Infant Sleep Tip #6

Happy August to all. Hope your families have been able to enjoy the abundant sunshine and summer action. Life with 3 young ones has proven to be as fabulous – and as full on – as friends had promised. So I apologize for writing so little recently.

Infant Sleep Tip #6: Encourage soothing techniques other than feeding.

When we hear our babies crying, many parents and caregivers instinctively reach for a bottle or the breast. While comfort feedings can be a wonderful bonding time for you and your little one, it’s important to remember that we have lots of options in our soothing toolbox. This can be a game changer for nursing moms, who were feeling like they were walking pacifiers, partners of nursing moms who were feeling inadequate because they didn’t have the “secret weapon,” and all caregivers who were feeling like they were perpetually overfeeding their baby just to keep them from crying. 

So what are our options? Wear your baby, swing, rock, swaddle, sing, shush, offer a pacifier, massage, take a walk outside, repetitive soothing sounds or music, bounce, or let a partner, friend, or grandparent try their luck. Sometimes a change of chemistry or scenery is all it takes.

If you haven’t found a carrier that is comfortable for you yet, make that one of your first goals. Many swear by the k’tan wrap, Ergo (the new Ergo 360 allows for a forward facing hold as well as all the other positions, which is great when your baby is eager to check out the world), the Beko Gemini, or Moby wrap. As some carriers are expensive, try out friends’, buy a slightly used one, or go to a local store where the salespeople have real know-how. If all the options are overwhelming, I strongly recommend www.carrymeaway.com. The website offers excellent explanations as well as an online form you can fill out for a personalized recommendation from the Sling Lady. They also offer email and phone support and free returns, making it super parent friendly. Laurel was a great support to my family in helping us find carriers that would be comfortable for both my husband (who is 6’2”) and me.

Dr. Harvey Karp in Happiest Baby on the Block offers detailed explanations for the benefits of the 5 S’s – swaddling, side or stomach, shushing, swing, and sucking. Some babies may benefit from all of them done simultaneously, while many babies are comforted by one or two of these techniques.

There is no one size fits all here. Each baby has preferences and naturally those preferences will change over the course of the day, weeks, and months. But mixing it up and trying new techniques can be hugely liberating.

Infant Sleep Tip #5

Happy spring to all! My apologies for being slow to post more infant sleep tips. My household has been busier than usual this month, partly due to my son’s recent obstructive sleep apnea (OSA) diagnosis and subsequent tonsillectomy and adenoidectomy. Much more on that very soon. Suffice it to say, I am now on a crusade to tackle pediatric OSA.

But for now, here are another tip for your infant’s sleep. If you missed the first few, please click here.

Infant Sleep Tip #5: Create a quiet, sleep-friendly environment.

Your baby’s environment strongly affects her sleep. Whether she sleeps in your room or her own, the space should be peaceful, safe and generally free of stimulation. This means room darkening shades and calm soothing colors in the bedroom and on her sheets. In short, the sleep environment should be B-O-R-I-N-G! Comfortable, cozy, but boring! Avoid mobiles, lights, crib toys, and busy patterns. When I walk through the bedding department at stores, the incredible number of boldly patterned crib and bedding accessories always surprises me. At bedtime, we want the message to the brain to be “Slow down,” not “Stay up and focus on the fuchsia colored giraffes lining your crib!” This is particularly true if your child has an alert temperament.

We also want the crib to be a place for sleep and maybe a few minutes of quiet play after waking. It’s not a place to park the baby while you wash the dishes or a pen for the baby to play in when she begins to crawl. Those associations make a difference.  Again, we want the message to be clear: this is the place where you sleep.

As Dr. Harvey Karp recommends in Happiest Baby on the Block, white noise can be very calming, particularly for alert babies because it helps them shut the world out. If you have a busy, noisy household with older children, barking dogs, ringing phones, or street noise, white noise can be a game changer. I recommend white or gray noise because they are constant and buffer noise best. Sounds like crashing waves, chirping birds, etc., which may sound nice to us, do not work well in this regard. Be mindful of the volume – which should be relatively low – the sound is meant to buffer noise, not block it out completely.

