No-cry sleep solutions - sleeping babies

Elizabeth Pantley is an author who helps parents with their babies. She put her collection of pictures, sent by parents into this delightful show. This is inspired by the No Cry Sleep Solution. Visit her website here.

Trouble sleeping?

Everyone has times of stress when sleep eludes you.  Pregnancy brings the added sleep problems relating to position, aches and pains.  You may find yourself restless and unable to sleep in spite of being exhausted at the end of the day.  Here is a non-pharmaceutical relaxation technique which can result in better sleep.  Try Progressive Muscle Relaxation.   More sleep info in pregnancy can be found here.

You will find many other stress-relieving techniques as well such as Yoga, Meditation, Water Exercises, and deep breathing, as well as stress relief tips.

Sometimes other things in our lives cause stress without our being aware of them.  Clutter can do this to you.  This site addresses Clearing the Clutter. 

Clutter can be a chronic source of stress. The stress of being surrounded by clutter often isn't realized until the clutter is removed and we feel the relief of being clutter-free. Clutter bombards the brain with excessive visual stimuli, creating stress. Clutter makes it more difficult to relax or to focus on anything because clutter is an irritating distraction. Even those who seem oblivious to their surroundings are aware of everything in their environment on a subconscious level. Your brain is constantly filtering messages from all your senses.

 

SIDS awareness & Trade-in event

Babies Sleep Safest - Alone, on their Backs, in their Cribs

Some good videos have been produced to help educate parents about measures that can be taken to reduce the incidence of suffocation and SIDS.  The following was produced in Missouri:

The Michigan program, Tomorrow's Child, has also produced several excellent videos about safe sleep with cultural awareness in mind.  It is important that all of the baby's caregivers understand this concept because now that we know better, we can do better.  Check them out here:

http://www.youtube.com/watch?v=0zoQ7n3omqQ

http://www.youtube.com/watch?v=L81CnyJR8Bk

http://www.youtube.com/watch?v=GtvKp8TeaOc  (Spanish with English subtitles)

http://www.youtube.com/watch?v=VFepRLn2lzA (short reminder of safe sleep)

Read about the Great Trade-in event at Toys "R" Us and Babies "R" Us at First Candle or at their site.

From Friday, January 28 through Monday, February 21, Babies“R”Us and Toys“R”Us stores nationwide are holding the “Great Trade-In” event, urging customers to trade-in any used cribs, car seats, bassinets, strollers, travel systems, play yards, high chairs or toddler beds in exchange for a 25% savings on the purchase of any new baby item, in any of these product categories, from select manufacturers.

Maternal sleep and feeding methods studied

Some good information because perceptions can be deceiving.

November 8, 2010 — Breast-feeding mothers do not get less or worse sleep than mothers using formula feeding, according to the results of a study published online November 8 in Pediatrics.

"Breastfed infants are reported to awaken more often and to sleep less," write Hawley E. Montgomery-Downs, PhD, from the Departments of Psychology and Pediatrics, School of Medicine, West Virginia University in Morgantown, and colleagues. "Because of its well-established benefits for both infants and mothers, any perceived disadvantage of breastfeeding should be evaluated carefully. Feeding method effects on maternal sleep are relatively unknown."

The goal of the study was to evaluate maternal sleep measured actigraphically, subjective sleep reports, and daytime functioning, and their association with feeding method status during postpartum weeks 2 through 12. Outcomes included objectively measured total sleep time, sleep efficiency, and sleep fragmentation; and subjectively reported numbers of nocturnal awakenings, total nocturnal wake time, and sleep quality. The fatigue visual analog scale, the Stanford Sleepiness Scale, or the Epworth Sleepiness Scale allowed determination of sleepiness and fatigue.

Women who were exclusively breast-feeding, exclusively formula feeding, or using both methods did not find differences in these outcomes, although the study had sufficient power to detect such differences.

Limitations of this study include lack of generalizability to depressed or anxious women, possible selection bias, and lack of validation of the Epworth Sleepiness Scale for use with postpartum women.

"Efforts to encourage women to breastfeed should include information about sleep," the study authors write. "Specifically, women should be told that choosing to formula feed does not equate with improved sleep. The risks of not breastfeeding should be weighed against the cumulative lack of evidence indicating any benefit of formula feeding on maternal sleep."

The National Institutes of Health supported this study. The study authors have disclosed no relevant financial relationships.

Pediatrics. Published online November 8, 2010.

Sleep Positioners - warning!

