Breastfeeding and Sleep

The two most common topics you’ll hear about when you have your baby is: feeding and sleeping. The amount of “advice” out there can sometimes be conflicting and overwhelming. I get it! I have been there before, and even with my 4th child the guilt and confusion was there. Heck, we’re all parents. But it can be overwhelming to navigate. I often hear parents ask me about breastfeeding AND sleep; ‘Will my baby sleep well or through the night if he is breastfed”? Many are told to switch to formula to get their newborn sleeping.  This can often leave Moms feeling sad and confused on what she should do with her breastfeeding journey.

With breastfeeding, it is important to make sure that the latch is established in those first few days, and any concerns are addressed with your lactation consultant. Feeds are done frequently throughout the day as well as night. A newborn’s feeding schedule changes a lot those first few months, as they are going through growth spurts. For night feeds, there are some pediatricians who suggest waking your newborn to feed every 4 hours, while others suggest waiting for your baby to wake up to feed. Often, your newborn will fall asleep while feeding, making it easier to put him down. The feeding to sleep association at first is easy and helpful. However, as he gest older and moves out of his newborn stage, this is definitely a habit you want to remove.

Around 3 months your baby will hit another growth spurt, and around 4 months, the 4-month regression. At that point, your child is leaving the newborn stage and entering the infant stage. He is becoming more alert and aware, and nursing to sleep may not be as effective. This is often when I hear from desperate, tired parents who want their baby sleeping longer stretches. And this can happen!! You do not need to stop breastfeeding in order to get your baby sleeping through the night.  What you need to work on is, changing the habit or behavior or your baby needing to be fed to sleep. If your little one is latched to the breast and falling asleep, when he wakes up in the middle of the night, he will need to latch back on. And this is what we work on. Stopping the feed to sleep association. Changing the habit.

A few things to note with this:

1.      First and foremost, as I mentioned before, you can continue breastfeeding and have your child sleep through the night. You do not need to stop nursing, and swap over to formula, if you don’t want to.

2.     You want to make sure that at this point your baby is nursing enough in a 24-hour period. That he is gaining weight and thriving. Most babies at 4-5 months are still nursing 4-5x a day, and about 1-2x a night. Any issues should be discussed with your pediatrician.

3.    Night weaning is usually part of the sleep training process, but not always a must. Depending on the age of your child, we work on slowly reducing and removing feeds. However, some babies are sometimes not ready to remove all feeds, and that’s OK. With my youngest one, she was underweight, and while I worked on changing her sleep habits (sleep training), I still managed to keep 2 breastfeeding sessions at night.

4.    Ensure that your child is not falling asleep at the breast before bedtime. This is the main thing with seeing sleep training success. Your baby should be nursing for a feed, but not to sleep. Make sure you are feeding him as part of the routine, but not at the last minute when he should be in the crib. Move the feed a bit earlier in the bedtime routine process. Sometimes keeping the lights on, or nursing in another room, can also be helpful.

5.    In the middle of the night, while sleep training especially, it is suggested to have the non-nursing parent to respond. If you are working on reducing feeds and/or teaching your child how to put himself back to sleep without feeding to sleep, it may be easier for him if the other parent responds as he won’t expect to be nursed. While in the beginning it may be hard for your baby, he will learn and get used to going back to sleep without a feed.

6.    While night weaning feeds, you want to make sure you do it slowly and in according to what’s best for you and your baby. When working with my Clients, I look at each child individually and offer case by case recommendations. One thing I do always recommend is pumping before you go to sleep. This helps fully drain out anything remaining so that your breasts don’t engorge at night. It also allows the continue supply of milk so that even though you have removed middle of the night feeds, you are still producing enough. And lastly, of course, you can store some extra milk if needed ;).

If you are a breastfeeding parent, like I was, and still have concerns about your child’s sleep and your breastfeeding journey, let’s talk!

10 Common Sleep Mistakes

As parents we are always learning. Unfortunately, this parenting gig does not come with an instructional manual, and we really are learning as we go. A lot of times we will make mistakes and realize we are doing so, and then fix them. And sometimes, we don’t even realize they are mistakes, and we can’t figure out the solution to our problem.

What are common sleep mistakes that you may not realize you’re doing?

1.     Skipping a nap: Have you heard of sleep begets sleep? Better day sleep = better night sleep. Many parents think that if their baby skips her nap, she’ll be even more tired and will sleep more at night and catch up on sleep. That’s actually the opposite! When our kids don’t get the right amount of sleep they need during the day, it can affect their night sleep overall. They’ll wake up frequently and have early rising. During the day our little ones need that deep sleep, in order to get that deep sleep at night.

2.     Do bedtime later: Another common mistake, also related to the one mentioned above is, pushing bedtime later so that she wakes up later the next day. Unfortunately our little ones are not teenagers! They won’t just go to sleep really late and wake up really early the next day. In fact, the opposite, they will wake up at their usual time or even earlier! Our kids have a certain awake window by age. They can only stay up for a certain amount of time. If we exceed that awake window, keep them up far later than they can handle, they will actually fall asleep overtired, with cortisol kicking in their system. And when an overtired child exceeds her awake window, she will actually have early rising, and wake up *earlier* the next day.  

