Gentle parenting verses sleep! Can we achieve both as parents?

What do you think of these days when you hear the term gentle parenting? Is it synonymous with or distinct from attachment parenting? In my understanding (and I may be wrong!) attachment parenting is a set of ideals and a way of ‘being’ whereas gentle parenting tends to be an ethos of understanding and connecting with your child to help them learn about life and themselves.

Let me point out – both parenting styles are very positive and an effective loving way of raising a child. There are many other positive parenting styles too and as long as there are some gentle but consistent boundaries in place for the child, a parent will do a great job!

Parents can find zillions of blogs, articles, websites, Facebook groups that will give advice and support with behaviour, parenting style and sleep. There are umpteen free resources out there!

Many parents identify with a gentle parenting style – after all love, comfort, reassurance and joy are the cornerstones of parenting and no-one would describe themselves as not gentle!

So, can we marry sleep coaching, training, improvement, strategies etc (call it what you will) with a loving and gentle parenting approach?

We are bombarded with concerns regarding attachment, emotional literacy, infant mental health, and long-term emotional damage to our children if they experience distress. It makes it hard to see the wood for the trees. No parent would allow their child to do something harmful to themselves and yet denial of the dangerous object or activity causes distress and frustration to that child. It’s called the ‘greater good’ – therefore is there a place for ‘greater good’ in the world of sleep?

The answer to that will depend on where your parenting ethos lies – some will say definitely ‘yes, I need my sleep to function as a parent’ – some will say absolutely ‘no, waking and feeding frequently at night is ‘normal’ into a baby’s second year’. To clarify on this point – yes, it is normal for a lot of babies – but not all of us can function that way.

Is there a middle ground?

In my journey as a sleep coach and small business owner I have watched, downloaded, and googled more marketing hacks than I care to mention! A reoccurring theme is that to be noticed in the ‘online space’ your content has to be divisive – one way or the other – there does not appear to be a market for the middle ground opinion anymore! BTW this does not only appear to be applying to the world of sleep!

And yet the majority of humans do appreciate the middle ground – we are, by nature, a kind, adaptable and compassionate species who thrive on human relationships and companionship – compromise is therefore natural for us.

So, who in the dyad (triad?) of parent and child and sleep issues does the compromising?

Again, this goes back to your parenting ethos – old style methods would ask the baby/child to compromise! Attachment/gentle methods would expect the parent to compromise! Why can’t both parent and baby learn some flexibility and new skills?

We expect our children to learn to walk, talk and share – why can’t we expect them to learn to sleep? By staying with our children as they learn a new way of sleeping, we can support them through the distress and frustration of not knowing how to fall asleep without their old ‘prop’. By gently withdrawing and introducing new methods we build up their confidence in themselves and their environment. Thus, going to bed at bedtime and sleeping an appropriate length of time for their age and development becomes a pleasure rewarded by more enjoyment with their parent the next day. I cannot promise there won’t be tears, frustration and upset and any change to sleep makes it worse before it gets better. However, you may find the compromise is worth it!

Points to consider when looking at your child’s sleep.

  • Consistent boundaries – does your child have some consistent boundaries during the day? Are they having some learning opportunities to tolerate uncomfortable feelings? By this I mean the distress caused by saying ‘no’ to a biscuit just before lunchtime for example!!
  • How do we put gentle boundaries around our child’s sleep? Decide in your family what is acceptable and what isn’t. For example; where do you want your child to sleep, what is an acceptable wake-up time for your family, do you have several bedtimes to manage close together on your own? All these factors determine our evenings and our boundaries.
  • Should we put boundaries on sleep? How old is your child? Do they have any health or development problems? Do you or other carers have any health problems? Are they particularly anxious around bedtime? Place the boundaries in gently at a time which you feel is right for your family.
  • How does putting boundaries in place make you feel? Consider how you feel about being consistent and saying no – does it worry you, frustrate you, or do you see it as a healthy but challenging part of parenting?
  • How does your child’s frustration, tiredness and (dare I say it – distress) make you feel? Our emotions, reactions and subsequent behaviours stem from our past experiences – consider what you can tolerate and gently push yourself in all areas (and not just parenting).
  • Can you help your child tolerate an upsetting situation or do you need to alleviate it at all costs? Linked to the point above – if you find your child’s distress intolerable it may be time for some deep thinking or chatting through with a loved one or trusted friend or professional. Often what we wish for our children stems from our own childhood and upbringing.
  • Is your child’s sleep pattern common?  Read here for more information on naps and sleep needs. I use the term ‘common’ rather than normal as ‘normal’ implies a parent must accept this behaviour indefinitely – some can, and some can’t –there is no shame in this. If your child’s sleep is appropriate for what they can reasonably manage for their age and development then consider strategies to help your own sleep, relaxation and enjoyment of your days. If not, then consider making some changes.

Author: Rachel Greaves, Goodnight Solutions 2020

 

Rachel Greaves is a registered midwife and public health nurse, a member of the International Association of Child Sleep Consultants, World Sleep Society and British Sleep Society. She has completed extensive training in paediatric sleep and has worked with hundreds of families over her NHS career. She works privately at Goodnight Solutions and specialises in gentle family sleep support. Rachel now offers online sleep coaching providing individual support over a 4-week period. Visit www.goodnightsolutions.co.uk for more information.

Naps and daytime structure!

Let’s chat about naps! When our babies are tiny, they feed and sleep and feed and sleep! Then they wake up around 4-5 weeks old and suddenly naps become a ‘thing’!

Some babies are great at dropping off and naturally regulating their day sleep regardless of where and how. Other babies are more stimulated, interested, distracted etc and really do struggle to fall asleep. Others drop off easily but do not stay asleep for more than 15 minutes, and others wake when they are moved from one place to another. If your baby is getting enough sleep in the day and bedtime and night-time do not cause a problem, then leave well alone!

Young babies move between light sleep and deep sleep during both naps and night sleep. They are not capable of staying awake for long periods of time and will easily drift into light sleep. If there is a feeding problem such as reflux or milk allergy, we often see them wake easily due to pain. Therefore, if your tiny baby is not settling then it is worth reviewing their feeding.

Past 4-5 weeks often babies struggle to fall asleep as they are not easily able to avoid stimulation and start to need more parental help to fall asleep, be that rocking, cuddling or feeding to sleep. This is not a problem on its own and does not necessarily lead to later problems.

Overtiredness

When babies and children are overtired, they release cortisol and adrenaline (stress hormones). These hormones help them to keep going, but they also can make our babies and children appear ‘not tired’ and even hyperactive. This overtiredness can build throughout the day, so that one late nap can cause the next nap to be delayed, and then a late bedtime and so on. Children also move in and out of the mood and mindset to fall asleep. If you miss this critical window of time, it can take a long time and a lot of effort to get another window of opportunity. This applies to bedtime as well as naps!

