.

And it also provides you an opportunity to bond because you're very close together during the feeding during the feeding process. There's also a lot of pressure around infant feeding. You know, do we breastfeed?

Do we formula feed? What if breastfeeding is not going well? But I know breast milk is best.

And am I not providing the best for my baby if it's not working out? So, there's a lot of pressure around infant feeding. What's your message to parents on this topic?

[Dr Joanna Parga-Belinkie]
It's really hard because if you want to give breast milk to your baby, the United States in particular does not give a lot of support for breastfeeding families. Right. So again, it's like you said, pediatricians always say breast milk is best.

You got to try to breastfeed. But when you don't have parental leave and you know, because breastfeeding is a relation a relationship in and of itself. Right.

Like you have to be there. If you're direct breastfeeding and putting baby on the chest, you have to be there. Right.

And we don't give our parents enough time to be with their kids here in the United States. And so, I think there needs to be more advocacy around that. And that would help sort of ease some of the stress of using breast milk and breastfeeding.

Right. Because breast milk is the gold standard type of milk. Right.

Formula is nutritious. It's great. It's going to provide good nutrition for babies.

It's going to help them grow. A lot of formula is trying to have similar nutrients to breast milk and similar composition. But when it doesn't have, you know, breast milk is really interesting.

There's a whole science behind this, too. But breast milk changes, you know, as the baby gets older, it changes from when the baby starts feeding to the end of the feed, kind of the components of it. And it also gives this extra immunity.

So, it is more dynamic than formula. Right. And in order to breastfeed early on, right after delivery, you have to start thinking about it.

Right. And that's where we have this golden hour where the baby's put on your chest. And I think people think of that as like a bonding moment.

But actually, the literature is really about that as a way to kickstart breastfeeding. Right. And get your milk supply in and get your body primed like, hey, I just delivered.

I need to start making milk. Right. And so, I agree.

I think there's a lot of pressure early on for families to breastfeed because biologically that's when their milk is going to start to come in. And the body and breastfeeding is one of those things. Right.

That is a true supply and demand. So, the body is going to make what the baby needs. Right.

And so, you need to if breastfeeding is part of your goal or using breast milk, you need to get that baby on the breast right away. Yeah. Right.

And you need to have that education in the first few days. And I but I want to be clear. You shouldn't feel I mean, I think you're going to feel stressed because like you're feeding your baby.

And that's but it's not meant to it's meant to be a biological stimulant. I think more than it's meant to stress out families. And I wish we had more supports for families so that they could get through this really intense time of early breastfeeding.

Right. And but if breastfeeding for whatever reason is not going to work for you, maybe you already know that before you deliver or maybe it's affected your mental health so much, you know, in that first week that you just can't do it. I always try to tell new, you know, lactating individuals that, you know, you got to have grit to do it in the beginning.

Right. And even if you need to supplement with some formula, see how you feel after the first two weeks, because there's so much change in those first two weeks of your body and the baby. Right.

To see how it goes. But if it really is not working out for you, then talk to your pediatrician, find the right formula for you and your family and feel confident that you're going to do what's best for your baby. Right.

If you're already listening to this as a new parent, you're thinking about how you're going to feed your baby. You are already showing how much you care about their nutrition. Right.

And so whatever form you wind up giving them is going to be what's best for you and your baby and your family.

[Dr Mike Patrick]
Yeah. If you are at that point where, OK, breastfeeding is not working out and we're going to go with formula, there's so many formulas out there now. When I was a resident, I'm going to date myself here, but there were like three choices.

And now, like, there are just all of these choices. And infant formula companies sell old recipes to other companies. And so, you know, like old infant milk, it's marketed as something completely different.

You know, we have ones that are based on cow's milk, and we have soy, and we have ones where the proteins are all sort of partially digested before you even drink it. I guess that the advice there is just to talk to your pediatrician because we could do an entire hour on infant, the different infant formulas. Right.

[Dr Joanna Parga-Belinkie]
Yeah. I mean, absolutely. I think you have to talk to your pediatrician about what the specific needs are for your family and your baby.

I do want to say, though, that formula can get sensationalized in the headlines. You know, a lot of talk about, you know, things that might be unsafe in formula. But however, formulas actually have most formulas have low levels or no contaminants in them at all.

You know, they're very safe and they're monitored regularly so that the components of them are safe for babies. Right. And so, I think parents can overall have confidence in that, you know, because there's this regulation around what's in them.