Motion sleep can trip up parents. Babies are very portable. They can sleep wherever you put them – car seats, strollers, swings, carriers, and noisy cafes. But even though they can do this, it doesn’t mean they should. It’s ok some of the time, especially in the late afternoons when their naps are shorter and less restorative anyhow. But try to have them nap in a quiet crib or bassinet most of the time – especially after the first few months. Motion sleep keeps the brain in a light sleep and as babies mature, they need deeper sleep as well. Think about it, when you doze off in a car, do you feel as refreshed as if you had slept in a bed?

Getting her out of the car and into the crib may mean that you will be more housebound, until your baby develops more predictable nap patterns. If you go stir crazy, invite a friend to visit, make a deal with your partner so you can get some time off. You don’t have to be super rigid; an occasional stroller or car nap is fine. But respecting your baby’s need for quality sleep is important and will pay off in spades.

Enjoy this time with your little ones. More tips coming soon!

Escape Artists

1:30pm. I’m working on my computer as my two-year old daughter settles down for her nap in her crib. Or so I thought. Suddenly I hear the pitter patter of little feet. She appears around the corner, looking quite surprised – and pleased – with her newfound skill…

My daughter was a great napper and loved her crib. Whatever possessed her to climb out?! And how do I respond?

Temperament and age are big factors here. Some children simply need a few, firm reminders to keep them from trying again. Others just can’t resist the temptation to test their skills, climbing out over and over again whenever they have the chance. Some are old enough to safely and smoothly transition to a bed, whereas others, particularly those under 2.5 years, are usually too young to make the switch.

Most children under the age of 2.5 years old lack the cognitive ability to fully understand the concept of “staying in bed all night long.” With a lot of effort and patience, some can learn to sleep successfully in a bed (more on that in another post!). But generally speaking, transitioning to a bed prematurely can lead to LOTS of struggles and safety issues (i.e. wandering around a dark room/house alone in the middle of the night).

I believe most early climbers actually do find tremendous security in their cribs, and their climbing should not be misinterpreted as a sign that they are ready for a bed. Just as babies practice their rolling, sitting, pulling up, walking, and talking in their cribs – sometimes to the detriment of their sleep – so too with climbing.

Toddlers and many preschoolers truly benefit from the comfort and cozy containment that a crib provides. Now that crib tents have been recalled, unfortunately our options for physically keeping young climbers in their cribs are more limited. But here are some suggestions, starting with the most minimal interventions.

·      Make sure her crib mattress is set to the lowest possible position. Baby's Dream makes a crib with an extra low mattress (6" lower than usual), though it is expensive.

·      If the back crib railing is higher, you could try wedging the crib in a corner with the taller side facing out.

·      Remove large stuffed animals she may have used as a launch pad.

·      Place pillows on the floor for safety.

·      Start putting her to bed in a sleep-sack, which limits her ability to hoist her leg up and over the railing. Or try a long t-shirt. Some parents find it discourages them from swinging their legs up. There are also product - Cribberz  and Crib Pants - on the market that I've heard good things about. Of course, if she’s using her arms to pull herself out, these interventions won’t really help.

·      If she climbs out, put her right back in her crib with minimal interaction – a firm, “No climbing” will do. Then position yourself nearby, out of her line of vision (just outside the bedroom door). When she goes for her next attempt(s), remind her, “No climbing,” and return her to her crib if necessary. Your response should be minimal, firm, boring, and consistent.

·      If she is persistent but not ready for a bed, there are some tent-like options out there that enable you to zip them in, such as the Nickel Bed Tent by ReadySetBloom. It’s a sturdy, tent-like structure that secures to a twin mattress. Nice colors to choose from and great for travel too. Many kids love the feeling of being contained and cozy in a tent, especially when it is pitched as a fun, special place (and not "this is to keep you in your bed!").

Just remember, your child may not be thrilled about the changes you make. Chances are, the “it’s for your own good” rationale will be lost on her. But don’t second-guess yourself if she protests. You are setting her up for good sleep, while ensuring her safety – one of your most essential jobs as her parent. She will get over it soon enough and will go back to sleeping like a champ. And so will you!