3.     Respond right away when baby is stirring at night: Most first-time parents aren’t used to the crying and the different noises the baby makes. Some of us are a little more anxious and when they hear a sudden noise they rush to the baby. Sometimes leaving them be, rather than rushing to their room is a good thing. We give them the opportunity to relax and self-settle without disruption.

4.     Sleep crutches: It is recommended to use any means (as long as it’s safe) to help your newborn sleep. There are no bad habits those first few months. But what many parents don’t realize is that those do turn into bad habits if you continue them far beyond the age of 6 months old. Parents will often continue rocking, holding, or feeding their little one to a sleepy drowsy state far beyond the age necessary for that. Then, the child starts depending on these sleep crutches, which can in turn create sleep issues later. The child will need this sleep crutch to help fall asleep and fall back asleep, and that’s where night issues arise.  

5.     Not having a routine: Kids thrive on routine and predictability. It helps calm them down as they don’t like the unexpected. They love the same book over and over again. They love watching the same show or hearing the same song over again. Same with sleep. It is recommended to create a sleep routine before nap time and bedtime. Studies show that if you set up a routine of about 10 minutes before nap time and bedtime, and repeat this every day, it can create better sleep overall. It helps the child transition from playtime to sleep in a calming soothing manner. The child doesn’t feel rushed in going to sleep and spends some time winding down the same way every day.

6.     Not having a sleep space: Getting used to the life of parenting, often involves having to buckle down and not have the freedom of being out and about all day. This may be a hard change for some parents, and then they start compromising their little one’s sleep. Sleeping on the go is not as comfortable as sleeping in our beds. Sleeping in a noisy, bright place also doesn’t really promote sleep. It is recommended to create a sleep space that is conducive to sleeping; dark, quiet, and cozy sleep environment. Your child will start associating sleep with that space want to go to sleep.  

7.     Too much day sleep: Naps are important, but when our little one’s sleep too much, it can take away from their night sleep. Our children have a max total amount of sleep they should be getting in a 24-hour period. While some will nap less than others, the ones that nap too long, will not be as tired for a regular bedtime (have a later bedtime) and will sleep a lot less at night and wake up earlier.

8.     Removing the pacifier too soon: Many parents rush to get rid of the pacifier when their toddler is 2 years old. I often find that getting rid of it at a young age will result in the child boycotting naps, and sleep falling apart. It is easier to remove the pacifier when your child is 3 years old, so you can have a conversation with her explaining the change. It will take some time of adjustment, but she will soon get the hang of it.

9.     Moving to bed: Another common mistake that parents do too soon is transitioning their little one out of the crib and into a bed. This is another transition that I would suggest doing once your child is age appropriate to understand what it means to have the liberty of coming out of the bed, but not doing so. Toddlers under the age of 3 years old, don’t understand that they must stay in their bed and not wander around. Unless your little one has jumped out of the crib, she can sleep comfortably in her crib until 3 years old or even older!

10.  Missing the sleepy cues: Sleep cues tell us when our child is tired. When they start secreting melatonin and are getting tired and ready to fall asleep. If we miss those cues, we tend to keep our kids up longer, stretching their awake window. Make sure to know those awake windows well, and then look for those cues at that time. Get to know them as each child can present them differently.

Sleep & Feed Myths

As parents we are often given ‘free advice.’ Our friends and family will often tell us what worked for them, suggesting we should do the same. The internet provides us with so much information at our fingertips, which can cause more confusion. There’s SO much information out there that isn’t always right. So as parents, we’re often left confused and doubting what is right and what is wrong. One reoccurring topic is feeds and sleep. There are many myths out there on how to get your child sleeping through the night better, and what must be changed in their eating habits in order to get better sleep.

5 commons myths:

1. Formula-fed baby will sleep through the night, not a breastfed baby: This is far beyond the truth. A breastfed baby can sleep just as much as a formula fed baby. You don't *HAVE* to give your child formula to get her sleeping through the night. You do you.  Remember: fed is best.

2. Breastfeeding: Some will say you even need to stop breastfeeding all together, however, this is not true. You absolutely can continue breastfeeding your baby before bed. What you want to make sure you do is not breastfeed TO sleep. So you can feed, unlatch the baby, read some books, and then put down awake; rather than feed to sleep. Here your little one will be able to breastfeed and you will be able to put her down awake, so she can put herself to sleep without relying on nursing to sleep.

3. Load the bottle with cereal: This is the most common myth of them all; load the bottle with cereal to make the milk thicker and she'll feel fuller and sleep longer. This can actually have a reverse affect and cause bloating and discomfort on your baby. This is *not* suggested unless they have bad reflux and can't keep their milk down. Consult a physician before doing this.

4. To “sleep train” means to remove all night feeds: This is NOT true. You can absolutely keep night feeds and teach your child how to self-soothe and sleep and keep any night feeds she still may need. Most babies under the age of 6 months still need 0-2 feeds a night. At around 6 months, babies will start to reduce their night feeds.

 5. Start solids early: Many parents think that starting solids before the 6-month mark will get their baby sleeping through the night. The problem is that most babies so young aren’t ready for food. They are still so young at 4 months, their tummies are still small, and feeding them fruits and veggies can have an opposite affect and cause discomfort.

How Long Should My Baby Be Sleeping?