Average naps lengths and gaps;

These times are an average based on guidelines published by the National Sleep Foundation(2019), however it is argued that these charts were determined by small sample sizes, thus reducing their validity (Marticciana et al, 2013). As a sleep coach, I only see parents who are concerned about their children’s sleep. It may be that if a parent and child function well on a smaller or greater amount of sleep then this is optimal for them.

Age Day sleep Night sleep No of Naps Nap interval
1 week 8 hours 8.5 Often awake only to feed
4 weeks 6-7 hours 8-9 hours Able to stay awake up to 1 hour – varies!
6-12 weeks 4-5 hours 10-11 hours Numerous 1-1.25 hours awake
4-5 months 4 hours 11 hours 4 1.5-2.25 hours awake
6 months 3 hours 11 hours 3-4 2-2.75 hours awake
7-8 months 2.5-3 hours 11 hours 2-3 2.25-3 hours awake
9 months 2.5 hours 11 hours 2 2.5-3.5 hours awake
12 months 2.5 hours 11 hours 2 3.5-4.5 hours awake
2 years 1.5 hours 11.5 hours 1 4-6   hours awake
3 years 0-45 minutes 11.5-12 hours 1 5-7 hours awake

 

How does this work in practice?

Babies under 6 months generally need 4-5 naps of around 30-60 minutes. Babies of 6-9 months would commonly have a 45-60 minute morning nap, a midday nap of 1.5-2 hours and a short afternoon nap of 30-45 minutes. As they get older naps space out, a baby of 9-16 months for example may have a short morning nap of 45 minutes and a long afternoon nap of 1.5-2 hours. An earlier bedtime might be needed as the 3rd nap is dropped. Toddlers generally need a midday nap of about 2 hours – usually up to the age of 3 and possibly older.

Why are naps important?

Naps are important to ensure that a baby/child is not overtired at bedtime. An overtired (or under tired!) child will resist bedtime and often we see a long-prolonged settling which is distressing and frustrating for both parent and child. Day sleep refreshes babies and children and allows them to eat better and play and learn more easily. When a child is overtired, they can fall asleep very quickly at bedtime but may then wake frequently at night. This is because they have not learnt to move slowly through the sleep stages and may then wake each time their brain experiences a change. Taking 10-15 minutes to fall asleep is normal and beneficial for children and adults. It allows us to fall asleep calmly meaning that when we rouse overnight (which is normal – we all do it) we are in a calm state and can easily fall asleep again without any other help.

Overtiredness will also cause frequent evening waking. The deepest portion of sleep is usually between 7pm-12pm. But if children are overtired what happens is that they skip the deep portion of sleep and concentrate on catching up on the light phase of sleep which is important for brain development. This can result in frequent waking in the evening–often every 30-45 minutes until your child has caught up. Ironically this is reversed in adults – our brains prioritise deep healing sleep when we are over-tired.

As a caveat to the above, if your child is content at bedtime and sleeps well at night then there is no need to alter day sleep and naps unless it is a concern for you.

Timing of naps

Nap length and timing are determined by sleep pressure rather than circadian rhythm; therefore, the environment does not have to be dark as there is very little melatonin involved. It is the length of awake time in-between sleeps that determines this sleep pressure – each nap decreases the amount of sleep pressure hormone and allows the child to wake refreshed.

Therefore, our aim is arrive at bedtime with a child who is not over or under tired. Naps are constantly evolving, and parents often feel on the back foot with them. Aim to prioitise the first nap of the day, so that the rest of the day is on track. Never try too long or hard to get a child to sleep in the day, move on and try later if appropriate. If you are making changes to your child’s overall sleep, then work on the timings of naps and not ‘where or how’ – these can be tweaked later if needed.

A child with a parent who is able to achieve what they need to in the day and get out and about as required, will ultimately benefit more from the calmer parent than the rigid nap schedule. Naps in the pushchair, car seat or when out socialising with friends are just as restful as a nap in the cot. Sleep is sleep – it all helps!

Where to nap?

As discussed above this does not really matter, however I see a lot of parents who are concerned their child will only nap on them, or on the boob or on the move for example. If you are making changes to improve night-time sleep then just work on timings. If you are wanting a bit of daytime back (not completely unreasonable!) and are aiming for a nap in the cot then gradually get your child used to that environment. In addition to this, add in some extra sleep cues (such as touch, smell, voice etc) and carry on as you are. Over a period of weeks gradually reduce the main sleep need- be that movement, body contact or feeding to sleep. Mix and match your nap locations so that you know that your baby/child will sleep if the jobs of the day dictate a change from the norm.

How to get babies and toddlers to fall asleep!

Babies under 6-9 months;

  • use a predictable schedule to the day and a ‘mini’ bedtime routine prior to naps
  • look at sensory input – too much or too little? Adjust this to your baby’s temperament
  • feeding before a nap is common and induces sleep – do not feel bad!
  • read your baby’s individual sleep cues or if they are very subtle work on trying a nap after an average awake time for their age
  • be aware of your emotional state and approach naps as an enjoyable activity for all – if the nap is not happening without sleeping on you then enjoy this, put your feet up and try a different way next time

Older babies and toddlers

  • by now their circadian rhythm is well established, therefore days are more predictable
  • aim for regular wake times, bedtimes and mealtimes
  • plenty of light exposure first thing and throughout the day
  • ensure plenty of outside time, exercise and fine motor activities
  • introduce a calm down period prior to naps and use your ‘mini’ bedtime routine
  • always think timing rather than location
  • ensure awake times, bedtime and length of naps are age-appropriate

Napping too early?

Causes; early rising, tiredness, badly timed care ride (often unavoidable!), over-stimulation in the late afternoon or evening, high sleep need, strict schedule or boredom.

Solutions; bright light on waking, delay nap by small amounts until at appropriate time, appropriate sensory input – avoid boredom and over-stimulation (read your child’s cues), ensure enough playtime both in and outdoors, avoid over-tiredness, earlier bedtime.

If early napping is not causing an impact on the rest of the day then do not change!

Napping too late?

Causes; busyness or other sibling needs, distractibility (big one at 4-5 months!), low sleep needs, ready to drop that nap, adhering to a strict schedule, lack of cues – either from baby or from environment, lack of stimulation or exercise.

Solutions; observe and learn individual tired cues (remember the effect of adrenaline), ensure that sleep is age-appropriate and review genuine sleep needs and balance with child’s behaviour, flexibility – some days a nap is needed and some days not, earlier nap, light exposure in the mornings, appropriate stimulation and sensory input.

