Many times we look at each other and are glad our children were born 30 years ago! The plethora of advice given to new parents is mind boggling to say the least.
In our day we just did what came naturally and likely what our mum’s and grandmother’s had done throughout hundreds of years of child rearing.
Then research came along in all it’s infinite wisdom and put a spanner in the works of “what came naturally”.
Two articles written recently caught our attention about the co-sleeping controversy. Dr Nils Bergman states co-sleeping reduces stress. promotes bonding and quiet sleep cycles. However, the cohort of babies studied was small – just 36! Tbh – it’s common sense that a baby will feel reassured with skin-to-skin contact or nearness of a parent. Which begs the question of when should babies learn to sleep independently?
The common sense approach must surely be that in some babies independent sleeping is a skill that needs to be taught gradually – while other’s will respond quite naturally and sleep independently from birth.
In practice we meet many parents with small babies who say their babies will only sleep “on them” or “with them”. In which case it is really important that parents know about the safest way to sleep with their new baby. Yes – there is a “safer” way of bed sharing with your baby! Unicef and FSID created this leaflet – so please take a look.
www.unicef.org.uk/Documents/Baby…/caringatnight_web.pdf
As health professionals we are guided by research and evidence based practice and would always recommend FSID SAFE SLEEP guidelines. These clearly state that the safest place for a baby to sleep is in his cot/crib next to you;
Sleeping With You
The safest place for your baby to sleep is in her cot. For the first six months, it is best for her cot to be in a room with you. If there is not enough space, you should have her in the next nearest room, with the doors left open.
You should especially avoid having your baby sleep in bed with you if:
• Either parent is a smoker [even if you don't smoke at home.]
• Either of you have been drinking alcohol or have taken drugs or medication which might cause drowsiness.
• Either of you is very tired.
• Your baby was premature or of low birth weight (less than 2.5kg or five and a half pounds)
If you do choose to have your baby sleep in bed with you, you need to be aware of the dangers of rolling over and suffocating her, or of her falling out of the bed or getting trapped between the bed and the wall. Avoid any unnecessary risks by placing her in the cot before you settle down. Having the cot next to the bed is it’s ideal position, allowing you to easily check on her during the night.
FSID 2011
ARGUMENT FOR CO-SLEEPING
Babies ‘should sleep in mother’s bed until age three’
Newborn babies should share their mother’s bed until they are at least three years old, a paediatrician has claimed.
A paediatrician has claimed that sleeping on their mother’s chest provides young babies with a better rest than being put in a cot for the night
By Sarah Rainey
8:18AM BST 28 Oct 2011
8:18AM BST 28 Oct 2011
The suggestion, which goes against health warnings, suggests that babies’ hearts are under more stress if they are left to sleep on their own.
It claims that sleeping on their mother’s chest provides young babies with a better rest than being put in a cot for the night.
The suggestion comes from Dr Nils Bergman, a paediatrician at the University of Cape Town in South Africa, who found that sleeping alone makes it harder for the mother to bond with her child.
Brain development can also be damaged by nightly separation, which can lead to behavioural problems in later life, the research claims.
But letting a newborn sleep in his or her mother’s bed goes against previous warnings on the controversial issue, which urge parents to let babies sleep in their own cots.
It follows years of mounting concerns over cot deaths in Britain, and the risk that a mother could injure or suffocate her child while sleeping.
A recent study of sudden infant deaths in the UK found that almost two-thirds of unexplained deaths happened when bed-sharing was involved.
While the National Childbirth Trust is in favour of newborns sleeping in their mothers’ beds, under a strict set of guidelines, the Foundation for the Study of Infant Deaths remains against it.
It recommends that the safest place for a baby to sleep is in a cot in his or her parent’s room – but not in their bed.
Dr Bergman, however, insisted that cot deaths and other infant injuries were not caused by the presence of the mother.
“When babies are smothered and suffer cot deaths, it is not because their mother is present,” he told the Daily Mail.
“It is because of other things: toxic fumes, cigarettes, alcohol, big pillows and dangerous toys.”
Dr Bergman, who founded a movement called ‘Kangaroo Mother Care’, emphasising the benefits of skin-to-skin contact between a mother and her newborn, studied the sleeping patterns of 16 infants for the research.
He found that the babies hearts were under up to three times more stress when they slept in a cot, rather than on their mother’s chest.
Just six babies in the research group had a quiet night’s sleep on their own.
The study also revealed disruption to the brain sleep cycle, which is vital in the organ’s development, in babies sleeping in cots.
Dr Bergman warned that a lack of sleep at this stage could cause behavioural problems for the child in later life.
Disrupted sleep and stress to the heart could make it difficult for them to form relationships, he claimed.
AND AGAINST CO-SLEEPING
New study into cot deaths raises concerns over co-sleeping
Posted by: Great Ormond Street Hospital Children’s Charity
26th October, 2011
The national cot death charity, The Foundation for the Study of Infant Deaths (FSID), called today for the collection and publication of local infant death data, as a new post-mortem study reveals that almost two thirds of babies died while they were sleeping with a parent.
