In Young Kids, Lack Of Sleep Linked To Obesity Later

Can you sleep away pounds? Well, not exactly, but research has shown that people who sleep a good eight hours-plus are more likely to maintain a normal weight than those who sleep less than eight hours a night. Now, a new study finds that even for infants and preschoolers, a good, long night's sleep may be just as important as diet and physical activity.

Over the past three decades, obesity rates have doubled among children age 2 to 5, and tripled among 6- to 11-year-olds. So University of Washington maternal and child health researcher Janice Bell wanted to know whether sleep had anything to do with it.

She looked at federal data collected on nearly 2,000 children and compared those who slept 10 hours or more a night with those who slept less. She also looked at how much the children weighed over a five-year period. The most striking findings had to do with infants and toddlers. The study appears in the Archives of Pediatrics and Adolescent Medicine.

"They were nearly twice as likely to move from normal weight to overweight, or overweight to obese in that five-year period," she says.

Can't Catch Up With Naps

This is also an important message to parents, Bell says, to encourage them to help their children get on routine schedules of a long and solid night's sleep. Especially, she says, because it turned out that napping during the day did not reduce the risk that these kids would gain weight.

"We found that their napping didn't have any effect on their later obesity, whereas the nighttime sleep was significant," Bell says. That led her to conclude that napping didn't seem to be a substitute for nighttime sleep in terms of obesity prevention.

Psychiatrist Emmanuel Mignot, who directs the Center for Sleep Sciences at Stanford University School of Medicine, suggests that one reason naps may not work is because daytime sleep is qualitatively different than nighttime sleep. Mignot says that sleeping at night is deeper and therefore more restorative than sleeping during the day. It makes sense, he says, that one can't "make up" for lost sleep by dozing during the day or even having scheduled naps as toddlers often do.

Why The Connection?

Bell's study didn't examine the reasons why children who sleep less have an increased risk of gaining weight within just a few years, but she does have some theories.

"It may be that children who don't sleep enough at night are too tired to engage in the kind of physical activity that may prevent obesity," Bell says. She adds that another reason may be the result of the relationships between hormones that control appetite and sleep.

Mignot says that studies done in his sleep lab found that if you sleep less, certain hormones like leptin and ghrelin change in a way that stimulates appetite. Leptin, which is a starvation signal, decreases and gives you the feeling that you should eat more. At the same time, levels of ghrelin, which stimulate the appetite, increase.

It's an unfortunate combination adding up to an increased risk of weight gain. Mignot's studies were done in adults, but he says a similar hormonal shift likely takes place in children as well. This hormonal shift also increases cravings for unhealthy foods like those high in salt, sugar and fat.

On average, Mignot says children up to age 5 need at least 10 hours of sleep a night. Infants and young toddlers, of course, need even more.

 

When Should You Start Potty Training?

From Vincent Iannelli, M.D.,
Your Guide to Pediatrics.

 About.com Health's Disease and Condition content is reviewed by our Medical Review Board

Question of the Week

Q. My son is 2 1/2 years old and has no interest in using the potty. Is that normal?

A. Most children begin potty training sometime around 18 months to three years of age, so yes, if he is otherwise growing and developing well, it is probably normal that a 2 1/2 year old does not want to use the potty.

Although many parents feel like 3 years is a magic age by which their child must be potty trained, that is not always the case. A recent poll on keepkidshealthy.com showed that almost 25% of kids weren't potty trained until they were 3 1/2 or 4 years old.

Even in an older child, it is important to look for signs of readiness before you begin potty training, including:

• staying dry for at least 2 hours at a time
• having regular bowel movements
• being able to follow simple instructions
• being uncomfortable with dirty diapers and wanting them to be changed
• asking to use the potty chair
• asking to wear regular underwear

You should also be able to tell when your child is about to urinate or have a bowel movement by his facial expressions, posture or by what he says. If your child has begun to tell you about having a dirty diaper you should praise him for telling you and encourage him to tell you in advance next time.

Even if your child isn't totally ready to begin potty training, you can still get him a potty chair and have him decorate it with stickers and sit on it with his clothes on to watch TV, etc. to help him get used to it. Whenever your child shows signs of needing to urinate or have a bowel movement you should ask him if he wants to use the potty or take him to the chair and explain to him what you want him to do.

Only keep him seated for a few minutes at a time, don't insist and prepared to delay training if he shows resistance. Until he is going in the potty, you can try to empty his dirty diapers into his potty chair to help demonstrate what you want him to do.

Another good techniques is modeling, where you allow your child to see family members or other children using the toilet, and using observational remarks. This involves narrating what is happening and asking questions while potty training, such as 'did you just sit on the potty?' or 'did you just poop in the potty?'

Things to avoid when toilet training your child are beginning during a stressful time or period of change in the family (moving, new baby, etc.), pushing your child too fast, and punishing mistakes (treat accidents and mistakes lightly). Be sure to go at your child's pace and show strong encouragement and praise when he is successful.

Encouraging Good Behavior

The first step to better discipline is to learn to encourage good behavior in your child. It is much easier to reinforce good behavior than to have to try and change bad behaviors. Here are some tips for encouraging better behavior:

Just before their first birthdays, babies learn the meaning of "no." They spend lots of time shaking their heads "no"—even when they mean "yes!" This may be frustrating for you. But it means your baby is growing up. He is becoming independent. He feels secure enough that he's sometimes able to risk your disapproval. He's beginning to learn right from wrong.

To get your attention, your baby might do these kinds of things:

 

• Turn the knobs of the radio to a blast of noise.
• Throw food on the floor.
• Push the buttons on the telephone.
• Pull the dog's ear.
• Bite while he's nursing.

Your baby will test his limits—and yours. As he moves toward the telephone, for example, he may look back at you. He may have a guilty look on his face. He needs an immediate response from you—a facial expression or a gesture that says, "I'm paying attention to you. It's not OK to play with the telephone."

Don't overreact. Avoid yelling and strong corrections. These give your baby the attention he wants, and he will likely repeat the behavior just to get your attention again.

Instead, try to anticipate your baby's behavior. Have you left him alone for too long? Is he bored with his playthings? Does he need a hug? Give him positive attention—he'll be less likely to do something that you disapprove of.

You can also distract your baby. Offer a different activity. Move the attractive, but forbidden, object out of your baby's reach.

Avoid saying "No!" too often. The word will lose its impact. Save it for important times, like when safety is an issue. In the examples above, respond firmly—don't smile—and tell your baby the right way to do the activity.

For example, if your baby is banging on the table with a spoon, stop him by gently holding his hand. Say, "This spoon is for eating. Would you like another spoonful of peaches? After dinner let's find a big box for you to bang like a drum."

Give him information he can use in the future. Let him know your limits. Enforce your rules the same way every time.

These tips were reproduced from the U.S. Department of Education.