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My views on sleep habits

As an early childhood nurse, I support parents in many ways with medical knowledge and skill. My highest priority is to empower parents and to make them feel good about the parenting choices they make as long as their baby is safe and as healthy as they can be.

There are many different views on whether “sleep training” for babies is safe or harmful but it is evident that many people have very strong views one way or another.

It saddens me that the information is presented in such a way that can cause parents to feel they may be harming their baby by changing sleep habits. My response to them is that while I don’t dispute the scientific data, I think the spin on the conclusions evoke more questions than answers and I try to give them the following reassurance:

Firstly, for a study to be evidence based it should have specific controls and variables which can be measured scientifically. I cannot imagine how such a study might be even remotely possible with babies given the individuality of any given baby and parent – such control groups would verge on impossible.

Secondly, language such as “thought to contribute to”, or “may be associated with” is not strong evidence.

Some studies mention stress levels in babies following “sleep training”. It is a scientific fact that sleep deprivation also raises these levels. It does not surprise me that there would be an elevated level continuing for a few days following some good sleep which would naturally decrease, but I don’t think any of the studies followed up any further than the first day.

My understanding of the studies that have been carried out is that the groups are small, making conclusions less reliable.

I believe (although this is also not scientific) that stress levels are high to begin with because of sleep deprivation and I often ask my parents, “Do you think it is more harmful to continue with the current levels of stress long term or do you think that the stress of changing a behaviour short term for long term benefit is a better, healthier option?”

In my experience (again, not scientific), the entire family benefit from better sleep and feel much more able to cope generally. I believe this would be similar for baby. In fact, many parents comment that there is a notable difference in their baby’s ability to cope in general when they are getting better sleep.

I sometimes direct them to this study just to give them a bit more reassurance. 
http://www.abc.net.au/…/controlled-crying-babies-no…/7443878

Furthermore, a recent study shows extremely detrimental results due to sleep deprivation. It is not only baby that needs consideration but the entire family. 
https://www.sciencedaily.com/releas…/2019/…/191121183923.htm

For studies to conclude that “sleep training” baby ”may be associated with” or “might contribute to” things that cause parents anxiety about their choices is unhelpful.

I will always support, encourage and empower parents to be the best parents they can be in their own way.

If you are happy with your settling techniques, whether that is holding your baby until they fall asleep, feeding to sleep or allowing to self-settle and feel you and your baby are getting adequate amounts of good quality sleep, then keep up the good work! If you feel that you and your baby could benefit from some professional advice about changing sleep behaviours, please contact me.

Kathy

If you have any questions or there are any topics you would like to see in future posts please don’t hesitate to get in touch.

It’s okay to get help

Many of my mums ask why they waited so long before getting help to sort out their sleep issues.

There are many reasons-they think they should be able to handle it alone, they feel like failure to ask for help, many strong opinions about sleep behaviours and how it should be handled are confusing and they don’t know where to start or how to keep going.

Sleep deprivation is not normal, can impact health in a negative way, impacts relationships and can affect coordination (even when driving). There is a reason it was used as a form of torture.

You can do something about it and it is never too late.

My favourite day is checking in with my families after 1 week to see how they are going. Not surprisingly, I hear of benefits such as improved mood, energy and general well being not to mention much better and less interrupted sleep.

Of course, it is a matter of listening to what my mums and family want and need, then finding a way to bring about change. There is a period of learning and relearning for mums and babies that takes a bit of time and practice.

There is certainly some work and effort involved but that is my job…showing parents how to progress, and support them in the process of change, giving them confidence to continue and reach for what initially seems like a goal too far.

There are a variety of choices my families make about how they proceed and not everyone will use the same methods but the principles I teach them are the same.

If you are struggling, it is OK to get some help. Don’t suffer unnecessarily.

Kathy

If you have any questions or there are any topics you would like to see in future posts please don’t hesitate to get in touch.

Dream feeds

A dream feed is given last thing at night, usually around 10-11 p.m. without fully waking baby.

The purpose of a dream feed is to help provide a longer period overnight before baby wakes for the next feed giving mums and dads (and baby) a longer sleep.

Dream feeds, when successful work really well and are a great way to extend the next feed, ensuring a few hours of rest for all. Many of my mums use them and find they have success and gain a few extra hours of valuable sleep. One of my mums said that dream feeds were the best because her husband did them-as I said, when they work, they are great.

Some of my mums who have tried them without any advantage say that it made no difference. Some felt they were interrupting a perfectly good sleep and felt it just added an extra feed they had to wait up/wake up for. Some felt they were giving baby a feed they didn’t need.