This is the blogpost that you want to save forever! This will give you all the information on how much sleep your child needs. Below you can find awake windows per age as well as sleep needs (day, night, and total).

Average Sleep Needs & Windows of Wakefulness by Age

Age	Wakefulness Window	Number of Naps	Total Daytime Sleep	Total Nighttime Sleep	Total Sleep
0 – 5 Months	0 – 1.5 Hours	4 – 5 a day	8 Hours	8.5 Hours	16.5 Hours
6 - 8 Months	2 – 3 Hours	3 a day	3.5 Hours	11 Hours	14.5 Hours
9 – 11 Months	3 – 3.5 Hours	2 a day	3 Hours	11 Hours	14 Hours
12 – 18 Months	4 – 5.5 Hours	1 – 2 a day	2.5 Hours	11 ¼ Hours	13 ¾ Hours
2 Years	5.5 - 6 Hours	1 a day	2 Hours	11 Hours	13 Hours
3 Years	6 – 12 Hours	1 a day	1 Hour	10.5 Hours	12 Hours
4 Years	6 – 12 Hours	1 a day or quiet time	0 - 45 minutes	11.5 Hours	11.5 Hours
5 Years					11 Hours
6 Years					10 ¾ Hours

Dad's role in sleep

With Father’s Day coming up, I thought it would be great to dedicate this post to talk about how important Dad’s role is to our child’s sleep. As I always like to say, my husband and I co-parent. We both work. We both raise our kids. We both bathe our kids. We both feed our kids. So why can’t we both sleep our kids? (Don’t worry, we do 😉).

Newborn Stage:

This stage I often refer to as “survival mode.” It’s a bit of a chaotic honeymoon stage. We’re in love, and we’re over the moon with our new addition. Yet at the same time, we’re exhausted and don’t know how to do it all. However, the newborn stage is when we need all hands on deck! We need BOTH parents doing it all, to help each other out, and more importantly, to bond with our newborn. Yes, even though Mom chooses to EBF, Dad can play a HUGE roll in newborn’s sleep.

1.     Bedtime routine: Dad can take over 3 (if not all 4) of the 4 B’s for the bedtime routine (bathe, bottle, book, bed). If Mom is EBF, Dad can still do the other parts to the routine. Bathe newborn and offer a nice yummy massage. Read a book and swaddle and rock your newborn to sleep.

2.     Middle of the night wake-ups: Those first few months your newborn will be up many times for many reasons. Sometimes to feed, but sometimes just to regulate breathing and temperature, or want that one-on-one contact. If Mom is EBF, then perhaps Dad can take over the other wake ups, and settle baby to sleep. This will help Mom get a break and get some rest too.

3.     Naps: Dad can take over a nap (or two) to give Mom a break. This is the time when we are supposed to swaddle, rock, hold, or even bounce our baby to sleep. So have Dad spend one-on-one time with her, and hold her as long as he wants!

 Infant and toddler stage:

Coming out of the newborn stage and into the infant stage, she will start settling into a nice sleep routine. Again, we will need Dads to help us in so many ways!

1.     Sleep Training: Your infant will need to learn the self-soothing techniques to put herself to sleep. When you begin sleep training, you will BOTH need to help each other out throughout the process. Supporting each other, staying consistent, and allowing the other one to catch up on some rest after being up sleep training. Even more so, if there is a strong nurse-to-sleep association, we will need Dad to help Mom break this habit (not stop nursing, just break the feed to sleep association).

2.     Bedtime routine: Now more than ever will we need Dad during the bedtime routine. This routine is crucial to healthy sleep habits for your infant. If Dad is able to be home for 3 or 4 of the 4 B’s, it would be so helpful!

3.     Naps: Your infant will need to nap 1-3x a day and what better way to help, than doing nap time routines on the days he’s home! This will give Mom a chance to be with the other child, or even just take a break from it all.

Have special situations that you have questions on? Sure, not a problem! Schedule a call and let’s talk it over.  

Setting Up Your Child's Sleep Space

The first step in creating healthy sleep habits is setting up your child’s sleep space. The most important part of the sleep space is not WHERE they will be sleeping but HOW they will be sleeping. Your baby should be sleeping on his back, on a flat surface, and bare (with no pillows and blankets). In order to practice safety sleep habits, you want to make sure your child is separated from your sleep space in either a bassinet, crib, or pack-n-play. (If you choose to co-sleep, you can, but you must make sure you follow the correct guidelines for co-sleeping.)

After setting up your baby’s sleep space you may want to take a few other things into consideration:

1. Darkness: Make sure the room is dark, and shades are closed for naps and night. While you don’t need to go out and purchase the most expensive black-out shades, (you can purchase temporary shades, or put up aluminum foil or a plastic table cloth), I do recommend closing the curtains during nap time to make it darker and so your child knows it’s “time to go to sleep.” For the older kids (2 years old and up), you may want to put a small little night light as they may scared of the dark.

2. Temperature: Research suggests the ideal room temperature should be between 68-72 F. I full recognize that for some that can be too cold, depending on where you live and how you use your ac (or not). Take into account that your child won’t be using blankets and doesn’t have the body warmth of someone sleeping next to them. Take a look at the air vents, is the room small or big, does the room warm up with the sunshine during the day?