Currently, a wealth of detailed information regarding the circumstances in which babies die is gathered by individual Child Death Overview Panels (CDOPs) in England, but it is not collated and published nationally.
A recent study from a specialist team at Great Ormond Street Hospital, published today in the Journal of Paediatrics and Child Health, reveals that over a 10-year period, almost two thirds of babies who were referred to the hospital for post mortem were sleeping with a parent when they died.
The expert group of paediatric pathologists, led by Prof Neil Sebire, analysed findings from 1,516 post mortems performed between 1996 and 2005. Of these, 546 met the criteria for sudden unexpected death of an infant (SUDI).
Prof Sebire said: ”The results of our study show that co-sleeping was involved in nearly two thirds of all SUDI infants referred to Great Ormond Street for autopsy.
“This is the largest single-centre pathology study to date, but in some cases, information regarding the presence or absence of risk factors such as parental smoking or alcohol use was not available at the time of post mortem.
“Several international studies have shown an increased risk for babies, less than four months old, who co-sleep with a non-smoking mother, but it is only in the last two years that data on risk factors has been routinely collected by local UK agencies. We back FSID’s call for collation of the CDOP data. This would be of enormous benefit both to future research and public awareness campaigns.”
FSID’s Chief Executive, Francine Bates, said: “The new Study strengthens what previous research has shown, that co-sleeping is associated with a significant number of unexpected deaths of babies in the UK, but it also highlights the need for more research which examines the relationship between co-sleeping and other risk factors.
“The UK has one of the best Child Death Review processes in the world so it is very odd that this vital local information is not widely available. Failure to collate and publish it is a missed opportunity to help us to prevent and reduce cot death still further.”
To hear a brief interview with consultant paediatric pathologist Dr Marian Malone about this study, please listen to BBC London Radio “Drivetime with Eddie Nestor” (at 34 minutes in).
FSID runs a freephone Helpline (0808 802 6868) for parents and professionals seeking advice on safe baby care. The Helpline also supports bereaved families. Advice for parents and professionals can also be found at www.fsid.org.uk. For more information on research carried out at , please visit our Bringing Research to Life website.
Great Ormond Street Hospital
OUR CONCLUSION
Well – as with every part of parenting the choice is yours. Certainly if either parent smokes, takes prescribed or non prescribed drugs that induce sleepiness, abuses alcohol and all that rock and roll – it is dangerous to co-sleep with your baby. We have to be guided by research which clearly states there are risks associated with co-sleeping.
ALSO – the good news is that babies and tot’s who sleep independently have more consolidated night sleep (and that means more sleep for you).
However, parents are only human! The exhaustion of parenthood leads many of us into survival status. If you decide to co-sleep our best conclusion is to do it as safely as possible by following UNICEF guidelines.
We’ve had a number of enquiries from parents who are worried LO’s naps are too short. Typically these LO’s will wake after 30 – 50 minutes of sleep which is the length of the first sleep cycle.
The key question to ask is “Does my LO wake happily from a nap?”
If the answer is “Yes” and LO is sleeping well at night, it may be LO is getting all the sleep he/she needs – contrary to what the books say!
However, if LO wakes crying, grumbling and grizzly it’s likely he/she hasn’t had enough sleep. Another tell tale sign of too short naps is if LO becomes more cranky, clumsy, lacks concentration or is more prone to temper tantrums towards the end of the day.
Here is a check list for you with some of the reasons (and solutions) LO’s wake too early from naps:
1. The most common cause is difficulty is transitioning from light to deep sleep. LO’s may wake when they realise that they are alone, are in a different place from where they fell to sleep such as after being rocked to sleep in parent’s arms or have lost their “prop” such as a dummy or a cuddly.
Solution; Remember to put LO to sleep “drowsy but awake”. This is impossible with small babies who tend to fall asleep on the bottle/breast. BUT it’s a good idea to adopt this mantra when a baby reaches 10 – 12 weeks of age.
Try re-settling your baby as soon as you see them squirming to waken. In small babies try applying a little pressure with the palm of you hand on to their chest or tummy OR stroking your baby’s head. in older LO’s you can try the same or simply leave them for 10 minutes to see if they will re-settle themselves!
2. LO is overtired! Remember the importance of watching for LO’s sleepy cues before they get overtired? Overtired LO’s will fight sleep, cry, protest and likely have emotional melt down when put down for sleep
Solution: Always start wind down time AS SOON AS YOU SEE FIRST SIGNS OF LO’s SLEEPY CUES!
If your LO is excited by the world and has difficulty “switching off” try taking them into a darkened room for 10 – 20 minutes to calm and relax them
3. LO is overstimulated. Remember that everything is stimulating to your LO. The world is full of strange new sights and sounds which we take for granted.
Solution; Again we would say a mini wind down routine in a darkened room for 10 – 20 minutes is the best way for baby to switch off. Small babies may benefit from a little rocking while older babies (over 3 – 4 months) may settle with being held firmly in your arms. Remember to keep eye contact to a minimum as your face/eye contact will also overstimulate.
4.LO has learned something new such as rolling, sitting, pulling to stand and wants to practice this even at the expense of his naps.