Co-Sleeping Safely

The overwhelming majority of parents co-sleep with their children at some point. Kim West, author of Good Night Sleep Tight, divides them into three categories: committed co-sleepers, short-term co-sleepers, and reactive or “we didn’t plan it this way!” co-sleepers. Committed co-sleepers believe in the family bed philosophy and bed-share for years. Many parents opt for short-term co-sleeping during the newborn stage, while others end up doing it reactively (i.e. when it’s 3am and they are too tired to take on another waking).  Regardless of the reason or rationale, it is essential that parents take precautions to ensure that their little one is safe.

The US Consumer Product Safety Commission (CPSC) and The American Academy of Pediatrics have formally recommended against co-sleeping with a child under two years of age because of the risk of death or injury. First Candle, an organization dedicated to reducing sudden infant deaths, cites research that suggests that 80% of sudden infant deaths occur when the baby is sleeping with a parent or other adult.

However, as Dr. Harvey Karp states in Happiest Baby on the Block, “The vast number of infant deaths in bed are preventable by taking a few reasonable precautions. For example, 80% of the deaths noted by the CPSC could have been avoided by filling the spaces around the bed to keep babies from getting wedged in and by never sleeping on waterbeds. Most of the remaining 20% of deaths could have been prevented by using a co-sleeper attachment.”

A co-sleeper, such as Arm’s Reach Co-Sleeper Bassinet, is a great option. It allows parents to sleep alongside their baby, easily bringing them into bed for feedings, without worrying about their baby rolling off the bed or getting accidentally smothered.

What follows is a list of safety tips from various sources, including First Candle, Dr. Harvey Karp, Kim West, and SafeBedSharing.org.

·      Your baby should sleep on a firm surface, covered by a well-fitted sheet that can’t be easily pulled off.

·      Avoid pillows, toys, or loose bedding (including quilts, sheepskins, blankets, mattress pads, etc.) that could smother your baby.

·      Never leave an infant or toddler unattended on an adult bed.

·      Never let your baby sleep on a waterbed, sofa, or another soft, flexible surface.

·      Eliminate spaces between the mattress and the wall or nearby furniture, or the mattress and the structure of the bed (headboard, footboard, side rails and frame), where your baby’s head might get trapped.

·      Let your young baby sleep only on his back.

·      Never let another sibling sleep next to your baby. Children sleep deeply and may roll over onto the baby.

·      Never sleep next to your baby if you are intoxicated or have been using drugs, are taking medications, are overly tired or in any other way feel that your ability to be aroused could be affected.

·      Do not sleep with your baby if you are very obese.

·      Do not let your baby overheat during sleep.

·      Do not smoke around your baby or allow anyone else to do so. Smoking exposure may increase the risk of SIDS.

·      Tie back very long hair in a pony tail or braid it. Long hair could cause suffocation or strangulation.

There’s a lot of contradictory information floating around and recommendations are always changing, so it is best to regularly re-visit safety issues with your pediatrician.

For more information, here are some helpful starting points:

www.healthychildren.org

www.firstcandle.org

www.safebedsharing.org

*Information for this post came from First Candle, Good Night Sleep Tight by Kim West, The Happiest Baby on the Block by Dr. Harvey Karp, and SafeBedSharing.org.

Ensuring Good Sleep, Even on the Road!

Here are some tips to make your vacation as smooth as possible, sleep-wise.

Prepare a sleep-friendly environment. Whether you’re staying in a hotel, rental house, or with family, try to create a sleep-friendly environment for your little ones. Bring along unwashed crib sheets (the familiar scent will be soothing), favorite loveys and blankets, sound machine, and night light. If you’re not sure the window shades will be dark enough, pack black trash bags and masking tape or thumbtacks for makeshift blackout shades. The Phil & Teds “Traveller” cot is a great alternative to traditional pack n plays; it is small and light enough to fit inside your suitcase, has no uncomfortable crossbars, and has the added advantage of an optional top in case you’ve got a climber on your hands. (More on that subject in another post!)

Respect your child’s need to sleep – even on vacation. Yes, your child may miss a few naps due to travel and bedtime may be a little later due to older cousins. But try to not abandon your child’s schedule altogether, particularly if you are away for more than a few days. If normal crib naps are not possible, plan to drive during nap times, squeeze in catnaps to take the edge off, and opt out of a late dinner if your little one is showing signs of fatigue. You’ll be glad you made the sacrifice – over-tired children usually don’t make the best travel companions anyhow.

