Good associations from the start – World Breastfeeding Week – 1-7th August 2018

The theme of this years World Breastfeeding Week is to inform people about the links between good nutrition, food security, poverty reduction and breastfeeding. Following on from this (more relevant in the developed world) having a well-slept workforce may also reduce poverty and increase wellbeing, through improved mental and physical health.

Breastfeeding is a essential skill for a mum and baby to learn for nutrition, comfort and baby’s development- therefore there is plenty of help and support available to new mums and babies. It is recognized by most people as something that needs to be learnt and practiced.  So why is it a surprise that babies need to be helped with another essential skill – learning to sleep?

Perhaps it because it may be emotionally harder for a breastfeeding mummy resettle her baby without the go-to method of comfort which is breastfeeding? But breastfeeding does not automatically mean no sleep for mum.

The study discussed in my previous blog talked about the length of time a baby may cry for before settling themselves (https://www.goodnightsolutions.co.uk/babies-can-resettle/). The babies in this study were all breastfed – showing that a breastfed baby is just as likely to sleep for longer stretches at night as a formula fed baby.

Here are some tips for teaching your young baby to sleep well as they grow bigger.

Show your baby the difference between night and day – walks outside in the afternoon perhaps and darkness and dim lights at night.

Make sure they are calm enough to sleep.

Introduce positive sleep associations – for example a story or familiar words, a comfort toy or an item of clothing with mum’s smell on it.

Temperature – not too warm and not too cold – bare feet help a baby cool themselves and coolness helps melatonin release.

Place your baby down to sleep when they are showing tiredness cues.

Have predictable routines in the day and a short bedtime routine.

Don’t respond too quickly if your baby cries (remember the 1 minute 6 seconds from last week?). Some babies need to generate their own ‘white noise” to settle themselves.

See www.goodnightsolutions.co.uk for more information.

http://worldbreastfeedingweek.org/

Babies can resettle – the controversial subject of ‘self-soothing’  true or false?

If you have read Goodnight Solutions blog – Sleep cycles , normal sleep?  (https://www.goodnightsolutions.co.uk/sleep-cycles-normal-sleep/)  you may remember that waking in the night is normal for babies and adults alike.

So how then do some parents report their babies as young as 5 weeks will sleep for 5 hours? Answer – by having a baby who does not signal to his or her parents when they do wake.

A small study performed in 2015 on 101 London babies by Ian St James-Roberts et al showed the average time of crying in the night at 5 weeks old was 1 minutes 6 seconds before the baby fell asleep again, this was slightly increased at 3 months to 1 minute and 19 seconds of crying before settling again without parental help. Amazingly the study also showed that in the 6-7 weeks between 5 weeks and 3 months these babies managed an extra 2 hours sleep at night – quite a developmental achievement in a short space of time!

Another interesting finding of this study was that those babies that were allowed to resettle themselves at 5 weeks, had those same skills at 3 months and beyond. In contrast the babies who signaled (ie cried) and were not given an opportunity to resettle themselves before parental  intervention were shown to still need parental help to sleep at 5 months of age and were more likely to have longer term sleep problems. Obviously there are limitations from this study (as outlined by the researchers themselves) and only 101 babies from mainly affluent well-educated parents were videoed, but none the less food for thought!

What does this teach us about babies resettling themselves or ‘self-soothing’ ?

Firstly they need an opportunity to be allowed to learn this skill.

Secondly 1 minute 6 seconds is a huge length of time to listen to your baby cry for in the middle of the night – hence quite emotionally challenging  to acheive!

Thirdly if your baby is still audibly distressed and not calming after that average time of 1-2 minutes then most likely they need feeding and attention.

If you would like the full article read it here;

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4459553/

Visit www.goodnightsolutions.co.uk for further information.

So when and why would you use a sleep practitioner? Consider the cycle of change!

The image above is taken from Steven Aitchison’s excellent website (www.stevenaitchison.co.uk). It is based upon the cycle developed by Prochaska and DiClemente in 1983. It describes the thought processes we use when thinking about changing something in our lives – in this case sleep issues!

So lets think about this!

Pre-contemplation

This is maybe where Gran says ‘that baby should be sleeping more by now’ or ‘you are making a rod for your own back letting that toddler sleep with you’. Is this a problem for you at this point?  Probably not!

Contemplation

Maybe we are several months ( or years? ) down the line and our sleep situation is becoming a problem. We consider making some changes – this consideration is the start of our change journey.

Preparation

We are now thinking about what we can do to improve our family’s sleep. Maybe we google some websites (https://www.essentialparent.com/) (https://www.goodnightsolutions.co.uk/) for example or look up one of the many sleep training books on Amazon! Maybe we even manage to read one of these books.