[Dr Mike Patrick]
Yeah. Yeah. And a lot of, you know, we've talked about babies often being very fussy during the first few months of their life.

And colic is a real thing and doesn't always mean that baby is stressed. You know, their brain just might be telling them to cry, especially if it happens, you know, routinely at the same time of day. And, you know, they're between two and four or five months of age.

But a lot of times parents will try to switch formulas because they think that the baby's uncomfortable with a particular formula. But there's just many breastfed babies who are also fussy. Right.

And often it's not really the formula. It just they just need more time.

[Dr Joanna Parga-Belinkie]
Yeah. I think the gut gets blamed a lot for fussiness. Right.

But it's something we can control. So, I think parents must feel that, too. But I will tell you, you know, I had the same experience as you, Mike, where, you know, all three of my kids have different personalities and they were all different as babies.

And I but I started to see kind of their temperament as a baby. And what was probably good for. Well, my first baby, I don't know if this was good for me or not, was my fussiest baby.

You know, but I'd never had a baby in my house before that I was taken care of. So, I didn't know, you know, that this was the fussiest baby I was going to have. Right.

And exclusively breastfed, you know. And I should note that, you know, breast milk, the composition of it does change, you know, but like surprisingly, if you look at like different diets of women who breastfeed, you know, the overall components of the breast milk are pretty similar. Right.

And so, I think a lot of breastfeeding moms will put a lot of pressure on themselves to like change their diet to when their baby is really fussy. But I would say talk to your pediatrician about that because it might not have the kind of like change in composition of your milk that you think it might. Right.

So, but anyway, my first baby, super fussy and that witching hour that you described. Right. Like it was almost like you could look at a clock and somewhere between 530 and 6, she was crying.

And it didn't. I had a cry checklist. Right.

That I'd go down. You're fed. You're changed.

I burped you. You know, I made sure you're, you know, you're not. And then uncomfortable.

You know, I would try different positions, but it wouldn't you know, they it seemed like she just needed to cry. So then and have you ever watched Phantom of the Opera?

[Dr Mike Patrick]
Oh, yeah. Yeah.

[Dr Joanna Parga-Belinkie]
I know it's not on Broadway anymore. You know, I grew up outside of New York City, so I saw it when I was little and still want to go see. Yeah.

But there's this one song, you know, past the point of no return, you know, and it's when the Phantom takes kind of the lead opera singer in the play and like takes her down to his lair and it's gonna like keep her there forever. You know, I won't ruin what actually happens. But that was the song I would play as I was like dealing with this incessant crying at the witching hour because we were like past the point of no return.

She was going to cry. It kind of didn't matter what I did. And some days I'd just walk around with her and some days I'd pass her off to somebody else.

This is not easy.

[Dr Mike Patrick]
I know this is not an episode on colleagues specifically, but so many parents do deal with this. Yes. And a couple of points that I always like to make is, of course, it looks like their belly hurts because when you're upset and you cry and you're angry and you're lying on your back, you're going to ball up your belly.

And when you do that, you're going to pass gas because you're pushing, basically. And so, from the parents’ point of view, like, oh, look, their belly is all balled up and they're passing gas and they're crying. They must have a belly ache when really those signs are just a symptom of all that crying.

And I and I've described this to parents many times. And a lot of times there's a little switch that flips when I mention this. And I don't even know if it's true, but it makes sense to me because we don't know what's going on in baby's head, really.

But one way that it was described to me was that there's so much stimulation that by the time you get to that witching hour, by crying, they can block everything out, like they're just so stimulation overloaded. And so that crying is a way for them to kind of retreat back in and ignore everything that's around them. And I just I love that explanation.

[Dr Joanna Parga-Belinkie]
Again, I don't have any evidence that that's true, but it makes a lot of general pediatricians say, you know, and it's like they're so done by the end of the day because usually like it's around that six o'clock hour. My daughter used to go to bed at like seven, seven thirty. So, she would like cry, cry, cry, cry.

And then that was kind of the end of her day.

[Dr Mike Patrick]
Yeah. Yeah. Yeah.

And then, you know, these babies make their way into the emergency department and usually by the time they get in there, they're done crying.

[Dr Joanna Parga-Belinkie]
They're passed out.

[Dr Mike Patrick]
Yeah. Yeah. And then the parents like, no, really, they were they were so upset and like, they look fine now.