Dropping naps!

Dropping naps can be a tricky one! Generally, naps reduce in frequency and increase in length at around 4-5 months, 7-9 months, 16-18 months and 2.5-3.5 years. Ironically it is common to think that if a child is resisting bedtime or awake more frequently at night then they need to reduce their day sleep – often the opposite is true.

Struggles with naps also occur around the times of big developmental progressions and readiness to drop a nap is often not straight forward, with a child needing it on some days and not others for example.

As a starting point try changing the timing of the nap or shortening the nap before dropping it and review how this impacts night sleep or bedtime. Ideally a sleep latency (time taken to fall asleep) of 10-15 minutes at bedtime is ideal.  If your child is falling asleep quickly in the buggy or car then it suggests they are not ready to drop that nap.

A good guideline is when having that nap leads to less overall sleep in 24 hours then it is time to drop it!

Author: Rachel Greaves, Goodnight Solutions 2020

 

Rachel Greaves is a registered midwife and public health nurse, a member of the International Association of Child Sleep Consultants, World Sleep Society and British Sleep Society. She has completed extensive training in paediatric sleep and has worked with hundreds of families over her NHS career. She works privately at Goodnight Solutions and specialises in gentle family sleep support. Rachel now offers online sleep coaching providing individual support over a 4-week period. Visit www.goodnightsolutions.co.uk for more information.

References;

Matricciani. L, Blunden. S, Rigney. G, Williams. M and Olds. T (2013) Children’s Sleep Needs: Is There Sufficient Evidence to Recommend Optimal Sleep for Children? Sleep 36(4) Accessed at: https://academic.oup.com/sleep/article/36/4/527/2595961

National Sleep Foundation (2019) How much sleep do we really need? Webpage. Accessed at: https://www.sleepfoundation.org/articles/how-much-sleep-do-we-really-need

 

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Life in the first 6 months of being a parent! Feeding methods and parental factors.

In this series of mini blogs we look at life in the first 6 months of your baby’s life. Week 2 discusses how feeding methods and parental factors affect baby sleep.

Does feeding method make a difference to baby sleep?

There is evidence to show that exclusively breastfeeding mothers get the most sleep in these early months and that mixed feeding mothers get the least! This is not meant to discourage a mother from mixed feeding her baby, as any amount of breastmilk is highly beneficial. It is merely meant to demonstrate what effect parental behaviour can have on baby sleep. Let me elaborate!

Breastfeeding – not compatible with sleep?

Breastfeeding mothers who co-sleep with their babies – whether this is in the family bed or in an adjacent baby sleep space get the most sleep of all mothers despite their babies waking more frequently. This is because the baby is in close proximity and because breastfeeding induces melatonin in the mother and passes to the baby. Therefore, despite more waking, mum and baby settle quickly back to sleep, and often mum is unaware of how many times her baby may have fed in the night.  Why is baby waking more frequently? Most likely due to the need for a breastfeed to induce sleep – i.e. baby associates breastfeeding with how they get to sleep so every time they stir and move through a sleep cycle, they need a quick feed to resettle them. This is only a problem if mum deems it so and has been the biological norm throughout human history.

So, what is a bottle-feeding mum doing differently?

Firstly, bottle feeding babies are not as safe in the parental bed as a breastfeeding baby – this is due to baby being in a deeper sleep and baby not associating the breast with night-time comfort. This means baby is more likely to be closer to mum’s face rather and therefore nearer pillows. Breastfeeding mums also assume a curved side lying sleep position automatically, which bottle-feeding mummies do not seem to do.

Secondly, getting up to prepare a bottle (regardless of prep method or whether it is expressed breast milk) is generally much more disruptive to maternal (or paternal!) sleep than offering a quick breastfeed. Therefore, bottle feeding mums will often offer an alternative source of comfort and settling. This reduces baby’s dependence on one method of settling only, in addition it takes time to get up and prepare a bottle thus baby is naturally having to wait before comfort and/or milk arrives.

Whether this is beneficial or not depends on your point of view – sometimes baby will be very cross about the wait and therefore take into more air, feed more vigorously and take longer to settle after a feed – obviously not ideal at 3am! Sometimes however, baby will stir, shuffle about, whinge a little and then drift off back to sleep. If mummy has to get up to make a feed, she is likely to wait to see if baby is really going to shout for this feed before leaving the warmth of her bed – therefore she gives her baby a chance to resettle themselves, and they start to learn this skill.

Breastfeeding mummies know that if they offer the breast quickly at first sign of baby stirring then baby will drift off to sleep after that feed without a fuss. There really is no right or wrong between these 2 scenarios.

So how does the poor mixed feeding mummy end up with less sleep?

Interesting Kendall-Tackett et al (2011) report no statistical difference in maternal physical health and self-reported energy levels between mixed and fully formula feeding mums. Although these mums did report increased tiredness over formula feeding mums. In a large Chinese study, however, it appeared that partially breastfed infants woke more frequently than exclusive breastfed babies and formula fed infants (Huang et al, 2016). Increased night waking among partially breast-fed infants in the above study may be explained by more frequent infant feeding among partially breast-fed infants compared to exclusively formula-fed infants. It may be that the exclusively breastfeeding mums did not realise how often their babies were feeding?

So, what about regressions and leaps?

Are these a ‘thing’? We have seen in part 1 that a baby’s sleep changes dramatically at around 4-5 months – is this really a regression or a huge development?

Leaps is a term coined by Frans Plooij and his wife in their popular ‘Wonder weeks’ book and app – they describe weeks during a baby’s first 20 months which are particularly disruptive to sleep. The research behind this book has not been able to be replicated and it was based on a very small sample size. Regardless of the debate of the validity of the research, there is no doubt that as a baby makes physical and cognitive developments, their new perspective of their world will understandably lead to disruptions in sleep.

What parental factors do we need to think about?

Family dynamics – some of the factors which influence how a family feels about their sleep situation are listed below. Often a parent feels that improving a child’s sleep will improve their sleep and therefore their daytime functioning. While this is true in some cases, often there are lots of variables in each family’s situation.

Factors such as; parenting without support, the influence of surrounding community or culture and whether grandparents/partner and/or friends are supportive, can have a huge influence on how a parent feels about sleep.

Herman et al (2012) found less parenting stress was related to more positive parenting perceptions. As parental stress will affect child behaviour and stress levels (Barsade, 2002) supporting a parent with a holistic approach may improve family sleep by itself.

Emotional health of the parents is not the only factor in influencing family sleep, physical health made worse by lack of sleep is often an issue (Walker, 2017). This also makes it very hard for the parent to have the resilience or ability to make changes. Financial and work situation is often a motivator for parents to make changes as they are concerned about how they will manage work on a lack of sleep. This might result in a situation where the child’s sleep is developmentally normal, but the parent cannot manage their daily tasks on top of poor sleep (Meltzer and Mindell, 2007).

