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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

So how do you cope with the really bad days?

We all have them, days when we have had very little sleep, days when everything takes ages, days when everyone says ‘no’, days when we just want to be left alone! This Thursday is World Mental Health Day , and this year they are focusing on suicide prevention. This may seem dramatic for a blog focusing mainly on parenting and sleep deprivation but many of us have had days where we feel we just can’t carry on. We have all heard the suggestions for improving our mental well being, such as a healthy diet, exercise, ‘me time’ ( what’s that?), warm baths and doing something enjoyable. These are very valid solutions and do help in the longer term. However, what do you do when you are at your wits end, everyone is crying, the kids are fighting and you haven’t had a minute to either shop or prepare lunch?

First – stop and breathe! How bad is the problem?

Let’s scale the problem! Sometimes a hug from a loved one at the end of a tiring day is enough and sometimes we are at breaking point. How bad is your problem right now?

  • Reassurance and encouragement – we all feel better when sometime we care about and respect tells us we are doing a great job. It is normal to find parenting really hard work, especially with today’s pressures and lack of time. Accept your hug and take a breath – this phase will pass!
  • Ok hugs aren’t cutting it! Do you have any practical help available to you? Can you call a friend or family member for some back up? What tasks/chores etc can you ignore for today so you can all get through until bedtime? Do the bare minimum and congratulate yourself for still being upright!
  • Do you need to some simple sleep and parenting tips to help with each day? Simple tweaks such as an earlier bedtime or a cuddle nap in front of the TV can make all the difference. Try some active outside time for the children and if the weather is ok take a simple picnic for their dinner. Regular meals, exercise and naps for little ones do make a huge improvement to nighttime sleep.
  • Are you at crisis point right now ? Are you ‘touched out’ by a baby needing to be held and fed constantly or a toddler clinging to your leg, and fed up of managing everyone else’s emotions? Sometimes reassurance and hugs are just not enough!

What can I do right now to help me cope?

Stop – whatever chaos is ensuing – just stop. And take 1-2 minutes to breathe. Our minds and our stress responses  are designed to be in-tune with our breathing – this has evolutionary advantages and is described as Polyvagal theory. When you have  time – this is a great link to check out. Right now breathe in, hold and breathe out slowly – repeat 5 times if possible!

Give yourself a hug – we can release our own oxytocin by a firm self-hug, or pressing on our chest just above and between the breasts, there is also a pressure point between the thumb and forefinger in the fleshy bit just before the joint.

Now put on some uplifting music that you like, start by swaying and humming and then really dance out that stress and tension. Young children love this to and it may be enough to distract them from whinging.

Ok – now write down some of those feelings and thoughts any old way!

Consider some aromatherapy – try out scents for yourself – patchouli, frankincense, and clary sage are great for mood and hormone balancing but anything which you like will help!

Simple mindfulness techniques can also help – breathe in the smell of your little ones head as you cuddle them. Really look at your older kids and note what you adore about them. Look around your home and remember occasions when good things happened!

Now look at what you may have written down and see if you can re-frame it to be slightly more positive. You can change the internal voice that says everything is rubbish – see if you can find a little bit of calm and happiness within the mayhem.

How do I cope with my children today?

This blog post is aimed at those of us with no social support to call on – perhaps family are not available or not interested, perhaps you’re a single parent or partner works long tiring hours? If you have someone to call on – do it – now! There is no shame in asking for help! When you do – tell your cavalry what you want them to do! This is your choice – not theirs! Sometimes we want an hour away from the kids and sometimes we don’t – let them know!

For those with no-one available right now – first make sure the kids are safe. Now make sure everyone is fed – you first – hot drink and snack first and then everyone else – it doesn’t have to be healthy right now !! It can be healthy later on today or tomorrow or on an easier day!

What do you need to do now to feel better?

If you need to yell – go into the next room and yell into a pillow! Will your child wonder what’s going on? Yes – but this is ok, they are safe and loved and you are not yelling at them!