Infant sleep positioners: Consumer Warning - Risk of Suffocation

[Posted 09/29/2010]

AUDIENCE: Consumers, Pediatrics

ISSUE: FDA and the Consumer Product Safety Commission (CPSC) issued a warning not to use Infant sleep positioners. In the last 13 years, the federal government has received 12 reports of babies known to have died from suffocation associated with their sleep positioners. Most of the babies suffocated after rolling from the side to the stomach.

BACKGROUND: The most common types of sleep positioners feature bolsters attached to each side of a thin mat and wedges to elevate the baby’s head. The sleep positioners are intended to keep a baby in a desired position while sleeping. They are often used with infants under 6 months old.

RECOMMENDATION: Consumers are warned to stop using infant positioning products. Never put pillows, sleep positioners, comforters, or quilts under the baby or in the crib. Always place a baby on his or her back at night and during nap time. See the Consumer Update for links to additional information, including product photos.

Click here for warning with photo.

Shopping Carts, Kids, and Car Seats

Here is the statement by the AAP (American Academy of Pediatrics)

With the potential instability of some existing shopping cart designs, and because it is difficult for a parent to easily ascertain a cart's safety simply by looking at it, parents should carefully consider the potential for injury before placing a child in a shopping cart, according to the policy. Instead of putting children in shopping carts, parents can try one of the following alternatives:

· Get another adult to come with them to watch the children while shopping.
· Put children in strollers, wagons, or frontpacks instead of in shopping carts.
· Ask older children to walk and praise them for behaving and staying nearby.
· Leave children at home with another adult.
· Shop online if local stores offer shopping on the Internet.

If a parent chooses to place a child in a shopping cart, he or she should ensure that the child is properly secured in an effective and age- and size-appropriate belt or harness.

Parents and caregivers should never:

· Leave a child alone in a shopping cart.
· Allow a child to stand-up in a shopping cart.
· Place an infant carrier on top of the shopping cart.
· Allow a child to ride in the basket.
· Allow a child to ride on the outside of a cart.
· Allow an older child to climb on the cart or push the cart with another child inside.

And as for car seats...

Car seats are designed for use in the car, making the ride safer for your baby. But, there are times when the seats are used improperly outside the car, especially on elevated or soft surfaces (tables, grocery carts, beds, etc.)

The center of balance in a grocery cart makes toppling a real risk, especially if you have a toddler along, riding on the side of the cart as well. Your baby will be safest in an infant carrier on you (with face free to the air) or in a low place. A stroller is a better option than a shopping cart. Of course this does raise the question of what to do with the groceries...

STUDY EXAMINES USE OF CAR SEATS OUTSIDE THE CAR A study published online July 5th in the journal Pediatrics examines hazardous use of car seats outside of a car in the US. The study authors note that when used improperly or for unintended purposes, car seats can place children at risk for injury or death. They examined car seat-related injuries to children under one year of age who were treated in emergency departments from 2003 to 2007 (excluding injuries caused by motor vehicle crashes). They found more than 43,500 car seat-related injuries during this time period, with 62.4% of the injuries occurring in infants younger than four months. The most common causes of injury were infants falling from car seats, car seats falling from elevated surfaces and car seats overturning on soft surfaces. The study concludes by stressing the importance of injury-prevention efforts focused on hazardous use of car seats outside of the car, and the need to caution caregivers against placing car seats on elevated or soft surfaces. (click this post title to read the full report)

While we can't prevent all accidental injuries, we can make a few modifications that should improve the odds. It is also safest to move your sleeping child into the crib once you arrive because the car seat is not an ideal sleep surface for infants.

According to the American Academy of Pediatrics, your baby should sleep:

• in a bassinet, cradle, or crib that is near her mother's bed.
• on her back, not on her side or stomach.
• on a firm sleep surface, such as a firm crib mattress, which has been covered by a well fitted sheet.
• without any soft objects (pillows and toys) or loose bedding (blankets and sheets) in her bassinet, cradle, or crib.

Baby Sleep - naptime!

This slideshow will give you ideas to help your baby sleep better.

ABC for safe sleep

Alone, on their Backs, in a Crib...





See this link for safe sleep recommendations (American Academy of Pediatrics). National Infant Sleep Position website has more information.

A little humor for a Monday...

Embedding of this YouTube has been disabled but you can click here to view this funny, real-life video of a father helping his baby to sleep. We can relate to this frustration!

And, on a more serious note - a friendly reminder for the newborn...

Safe Sleep; Round Heads

There is nothing more tragic than the loss of a precious baby! Advice comes from USCPSC (U.S. Consumer Product Safety Commission).