Sometimes the family’s antenatal experience has led to unresolved issues, such as a child not being planned, or health issues of the unborn baby, mother or any other siblings. There is evidence that in-utero environment for babies of mothers with anxiety or depression affects that child’s sleep once born (O’Connor et al, 2007).

Parental biological chronotype –morningness or eveningness (known as chronotype) is determined mainly by genetics and refers to whether a person is naturally more alert in the early morning or evening. 40% of the population are morning types, 30% are evening types and the rest are in between (Walker, 2017). There is some evidence to suggest that morning types report more positivity than evening types (Biss and Hasher, 2015). It may be fair to say though that if a morning-type adult has a child who takes a long time to settle for bed, they will struggle with this. Likewise, an evening-type adult may find early rising in their child particularly hard to deal with. Thus, it is prudent to discuss these aspects with parents and factor them into any suggestions made to improve sleep.

Personality – La Vigouroux et al (2017) looked at the personality types of parents who experience burnout. They found that parents who have difficulty maintaining affectionate relationships with their children, those that struggled to respond to their children’s needs and those who found implementing boundaries hard – were at the most risk of parental burnout. In addition to the above, considering whether parent and child are more extroverts or introverts will also help resolve sleep problems. An introverted parent may find a high-need wired lively child exhausting. Conversely an introverted baby or child may find some parental social occasions or being passed around much more stressful. Both situations will impact upon sleep or perception of sleep problems. Siblings may also factor into this – for example if the new baby or younger child is a different personality type to older sibling(s) the parent may need to use different techniques with each child.

Blog will continue in part 3 where we look at day-time rhythms, naps and family diet.

Rachel Greaves is a midwife, public health nurse and accredited sleep coach. She volunteers at local breastfeeding support groups and works privately at Goodnight Solutions 

References

Huang, X, Wang. H, Chang. J, Wang. L, Liu. X, Jiang. J, and  An. L (2016) Feeding methods, sleep arrangement, and infant sleep patterns: a Chinese population-based study. World Journal of Paediatrics. 12(1) pp 66-75 Accessed at: http://www.wjpch.com/UploadFile/010%20%2013-201.pdf

Kendall-Tackett. K, Cong. Z and Hale. T (2011) The Effect of Feeding Method on Sleep Duration, Maternal Well-being, and Postpartum Depression. Clinical Lactation. 2(2) pp22-26 http://breastfeedingmadesimple.homestead.com/kendall-tackett_CL_2-2.pdf

Herman. M, Mowder. B, Yasik. A and Shamah R.  (2012) Parenting Beliefs, Parental Stress, and Social Support Relationships. Journal of Child and Family Studies.21(2) pp190-198

Walker. M (2017) Why we sleep. Chapter 2 Caffeine, jet lag and melatonin. pp13-37 Allen Lane. London.

O’Connor. T Caprariello. P, Robertson Blackmore. E, Gregory. A, Glover. V and Fleming. P and the ALSPAC Study Team. (2007) Prenatal Mood Disturbance Predicts Sleep Problems in Infancy and Toddlerhood  Early Human Development 83(7) Accessed at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2853892/

Biss, K and Hasher, L. (2012). Happy as a lark: Morning-type younger and older adults are higher in positive affect. Emotion, 12(3), pp437-441. Accessed at: http://dx.doi.org/10.1037/a0027071

Le Vigouroux. S, Scorla. C, Raes. M, Mikolajczak. M and Roskam. I (2017) The big five personality traits and parental burnout: Protective and risk factors. Personality and Individual Differences 119, pp216-219 Accessed at: https://www.sciencedirect.com/science/article/abs/pii/S0191886917304658

Life in the first 6 months of being a parent!

In this series of mini blogs we look at life in the first 6 months of your baby’s life. Week one discusses what normal baby sleep looks like.

What is normal young baby behaviour?

Our society and cultural expectations have changed over the years, as have our experiences and expectations as parents. However, our babies’ innate behaviour and needs have not!

I’m not an expert but mammals appear to be divided into caching species (i.e. hiding their young when mum goes off to hunt for food) and carrying species, whereby mum carries her infant and feeds it frequently. Dr Blurton Jones in 1972 concluded from several anatomical, behavioral and physiological comparisons, including the composition of the milk, that humans are a carrying species, which breast feed their young frequently. In addition, to this Dr Emmy Werner (again 1972 – busy year!) studied groups of infants in ‘traditionally’ reared rural communities’ verses ‘Westernised’ urban infants across 5 continents. Dr Werner found that traditionally reared infants had greater motor development than the urban infants. These traditionally reared infants, regardless of the continent, lived within an extended family system with many caretakers, breastfed on demand, day and night, had constant tactile stimulation with the body of the adult caretaker who carried the infant on her back or side, and slept with him. As these infants were with an adult continually, they participated in all adult activities, with frequent sensorimotor stimulation and had no set routines for feeding or sleeping. Interestingly, many parents in our Western society often comment their baby appears most settled when ‘out and about’ or when surrounded by the normal daily rhythm of adult life.

Baby brain development!

Due to evolution and the development of the large human brain, babies must be born at a stage of maturity when other mammals would remain safely in the uterus. For these large heads to fit through their mother’s pelvis babies are born gestationally very immature. This is also seen in marsupials, such as kangaroos and koalas, but they have the convenience of a pouch supplied with a nipple! Normal human baby behaviour includes frequent breastfeeding and sleeping for short periods in bodily contact with a parent. In the first 3 months feeding and sleeping are very closely linked – conveniently feeding releases gut-induced melatonin and promotes sleep.

As human babies have lots of brain development to do, human milk is high in sugars to facilitate this. This means that our babies must feed frequently. Compare this to the young of a sea-based mammal, for example, who have milk with very high fat content to allow their young to be left for several days while their mothers hunt for food in the ocean.

Due to this human baby immaturity mother-infant attachment is needed from birth, long before the baby develops true infant-to-mother attachment. During this time babies like to be held and carried, for their own security, as a baby can do little to overcome a potentially dangerous separation except cry to ensure they are picked up again. In the early weeks and months, this close carrying and care tends to be provided by the mother or primary care giver. As the first year progresses into the second, infants may have several attachment figures, usually including father, siblings and grandparents, depending on who has cared for them. In non-parental childcare they develop attachments to care-givers if the care is sensitive and favourable.