Maintain the rituals. Try to maintain your family’s pre-sleep routine, or at least an abridged version of it. The familiar books, songs, and other positive sleep associations will be especially comforting to them as they adjust to their new environment.

Talk to your children. Even one year olds often understand a lot more than we think. Let your little ones know that you are doing things differently than usual because you are traveling. “Today we are going to take our naps in the car because we have a long drive to grandma’s house. You can rest in your car seat, and we will wake you up as soon as we get there!”

Avoid using the same crutch you just broke. Sure, some sleep regressions may happen during travel. However, if you have recently worked hard to stop nursing your baby to sleep, try rocking her or patting her down instead. It’s less confusing and less intermittent reinforcement, which means ultimately it will be easier to undo.

Nip bad habits in the bud. Let your little ones know that once you are back home, it’s back to business as usual. So if you had a co-sleeping nurse-athon in order to keep her quiet at your in-law’s house, the “open bar” officially closes when she kisses grandma goodbye. It’s much easier (i.e. less crying) to tackle new sleep issues before they are fully engrained.

Enjoy your vacation!

Bon Voyage!

Planning a family trip this summer? Wondering how to prepare for airplane travel? Not sure what to pack? Hopefully these suggestions will alleviate some of your pre-travel stress.

Carry-On Packing List

·      Loaded diaper bag – extra diapers, wipes, sanitizer, washcloths, diaper trash bags, etc.
·      Ziploc medicine bag – Ibuprofen, Rescue Remedy, Arnica, diaper cream, etc.
·      1-2 extra outfits for child (and shirt for mom!) plus sweatshirt/fleece
·      Snacks – LOTS! We bring a whole reusable shopping bag full. All of her favorites and then some. Save a few good ones for the last 30 minutes when you are landing. Fresh berries (washed in plastic container), cookies, clementines, edamame, Bunnies, raisins, cheese sticks, baby carrots, apples, organic food pouches, water bottle, etc. Plus a little container so she can feed herself.
·      Books – a few favorites (paperback!)
·      Toys – favorites plus new ones that are still in packaging – they take a few minutes to unpack and on some flights, every second counts! Matchbox cars, little dustpan and broom, doll with accessories, lacing cards, magic drawing board, magnetic things
·      Arts – stickers, crayons, notebook for doodling, stamps and stamp pad, pipe cleaners and beads with wide hole (get your toddler making bracelets for everyone!), play doh
·      Portable DVD player or iPad and headphones (if appropriate) with favorite home videos/DVD’s
·      Playaway (portable books on tape player) with headhones
·      Carrier – particularly important for long flights if child having trouble resting/napping, can be very soothing to just snuggle in with mom/dad; also helpful in airport
·      Stroller (to gate check) – helpful for lugging children and/or gear around airport

Checked Luggage Packing List

·      Sleep essentials – lovey, special blanket, sleep sack, night light, white noise machine, big trash bags and pushpins or electrical tape (if may not be curtains where you’re staying)
·      Portable crib if needed and sheet (unwashed crib sheet from home can be a real comfort)

Products I Like

·      Classy Kid Keep Me Tidy Biodegradable Diaper Sack
·      P'kolino Triangular Crayons (won’t roll off tray easily)
·      Lacing Cards
·      My First Sticker Encyclopedia series and Ultimate Sticker books
·      Phil & Teds Traveller Crib – compact enough to fit in suitcase, fits most preschoolers, comfortable. Can order sunproof top separately.
·      Phil & Teds Lobster portable high chair – very compact, works on most tables
·      www.totsonthego.com and www.travelingwithkids.com and www.onestepahead.com
·      101 Activities for Kids in Tight Spaces (Carol Kranowitz) – great tips for travel & home

On-Flight Tips

·      Don’t underestimate the novelty factor – borrow/buy lighter, travel friendly toys
·      A well-rested child travels much better. Morning flights are usually easier than late afternoon ones. Try for a good night’s sleep or normal nap leading up to flight if possible. Bring your carrier even if it's for a nap before the flight in the airport
·      Easy slip on/off shoes for getting through security quickly
·      Befriend flight attendants during boarding.
·      Try to nurse/sippy cup/food pouch during takeoff and landing.
·      Keep your sense of humor, ignore the haters, and bring yourself a treat too ;-)