Solution; When LO learns to sit or stand try and teach them to lie down on their own during wake time. Make this a fun game! If LO keeps pulling to stand don’t repeatedly place LO on his/her back again – that will cause great excitement and be very trying for you! Try putting your hands through the cot bars and patting the mattress to encourage LO to sit then lie down on his own. This skill usually takes a couple of weeks to learn.
5. LO has been out of routine. Boy – it can only take one day out of routine and LO’s need re-teaching the routine again. The good news is that if you have established a routine LO’s will very quickly fall back into it.
Solution: Persevere with re-teaching!
6. LO’s nap routine is in a transitional stage. How do we know if LO is giving up naps?
Solution; If LO repeatedly fights naps for 2 – 3 days and is at the right stage to drop a nap then it’s time to forget that nap! However, you may well find that LO needs a nap at this time every second or third day for a couple of weeks while they adjust so – BE GUIDED BY THEIR SLEEPY CUES.
Remember LO may well need his/her next nap earlier or need bed time brought forward a little.
7. LO has had too little awake time.
Solution; Watch out for sleep cues! If LO repeatedly fights naps try lengthening awake time. Even a 15 minute awake slot can make all the difference.
8. Remember a daily dose of light is really important for all of us to set the circadian rhythm. Very often mums will tell us LO’s won’t nap if they’ve been stuck inside all day. This is particularly relevant for LO’s over a year.
Solution; A daily dose of natural light, such as a trip to the park/shops/friends preferably in the morning.
9. LO is ill or teething. Illnesses – particularly a virus is often harboured the body for several days before there are any outward signs.
Solution; Take LO’s temperature and look for other signs such as rashes or snuffles – even a small snuffle will make LO feel insecure and need extra TLC.
10. Inconsistent routines. Very often, older LO’s stop showing sleepy cues. They are so wrapped up in play they finally dissolve in to tired tears. By then it’s too late and they will fight sleep!
Solution: Okay – we know routines can be very boring for us BUT LO’s thrive on them. If LO knows that he/she has a nap in his cot after breakfast/ lunch every day they will expect it! BE CONSISTENT!
11. Overall sleep pattern particularly with small babies. Parent’s are often surprised when we add up LO’s night and day sleep. It’s often a lot more than they gave their LO’s credit for!
Solution; Keep a sleep log for 3 days and total up the average amount of sleep LO is having. Then check it through with average amount of sleep needs for LO’s age. However – it’s LO’s mood and presentation that will tell parent’s if LO isn’t having enough sleep!
If naps are elusive for a few days in a previously good napper – there is probably a good reason for this. The key thing for parents is to persevere in spending a few days re-teaching good habits and not to panic!
Hope this helps.
Sleep tight – Deborah & Maggie
Grrr! We know how frustrating it can be to have a tired grizzly baby who just won’t nap.
But the first question we always ask is, “Does your baby sleep well at night?”
Most of the books and sleep experts tell us that a baby who naps well sleeps well at night too. They tell is that a baby who does not nap in the day is more prone to fragmented night sleep. WELL! Here at Sleepy-Tots we have learned this is not always the case.
Many baby’s particularly those under 6 months of age sleep very little during the day but manage a good night’s sleep. So much for what “they say”. To be honest, if your baby manages a reasonably consolidated night sleep but only takes short naps and is happy during the day – then that’s fine.
We’ve met babies who will only nap in their buggy/car seat/on mum or on dad. Babies who will only nap in a sling or lying on the bed with mum close by. Babies who prefer silence and babies who prefer noise. Babies who will only sleep in the dark and babies who will only sleep in light.
As adults we know how sleep can be elusive in a new bed/bedroom. When staying with friends and family how we become easily disturbed by new sounds or even lack of them. If you’re used to the drone of a busy road as you drift to sleep the silence of the countryside can be infuriating. The creaking sounds in an old house are enough to wake those who live in a double glazed new build. The ticking of a clock can feel like the chimes of Big Ben if we’re not used to it.
Get the drift? As human beings we get used to the environment that we sleep in.
Are babies and children any different? Of course not.
Most adults have established biological clocks too. A few late nights and boy do we feel it. Let’s face it most mum’s with a baby of 3 months know they aren’t getting enough sleep and how it affects them.
So – it stands to reason that babies and tots feel exactly the same way as us when they don’t get enough sleep. Here are a few tips for happy napping;
Tips for happy naps 3 – 6 months
1. When establishing naps in babies 3 – 6 months (if you can do it before this you’re a genius) it’s best to consolidate what’s working first. Watching for sleepy cues and acting quickly before baby becomes over tired is key to successful naps. If the buggy is the only place baby will nap then we say do it!
Many mum’s are surprised when we tell them to take three walks a day to enable their baby to sleep at more routine times. This helps to establish some sort of daily nap rhythm. We say do whatever it takes to get your baby to sleep.
2. Many small babies find it difficult to “switch off” from the stimulus of their surrounding world. Having a mini “wind down” routine before naps such as a taking baby into a darkened room a little rocking/soothing to help baby become drowsy and then into cot.