Robin Grille writes a reassuring article about parental guilt and postnatal depression, in which he makes the point that parenting was not supposed to be done in isolation. In the past raising small children was done as a group – long before the mother became exhausted, she was supported by other adults caring for the child. Yes, the mother breastfed and slept with her child, but she also had help and support during the days and nights.

Where does that leave us as new parents?

Unfortunately, our society has moved on and values babies who are content being placed down. This is compounded by the workload most parents face. Even whilst on maternity leave – most new mothers often have emails, social media, health appointments, expectations to be at groups and must look after either older siblings or do household chores.

Add into this mix parental exhaustion (either from pregnancy, workload, birth or the early days of baby’s life) and underlying anxieties about parenthood or a pre-existing mental health problem. It is therefore, not surprising that a young baby who can be placed down is desirable or necessary!

Babies pick up on their parents’ emotions very quickly. From a survival perspective a baby needs to be near his carer, they have no other way of protecting themselves. A baby is designed to read body language, therefore a parent who is depressed, frustrated, anxious or cross is going to induce those emotions in their baby. The baby will not know why their parent is upset; they are using an innate survival mechanism which the primitive brain is assuming is an immediate threat to the baby – i.e. an imminent attack by a sabre tooth tiger! In this situation, baby does not want to be left behind if the parents run, so by crying the baby is ensuring that they are noticed by the parent and therefore picked up and stay safe.

There are not many situations where the above scenario is true these days – however this has not altered baby behaviour. This does not mean to say that parents cannot experience or show these emotions but is does explain why baby may react as they do. When parents do feel like this – taking some time out to stop and breath, cuddle your baby and reconnect can make everyone feel better.

For many new parents their tiny babies sleep well in the first few weeks at home, and then they wake up about week 4 and decide that they will not be put down again ever! This can either go 2 ways – parents wondering what on earth they have done wrong or parents accepting this as the norm and carrying and co-sleeping with their baby. The next scenario is a parent who is happy to do this for a few weeks but then starts to become really exhausted with the relentlessness of the carrying. Some parents surrender to this and happily carry their babies’ long term, others would like to do the same, but logistics prevent them and for other parents this scenario is just not either physically, logistically or emotionally practical.

What can we do to support new parents and their babies in this situation?

Firstly, look at feeding – is the baby’s reluctance to be put down a symptom of tummy ache – does baby need to be in an upright position to be comfortable? Is frequent waking caused by either under or over feeding? This is not meant to be a piece on breast or formula feeding – but feeding and sleep cannot be separated in the first 2-3 months.

Let’s assume that baby is being fed responsively when he/she asks for it – either for nutrition or comfort. Let’s also assume that there are no breastfeeding, supply or anatomical problems which may affect feeding. Let’s assume that if bottle feeding (either formula or expressed breast milk) that baby is being fed by a paced technique where they can regulate their intake and take breaks as needed. Let’s further assume that there are no cow’s milk protein allergies or reflux in the picture. If any of the above are suspected, then a feeding assessment and/or medical review is recommended.

What does normal young baby sleep look like?

Again, this piece is not an academic essay and I will use some more accessible terminology when describing sleep cycles.  Simply put – light sleep is a term for rapid eye movement sleep (REM or more commonly known as dreaming sleep) and quiet (or deep) sleep is known as non-REM sleep. As babies mature this sleep changes and incorporates REM sleep, light sleep – stages 1 and 2 and non-REM sleep stages 3 and 4.

In the first few months babies spend the majority of their sleep time in light REM sleep. This is thought to be due to the huge amount of brain development taking place – in REM sleep there is almost double the blood flow to the brain than in quite/deep sleep. This light, rousable sleep is also thought to be protective against SIDS.

A young baby’s sleep consists of cycles of around 30-40 minutes, baby enters light sleep first then shifts to deep sleep and back to light sleep etc. As this sleep shifts are relatively simple babies find this easy to achieve. Disruption to these sleep cycles is likely when babies are in pain – for example reflux or CMPA – this is often seen as a baby who only sleeps for 20 minutes or so when placed down.

Babies do not produce their own melatonin until about 3-4 months of age, up until then the precursor of melatonin, tryptophan, is available in breastmilk. The first circadian rhythm (i.e our body rhythms over the 24-hour period) to develop in a new-born is the body temperature fluctuation which appears at 1 week of age. By 3-4 months the baby’s light/dark circadian rhythm is established. There is evidence to suggest that a baby who is exposed to 12 hours of dark, quiet and reduced stimulation and 12 hours of light, noise and daytime activities, over the 24-hour period will develop this circadian rhythm sooner than a baby who is not shown these differences.

How does this sleep change?

As babies develop over these early weeks and months, they are gradually able to spend more time awake in between sleeps. Especially around the 3-4-month period parents often feel their baby is so alert and distractible that they are unable to settle to sleep and often struggle to achieve much day-time sleep. At this stage overtiredness is often a factor as babies may not show obvious signs of being tired. In fact, an overtired baby can appear livelier as they produce adrenaline and cortisol to keep themselves going. Frustratingly overtiredness often results in more fractured and disrupted night-time sleep, therefore it is essential to consider daytime sleep when addressing night-time sleep.

Often this combination of being awake longer, being less able to calm or settle, being more distractible and being overtired, leads to a fractious fussy baby who resists being put down.

Somewhere between 3 and 6 months the baby’s sleep cycle matures into a ‘sleep architecture’ that lasts all their lives! This change in sleep pattern is extensive and often results in worse sleep for several weeks. Instead of a simple light/deep cycle, the baby’s brain is now moving in between 2 stages of deep sleep (NREM 3and 4), 2 stages of light sleep (NREM 1 and 2) and REM sleep. Each sleep cycle therefore ‘looks’ something like this; NREM1-NREM2-NREM3/4-NREM2- NREM1-REM.

The biggest change to this is the fact that babies are now going straight into deep sleep rather than drifting from light to deep sleep as they did as newborns.  These many stages can cause frequent waking as the baby is not used to this pattern and at each transition, they may wake – this is much more likely if they are overtired. When a baby is overtired, they ‘crash’ straight into the NREM3/4 and do not get to practice the changes in sleep state. Therefore, over the night period every time their brain moves into a different sleep state they wake up. When this change in sleep architecture is combined with a sleep association provided by the parent (for example feeding, rocking, cuddling etc) then every time the baby’s brain changes sleep state the parent is needed to help baby settle again.

Blog will continue in part 2 which will look at whether feeding method affects sleep, and the influence of parental factors on baby sleep.