3. Music: During those first few months, you can have soft lullaby and music playing throughout the day, as this can help them distinguish night vs day. But as your child gets older, it’s better not to have the music playing while they sleep, as it can distract them and even cause more of the light sleep.

4. White Noise Machine: This is definitely my favorite part of the sleep space. If you have other children in the house, a loud dog, or live on a noisy street, the white noise machine really helps drown out the exterior noise. It is recommended to have it on a medium to low setting, not so close to the crib, and on the whole time your child is sleeping. Check out a few of my favorites here.

5. Mobiles: These are OK to use the first few months. It’s great for entertaining and relaxing your newborn. However, I don’t usually suggest keeping them once your child is 5 months or older. As your child gets older, the mobile can become a safety issue when he starts standing and pulling on it. Mobiles can also cause a distraction. Too much noise and sound can actually distract and stimulate your baby, rather than relax and get him ready to sleep.

6. Pillows, blankets, and bumpers: None of these are suggested to have in the crib if your child is under the age of 12 months. Some parents choose to use mesh bumpers or even individual railing bumpers. Pillow and blankets are not needed and they should wait until he is closer to 3 years old to use them.

7. Bed railing: If your child is in a bed, it is important to have a bed railing on the side. Most toddler beds come with one, but the bigger beds don’t.

If you have specific questions on your child’s sleep space, let’s talk!

How Much Sleep Does My Baby Need?

Day sleep is so important for our little ones! Not only do they need to rest their little bodies and minds, they also need to get in good day sleep in order to get in good night sleep. Studies show that if your child is taking short catnaps, that is less than 45 minutes where she isn’t reaching the deep sleep (Non-REM), chances are she will wake frequently have interrupted sleep at night. This is where the phrase “Sleep Begets Sleep” comes from.

But how much should my baby sleeping? It really all depends on her age. When they are younger they need more day sleep, and have less awake windows. As they get older, their awake window increases (meaning they can be awake for longer periods of time), and will need less day sleep overall. The most important thing to know is that your little one will need to nap up until the age of about 3-4 years old.

Here’s a friendly chart to help guide you with your child and her naps those first few years:

Age Wakefulness Window Number of Naps Total Daytime Sleep

0 – 5 Months 0 – 1.5 Hours 4 – 5 a day 8 Hours

6 - 8 Months 2 – 3 Hours 3 a day 3.5 Hours

9 – 11 Months 3 – 3.5 Hours 2 a day 3 Hours

12 – 18 Months 4 – 5.5 Hours 1 – 2 a day 2.5 Hours

2 Years 5.5 - 6 Hours 1 a day 2 Hours

3 Years 6 – 12 Hours 1 a day 1 Hour

4 Years 6 – 12 Hours 1 a day or quiet time 0 - 45 minutes

Sleepy Cues

How do you know your little one is ready to sleep?

When your child starts getting tired, he will start showing you signs that he wants to go to sleep. It’s his way of communicating with you that his melatonin started to kick in, and he is getting sleepy.

We all secrete melatonin when we are getting tired and ready to go to sleep. The thing is, with our babies they are secreting them more often, since they need more day sleep (and sleep overall). When they’ve hit their sleep window, they will secrete the melatonin, which is a calming hormone that helps their body calm down and get ready for sleep. 

A lot of times, we may miss the cue, so we have to be very careful to make sure we catch them at the right time, otherwise we will miss their sleep window, causing them to be overtired and making it harder for them to fall asleep. 

Some common sleepy cues to look out for are:

-       Rubbing eyes

-       Rubbing nose

-       Pulling ears

-       Red/droopy eyes

-       Yawning

-       Cranky and crying

Want to learn more about when your child should be showing sleepy cues? Contact me and we can talk about your child’s sleep windows.

Planning Your Next Family Trip

It’s already starting to feel like summer around here in Miami. School’s almost out, and the days are getting longer and warmer. Most of you are already planning ahead for that summer trip (not vacation, as we know when we travel with our kids). Of course, traveling with younger kids is always harder, but doesn’t always have to be if you can prepare yourself accordingly. Here are my top 5 suggestions in helping make your travel plans smoother.

1.     Departure Travel Time: If you have a child that still naps, you want to try to book your flight (or departure time) around nap times. Having your child nap during the flight or car ride will not only make the travel time easier for you, but will help your child adjust to arriving to a new place without being overtired. Many parents are concerned with how to nap their baby. On the plane, anything goes! You can hold, rock, feed, or even put your little one in a carrier and walk the isle back and forth if you have to. This will not create bad habits, as it’s only a one-time scenario while traveling. Try to avoid flying in the later afternoon, which will bring them to a later bedtime in a new place. They will need time to adjust to their new sleep setting first (see below #2, and you don’t want to get there too late.  

2.     Sleep Space: When deciding on where you will stay, try to figure out where your baby will sleep. She does not need her own room, but if you can set up a pack-n-play in the corner or hallway of the room (away from the bed), it will help. If your child normally sleeps in a crib at home, find out if your hotel provides one, and if not make sure to bring your own pack-n-play. There are also companies that rent out baby gear. Once you get to your new sleep space, make sure to set hers up with her crib sheets, toys and blankies. Have her play in and around the area so she can familiarize herself with it before bedtime.