Since the implementation of the "Back to Sleep" campaign in 1994, SIDS and other unexplained sleep-related infant deaths have been reduced by 50% (85% among exclusive back sleepers). This is wonderful news but we still have more to learn. This is a simple message that reaps great results when it is practiced.

Sometimes, even nurses in the hospital do not follow this recommendation so if you see it done improperly there, don't repeat what you see! In fact, call the nurse on it. They may need to be reminded because old habits die hard. It takes about 17 years for health practices to change, even when we know better ways to do things. We used to believe the baby on its side or tummy would have less chance of aspiration if he or she was spitty, but now we know they can actually handle it better when on their backs and the other benefit definitely make this the right position for a sleeping baby.

What risk factors have been identified?

A risk factor is not a cause, but it can suggest complications that might increase the likelihood of this tragic event. Risk factors do not exist in all SIDS deaths.

• Smoking by others in baby's environment (Just say "no!")
  
• Teenage mother
• Preterm baby or small size (small for gestational age)
• Wrong sleep position (other than back) - should not happen, even for naps
  
• Sleep environment concerns (too-soft sleep surface, bumper pads, pillows, loose, fluffy bedding, toys, bedsharing*, lack of air circulation, overheating)
• Childcare provider or family member who does not understand this newer concept and does not place child on the back (even side position is risky because baby can slide to tummy).
  
• Overfeeding may be a risk factor, especially if placed on tummy afterward. Breastfed babies eat about every two hours at the beginning and do not take more than they need so overfeeding is not a problem there.
  

The most common risk factor is bedsharing. Babies do best when they are not co-sleeping with an adult or sibling, though having the baby close by is protective. Sofa-sleeping is not safe, but especially when it is with another person who could roll onto the baby or the baby gets wedged in the cushions and pillows where oxygen is insufficient.

*As with all such data, there is controversy surrounding the studies and results. Conflict of interest also enters in. Dr. Sears has an excellent article discussing the findings and showing alternatives for parents who prefer co-sleeping with their babies. He contends that the Juvenile Products Manufacturers Association which co-sponsors the campaign discouraging co-sleeping may have a conflict of interest and he gives compelling data on how you can sleep with your baby safely. The trouble is that so many adults do not know what that means. Read his view here. If you choose to sleep with your baby to facilitate breastfeeding, be sure you have read this article.

What is a safe sleep surface?

The American Academy of Pediatrics (AAP) states that safe sleep means sleeping in a safe crib, bassinet or play yard--a flat firm surface. Deaths have occurred in car seats when the baby was brought in from the car, in the car seat, bundled up with blankets over their faces, presenting multiple risk factors. Check out Sleep Sacks

Tummy Time

In addition to the risk of Sudden Infant Death Syndrome (SIDS), too much time in a car seat and swing often results in babies with flattened heads. While sleeping on the back is the right way to do it, your baby needs tummy time as well. This is "awake" time when you are near by, hopefully interacting with your baby.
Getting the baby out of the seats, carriers, bouncers and swings, sometimes even referred to as "buckets" will result in a rounder head and the baby will develop his or her neck muscles appropriately. Underdevelopment of these muscles is an unpleasant side-effect of the otherwise successful "back to sleep" campaign. Some parents erroneously believe they should NEVER put their babies on their tummies or sides. This is false; it's just that the babies should be attended when in another position - when left to sleep, they must be placed on their backs without pillows, comforters, fluffy blankets and toys, etc.

An ideal way to carry your baby is in a baby sling. This helps free your arms while still snuggling your baby next to your heart. Nursing moms find this ideal because they can get so adept at breastfeeding, she can nurse without much interruption at all - the baby is in a comfortable and convenient position when the need to nurse arises. By the way, breastfeeding babies have a decreased incidence of SIDS.Click on the post title to learn more about safe sleep tips for your baby.

Here are some recommendations for your baby's sleeping place. It does not have to be a decorator nursery and your baby won't know if his/her room is from Pottery Barn. Keeping the baby in the parents' room is often ideal.

A fan for circulating air in baby's room is a good thing. Of course you don't want a fan that is low enough the baby could get a finger caught. A ceiling fan is good. The idea is to be sure the baby gets good air flow and oxygen during the immature first year of life when SIDS is a risk for all babies.

Taking these few steps will help you to sleep better at night too - on your back, side or tummy!

Sleep, glorious sleep!