Rachel Greaves is a midwife, public health nurse and accredited sleep coach. She volunteers at local breastfeeding support groups and works privately at Goodnight Solutions 

References

Cook. P (1997) The Species-Normal Experience for Human Infants: A Biological and Cross-Cultural Perspective. Early Child Care: Infants and Nations at Risk Melbourne: News Weekly Books. Accessed at; https://www.naturalchild.org/articles/peter_cook/ecc_ch1.html

Grille. R (2019) Parent Guilt – A Silent Epidemic. Accessed at: https://www.naturalchild.org/articles/robin_grille/parent_guilt.html

Grille. R (2019) Post Natal Depression – Mental Illness or Natural Reaction? Accessed at; https://www.naturalchild.org/articles/robin_grille/post_natal_depression.html

Everything a new parent needs to know about baby colic! What it is, how to relieve and treat it and what works and what might work!

This blog is written from my professional experience of working with hundreds of new parents as a midwife and health visitor in combination with on-going learning and up to date evidence from the Holistic sleep coaching programme. This includes in-put from lactation consultant Shel Banks  and health educator Maureen Minchin.

The definition of colic was updated in 2017 and is included in the functional gastrointestinal disorders category of the Rome IV diagnostic criteria. Why is this important? Because it acknowledges what many parents have always attested to – that it is a tummy pain! The term “colic” refers to unexplained and acute abdominal pain. The Rome definition states ‘Infant colic can be considered as a behavioral phenomenon in infants aged 1 to 4 months ( sometimes now from birth) and involves long periods of inconsolable crying and hard-to-calm behavior.’ OR Inconsolable, unexplained and incessant crying in healthy infants lasting for more than 3 hours a day.

The crying occurs for no apparent cause and this is one of the main reasons it is distressing and worrisome for parents. For those who like the science the full criteria can be found HERE.

The key point to note is that colic is a symptom and not a cause – i.e. the crying is due to something which is distressing the baby therefore addressing the cause of the distress will relieve the symptoms namely ‘colic’.

What is the cause of your baby’s distress?

Firstly 5% of babies will have an underlying disorder – that’s a small number but enough to warrant a trip to the GP to rule out any medical causes of your baby’s distress.

Secondly address any non-tummy related causes which can be causing your baby some discomfort or anxiety. These include but are not limited to:

  • Uncomfy clothing – ie tight/big label/seams/can’t stretch feet out etc
  • Under stimulated baby– ie wanting to be held and touched
  • Over stimulated baby– more common – for example trying to get baby to repeat a cute new skill for other family members or not noticing baby’s ‘tired cues’
  • Smell – key sense in babies and strong perfumes or room air fresheners can be overwhelming – try gentle relaxing essential oils in a burner or diffuser instead
  • Smoking – smoking during pregnancy increases the likelihood and severity of colic, it is suggested infants may be allergic to exhaled cigarette smoke.
  • Maternal stress – during pregnancy and after birth appears to make babies more likely to suffer from colic. Try some mediation or mindfulness whilst feeding which can also help with baby sleep. See this link Breast feeding relaxation therapy helps babies eat more.
  • Behavioural factors – perhaps baby is just tired – or doesn’t like the way they may be handled

 Colic is tummy related so read on!

Tummy related causes of colic could be;

  • Trapped gas – is very common and caused by swallowing air whilst feeding and/or a reaction in the tummy
  • Hunger – sometimes but more often pain is related to over-feeding
  • Over-feeding – babies suck when in pain and it is very easy to over feed on a bottle – gradually our tummies stretch, and we want more food.
  • Bottle feeding a baby in a lying down position or sub-optimal position and attachment at the breast and/or oversupply. For a good explanation of paced bottle feeding click HERE
  • Cows Milk Protein Allergy (CMPA) –  allergy to the protein in cows milk is becoming more common. CMPA causes tummy distention, cramping, vomiting, skin reactions and diarrhoea ( sometimes constipation also). If there is a family history of allergy or your baby has the above signs please see your GP. See below.
  • Temporary lactose intolerance – this is a due to a lack of the enzyme lactase, which can be due to a tummy virus. Your baby will show tummy symptoms such as continual diarrhoea and difficulty passing gas. It can also be as a result of an inflammed gut when CMPA is present. Again see your GP. Congenital lactose intolerance ( ie from birth) is very rare and serious.
  • Gut bacteria out of balance – this is where the bad bacteria outnumber the good bacteria! The gut microbiome might be altered by birth practices and antibiotic use, read more from Maureen Minchin if you are interested in this fascinating subject!  Altering the bacteria in the gut causes fermentation (ie gas), cramping and bloating.  This can also be caused by incorrect making up of bottle feeds ie with water which is not over 70C. Your baby may not show signs of illness but may be very windy and in discomfort.
  • Please note in young babies straining and going red when passing a stool is common as long as the stool is a normal colour (yellow/brown) and of toothpasty/watery consistency. This is known as infant dyschezia. There is no need for laxatives at this point. A useful pdf guide is HERE.

Please note;

CMPA is getting more common and parents should see their GP if they suspect it or have a history of allergy themselves. Signs are faltering growth, vomiting, rashes, incessant crying, diarrhoea. It takes 6 weeks to clear in mum and baby if present, although improvements will be seen in 2-3 days. Sometimes a lactose intolerance will be present in CMPA due to inflammation of the gut due to allergy.

What about reflux?  40-50% of babies under 3 months will posset some of their feed – non-forceful regurgitation normal physiological process very common as babies spend most of their time on their backs. It is often seen as recurrent hiccups, frequent coughing, irritability or crying and frequent night waking. The techniques below should help with physiological posseting.

Gastro-oesophageal reflux disease (GORD) is more serious however and is covered under NICE guidance. This needs treating as the stomach acid in the oesophagus (food pipe) can lead to longer term damage. Babies with GORD often have difficulty gaining weight with frequent forceful vomiting, possible old black blood in stool or in vomit.

What works and what doesn’t!

There are several products marketed at parents which suggest they can help resolve colic symptoms in a baby. Simeticone and dimeticone (brand names Infacol and Dentinox) are no longer recommenced by NICE due to not enough evidence of effectiveness. It is suggested they work by reducing the surface tension of gas bubbles in the stomach thus making many small bubbles into one bigger bubble. This will only help if the bubble is underneath the sphincter (ie tummy opening) at the time the baby is burped! However both of these products contain sugars (artificial or real) – sugar is well known as a pain relief for babies. Therefore mild pain reliving effects may be seen.

Lactase enzyme (brand name Colief) is also not advised by NICE. Primarily because if a baby has a congenital lactose deficiency then medical advice will be needed. The suggested way of use of the product is also fiddly for both breast and formula fed babies – but it contains sweeteners so a pain relieving effect may be seen. However in a baby/toddler who has had a diarrhoea and vomiting virus there may be a temporay lactose intolerance due to damage to the gut wall – a lactose free formula or lactase enzyme preparation may be suitable for use in these circumstances.