Opinion is divided about the advantages-some suggest it is a great idea and some claim it interferes with a baby’s natural sleep rhythm. One article says dream feeding is a good way to try difficult feeders when they are sleepy and relaxed.

Personally, I failed at dream feeds (how can any new mum possibly stay awake after 7?) but ended up with a long sleep period from 6pm – 2 am, and that had it’s own advantages.

Babies will usually find there own patterns and whilst we can encourage a longer sleep overnight, it might just be that your baby will be the best guide.

I would love to know (and my new mums) if you used dream feeds successfully or not.

If you have any questions or there are any topics you would like to see in future posts please don’t hesitate to get in touch.

Toddlers and bed time

Developmentally, toddlers are learning about themselves and relationships. They have trouble controlling emotions and understanding rules. They have difficulty making choices, sharing and they say no a lot, all whilst needing strong emotional and physical reassurance.

Of course, bed time routine and ritual are all important but getting toddlers to bed can be tricky. 
If you find you end the routines and rituals and then the trouble begins, look at how you are responding and think about the 2 option rule.

I have mentioned this before and it can be applied to any situation as well as bed time. Remember, toddlers have difficulty making choices but are trying to gain some independence as well.

Here are a couple of things that can help if you are on the difficulty getting to bed round-a-bout. Offer your toddler 2 choices such as: would you like me to carry you to bed or would you like to walk yourself? What you are saying is, it’s time for bed but you are giving some control about how to get there.

If your toddler is one of the ones who has learnt that they can string out bed time by having one more book or a drink or some other diversion, let them know in a calm manner that it is now bed-time, unless there is a good reason they might be thirsty. Let them know in advance it is one book, three books-whatever. Try and offer any extras before bed time starts.

If staying in bed or getting out is a problem, explain calmly: 
If you lay down and close your eyes I will stand a the door. if you get up I will leave. OR, If you stay in bed, the door can stay open, if you get out of bed, the door will be closed. Both of these options must be followed by honest action (ie, leave as you said or close the door) if the toddler is getting out or not lying down.

Undoubtedly, some of you will be shaking your heads saying, I have tried this but I imagine you have tried, then given in to the yells, requests or undesirable behaviour by your toddler knowing that it will get you some peace. Chances are that if you have done this, your toddler is learning that noise gets results. Changing this will take some repetition and practice-like any new skill.

I can tell you that if you keep repeating the 2 options and stand firm calmly, your toddler will soon get the message that they really only have two choices. This may take all of the strength and control you can muster, and some repetition but it will bring change.

One of my favourite sites for advice on toddler behaviour and tips is Triple P parenting. If you get a chance to attend one of their free seminars, it is well worth the time spent. I always get great feedback from parents who tap into this great free resource.

https://www.triplep-parenting.net.au

Thanks.

Kathy

If you have any questions or there are any topics you would like to see in future posts please don’t hesitate to get in touch.

Transitioning from cot to bed

Transitioning from a cot to bed can happen anytime after the age of 2 and usually sometime before the age of 4. 
There are many reasons that influence the need for change including; a new baby on the way, climbing out of the cot, the ability to be able to get to the toilet at night and of course, the age of the toddler.

Maintaining safety in the bedroom is most important-your toddler can now get out of bed independently, and they probably will, so check the room for choking and suffocation risks. Tie up curtain cords ( newer curtains and blinds have safer adjustment cords), consider what is tempting for them to climb on and how sturdy it is (and what they may be able to reach), consider a safety door for a short time to prevent night time wandering to other areas of danger and temptation. Look at what may be shiny and tempting for your toddler and assess it’s safety-especially things that can be pulled over or swallowed. You might like to think about safety rails or starting off with the mattress on the floor.

Make starting off in a big bed something your toddler can be involved in and talk about the change before hand. If your toddler can be involved in helping choose the bed, setting up and seeing the new bed take shape, it can help them be more interested. Remember toddlers are developing emotionally and are trying to gain some independence. Be careful though that you don’t over excite your toddler about the new bed-you do want them to go to sleep, not think it’s a party bed.

If you are moving to the bed because there is another baby on the way, make sure the transition happens some time before the new baby. Your toddler will have adjustments to make with the new baby, so you don’t want it to appear the baby has stolen the cot.

If you haven’t already, now is a great time for bedtime routine & quiet time before bed. It might also be helpful to keep a blanket from the old cot and transfer it to the new bed. Praise your toddler and be proud of the transition, encourage your toddler to climb into bed on their own and let them know you will be there in the morning.