3. Remember average “awake” times (found in our June 11 blog). If your baby shows no sign of being sleepy try a “wind down” routine after average awake time. Tired babies can often have “wide eyed” stares and it’s easy for us to assume they aren’t tired. In fact they are over stimulated and need parental help to shut the world out.
4. If baby needs a sleep when out in the buggy and is too interested in his surroundings try a black out shade on the pram.
5. Use the same sound/noise to help baby to sleep. This can be white noise in small babies or a musical lullaby. This helps create an association with sleep and can be a strong social cue for your baby to sleep.
6. From around 4 months babies will often fight day time naps. This is a key time to persist with “trying” to help baby to nap at consistent times. Try the shush/pat routine to help baby learn to settle in his cot without being rocked etc.
7. Small babies can nap through a hurricane! However, by 4 months many reach the stage when the hum of daily living is too distracting. You may find they need a quieter place to nap.
Tips for happy naps from 7 months
1. Don’t forget the 2 – 3 – 4 routine as a guideline for babies from 6 – 9 months. that is they need sleep 2 hours after “awake time”, then a nap 3 hours after “awake time”, then 4 hours “awake time”, before night time sleep.
2. Try and consolidate the early afternoon nap. A longer nap at this time of day helps regulate hormones for night time sleep. This is the best nap to have in the cot.
3. If you’re still feeding LO to sleep try the “Pantley pull off” method to guide LO to fall asleep independently. Best to start this method at the last night time feed – and day time naps will follow.
ELIZABETH PANTLEY’S – HOW TO STOP BABY FEEDING TO SLEEP
When your baby wakes, go ahead and pop his pacifier or his bottle in his mouth, or nurse him. But, instead of leaving him there and going back to bed, or letting him fall asleep at the breast, let him suck for a few minutes until his sucking slows and he is relaxed and sleepy. Then break the seal with your finger and gently remove the pacifier or nipple.
Often, especially at first, your baby then will startle and root for the nipple. Try to very gently hold his mouth closed with your finger under his chin, or apply pressure to his chin, just under his lip, at the same time rocking or swaying with him. If he struggles against this and fusses or roots for you or his bottle or pacifier, go ahead and replace the nipple, but repeat the removal process as often as necessary until he falls asleep.
How long between removals? Every baby is different, but about ten to sixty seconds between removals usually works. You also should watch your baby’s sucking action. If a baby is sucking strongly or swallowing regularly when feeding, wait a few minutes until he slows his pace. Usually, after the initial burst of activity, your baby will slow to a more relaxed, “fluttery” pace; this is a good time to begin your removal attempts.
It may take two to five (or even more) attempts, but eventually your baby will fall asleep without the pacifier or nipple in her mouth. When she has done this a number of times over a period of days, you will notice the removals are much easier, and her awakenings are less frequent.
“We got to calling this the Big PPO (Pantley-Pull-Off). At first Joshua would see it coming and grab my nipple tighter in anticipation — ouch! But you said to stick with it, and I did. Now he anticipates the PPO and actually lets go and turns and rolls over on his side to go to sleep! I am truly amazed.”
–Shannon, mother of 16-month-old Joshua
If your baby doesn’t nap well, don’t trouble yourself with trying to use the removal technique during the day for naps. Remember that good naps mean better nighttime sleep — and better nighttime sleep means better naps. Once you get your baby sleeping better at night, you can then work on the naptime sleep. The most important time to use Pantley’s gentle removal plan is the first falling asleep of the night. Often the way your baby falls asleep will affect the rest of his awakenings for the night. I suspect that this because of the sleep-association affect that I explained earlier. It seems that the way in which your baby falls asleep for the night is how he expects to remain all night long.
4. Remember in older tots the time they wake up may set their body clock for the day. It may be really tempting to let LO have a lie in on Sunday morning BUT – you will pay for it later.
5. As LO drops day time naps remember to adjust other sleep times. For example – you may need to bring bed time forward a little.
6. Being CONSISTENT in your routine and approach to LO’s naps is the key to successful napping.
As we said – some babies and tots won’t nap the way “they” (sleep experts) say they should. All you can do as a parent is give them the opportunity to achieve healthy sleep patterns.
Baby sleep training? The word “training” sounds like something we do with dogs! That’s why at sleepy-tots we talk about sleep teaching. So – what’s the difference?
The Oxford Dictionary defines the word training as; “come to a desired standard of efficiency or condition or behaviour”. Whereas the word teaching is defined as; “impart information or skill to a person”.
We all know that babies and LO’s don’t “behave” the way we want them to ALL the time. How can we expect LO’s to sleep “efficiently” when they are ill, teething, having developmental spurts or dealing with life changes. Of course they need parental reassurance and plenty of love and cuddles to help them through stressful situations. Extra parental TLC and predictable routines will help LO’s feel secure. But does this have to be during the night?
“Teaching” LO’s to sleep is not leaving them to cry it out on their own it’s about parents being with them during the process of learning. You only have to think back to primary school to remember the way you learned to read. That is by repetition, repetition, repetition. Until one amazing day the words made sense. As with any social behaviour sleep teaching is a skill that many babies need to be taught and learning is a process. Once taught LO’s often need to be retaught after disruptions to daily routines. Of course, this takes patience on the part of weary parents. But LO’s rely on their parents to teach them – well, nearly EVERYTHING!