It is important to note that I am not recommending giving a baby any kind of sugar preparation for pain relieving effects. Both breast and formula milk contain enough sugars and carbohydrates – preventing the cause of pain is the most effective way of helping a colicky baby. Gripe water contains dil oil, water and sodium bicarbonate (sodium hydrogen carbonate). BUT sodium bicarbonate added to stomach acid will produce hydrogen gas thus baby produces a nice big burp therefore it looks like its worked!

So what about the many infant milks for ‘special medical purposes’ which can be found on the supermarket shelves? There are many marketed milks and a lot of them are thickened, meaning they have to be made up at a lower temperature. This will increase the risk of bacteria overload as the powder has not been sterilised. Bad bacteria may accumulate in baby’s gut and produce extra gas and discomfort. In combination with a bottle making machine, which uses cold water to fill the bottles, this may be enough to produce a very windy and uncomfortable baby.

NICE also does not recommend manipulative strategies such as cranial osteopathy for colic due to lack of evidence of effectiveness for tummy pain. However in a baby with a tight jaw, neck or some kind of head or shoulder pain they may not be able to work their jaws as effectively. This means they not be able to form a ‘bolus’ of milk to swallow properly. This can lead to more air than necessary being swallowed with the feed. As there is no evidence of harm of these strategies  these treatments are worth investigating.

OK so what does work?

Firstly fix any of the above situations if they apply to your baby. Seek advice from your GP and breastfeeding group/or health visitor regarding feeding. Discuss under or oversupply with a knowledge breastfeeding adviser or peer supporter and attend your local well baby clinic.

Keep your baby upright after a feed, making sure they are winded properly before laying them down, therefore preventing the gas going into the intestine. When winding your baby try having them upright, leaning forward and slightly to their left – this give bubbles the best chance of escaping upwards! Lots of tummy time, massage and warm baths also help!

If formula (or bottle feeding with expressed milk) try the following;

  • Smaller, more frequent feeds.
  • Reduce pressure on baby’s abdomen – tight waist bands and nappies etc
  • Frequent burping and paced bottle feeding.
  • Avoid shaking formula to mix it – use a sterile spoon instead to avoid micro bubbles and froth.
  • Ensure formula feeds are made up correctly with water over 70 C and not left to stand for too long.
  • Feed babies at their early feeding cues – not when distressed on or a strict schedule
  • Try a vented bottle to reduce air intake
  • Don’t coax baby to finish the bottle – if this is hard to do try placing a sock over the bottle and follow your baby’s cues
  • Pay attention to sterilizing bottles and dummies – a build-up of pathogenic bacteria will lead to fermentation, cramping and discomfort.

If breast feeding try the following;

  • Avoid allergens in maternal diet if breastfeeding – see note below.
  • Burping after a few minutes if a mother has a fast let-down.
  • Improve position and attachment.
  • Keep babies upright after feeds and wind as above

The NICE clinical knowledge summary on infant colic and www.nhs.uk  give the same advice when it comes to helping your baby with colic. However both state changing maternal diet when breastfeeding is not indicated due to lack of evidence. It is not in my role to go against this advice. However I suggest that if you or your partner (baby’s father) have family histories of food allergy then identifying any foods which either of you avoid/dislike due to causing you digestive discomfort is a good idea. As mild as the discomfort may be to either parent, due to epigenetics these foods may be causing your baby more discomfort. Avoiding these foods you have identified may provide relief from the colic.

What is definitely needed?

A colicky baby is very hard to deal with so extra help and support can make all the difference to parents. If there is no physical help available from family or friends then parents can access supportive online groups or find a local supportive group. Considering which other aspects of daily life are causing stress and finding a solution to those is also a possibility. This could be a cleaner, extra childcare for older children, reduced working hours for a partner, or hiring some extra baby help for example.

If the above are not financially viable then parents can contact their health visitor or children’s centre to ask what local support is available.

Self-help measures a parent could try are;

  • Identify a supportive online group
  • Explore mindfulness – headspace has a lot of positive reviews
  • Exercise with your baby – there are many local classes designed for parents and babies
  • Look at your diet – alcohol and caffeine increase anxiety and dehydration worsens anxiety. Complex carbohydrates and protein will stabilise and boost mood.
  • Activites which boost oxytocin such as touch and massage or a calming smell
  • Spend time outdoors in bright light to boost melatonin.
  • A positive mindset and mental dialogue – this colicky phase WILL pass.
  • Foods (or supplements) rich in DHA, EPA and Omega-3. These have been shown to reduce inflammation which is a key influence of anxiety and stress.
  • Essential oils can also help – lavender, clary sage, frankincense, and vetiver are a few which may help.
  • A decent nights sleep is not possible or practical with a new and/or colicky baby and will affect milk supply if breastfeeding. However evidence has shown that a 4-5 hour stretch is protective of parental mental health and may be achievable with some help. This does not have to be overnight if help is only available in the day. After 2-3 days of a 4-5 hour stretch of sleep (plus additional hours here and there in the 24 hour period) parents can consider the above suggestions. Sleep first!

This blog has been written by Rachel Greaves of Goodnight Solutions – and information from Lyndsey Hookway’s Holistic Sleep Programme is acknowledged.

Please visit my website for additional support or to contact me.

 

For the next 4 months I’m privileged to be training with Lyndsey Hookway (BSc; RNC; HV; IBCLC) on her holistic sleep coaching course. Check out Lyndsey’s site here.

So what is holistic sleep coaching and how can it support you?

The key is in the title – ‘holistic’ ! This is a gentle exploration of all factors within a family and their circumstances. It should result in a family feeling reassured and supported.

Sleep ‘ problems’ do not happen in isolation and what one family can cope with another may not be able to. The Cambridge dictionary defines ‘ holistic’ as ‘ relating to the whole of something or to the total system instead of just to its parts‘. Family sleep is just that- a combination of other siblings, wider family support (or unhelpful suggests perhaps), finances, work circumstances and possible health problems. Sometimes trying to conform to what society deems is normal baby sleep can also be a worry.

Babies and children’s sleep can vary enormously in what is ‘normal’ for that child. It can vary enormously over the first 2 years without there necessary being a problem which needs ‘fixing’.

What factors affect sleep?

Age, developmental milestones, overtiredness, boredom, anxiety, feeding issues, allergies, sleep hygiene and environment. Circadian rhythms, excercise, naps and meal times, holidays and illness all affect everyone’s sleep!

Looking at this – it is no wonder that our babies struggle at times! On top of that, as young babies and children’s brains develop – sleep changes again!