If you have any great ideas that have helped your child change from the cot to the bed, please share them and let our families know.

Kathy

If you have any questions or there are any topics you would like to see in future posts please don’t hesitate to get in touch.

What is normal crying?

What is normal crying for my baby?
Well, there are so many answers here and so many more questions. There is usually some reason your baby is crying and it is the principle means of communication ear

There are about 1-2 hours of unexplained crying in a 24 hour period and mostly, babies are comforted by cuddles, feeding changing or repositioning. It is generally quite easy to settle and comfort most babies but there are some that just don’t seem to have an off switch for their cry button.

Firstly, if this sounds like your baby, then a trip to a Paediatrician is advised to rule out any minor, or major illness or condition that may be treatable.

If you have a diagnosis, then you can work on strategies to help your baby and enable you to understand where they are coming from. Sometimes this gives great relief, even if it doesn’t solve the crying.

Sometimes, regardless of a healthy baby, parents are faced with a baby who cries seemingly non stop and this can be devastating to say the least. There is nothing that is able to pacify baby despite every effort.

Here are some things that may be helpful: Diet-limit caffeine. I had a mum who had the most glorious baby until she started taking some supplements and on investigation, found them to contain caffeine. Sometimes eliminating dairy or some other foods can help but if you consider this, ensure you are still getting adequate nutrition.

Try a relaxation bath-for the baby (but hey, you might need one too). Fill the bath so that your baby is almost floating supported with just the head out of the water. gently move baby in the water. Most babies love this but there is the unavoidable getting the baby in and out of the bath which sometimes puts you back to square one.

Try a bit of baby massage: https://www.johnsonsbaby.com.au/skin-care/baby-massage…

Sometimes, it is about managing the situation if you are unable to find a cause and have exhausted endless possibilities.

Get help: There are friends who ask “can I do anything?”
Your resounding answer should be YES. Have them sub in even for a short half hour to give you a break. Allow them to hang some washing for you, get some essential food from the shops, just come and keep you company.

Look after your relationship: It is such a stress to have a baby that seemingly doesn’t respond to all of your care and cuddles and that can impact not only you but those around you. Remember, you are on the same team, even though the team doesn’t seem to be winning. One of my mums had 15 mins in the evening when she and her partner would sit down together and have their evening meal. They would put the baby in the walk-in wardrobe-don’t judge. The baby was safe and warm, the space was big and this was their only break.

The great news is that they all survived and that child is robust, healthy and beautiful. The parents as loving and supportive as they were in the early days.

Speaking of safe, if you are alone and feeling stressed to the max, it is OK to place baby in the cot and walk away for a few minutes to regroup and re engage. If you feel out of control, put baby down and call someone to help.

Surviving a crying baby is tough but like many who have come before you, you will all, with time get improvement and your life back.

Kathy

If you have any questions or there are any topics you would like to see in future posts please don’t hesitate to get in touch.

Introducing Solids

When should solids be introduced?

The general consensus remains that solids should be introduced around 4-6 months with emphasis on looking for signs that your baby is ready, showing interest in food and/or an increasing appetite. For example, you might notice baby taking an interest in the food you are eating or even mimicking your mouth opening when you are eating. However, whether full term or premature, baby should have good head control and be able to sit with minimal support prior to the introduction of solid foods.

For premature babies, the School of Paediatrics and Child health Uni WA Perth found 3 months – corrected age seems appropriate. http://www.ncbi.nlm.nih.gov/pubmed/22555187

Once you think your baby is ready, try offering small amounts of soft food and remember, it is going to take a bit of practice so be prepared for mess! Those fabulous mesh bags help contain some of the mess and are great for baby to hold and explore food with (everything at 6 months goes straight from hand to mouth).

Supervision whilst babies and small children are eating is of course essential.

It is very important to introduce only 1 food at a time (so that if a reaction occurs, you can identify the cause). Whilst you might be tempted to give solids in the evening to fill baby up so they sleep longer, it is preferable to always start solids and any new foods in the morning so if you have to deal with any upset tummies, it will be in the light of day.

It may also be helpful to add breast milk to foods as this is a familiar taste for baby and can make the texture softer.

Once you are satisfied your baby is tolerating any one food, you can add additional foods and you can offer proven “safe foods” in the evening.

You might be successful with your first attempt with solids but if you get a flat out refusal, simply try again at another time…the next day, the next week or the next month depending on the age of baby.

Kathy

If you have any questions or there are any topics you would like to see in future posts please don’t hesitate to get in touch.

Will my baby sleep through?