Whilst talking to a group of new parents the other day we heard the usual grumbles. “My baby will only sleep on me” said one mum. “Mine too” said most of the other’s. All were relieved to hear us say “That’s normal!”. Imagine how it must feel for a newborn to realise they aren’t cooped up in the noisy, dark environment of the womb. Babies need a gentle transition to life and being held close by their parents helps them feel secure.
BUT there comes a time when parents can gradually teach babies how to sleep in their own space. We’re not talking about leaving babies to cry it out but gently guiding them to independent self settling.
In the book “Bed Timing” by developmental psychologists Marc Lewis and Isabela Granic (parents of twins – so they should know) they write about the best times to teach sleep according to developmental stages. Here is a summary of their research:
0 – 2 1/2 MONTHS
Your baby’s body needs time to develop and stabilise it’s own cycles. Do whatever it takes to get you through night rocking, bouncing or cuddling.
2 1/2 – 4 MONTHS
This is a period of relative stability and resilience. There is no good reason not to try sleep teaching now if your intuition says “go!” and your baby responds favourably. However young babies find it hard to recover from intense distress, and past a certain threshold (about 5 – 10 minutes) they may continue to cry until exhaustion sets in. This may be a sign that sleep teaching now is not the right time.
4 – 5 1/2 MONTHS
As your baby learns new interpersonal skills – skills that call for expected responses from you and lead to a stronger bond between you – it’s better not to disturb them until they’ve really begun to solidify. Essentially sleep teaching at this stage can cause frustration and confusion because your baby needs you to be her playmate, not her disciplinarian. Continue to establish predictable and consistent bed time routines but don’t push anything that doesn’t feel right.
5 1/2 – 7 1/2 MONTHS – THE IDEAL TIME TO TEACH SLEEP!
Babies are engaged with the objects around them (more than they are with people) and show almost no signs of separation anxiety. This combination creates one of the best times to teach sleep. To get a full night’s sleep, you’ll need to eliminate night feeding. Try gradually reorganising your baby’s feeding schedule so that he consumes most of his nourishment during the day.
8 – 11 MONTHS
Separation means something to your baby – that you’re not responding to his attempts to bring you back – which can be upsetting and traumatic for your baby, and destructive to your attempts at sleep teaching. Continue to be consistent in your bed time routine but be responsive to your babies needs.
12 – 16 MONTHS
This is another emotionally stable period where your baby is as focused on the world around her as she is on you. If your child isn’t sleeping through the night this may be your last chance for an efficient and fully satisfactory sleep teaching experience. Play – not sleep – is number one on your baby’s list of priorities. You’ll need to balance loving attention and concern with a firm determination to avoid the tricks and traps your innovative toddler will use to avoid bed time.
(Excerpts from Bed Timing ISBN:978-1-55468-047-4)
Our conclusion? Well – we certainly agree that a good time to begin sleep teaching is between 2 1/2 – 4 MONTHS due to circadian rhythms and more adult type sleep cycles developing at this time. However, the most common time parents consult us about a sleep problem is between 8 – 11 months when separation anxiety is at it’s peak. And as we have successfully improved sleep patterns in this age group hundreds of times we’re not sure this is the “all is lost” period that Marc and Isabela suggest.
It goes without saying that teaching positive sleep patterns earlier rather than later can prevent sleep difficulties arising. And if there are disruptions to sleep routine gently reinforcing sleep patterns when life is back to normal is better than waiting until sleep difficulties become habitual.
It’s Friday morning and here at sleepy-tots we have our weekly business meeting. Poised with a cup of coffee (and a sticky bun!) we trawl the net looking for new articles, updates and research on infant/child sleep. Our first stop is Mumsnet sleep site to find out the “buzz” about baby/child sleep issues. Our hearts sink when we find comments such as “darling ds/dd didn’t sleep through until he was 2 – 3 – 8 years old”. What comfort is that to an exhausted mum of a 10 month old baby? There is a very common misconception that parents just have to “put up with it”. And there is no question in our minds that once any medical issues have been discounted such as allergy or enlarged tonsils behavioural intervention can make a huge improvement to LO’s sleep pattern. And we’re not talking CC here!
Maggie spotted the article by Helen Walsh in the Times Magazine (25.06.11) about the sleep deprivation she endured with her first son. Helen’s harrowing story of two years of sleep deprivation that nearly drove her crazy brought tears to our eyes.
Why didn’t she contact us we asked? After a lot of heated discussion we both agreed that “sleep trainers” have been given a bad press. Which is why at sleepy-tots we “teach sleep” not train.
If you’ve found this site it’s likely you have a baby/tot who isn’t sleeping and you are most probably exhausted. You only have to look at the numerous posts on sleep issues on Netmums/Mumsnet to see the extent (and confusion) about infant/child sleep.
Why do parents put up with it we ask ourselves? Sleep difficulties in babies and young children cause untold misery to thousands of families. But they are rarely talked about openly.
