Are your kids getting the sleep they need each night? Is your picky eater turning down fruits and vegetables at every meal? Are bedtimes and mealtimes a daily struggle in your home? This is the “tough stuff.”

Lindsay Uzunlar, MD, Pediatrician at NorthShore, answers these tough questions, sharing bedtime and mealtime solutions and tips to ensure every member of the family—large and small—is getting the sleep and nutrition they need to thrive.  

When should your child start to regularly sleep through the night? When should you be worried that they aren’t sleeping through the night or are waking up too frequently? 
Your child is biologically able to sleep through the night around 3-4 months, so with your help they should be able to sleep through the night by six months—meaning sleeping between 6-7 hours without waking up. If your baby is still waking up frequently at nine months, talk with your pediatrician about some possible sleep-training strategies. Consider talking to your pediatrician about sleep-training techniques earlier than six months, or even during pregnancy. 

How do you set bedtimes? How much sleep do children need?
A lot of babies need help learning when and how to sleep so this is where you can make a big difference. Observe when your child seems become naturally sleepy or when he starts to be fussier. When that time comes, put him to bed drowsy but not sleeping. 

The key to remember is that you are in charge of bedtime, from infancy until they leave your house.  Setting bedtimes is really important and can vary depending on age. Children will naturally start to go to bed later as they need less sleep. A newborn needs up to 15-17 hours of sleep; a six-month-old needs 13-14 hours; 9-24 months need about 12 hours; school age between 9-10 hours and adolescents 8-9 hours.

How long is it normal for a child to wet the bed? Is a family history of bedwetting a contributing factor? What can you do to stop it? 
It is still normal to have nighttime wetting up to the age of six, especially if there is a family history. There are different techniques that you can try. The simplest is just having scheduled wake-up times. With this technique, you set your own alarm and wake him up to take him to the bathroom. In a perfect world, you could wake him up before you go to bed (assuming you go to bed later than him) and then not worry about it for the rest of the night.

How do you wean an infant of needing a pacifier to remain asleep at night?
As you may have realized, children use pacifiers as a self-soothing object. So the key to helping them transition to good sleeping without is to replace the pacifier with something else. For instance, this is a great time for a teddy bear or blanket. Put them to sleep with both the pacifier and the new object so that they can learn to associate both with self-soothing. Then you can take away the pacifier and ideally he or she won't notice its absence too much. You can work on having the pacifier gone over the next 2-3 months. I would recommend that you take all pacifiers away at once, that way when he wants it, you can 100% truthfully say that they are "all gone."

What do you do if your child refuses meat? How do you ensure he or she gets enough protein? 
Vegetarianism is fine for kids but it is understandable to worry about protein intake. There are other sources of protein besides peanut butter and meat. Some other good sources are: eggs, milk, soy products and whole grain cereals. Try to make sure your child gets a combination of these at each meal. 

How do you handle a picky eater who won’t eat anything other than his or her favorite and probably unhealthy foods?
It takes kids about 10-15 tries of a food before they will like it. So making sure that they take a “no thank you” bite will help give them exposure to the new foods. You can also try introducing new tastes of food mixed with their favorites such as peas with macaroni and cheese. Your child should be eating the same dinner that everyone else is eating. If they don’t want it, then accept their opinion and let them know that this is the only thing that will be prepared tonight. He or she will be more likely to eat what has been prepared if they know that they don’t have other options. The key to helping instill change is consistency. So it is important that anyone who consistently cares for your child be on the same page about introducing new foods. 

What are some strategies to help children learn to explore more food types if they have texture sensitivities?
For texture sensitivities, it’s a good idea to attempt “try and try again." It can take kids awhile to get used to new things, tastes and textures, so just encourage a single bite each meal and if he or she takes it, consider that a success! If you find that this is taking longer than you think it should, speak with your pediatrician.

Are dairy and gluten considered safe for children? Are they a necessary part of a child’s diet?
Dairy-free and gluten-free diets are very popular right now; however, they are only necessary for a select number of people and otherwise are part of a healthy diet. Children who experience gastrointestinal symptoms like diarrhea, stomach cramping, vomiting or bloating after eating one or both of these may have a sensitivity. In that case, it is a good idea to see your pediatrician about safely removing these from the diet. If they don't experience these symptoms, they are fine and your children can continue eating food with dairy and gluten without issue.

When should babies start drinking animal milk? Do you have recommendations on cow vs. goat?
To help with brain growth, babies should remain on breast milk or formula until 12 months old. After that, trying cow's milk is best as it has a more complete set of nutrients. Goat's milk is an option if you feel your child may not be tolerating the cow's milk,but in that case, he should be taking a multivitamin with it.