3.     Child’s Sleep Essentials: Because you will be an unfamiliar place you want to make sure to bring as much of her sleep essentials as possible. A few good items would be: crib sheets, blankies, pacifiers, her regular bedtime books, and even a few of her favorite toys. Think of what your bedtime routine looks like at home and try to bring all the essentials that are part of it. You want to make sure she feels comfortable in her sleep space.

4.     Adjust To New Time: When traveling to a different time zone, your little one will need to adjust her circadian rhythm to the new time. It is suggested to adjust to the new time immediately upon arrival. Make sure to feed and sleep her with the new time as soon as you arrive! If you arrive during the day, expose her to sunlight to help adjust her rhythm. Jetlag can last a good 3-5 days, so hang in there if those first few nights back home are rough.

5.     Remain Consistent Yet Flexible: Our kids thrive on routine and predictability. They like to know what’s coming up ahead without the surprise and the unknown. This is why it’s recommended to keep to a schedule and routine daily when at home. However, it’s very hard to keep to the exact schedule when traveling, so don’t worry! Try to at least keep to the same feeding and sleeping times as best as you can. If you’re out and about and it’s time for a nap, try to sleep your child in the stroller, car, or in any means possible. Just because you aren’t home doesn’t mean she doesn’t need a nap. Adjust bedtime earlier if it’s been a day where she hasn’t napped well. If you’ve spent too many days out where all naps were short, try to stay back one day so she can nap in her sleep space and catch up on sleep. And most importantly, continue putting your child down awake at bedtime and nap time and respond consistently. If she’s between the ages of 9 months - 2 years old, she may be a little scared of her new sleep setting, and not understand what’s going on. You can provide extra support, but make sure you don’t go back to old bad habits. You can sit by her crib to provide comfort, but allow her to put herself to sleep.

How To Handle Holiday Travel

It’s that time of the year again! Holidays, New Year’s, school is out, and some are even taking vacations and family trips. While it’s great to take a break from the daily routine and get away, with the little ones this often means more work than not. Breaking from their regular routine can cause some hiccups along the way, especially with their sleep. It’s hard to keep to their schedule, but sometimes even the smallest things we can do to maintain normality will help avoid the major regressions and make it a little “easier” to travel.

Below are a few of my recommendations to help avoid major sleep regressions while traveling:

1. Book your travel around nap times: If your baby still naps, try to schedule the flight or drive around his naptime. Ideally he would nap on the go, so he can catch up on some of the day sleep that he needs.

2. Sleep Space: Often times when traveling it’s hard to accommodate everyone’s sleep space, especially when staying at a relative’s house. If possible, bring a travel pack-n-play for your little one so that you don’t start creating a new habit of co-sleeping. If there’s no extra room for your baby, try to set up a sleep space as best as you can. Perhaps a corner, a hallway, or even a breathable walk-in closet with the door open. Try to create the environment that is most conducive to sleeping; like making it dark, no screens/TV’s, and the right temperature.

3. Bring the essentials: Trying to replicate his sleep environment will help with the transition to the new space. Consider packing his crib sheets, a few extra loveys and pacifiers, his white noise machine and if possible, a few of his favorite books and toys.

4. Try to keep to the schedule with a little flexibility: Keeping to your child’s schedule and routine while being on vacation is hard, especially now with the holidays. We tend to be up later, have more family gatherings and meals; we’re even out sightseeing the whole day. You can still try to keep to his feeding and nap schedule as best as you can in order to avoid major tantrums. If there’s no time change, it should be easier to stop for a quick lunch when he needs it, or when it’s nap time, perhaps take him for a stroll in the car/stroller if you aren’t home. Ideally, the more naps you can offer your child in his crib, the better, as this will allow for longer/deeper sleep. If you know you’ll be out all day, try to squeeze in his morning nap at home before you go out. If his naps were short and on the go during the day, try to come home for an earlier bedtime.

5. Give some time to acclimate to new sleep space: When arriving to your new location, try to give your child some time to get used to the new space. Perhaps take out some toys and books, and allow your child to crawl/walk around the room, play, and familiarize himself so that when bedtime comes around, he’s already used to the new environment. 

Try to enjoy this time with your loved ones as best as you can. Travel and change will always cause some regression, but nothing that can’t be fixed once home. Try to stick to the tips mentioned above, and when you’re back home, more importantly, make sure to go back to your regular sleep habits.

How To Handle Daylight Savings

It’s that time again… when we change the clocks, but this time an hour ahead. This change isn’t as bad as when we moved our clocks back an hour last Fall. However, the 1 hour difference still makes an impact on our little one’s schedule.
 
Often times parents are happy with this change, as the early risers are now waking up later. For others, it may not have an effect at all. Regardless, you want to know what to do should it change your child’s sleep pattern.
 
What Can I Do?

• Gradual Approach: For the younger babies, or the children who have a harder time adjusting to the change, this option may be best. Starting the week before you want to make sure you start moving your child’s schedule by 15 minute increments. That means all feeds and naps should be pushed earlier by 15 minutes every couple of days. So that while you may have your child going to sleep earlier for a few days, by the time Sunday comes around your child will be adjusted to the new time.