More heated discussion at sleepy-tots HQ! Is it because parents of poor sleeper’s feel judged and and black listed as “bad parents”. Is it because parents are made to feel inadequate or guilty by the “smug set” who have angelic sleepers? Or is it that parents simply don’t go to the right place or people for advice?
We all know that a baby/child who sleeps well is described as “good”. But maybe they are “good” because they are simply getting an adequate amount of sleep. And we all know that the likely cause of night waking, particularly in babies and smaller tots is their inability to drift independently from one sleep cycle to the next. And that’s usually because they have an association that requires parental intervention to return to sleep.
Some say that parental emotional availability at bedtime is a predictor of a good night’s sleep. For sure, even a small baby let alone an older child is going to “sense” emotional discomfort from their parent/parents. A happy wind down time in a secure environment is bound to help LO feel more relaxed – that’s common sense!
Human beings – even small babies have a natural propensity toward cycles of behaviour. Very often, as parents we help LO’s predict those cycles by the way we as parents react.
At sleepy-tots we help parents identify their behaviours in order to create change. Changing parents behaviour toward LO will change their behaviour toward parents.
When dealing with LO’s sleep issues the crucial thing is to get someone other than the primary caregiver on board to help teach sleep. Hopefully this is dad – although we have had sleep teaching success with help from grandparents or good family friends. In fact anyone you trust to look after your baby/child will break unhealthy sleep patterns and teach LO the ability to sleep.
The summary of research below identifies the importance of father’s in predicting healthy sleep patterns in babies under 6 months. Why do babies sleep better for their dads?? Maybe it’s simply because dad’s have no milk supply and are more likely to help babies settle with less intervention. Mum’s often feel that dad’s simply can’t look after “our” baby as well as “I” can. And yet the “our” baby is the crucial thing for mum’s to remember. Even if mum’s are breastfeeding it’s important to remember that dad’s love their baby as much as you do – even though they just can’t seem to get it right all the time!
Infant Sleep and Paternal Involvement in Infant Caregiving During the First 6 Months of Life
Liat Tikotzky, PhD1,
Avi Sadeh, DSc2 and
Tamar Glickman-Gavrieli, MA2
1Department of Psychology, Ben Gurion University of the Negev and 2Department of Psychology, Tel Aviv University
All correspondence concerning this article should be addressed to Liat Tikotzky, Ben-Gurion University of the Negev, Beer-Sheva, 84105, Israel. E-mail: liatti@bgu.ac.il
Received July 21, 2009.
Revision received March 29, 2010.
Accepted March 30, 2010.
Abstract
Objectives The goals of this study were to assess: (a) the involvement of fathers and mothers in overall and nighttime infant caregiving; (b) the links between paternal involvement in infant care and infant sleep patterns during the first 6 months. Methods Fifty-six couples recruited during their first pregnancy, participated in the study. After delivery (1 and 6 months), both parents completed a questionnaire assessing the involvement of fathers relative to mothers in infant caregiving. Infant sleep was assessed using actigraphy and sleep diaries. Results Mothers were significantly more involved than fathers in daytime and nighttime caregiving. A higher involvement of fathers in overall infant care predicted and was associated with fewer infant night-wakings and with shorter total sleep time after controlling for breastfeeding. Conclusions The findings highlight the importance of including fathers in developmental sleep research. Future studies should explore mechanisms underlying the relations between paternal involvement and infant sleep.
Key words
father
involvement
infant
mother
sleep
Many of you have commented on why we don’t write about sleep confusion and “normal” sleep routines for LOs.
The truth is you can look on any website to find out average sleep needs for babies and LOs – so we tried to make our blog a bit “different”. However – it seems from the many comments we’ve had that you would like more information on average awake/sleep times.
The key thing to ask yourself is does your baby/LO wake up happy and well rested? Frankly – if the answer is “yes” whatever “the expert’s” say doesn’t matter. Some babies/LO’s just seem to survive on less sleep without any detrimental effects. Although if you read some books you are the devil incarnate if your baby/LO isn’t getting the correct amount of sleep!
It’s important to watch out for for sleepy cues and these are:
In babies;
In older LOs;
As SOON as you see sleepy cues it’s important to start a “wind down” routine to help LO prepare for sleep.
You will see from some “sleep experts” below there is a wide variation in expected “awake” times before baby/LO needs sleep.
The “Baby Whisperer” says average awake times by age are:
Gina Ford says average awake times are;
Baby wise says average awake times are;
The “No Cry Sleep Solution” says average awake times are;
Now you know average awake times here are the average amount of sleep needs per age: (Remember – we said average!)
| BY DAY | BY NIGHT | |
| 1–3 months | 8-9 hours | 8-9 hours |
| 3–6 months | 7-8 hours | 8-9 hours |
| 6 – 9 months | 4-6 hours (in 3 – 4 naps) | 9-10 hours |
| 9–12 months | 3–4 hours (in 2 – 3 naps) | 9-11 hours |
| 1–2 years | 2–3 hours (in 1 – 2 naps) | 9-11 hours |
| 2–3 years | 1–3 hours (in 1 nap) | 11-12 hours |
| 3–5 years | 1-2 hours (in 1 nap) | 11-12 hours |
PLEASE remember these are only a guide. Many babies and LOs sleep less/more than the recommended sleep time. Imagine 100 people and that the 50th person is on the average line. But the majority fall outside of the “average”. See what we mean? So – don’t worry if your baby or LO isn’t average.