But I get it. And it's you know, that also adds to the stress. And when you have a colicky baby and it is sort of nice when it's your first one, because that's how it was for us as well.

And so, then when the second one came along and they weren't colicky, it was like, wait, what? I thought they were I thought this was supposed to be more difficult than it is. So, it's kind of nice to get that over with the first the first round.

[Dr Joanna Parga-Belinkie]
I imagine it's probably worse to have the colicky baby second or third. Yeah.

[Dr Mike Patrick]
Yeah. Because then you think, like, what is wrong with my baby? Because the first one didn't do this.

So, I get it. This is all very difficult. And especially when you are sleep deprived, which is the next thing I wanted to talk about.

That just makes things exponentially worse when you're when you're lacking sleep. Right. Because you're just you can't think critically as well.

You can't kind of rationalize, you know, what's happening and make it OK. It's much easier just to sort of lose it. So, what should parents know about getting enough sleep and how can you do it when baby's up crying a lot?

[Dr Joanna Parga-Belinkie]
I think this gets back to kind of our first question, right, about like our consumerist society. Just think about, you know, if you're a parent, just think about how many things are on the market for newborn sleep. And then if you think about that, right, there are many people that are trying to figure out solutions for how a baby sleeps.

But the truth is that a baby does not sleep like an adult. They're just not wired to do it. And even what does sleep through the night mean?

You know, so if you look at papers on infant sleep, like there's a debate about how long that actually means. The six hours is eight hours. What you know what sleep through the night.

But the bottom line is babies don't have circadian rhythms or sleep wake cycles. So, they will sleep for 20 minutes. They will sleep for 90 minutes, you know, and they need to get up and eat when they're very young because they're grow.

Again, think of how much they're growing. They're like doubling their birth weight maybe by six months. You know, like they're doing this incredible amount of body growth and brain growth.

Right. And so, I'm real with new parents and you are not going to prevent sleep deprivation. You will feel it as a new parent.

So, you have to expect that it's going to happen, you know, and I was someone, again, who would do 24, 30 hour calls in the hospital, especially when I was in residency, trained in Los Angeles. I don't know if your residency was like that to make where you had just these long calls. So, I thought, like, I got sleep deprivation.

I've done it. This is not going to be a big deal for me with my babies, but it's the chronic sleep deprivation that really gets you. Right.

So, I think you have to be prepared to be getting less sleep. And what does that look like and how can you prepare for that? Well, having people that you trust, you know, other relationships that can maybe be there for you for feeding and changing either during the day or at night, you know, because you're going to need to tap out from this like 24 seven baby care at some point.

I think it's hard to sleep when the baby sleeps. Like, I never really liked that advice because you do have a circadian rhythm. Right.

So, like when it is daytime, you want to be awake. But I think naps are also something that adults need to get more into, you know, so thinking about how you can adult nap more and how you can fit that in your routine. And then also, I think it's really important and it's really easy in our society to overschedule yourself in the newborn period.

I got this appointment, this appointment, my digital calendar says this. I would say don't overschedule yourself in the newborn period, because that's going to allow for just more downtime. Right.

Especially when you know that a full night's sleep is not in the cards. And then I think from a very early age with baby, and this is going to be really important when they get older, like toddler age, start a nighttime routine that involves the baby, you know, and that's going to be good for you, too, so that you can start to help them. And really, some babies aren't even sleeping through the night at the end of the first year.

You know, my third baby is still not sleeping through the night. She's a little bit over a year. She still gets up at least once at some point, you know, and that has to do also with she's always been just a tiny baby.

And so, she's always needed the extra nutrition. Right. So, it's not like we can forego her being up at night, which I wish we could.

But at this point, like I'm a seasoned parent, so I know that I'm going to be sleep deprived. So, I put tools in place to make sure I'm dealing with that. So, I want to be real with parents that that's something that's going to happen.

[Dr Mike Patrick]
Yeah.

[Dr Joanna Parga-Belinkie]
You're not going to avoid it.

[Dr Mike Patrick]
Yeah, absolutely. And I and so really you are a great example of learning as you go. But each baby, that part of it does get a little bit easier because you do start to figure out what's the plan.

How am I going to have some self-care, try to get some naps in, but also do some things as an adult that I want to do when my baby's sleeping, because I may not have an opportunity to do those things, you know, otherwise. And of course, you know, finding trusted adults to help you with care and to get out and, you know, have a have a date night.