• Cold Turkey Approach: With this approach, you automatically adjust to the new time on Sunday. As soon as your child wakes up that morning, you go by their regular schedule according to the new time.

Additional Tips:

• You can help adjusting your child’s circadian rhythm by the exposure to light. You want to make sure you avoid bright lights/sunlight in the evening ex: TV’s and screens. And in turn in the morning when they do wake up, you can begin your day any time after 6:00 a.m. and expose them to the sunlight outside.

• Extra shades/black out curtains are crucial this time around. It will get darker later at night, and brighter earlier in the morning. Try to cover as best as possible those windows, so that no sunlight comes in.

• Remember that with the new time change, we will be losing an hour, so those first few days when you put your child down at the new bedtime, they may not be ready to go to sleep just yet. Try to be a little flexible perhaps in the timing of bedtime those first few nights, and always remember to respond consistently.

When To Get Rid Of The Pacifier?

Many children use the pacifier to soothe themselves to sleep and end up keeping it around for a while. Parents then come to me and ask, when do we get rid of the pacifier?

I’ll start off by saying that if your child does take to the pacifier, it’s not necessarily a “bad” thing. For those first few months, the sucking sensation for newborns is calming and soothing, and crucial for a newborn. More importantly, the AAP has said that pacifiers are known to reduce the risk of SIDS. Once they know how to re-plug themselves (at around 9 months), they can do it often during the day and at night, and no longer depend on you.

So when’s the ideal time to get rid of the paci?

Before beginning sleep training, I often tell my Clients they have a choice to keep or remove the pacifier. If your child is 9 months or younger, it is OK to proceed with the sleep training without the pacifier. Once your child is 12 months or older, I don’t recommend removing the pacifier as they have already created a dependency on it. 

I usually recommend getting rid of the paci once your child is older, closer to age 3. At this point you can have a conversation with your child to explain what is going to happen, and chances are she’ll understand.

Getting rid of the paci

1. When you are going to get rid of the pacifier, make sure you don’t do it at the same time a new sibling has been born, you’ve moved, or any major change in your child’s life.

2. If your child is one to have the binky with her all day, you can start limiting it to sleep only and leaving it inside the crib. Once she awakes from naps or in the morning, the pacifier must stay inside the crib.

3. Make sure to have a conversation with your child to explain how big girls no longer use the paci. Perhaps have your child visit the dentist so he can explain it to her.  Make sure to have these conversations a few days before beginning, so as to prep her.

4. You can read some books that address this topic. A few suggestions are: Bea Gives Up Her Pacifier by Jenny Album, Little Bunny’s Pacifier Plan by Maribeth Boelts, or Goodbye Binky:  The Pacifier Fairy Story by Sinead Condon.

5. After having the conversation and reading some books, you can then sit with your child and decide what she’d like to do with it. She can “give it away” to a baby who needs it, trade it in for a special toy from the paci fairy, or even put it inside a special stuffed bear (like Build a Bear) and then she’ll always have it with her.

Whenever you do decide to remove the pacifier, just be prepared for a few rough nights. Make a plan and stick to it consistently. Try your best not to go back and stick to it for a few days.  Good luck!

Security Object; What is it?

Loveys. Pacifiers. Sucking of thumb. Just a few examples of what's known as a security object. A security object is there to give your little one a sense of security and comfort while you aren't there with him. The sucking, holding, grabbing, smelling, squeezing of whatever that object is brings a sense of security and enables the child to self-soothe and self-settle without relying on someone.

It's suggested to introduce a security object to your little one as soon as you can. The more you expose your child to it, the greater the chances he will take to it and then will have it when you are doing the sleep training. As far as which one? Below I list the different kinds with the pros/cons of each. 

Pacifiers:

Pacifiers are great for newborns as the sucking really relieves the fussiness. The issue with pacifiers is that until your child can re-plug on his own in the middle of the night, you will have to do it for him. The pincer grasp comes around 9 months, and until then your child will depend on you to re-plug. The good thing about pacifiers, as opposed to thumb-sucking, you can limit/control when he has the pacifier as well as remove it at a later point. 

Thumb-sucking:

Contrary to the pacifier, the thumb (or fingers) are always accessible to your child. This makes self-soothing really easy for your child to do at any point during day or night. He will be able to decide when he needs to suck to soothe himself and when not to and not rely on you. The issue with this is that you can't remove/stop your child from sucking his thumb. While it is possible at a later age to have him stop sucking his thumb (just like the pacifier), until then he will be able to do it at any point. 

Blankies:

Blankets are most often used as security objects. Often times it's the special one grandma made or the soft one a friend gave us. With blankets you want to make sure that they are safe, first and foremost. Sometimes they are too big or too thick which can be hazardous. You also want to make sure that if it is a special blankie that you can get more of the same kind. Because if we lose the one, well then what? 

Loveys:

Loveys are small little blankies often with something attached- like an animal. They are often small and light, but very soft and cuddly. These are a "newer" version of the blankie, and often less hazardous as they are smaller and lighter than a blanket. 

Regardless of which security object you choose to give your little one, please remember the following:

1. Must be safe and not hazardous that can cause suffocation or strangulation. 

2. Purchase 3-4 of the same kind, so you have backups in case you leave one on the plane! 

3. Make sure you rotate them, so they are all equally "used" at all times. 

4. When introducing the security object try to perhaps sleep with it or hold it while feeding so the object attracts some of your familiar smell. 