The key thing is to ask yourself is baby/LO happy on waking – that’s a good sign they are getting enough sleep.
Well – one thing’s for sure, you are very lucky parents if your baby doesn’t have have a few nights (or sometimes even weeks) of sleep difficulties in the first 6 months of life.
The most common sleep regression occurs between 3 – 5 months of age.
THE REASON?
During the first few months (3 – 5 months) babies go straight into REM (active) sleep. What is REM? Rapid Eye Movement sounds more complicated than it really is. It’s just a name that refers to a phase of sleep. Babies spend 50% of their time in REM sleep (that’s why they make those jerky movements). REM sleep is thought to be when we process things in our memory banks. No wonder babies need more REM sleep!
Non REM sleep is the really still part of sleep. The part that makes you wonder if your baby is still breathing and coined the phrase “sleeping like a baby”. Non REM sleep is necessary for growth and tissue repair.
A baby’s sleep pattern changes between 3 – 5 months old as the human body matures. At this stage babies sleep cycle is more like an adult’s as they enter sleep through the four non REM sleep stages
BEFORE entering REM sleep. It may take up to 30 minutes for a baby to transition though stage 1 & 2 before entering the deepest sleep stages of 3 & 4of non REM sleep.
We all go through sleep cycles throughout the night. This means we transition from light to deep sleep and on average wake 3 – 4 times per night.
It is important to remember we have more deep sleep (non REM) during the first half of the night and more light sleep (REM) during the second half of the night. Hence the reason for babies learning to sleep more solidly (hopefully around five hours) during the first half of the night. During the second half of the night more frequent REM sleep means more waking in between sleep cycles.
STAGES OF SLEEP
This is a typical night of REM and Non REM sleep in an older baby (over 3 – 5 months);
Now we know there is more REM sleep during the second half of the night when babies are more likely to night wake what can we do about it?
This is when parents can start sleep teaching. We know you’re tired and at your lowest ebb. BUT believe us when we say the energy you put into sleep teaching now will pay huge rewards in the months to come.
So – if your 3 – 5 month old baby wakes every 60 – 90 minutes after midnight in between sleep cycles you need to teach self settling to enable your baby to get the benefits of a good night’s sleep.
Here are some things to try if baby wakes:
We all have to learn how to return to sleep in between sleep cycles. This is as much of a learned social skill as any of the other myriad of skills you will teach your LO over the first few years of life.
Eat, Activity, Sleep and You time (EASY) routines or Gina Ford’s “nanny knows best regime”, No-Cry Sleep Solution (fine for small babies) or Natural Nurturing and follow baby’s lead.
And if you follow any of the above maybe your LO does not!
Some babies will take to routines like a ducks to water. Others need more coaxing and teaching into the social world around them. And this depends on baby’s personality, genetic predisposition and parental response. Many parents we see at sleepy-tots have given their LOs masses of love and quick emotional response.
Now we are not saying that’s wrong! But by the time LO is 8, 9 or 10months old parents are exhausted and often resentful about frequent night waking and poor naps.
Truth be told the human body craves routine to feel healthy. Ask anyone who works shifts and they will tell you how much it affects their health both physically and cognitively. We both remember working night shifts as nurses and feeling completely disorientated at the end of a rota of nights. Think jet lag and it will give you some idea!
That being the case imagine how LOs feel out of routine? We’re not talking about routines of army discipline proportions but what we call a FLEXI – ROUTINE. Flexi-routines are sort of “round about the same time”. They don’t interfere with days out or holidays or YOU time. BUT they do need to be reinforced as SOON AS life is back to normal.
For example one of our clients who successfully taught her LO (10 months) positive sleep patterns was terrified to meet friends for lunch in case it interfered with LO’s established afternoon nap. Well – it did! He was so excited about all the activity and new sights and smells in the café no way was he going to nap in the buggy. So – that evening as soon as mum saw sleepy cues (which were an hour earlier than usual) she started wind down routine and put him to bed. Yes – he woke once in the night but thanks to the previous sleep teaching he was quick to re-settle and woke 15 minute earlier in the morning. The following day routines were back to normal.
It was parental response that helped (taught) him what to expect. What we’re saying is a big “YES” to flexi-routines. Of course, in the early months you are establishing (teaching) routines. You can try teaching routines from birth HOWEVER many babies take several months to adjust to life outside the womb. With repetition, consistency and parental perseverance positive sleep patterns can be taught and learned. And re-learned after high days, holidays and disruptions to routine
P.S If your baby isn’t settling well see your G.P to rule out any medical concerns such as allergy or intolerance.
Many of the parents we see at Sleepy-Tots want a “No Cry Sleep Solution”. I’m sorry to tell you guys the title of this book has been thought up by the very best marketing gurus in town! Well – definitely for baby’s over 6 months. At Sleepy-Tots we keep crying to a minimum with parental presence. BUT with a change in expected routine all babies will protest and maybe cry a little.