Action

We put into action some of the techniques we have read about or others have recommended to us. This stage is hard!

Your child has not read the books or websites and is not really motivated by the cycle of change. However you may have read a book that suits your ethos so you find the techniques acceptable and easier to stick to. Or you may try a variety of methods and conclude that your child doesn’t need as much sleep as is suggested.

Maintenance

You have seen improvements in sleep and are keen to keep this going! Well done – now you need all members of the family on board and also need to ensure you continue your routine or techniques after any illnesses or holidays ( but always respond to a poorly child – sleep can be addressed again when they are better).

Relapse

Perhaps an additional stresser has affected the family? Maybe a change in working hours or a new baby? Or perhaps the technique started in the action phase wasn’t sustainable for the long term?

This is a very common situation and families may have gone around this cycle of change several times before approaching a sleep practitioner. If we are prepared for relapse and aware of it when it happens then it is a temporary situation, and we move back into pre-contemplation.

True change happens when we pick the right solutions in the preparation phase and we have the right support around us in the maintenance phase. See goodnightsolutions.co,uk for how I can help you through this journey. 

 

 

Normal sleep? When I ask people what goal they would like for their child when they ask me about sleep training or sleep problems – in 99% of families it is for the child to sleep through the night. I start by explaining that non of us sleep through the night. If we perceive we have had a full night’s sleep we were not aware of these awakenings – on the other hand we may be very aware we have woken especially in this hot weather.

Normal sleep (from about 4 months onwards) is characterized by a periods of deep sleep occurring roughly 10-15 minutes after falling asleep. We then move into lighter sleep, REM sleep and wake periods which we cycle through for the remaining hours of the night. It is therefore normal (and evolutionary advantageous) to wake 2-3 times in the wee small hours. We wake to check we are safe – as an adult we usually are!

However if we are 7 months old or 7 years old (or anything in between) then maybe we are not safe? Maybe the reassuring nightlight has turned off or the lullabies have finished? Maybe mummy or daddy are no longer there? Or maybe we fell asleep on the sofa and now everything is different? Maybe the bottle of milk or the comforting breast feed is not there either? So what do we do now? Perhaps cry or come to find a parent? Sound familiar?

So how do you teach your child to sleep trough the night? You don’t! You teach your child to be safe and comfortable in their sleep space (wherever that may be) and you ensure that whatever soothed them to sleep at bedtime remains there at those wakings in the night. That means teaching your child to fall asleep happily at bedtime without needing you to sooth them at those night wakings. Unless you want to be there of course. Services

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Intermittent rewards – the one thing we all do as parents but the one thing that derails us!

For years I have wondered why my kids always asked for screen time – all day, every day, anytime they were not on a screen they were asking to go back on one!

I didn’t understand it – they were happy kids, interested in loads of other things and able to occupy themselves (mostly) although not without some sibling fighting.

Did I give them too much TV or too little and why did other people’s kids not seem to do it? Should I just leave the TV on all day in the hope they got bored of it – but I didn’t dare do that as I genuinely thought that they would watch 14 hours of TV a day. The only time they did not ask for screen time was before school as I had made a rule that there were to be no screens before school on the first day they started. A rule that still stands.

It was only very recently that I figured out the problem – I had inadvertently set up an intermittent reward system years ago! The challenge of having twins, followed by another child had left me in a position where I could say ‘no’ all day. Yet crucially on the 350th time of the kids asking, one of them would have poo’d, been sick, or hurt themselves and the other 2 kids finally got a ‘yes’ just to allow me to deal with the crisis in front of me.

This is the same reason we adults play the lottery, slot machines or gamble on the horses – we know that most times it will be a ‘no’ but just once, maybe, it will be a ‘yes’. Maybe just £10 but its still enough to keep us at it. No different to my kids and their hopeful continual questioning about screens!

This intermittent reward system can keep our youngsters waking at night and getting up to find us. We can be consistent all night putting them back to bed but maybe at 5am we’ve had enough and toddler comes into bed with us.  We know we are getting up in an hour and behind the curtains it’s already light– but to the youngster it’s finally the reward they were hoping for. They have no concept that it is now 5am and not 2am when they started asking to sleep with us.

Possibly it is only on a weekend that our babies get a breastfeed or a bottle with a lovely cuddle in bed at 5am – in the hope that we may snatch another 2 hours sleep. This is enough to keep them asking though – every night of the week.

Have my kids finally stopped asking for screens now I have grasped this important concept? No of course they haven’t – they are eternal optimists like all kids! But they no longer ask more than once as I have stopped wavering in my reply – if I’m ok with them having screens then it’s a big fat ‘yes’ and if there is something better to do then its ‘no’.  No more gambling in this home!