5. Keep on introducing it to your baby. It takes more than 1 day for your child to get attached to it. 

Be advised that the AAP does not recommend anything in the crib under the age of 12 months. Choosing a security object for your child is a personal decision. Please always make sure that it is safe for your child.

Rise and Shine!

Remember the days when waking up early meant 7:00? That definitely changes with kids... 7:00 is sleeping in, and 8:00 a blessing!

What parents don't realize is that a baby who wakes up at 6:00 a.m. or after is considered normal (given that he has slept well at night and woke up rested and happy). The amount of sleep your child requires, differs per age. What shouldn't change is the fact that day starts at 6:00 a.m. or later; not before!

If your child wakes up before 6:00 a.m. and won't go back to sleep, you will and should work on it, as it's not only a behavioral aspect but also an adjustment of their circadian rhythm.

Causes of Early Rising:

1.     Bedtime is too late: This is the most common cause of early rising. Often parents think that if they put their kids to bed later, they will wake up later. This is actually not true for kids under the age of 7. Late bedtime means you have put them to sleep in an overtired state which won't allow for a restful sleep and will cause early rising.

2.    Not enough day sleep: In order for your baby to sleep better and longer at night, he will need to get in good naps during the day.

3.     Large wakeful window: Your child shouldn't be awake for more than a certain amount of hours (depending on age, requirements differ). Keeping them up longer will only cause them to be overtired.

4.     Going to bed too drowsy: Some parents will often do a little too much at bedtime such as: rocking, holding, or even feeding their child until they are to the point of falling asleep, or too drowsy. Doing “too much” at the onset of sleep will only make it harder for your little one to learn how to put themselves back to sleep in those early morning hours. 

5.     Obstructive Sleep Apnea: This is a medical condition that is usually caused by enlarged tonsils and adenoids. Some common symptoms that your child may have OSA is: restless sleeping, sweating, loud snoring, mouth breathing, and even frequent ear infections. Because this is a medical condition that affects your child’s breathing at night and throughout the early hours, you should follow up with a pediatrician or pediatric ENT.

Adjusting Early Rising:

1.     Sleep Space: Determine if the sleep environment is conducive to sleep. Check if the curtains keep the room dark and that no sunlight is coming through. Do you have a white noise machine that can perhaps keep out the outside noise?

2.     Hunger: If your early riser is 6 months or younger, you may want to determine if it’s a hunger issue. Is your child getting enough feeds during the day? Does your baby perhaps need an extra feed to carry him over those last few hours?

3.     Coach back to sleep: If your child awakes before 6:00 a.m. you must treat it as it’s the middle of the night, and try to get him to go back to sleep. Quickly respond to your child and tell him it’s time to go back to sleep. Make sure you respond consistently as you do at bedtime.

4.     Keep your child in bed: Try your best not to take your child out of his crib until 6:00 a.m.

5.     Dramatic wake up: When you do take your child out of his crib, make sure to do what’s called a “dramatic wake up” to split the coaching to sleep, and him out of the crib. Go back in, turn on lights, and take him out to the living room common area space. Make him believe he is starting his day because you believe it’s time, not because he cried enough to get it.

6.     Hold off on feeds right away: Try not to immediately feed him. If possible wait a little before doing so.

7.     Morning nap not too early: If your child is still taking a morning nap, make sure you wait until 8:00 a.m. or later to put him down.

Early rising is very common with children, but unfortunately it’s the longest sleep “issue” to correct. It can take anywhere from 2-3 weeks or even months in the older kids. Make sure to follow these suggestions, respond consistently, and give it some time. This too shall pass….

How To Handle Sleep & Daylight Savings

It’s that time of year again. The day we all dread. Daylight Savings or “Fall Back.” One hour behind.  For the older kids it doesn’t really seem to affect much, but it can really throw the younger ones off. So while it’s still a few weeks away, you can start thinking and preparing so that the change isn’t so drastic on all of you.

You can take two different approaches:

1. Deal with it when it comes:

• On Saturday night, put your child to bed at his regular bedtime.

• On Sunday, when he wakes up with the new time you will need to immediately adjust his schedule according to the new time.

• So while he did “wake up an hour early” stretching him to the new naptime might be a little hard. Try your best to distract him and get him to take his nap to as close to the new time as possible.

• If you can’t adjust to the schedule on day one, try your best to slowly push it over in 15-minute increments, over the course of the next few days.

2. Prepare a few days before:

• Slowly adjust your child’s bedtime and nap times an hour later by 15 minutes a day, the week before Daylight Savings. This way, your child will already be adjusted to the time change when it comes.

• While you’re adjusting naps and bedtime, make sure that you also adjust mealtimes in 15-minute increments to help ease the transition.

However, once Daylight Savings hits:

1. Make sure to block sunlight & noise: If you don’t already have them in your child’s room, consider installing blackout curtains and using a white noise machine. Although the days are getting shorter, there may still be some sunlight coming in the morning, as well as some outside noise during bedtime.