By the time a baby is 7 – 8 months old habits such as frequent night feeding, rocking to sleep and use of dummies is well and truly entrenched.
The best advice we can give you is to prevent sleep difficulties in the first place.
As we say in our book Savvy Sleep the best time to start is when a baby is between 3 – 4 months of age. This is the time when babies naturally begin to sleep a little longer at night and understand night from day. Although some sleep expert’s suggest sleep teaching as soon as a baby is able to smile and coo from about 6 weeks of age.
Even then there may be a small amount of cries and protests as you put your baby to sleep in his/her cot drowsy but awake. And don’t rush to baby (over 3 months old) in the night as soon as he/she murmurs and assume they need feeding (as long as baby is gaining weight as expected). Try re-settling baby with touch and talk first. Time for dads to lend a hand to all you breast feeding mums!
True to say babies have different temperaments and personalities. Some will protest louder than others. And if you have one of these characterful little personalities our hearts go out to you. It’s probably nothing you’re doing wrong – simply that your baby is more of a “high maintenance” baby than others. You will have tremendous fun watching this feisty little baby mature and grow into a very individual human being.
However – it’s important to remember that many defiant tot’s who are emotionally labile are precisely that way due to lack of sleep. So it’s up to us as parents to teach our babies good sleep habits before they latch on to bad ones.
Now this is difficult if your baby has had colic, reflux or intolerance. All these things teach a baby to be cranky. But once these have been dealt with or resolved start sleep teaching ASAP.
A “No Cry Sleep Solution” is more easily taught in the first few months of life.
“The Controlled Crying Technique” is short and sharp and works for most cot bound babies. But who wants to leave their baby to cry? It can be more confusing for a baby if a parent “pops in” every 10 minutes. In our experience many babies become more agitated and upset at the sight of a parent who seemingly abandons them yet again. On top of which some research suggests babies become very stressed when left to cry which can be damaging to long term ability to deal with stress.
The jury is still out on the best method to use for LO’s with sleep difficulties.
Good sleep habits need to be taught in the first 6 months of a baby’s life.
As mama used to say “PREVENTION IS BETTER THAN CURE”.
During the first three or four months of a baby’s life most will have several periods of prolonged crying and fussing. No matter how much you pace the floor, cuddle, feed, wind, change the nappy – do everything the books tell you to do nothing seems to quieten those heart wrenching cries.
When we meet exhausted parents of small babies it’s important to take a detailed history of the baby’s birth, feeding habits and most important of all symptoms. Through our work we’ve seen an increase in babies presenting with dairy intolerance. It’s estimated about 2 – 7% of babies are dairy intolerant. These babies whether breast or bottle fed are often the most difficult to settle. Many will already have sought medical advice and been diagnosed with “it’s just a bit of colic” or “it’s just a bit of reflux” and given medication.
True milk allergy is very rare. Babies with a true milk allergy will have an acute reaction almost immediately after drinking milk. They quickly develop hives or a facial rash and vomit up feeds. Very,very rarely they may have an acute allergic reaction such as anaphylaxis and need urgent medical attention. Some babies have a delayed allergic reaction with symptoms such as colic, reflux eczema or dry skin, diarrhoea or constipation.
The symptoms of dairy intolerance are:
Most children grow out of dairy intolerance by the time they are 3 years old.
Many breastfeeding mums want to know how long it takes for milk proteins to come through breast milk which is difficult to define. However, as a general rule foods eaten by a mother take 4 – 6 hours to be exposed in breast milk but can take as little as 1 hour and as long as 24 hours.
Cows milk protein (dairy) needs to be eliminated from mum’s diet for at least 2 – 3 weeks to ascertain whether this is the cause of an unhappy baby. So – it’s no quick fix! It’s also important for breastfeeding mums to make sure they substitute their diet with appropriate foods. Calcium rich foods include; salmon, sardines and mackerel (with bones), sesame seeds, almonds, dark green leafy vegetables, calcium enriched tofu, beans and baked beans. But have a look on a website for dairy free calcium rich foods.
DO remember that it’s thought about a third of people who are intolerant to dairy are also intolerant to soy! So – soya based milk and foods may not be an option.
BEFORE you embark on a dairy free diet PLEASE discuss it with a MEDICAL PROFESSIONAL.
If you are formula feeding your baby you will need to discuss your concerns with a doctor or paediatrician who may prescribe an allergy free formula milk.
The majority of breast fed babies tolerate a wide variety of foods in their mother’s diet – even the odd vindaloo! We know that small amounts of taste from mum’s diet go through to breast milk probably to allow a baby to gently get used to spicy foods where it’s the cultural norm.
As we said we have certainly seen an increase in babies with dairy intolerance in the last 20 years. But do remember infant colic is far more widely reported than food intolerances! Infant colic should disappear by the time a baby is 4 months old. Circadian rhythms also become more established at 4 months and many babies will sleep for one longer period at night.
So – if your baby is still having difficulty settling after 4 months of age and there is a strong family history of allergy it is worth considering whether your baby may have dairy intolerance.