There are several questions that I am asked regularly by parents and I will answer some of these in the next few posts.
When will my baby sleep through?

I have heard of babies sleeping through at a very young age but realistically, there is an enormous range of when baby will be able to sleep for long periods overnight.

Bear in mind, some parents define overnight as 6 p.m to 6 a.m and some will say 10 p.m. onwards.

Somewhere around 4 months is not uncommon after the last feed in the later evening for a good long overnight sleep. Certainly, by 6 months of age, it is widely agreed that most babies will get adequate nutrition throughout the day so they do not require feeding overnight.

Mostly, your baby will start to shorten a particular night feed-they might feed for a shorter time or seem a bit less awake or interested in that feed. You can be pretty confident that this feed will be the first one they drop.

If your baby is a bit older and you are trying to eliminate a night feed, there are a few things that will encourage them to drop the feed: give them a cuddle and get them back to sleep without feeding; gradually decrease the feeding time or amount you are offering at that particular feed; offer water instead of breast or bottle.

Of course, baby will sleep for longer if they are full before bed time but a word of caution, don’t over do it, especially with solids or you might contribute to an upset tummy.

If you have a tip that has worked for you, I would love you to share with our mums.

Thanks,
Kathy

If you have any questions or there are any topics you would like to see in future posts please don’t hesitate to get in touch.

Anxiety and resilience in children

Earlier in the week, I had the opportunity to attend a seminar by Dr Kaylene Henderson on the topic of ‘Tackling Anxiety and Building Resilience in Children’.
Then session was an hour and a half well spent and I would highly recommend this talk to every parent. 
Dr Henderson gave a well presented talk, and covered building strong relationships with your children and strategies to help deal with anxiety and how to help at home.

Some of the key messages that I would like to share, which she gave greater detail and good examples of were:

• Watch over them as they learn, explore and take risks
• Delight in them
• Share enjoyment in activities with them
• Help them ‘just enough’
• Comfort them when they’re distressed
• Be a good role model. Sometimes we have to be as brave as we’d like our children to be!
• Teach your children that anxiety isn’t harmful and that it also doesn’t last.
Allow children to experience both the ‘ups’ and ‘downs’ of life.

If you would like to find out where her next seminar is, I have a link to the website.

www.drkaylenehenderson.com
www.adoseofawesomeness.com

Kathy

If you have any questions or there are any topics you would like to see in future posts please don’t hesitate to get in touch.

Milestones

Developmental milestones are an indication that we (health professionals and parents) look for to keep track of and reassure us that all is well with baby.

They are an INDICATION of normal development and while they are pretty reliable indicators, they are also flexible and depend on other factors, for example prematurity and environment.
Premmy babies have milestones assessed using corrected age. A full term baby who is the third in the family may be an early developer because they mimic older siblings behaviour or they may be slower developers because they have older siblings who do things for them.

So the point is that if you are looking at the normal development of your baby based solely on milestone assessment, then don’t be alarmed if they are not reaching expected goals.

Many babies reach milestones early and many babies reach them a bit later. The important thing is that they reach them at some stage and continue to develop and grow. Babies development is cephalocaudal which just means head to toe (brain to lower spinal cord) so it makes sense that the upper body-head and arm control happens before lower limbs and fine movement.

You can check your baby’s milestone indicators in the baby record book you are given in hospital (these booklets are a great resource for many things). Here are just a few of my favourite milestones that I enjoy looking out for.

The first smile (around 6 – 8 weeks)-
Highly prized and anticipated by parents.

Chuckles and laughs (around 6 months) – 
I don’t think there is anything that tops the sound of a baby laughing and after seeing the joy their laughter brings, they start to laugh at pretty much anything.

The pincer grip (around 9 months) – 
The transition from transfering an object from one hand to the other is refined to being able to pick things up and control them with the thumb and forefinger.

Searching for objects (also around 9 months) –
You will no longer be able to rely on the out of sight out of mind diversion that worked so well until now.

There are so many more and it is fun identifying and recognising that your baby is developing and learning so much. Remember, they are indicators and many babies will reach their milestones earlier or later depending on other factors. It’s not a race to see if your baby reaches a certain milestone first but if you have genuine concerns that milestones are delayed, then you should certainly have a conversation with your child health nurse or GP.

Feel free to share your favourite milestones.

Kathy

Kathy Collins 
RN.CM.ECHN
Sleep solutions for your family
☎ 0402 244 538
🖱[email protected]
💻www.babysleepwell.com.au

If you have any questions or there are any topics you would like to see in future posts please don’t hesitate to get in touch.