2. Dramatic Wake up and Toddler Clocks: Teaching your child about time might be a little hard when they are young. If you are constantly relying on the actual sun and moon to teach your child about sleep, it may get a little confusing with the time change. Dramatic wake up is a good method to help your child learn that the day has begun, even if they woke up early and didn’t go back to sleep. Behavioral Clocks are suggested for children over the age of 2 ½, as it helps them understand when its time to get up and start the day, and when it’s time for bed.

3. Sunlight: Make sure that you expose your child to lots of natural light first thing in the morning to help rest his circadian rhythm to coincide with the new time. Try going for a morning walk, or even just opening the blinds. Make sure to keep the blinds open up to 45 minutes before nap and bedtime to help your child adjust to the new time.

4. Stick to your schedule: Even though things may seem a little off whack, try your best to stick to your regular schedule according to the new time. The consistency of your daily routine is important for your child to adjust.

Keep in mind that it can take some children up to a week to adjust to this time change. Children who are very sensitive to change or have sensory issues may need a more gradual adjustment as well. Be patient but keep working on adjusting them to the new time. Good luck!

Sleep Tips For Your Summer Travel

It’s officially Summer and I’m sure you are planning your getaway. Although a vacation with kids is a whole other ball game, it is still manageable.  Your bags are now twice as heavy and your magazines are staying home, but spending some quality time with your family on the beach is unforgettable.

Many fear the travel, as it’s one of the main causes of sleep disturbances. But if your child was a great sleeper before, just like any regression, she will be a great sleeper after as well.

There are a few things you can do to try to avoid such a bad regression:  

1.     Keep to the schedule and routine as best as possible. We all know that staying inside the hotel room all day for your baby to nap her 3 naps isn’t going to happen. You want to explore and be outside of the room – well, isn’t that one of the main reasons why you’re on vacation? You still can! Just as you do the exploring keep in mind of your little one’s schedule. Perhaps stay indoors for her first long nap, and then go out onto the beach. If you are nearby your room, try to have her come back to her crib for the nap. And if you’re out and about be mindful of nap times and bring her lovey so she can at least take the nap on the go.

2.     Bring some familiar crib sheets and blankets. If you are going to a hotel or even a relative’s house, chances are they will have crib sheets and blankets. But sometimes bringing some of your own will help your child feel a little at home. The regular crib sheets will bring a little familiarity to her.

3.     Bring the essentials. Try to recreate her sleep space like she has at home, in the new setting. You can bring some plastic garbage bags to cover the windows to ensure that the room is dark enough. If your child normally sleeps with a white noise machine, you don’t have to bring the whole machine, you can download an app on your phone.  If your child has a favorite book, or a favorite pajama, bring those as well. And of course – don’t forget her loveys! Make sure to bring some extra in case you forget one on the plane or in the hotel room.

4.     Room & crib acclamations. If you arrive to your destination during the day, try to set up your child’s sleep space first and have her play in it for a while. Let her explore the room, the new crib, and play around so she becomes familiar with it.

As soon as you get back home, make sure to go back to the regular routine. You may need to do a mini-sleep train for a couple of days, but nothing like before. Your child should fall back into her regular sleep patterns relatively quickly.

Setting Up A Sleep Routine For Your Child

“In the great green room there was a telephone…” How many times have you read that line? I can recite that book with my eyes closed while standing upside down on one hand. I must have read that book a quadrillion times for my boys; over and over and over again…. Why does your little one want you to read the same book every night?  

Familiarity. Routine. Knowing what to expect. Children need routine--they need to know what to expect and when because it gives them a sense of security. Having their meals, play time, nap time, and bed time structured really helps the child understand time. This eases the transition from one activity to the next.

Same thing applies to their sleep. Your little one will need her day sleep (up until around the age of 4), and setting up her nap times according to her circadian rhythm will really help her understand what is coming. It will also help her body wind down and sleep better. While I do suggest a routine, make sure you allow some flexibility if needed. It’s the consistency that is reassuring for your child.   

When to begin?

I always suggest parents begin shaping these routines as early as day one. For newborns, make sure you are feeding your child on her regular hour schedule. If you need to wake your newborn during the day to feed, go ahead and do so. You don’t want her missing those nutritional feedings during the day, then looking for them at night instead. Also, newborns have a limited time that they can be awake, so make sure your baby sleeps every 1-1.5 hours, since her little body can’t be up longer than that.  

Once your baby is roughly 3-4 weeks old, start implementing a bedtime routine. While it is very unlikely that your little one will sleep through the night at this age, you still want to begin establishing a routine so she begins to understand those external sleep cues. She will begin familiarizing herself with this routine, which will be part of her bedtime process for the years to come.  

What to do?

I like the 4 B’s; Bath. Bottle/Breast. Book. Bed. Some like to add a massage after the bath; that’s OK. Use this as a guide and adjust it depending on age. For those newborn babies, by the time you’ve hit books your baby might already be sleeping. And for a 5 month old, she may just try to eat the book. But for an 8 month old, sitting and reading a short hard-covered book is fun! For your toddler who no longer drinks a bottle/breast, I would replace this with a Brushing of the teeth.   

Once you have set a routine that’s a good fit for you and your baby, begin the routine 30 minutes before bedtime, and 10 minutes before her naptime. Her naptime routine should be the same as her bedtime one, but a shorter version.