The concept of a ‘ parenting village’ is also popular at the moment. In effect meaning that in many cultures babies are cared for by several adults – not just one or 2. Social support is a big factor in parenting and sleep, and can really benefit parents assuming they find a like-minded community.

What factors affect me as a parent?

When looking for support with a sleep issue there is so much information available online, via social media, magazines and books! How much of this is evidenced and research based and how much is based on ‘personal experience’ and anecdotal or out-dated methods? And how do you know!

Has children’s sleep changed from previous generations? Or has the world around us and our lives as parents become so much more busy and complicated? Parents are well aware of the need for attachment, love and responsive care. They are also aware of the need to keep their jobs, home and lives secure for their families. There can be a conflict and a compromise between the too! They are also in need of a rest at times – parenting is hard work!

So is the ‘sleep issue’ really problematic and abnormal sleep or is it normal baby sleep in the context of a logistically tricky environment? Does it matter though? If sleep is an issue within the household then parents need support. This is where ‘holistic’ support is necessary – by optimising some simple aspects of a child’s routine, feeding, and settling method we can prevent larger problems. A ‘knee jerk’ reaction to a temporary sleep disruption can cause more unsettledness. In addition, a solution or plan which does not feel a ‘good fit’ for a parent will be unsustainable and therefore,  unsuccessful longer term.

So some quick wins whilst pondering the need for sleep support!

Maximize your family’s sleep hygiene – remember a cool and dark bedroom and if it’s noisy consider pink or white noise. A consistent short bedtime routine helps set up good sleep associations. Regular sleep and wake times also help daytime routines and mealtimes.

Optimise the timing of naps and consider an appropriate length of awake times, depending on your child’s age – overtiredness can really reduce sleep at night.

Watch for your child’s sleep cues ( some are very subtle) and offer a nap at this point. Conversely don’t obsess about this, some babies are bored rather than overstimulated – consider your child’s temperament when looking at this aspect.

Ensure 12 hours of daylight and 12 hours of dark – this will speed up the development of your baby’s circadian rhythm, outside time in later afternoon can really help a child/baby settle at bedtime.

Realistic parental expectations of what is normal feeding and night waking at your child’s stage of development can help reduce parental anxiety – a ‘solution’ to something normal may not help!

Optimise feeding – responsive breast and/or bottle feeding, effective breastfeeding and colic/wind/reflux or allergies will also affect a baby’s sleep. Switching to a bottle of formula will not necessarily improve sleep.

Get extra family or paid support for the really rough times, and remember that all things improve eventually – do whatever works to get the sleep your family needs right now and work on small steps to make the changes you may want.

For support and help contact me at Goodnight Solutions

 

Spring forward ! Bedtime back!

Resolve sleep issues with the clocks changing!

This Sunday 31st March the clocks go forward by 1 hour and British Summer Time begins! This is great news for those of us who love longer days and spring time.

Not so great for anyone working an early shift on Sunday morning and not so great for those of us hoping for an indulgent lie -in.

However it is excellent news for anyone on a night shift on Saturday 30th. And it is wonderful for those with small children!

How you ask?

If your child normally wakes at 5.30am – from Sunday morning they will be waking at 6.30am – much more acceptable!

Make sure you reinforce this sleep pattern by pushing Sunday evening bedtime routine 30 minutes later and placing them to sleep 30 minutes also. If you wish, keep shifting this back gradually until that hour is accounted for. Alternatively you may find your little one accepts this new sleep time and sleeps for a longer period of time.

Make sure that bedrooms are kept dark as the mornings become lighter – use well fitting blackout blinds. Light mornings affect our Melatonin levels and make it harder to fall back asleep in the early hours.

Small children get hungry!

So if you are delaying bedtime and hoping for a longer sleep into the morning make sure you give a ‘sleepy snack’ before bedtime. Milk, oatcakes, cherries are all good foods to provide tryptophan which converts into Melatonin. It also means a full tummy! https://www.sleepfoundation.org/articles/food-and-drink-promote-good-nights-sleep

Make wake time obvious for your little ones

Does your child know its time to get up? Make a clear difference between night time and morning time. Use timer switches on bedside lamps to signal daytime and make sure any early morning milk feeds are done out of the bedroom and that they signal wake time. A sleepy early morning feed in mum and dad’s bed is very confusing for a young child.

For help and support with your family’s sleep visit http://www.goodnightsolutions.co.uk

 

World Sleep Day 2019

World Sleep Day 2019® is designed to raise awareness of sleep as a human privilege that is often compromised by the habits of modern life (BSS, 2019).

World Sleep Day is an annual event, intended to be a celebration of sleep and a call to action on important issues related to sleep. These include medicine, education, social aspects and driving. It is organized by the World Sleep Day Committee of World Sleep Society (founded by WASM and WSF). It aims to lessen the burden of sleep problems on society through better prevention and management of sleep disorders. https://www.sleepsociety.org.uk/world-sleep-day-2019/

Habits of modern life!

The British Sleep Society (BSS) describes sleep as often compromised by the habits of modern life. Evolution has designed us to repair and renew ourselves overnight. Before the invention of modern lighting our sleep was much more in line with the ebb and flow of daylight. With mobile phone and tablet technology our ability to sleep has declined, despite updated features of light reduction on our devices.

It is not all to do with screen technology however! Have our priorities changed? Is it now more important to keep abreast with social media and communications than it is to sleep? Do our youngsters understand that late-night checking of their phones induces anxiety? Not only from what they are seeing but also because they are missing crucial sleep? Our teenagers go through a huge period of brain development and pruning and this is enhanced by REM sleep. Missing out on this REM sleep can deprive them of the social and emotional development they need to navigate their complex media worlds.

Not just youngsters!

In my work as a sleep practitioner I am seeing many adults who are struggling to sleep throughout the night. The main reason stated for this is a racing mind and worry about the day ahead. This self-perpetuates and can easily become a habit of not being able to sleep well. Our motivation to sleep is there as most adults recognise sleep as important, but perhaps our motivation to make changes to our lifestyles has not caught up?

What can we do to promote better sleep?

Make a good sleep a priority in the workplace – request more flexible hours perhaps or consider input from a sleep practitioner such as myself to improve employees sleep https://www.goodnightsolutions.co.uk/sleep-businesses/

Remember sleep hygiene  https://www.goodnightsolutions.co.uk/sleep-and-hormones/ and bedroom environment https://www.goodnightsolutions.co.uk/need-to-know-about-your-childs-sleep/

Ask for help for ongoing insomnia and techniques to help with this https://www.goodnightsolutions.co.uk/insomnia-or-sleep-deprivation-part-1/

And finally look at your motivation to improve lifestyle and sleep and what might be your barriers to change.

For more information and support contact me at https://www.goodnightsolutions.co.uk/contact/