In Utah we just started daylight saving time. For many this means spring is right around the corner and we welcome the extra sunlight which is a natural mood elevator and good source of vitamin D. Of course this also means some adjustment in our body's biorhythm and in pregnancy sleep is already a challenge. Either we just can't get enough of it and require a daily nap as well as 9 or 10 hours at night, or we can't find a comfortable position, have insomnia or wake frequently.

Click on the post title or here to see a good sleeping video from About.com

Sleep patterns can vary significantly from person to person but it is generally accepted that adults require 7 to 8 hours at night in order to function optimally during the day. In pregnancy you might need a lot more. Pregnancy can also bring other complications that interfere with needed rest.

Sleeping difficulties

• Obviously the growing baby can make it hard to find a comfortable sleep position and even shifting in bed can be a challenge, especially in later pregnancy.
• Pregnant women need to urinate more frequently because of the increased blood volume of pregnancy. With the extra fluid being filtered, kidneys must work harder. Along with this some women find the increased heart rate interferes with sleep and may cause worry. A 10-20 beat/minute increase is common.
• Some women feel short of breath resulting from the decreased space and pressure against the diaphragm. You also have increased oxygen needs and you may notice you breathe faster or deeper.
• Acid reflux is common in pregnancy, when the digestive system slows and the resulting heartburn can disrupt your rest. (there are acceptable meds for this so talk to your doctor)
  
• Constipation is also common (also relating to slowed digestion) and of course any discomfort can interfere with sleep. Make sure you are getting some exercise, drinking plenty of water, and eating foods with high fiber content. If this is not enough discuss use of additional fiber or mild laxatives with your health care provider.
  
• Aches and pains are frequent in pregnancy. This is often due to the extra weight you carry. Most doctors recommend acetaminophen.
  
• Some women have different sleep cycles with different dreaming patterns.
• Stress and worry can also get in the way.

These causes are all normal but if you feel your symptoms are excessive, talk to your doctor about possible additional sleep aids.

Sleep positions

Many women worry excessively about their sleep position because they have been told they should not sleep on their backs. They try a new position but find they have reverted during the night. Peg Plumbo, CNM at iVillage.com states, "expecting moms should sleep and rest in whatever position they are most comfortable" She goes on to explain that there are a few exceptions, relating to high risk pregnancies (preeclampsia, preterm labor or placental insufficiency. These conditions necessitate bedrest and it that case a side-lying position would be best.). It is also not recommended you lie on your back during labor since the uterus against the aorta can aggravate already compromised blood flow at that time.

When worrying about back sleeping, keep in mind you are not likely to spend the entire night there anyway between tossing, turning and trips to the bathroom. You can even sleep on your tummy until it becomes uncomfortable. Peg says, "the female body is uniquely prepared for such positions and they will not put the baby in jeopardy." That said, there is a position that is actually good for you in pregnancy. If you can do it, the left side-lying position with knees bent is optimal for blood flow. Unless you have a particular need for the left side due to complications, either side can be quite beneficial. The reason the left is preferred is because the liver is on the right. Even if you weren't pregnant, this would be the "best" position for sleep.

You can become quite comfortable on your side with extra pillows. I recommend four pillows for every pregnant woman. One to be tucked in behind her back (partner can help with this and it will support her so she can relax in the position). A second one for her head (duh!), the third to be placed between the knees (this helps keep the legs aligned and prevents hip pain) and the fourth is for the side-lying mom to hug, allowing the upper arm to have support. You'll be amazed how this can help. You may get so comfortable you have to force yourself up for that bathroom break.

Keep in mind that your mattress should be firm enough to support you well. Even with all these measures you still may need naps during the day.

Kidshealth.org gives the following recommendations to help your sleep success:

• Avoid caffeinated drinks as much as possible. If you do use them, avoid from afternoon on.
• Try not to go to bed on a full stomach or after lots of fluid taken late at night (the bladder problem). Be sure you get adequate fluid and nutrition earlier in the day, however. If you are feeling nauseated, eat a few crackers.
• Try to follow a routine sleep and wake time.
• If you get a leg cramp, press your feet hard against the wall or stand on the leg. Don't point your toe. If it is sore, use heat at first, then switch to ice. Be sure you get enough calcium in your diet. If you don't eat dairy, talk to your doctor about taking a supplement.
  
• Learn relaxation exercises, like Yoga, to help you unwind. Exercise should be approved by your doctor.
• Enrolling in a childbirth or parenting class may help decrease stress and anxiety. Sometimes fears about these things keep you awake

If you do find yourself tossing and turning, find a relaxing activity such as a book (not a thriller) or TV, music or puzzles to help make you drowsy. If you need additional sleep aids, you should talk to your doctor. Click this post title to read more.