[Dr Joanna Parga-Belinkie]
And can we talk about, though, like that first year is a blur. I think I just let it be that way.

[Dr Mike Patrick]
Yeah, yeah, yeah. Like all the planning in the world is not going to make it OK. One hundred percent.

Yeah, that's for sure. The book, again, is the baby bonding book, Connecting with Your Newborn from the American Academy of Pediatrics. If there's one big takeaway from the book that you hope all new parents remember, what is it?

If you had to distill it down to one really important thought, what would that be?

[Dr Joanna Parga-Belinkie]
I just want to give parents permission to just be there with their baby, to learn from them, to discover how they're communicating with you and to let your love be something that grows over time and to think about, you know, the newborn period is so impactful, but it's really short. Right. So, focus on how you want to love, how you want to parent and what kind of relationship you're going to want to have with this child when they're 20 years old, because that's going to happen quicker than you think.

[Dr Mike Patrick]
Yeah, yeah, absolutely. Great, great advice. We are going to have a lot of terrific resources in the show notes for folks.

Of course, we'll have a link to the baby bonding book. Also, the Pediatrics On Call podcast. There's a really cool conference in Baltimore in October called Zero to Three, the Learn Conference.

And that's pretty interesting. We'll put a link to that in the show notes as well. We talked about serve and return interactions from the Harvard Center on the Developing Child.

So that'll be there. Also, a great article on postpartum depression, what pediatricians need to know. So, we'll have a link to that in the show notes as well.

So, lots of resources. I'd encourage people to head over to pediacast.org and look up episode 579, and those will all be there for you. So once again, Dr. Joanna Parga-Belinkie, Whitney Neonatologist at the Children's Hospital of Philadelphia and author of The Baby Bonding Book. Thank you so much for stopping by today.

[Dr Joanna Parga-Belinkie]
Thank you so much for having me.

[Dr Mike Patrick]
We are back with just enough time to say thanks once again to all of you for taking time out of your day and making PediaCast a part of it. Really do appreciate that. Also, thanks again to our guest this week, Dr. Joanna Parga-Belinkie, Neonatologist at the Children's Hospital of Philadelphia and author of The Baby Bonding Book. Don't forget, you can find us wherever podcasts are found. We're in the Apple Podcast app, Spotify, iHeartRadio, Amazon Music, Audible, YouTube, and most other podcast apps for iOS and Android. Our landing site is pediacast.org.

You'll find our entire archive of past programs there, along with show notes for each of the episodes, our terms of use agreement, and that handy contact page if you would like to suggest a future topic for the program. Reviews are also helpful wherever you get your podcasts. We always appreciate when you share your thoughts about the show, and we love connecting with you on social media.

You'll find us on Facebook, Instagram, Threads, LinkedIn, X, and Blue Sky. Simply search for PediaCast. We're also on YouTube, and we not only have the audio of the podcasts on our YouTube channel, but we're also making some short videos on important parenting topics, just things like spring allergies, asthma, eczema, poison ivy, just really basic information that parents need to know that you can get in short little snippets, you know, just like five-minute videos.

So do check those out. Again, those are on our YouTube channel. Just search for PediaCast.

A couple of other podcasts that I host that you might be interested in, depending on your background and interest level in medical science. One is PediaCast CME. That stands for Continuing Medical Education.

It's similar to this program. We do turn the science up a couple notches and offer free CME credit for those who listen. And that's not only for physicians, also nurse practitioners, physician assistants, nurses, pharmacists, psychologists, social workers, and dentists.

And since Nationwide Children's is jointly accredited by all of those professional organizations, it's likely we offer the credits you need to fulfill your state's continuing medical education requirements. Shows and details are available at the landing site for that program, pediacastcme.org. You can also listen wherever podcasts are found.

Simply search for PediaCast CME. And then one other podcast that I host is FAMEcast. This is a faculty development podcast from the Center for Faculty Advancement, Mentoring, and Engagement at The Ohio State University College of Medicine.

So, if you're a teacher in academic medicine or a faculty member in any of the health sciences, then this is a podcast for you. And you can find FAMEcast at famecast.org, also wherever podcasts are found by searching for FAMEcast. Thanks again for stopping by.

And until next time, this is Dr. Mike saying, stay safe, stay healthy, and stay involved with your kids. So long, everybody.