If you need to have 5 minutes away – then go and lie down to breathe or cry – will your child wonder where you are for 5 minutes – probably but this will not harm them and may save you!

If you need to just hug a fractious baby rather than feed for the hundredth time that day – then do so – again this will not harm them – its ok!

If you feel you have not slept for days then its ok to ask someone else to have the kids for 5 hours. Did you know that a stretch of 5 hours unbroken sleep will work miracles – this does not have to be at night. If you are breastfeeding, most babies can cope with a big cuddle from dad or gran and an occasional one-off will not affect your milk supply or relationship with your baby.

We all know that responsive parenting is best, that being emotionally available for your children helps them grow and thrive, that modelling your emotions teaches them how to regulate theirs.

But we were not designed to do this by ourselves! Your children are loved and cared for ! You may try these suggestions above just once or you made need to use them more.

I feel guilty!

I think parental guilt is delivered alongside the placenta (please note there is no evidence for this!) We all want to do our very best for our children! Guess what? You are the best for your children! You are the one there for them, comforting them and loving them – no-one else can do that better than you!

Do you remember everything little thing about your early years? Your children will not look back and remember the times you needed to just ‘pop into my room’ to cry or ‘just going to the toilet’ to hide and yell into the hand towel! They will remember running to you for comfort, having a dance and laugh, sharing a treat! They don’t need perfection – they just need you – warts and all!

When this crisis has passed look at ways that you could make life easier! Look at just doing one niggling chore first thing in the morning then its done. Look at not multitasking – take enjoyment from the mundane and focus on one thing at a time. Ask for help or hire it in if you can. Aim to get outside each day for some fresh air. Look at swapping a couple of ‘reach for and grab’  foods for something more healthy.

Look at parenting or feeding support if needed! A couple of bad days do not mean you’re a bad parent! But sometimes a lack of sleep can exacerbate our stress and tension the following day which inevitably the kids pick up on. Try an earlier bedtime and a calming wind down period for everybody before bed.

Longer term support can be found through your GP, health visitor or charities such as Mind or Pandas

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 

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.

 

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!

Sleep inspirations? What made me start up a sleep teaching business? If asked I’ll say it was a desire to work for myself after years of helping families in the NHS. But after thinking about this post I’m not so sure!

It was kick started by one morning of listening to the Chris Evan’s breakfast show and his guest Matthew Walker. If you haven’t read his book ‘Why we sleep’ I suggest you do – it’s a full on read but it has totally changed my outlook on sleep as a crucial part of life.

I have always been a person who loves sleep was it wasn’t a hardship to ensure I got more sleep. At last I had solid scientific evidence to justify shutting the computer down and putting the phone away in the evening. What started as a holiday project to get a full 8 and quarter hours sleep a night, has become an aim for all nights.

It is not always possible with work, school runs, dogs to walk, washing PE kits, last minute homework and spelling tests and the occasional panic over a dress up day for Key stage 1, but I now make 8 hours sleep the norm rather than the exception to the rule. My evenings now have a period of relaxation before bed and instead of forcing myself out of bed at 6am for a half-hearted jog I sleep until 7am – this hour in the morning makes a huge difference.

Matthew Walker talks about an extra short period of deep sleep in the morning when we are normally in stage 2 sleep or REM sleep. He makes the point that all sleep is crucial; deep sleep is needed for body repair and REM sleep for emotional repair and regulation.

So I have ditched the Fitbit telling me that my sleep is disordered and ignored the apps which will wake me when I’m in a light sleep so I’m not groggy if woken when I’m in that last wonderful bit of deep sleep! I have ignored the inner Paula Radcliff telling me I should be jogging and trying to get fitter and slimmer.

Instead I am prioritising sleep – that wonderful life giver which is repairing my body and regulating my emotions and reactions to life. I may be slightly rounder and wobblier, but my husband is a happier man – less nagging and flying off the handle from his wife!

So why have a started a sleep teaching business – I have just answered my own question – not a desire to work for myself or reduce the rigors of working for the NHS – but a genuine fascination with all things sleep and how fantastic it makes us feel.

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