Another big year comes to an end and I find myself reflecting on the many consultations I have had with mums (and dads) when seeking expert help and support to help babies and toddlers improve their sleep routines. The feelings of anxiety and exhaustion were abundantly apparent but often the sense of personal “failure” was overwhelming.

The question most often posed is how to help your babies and toddlers settle to sleep with less resistance…and eventually self-settle calmly and contentedly.

At Mothercraft for Babies, about 75% of the customers we help with home visits or telephone/Skype consultations are about sleep issues. And mostly the reasons are overtiredness or unsuitable sleep associations due to missed “cues” when our little ones are trying to communicate that they need to rest their minds and bodies.

As new parents you will probably really struggle to make confident decisions for a while, overwhelmed with the amount of advice and research available to you and doubting your choices when different strategies don’t work. And when they arrive at the state of overtiredness all day, it’s pretty hard to work out when they need to be in bed!

Evidence will suggest that each baby has a different temperament and the parent child relationship evolves uniquely. It is a learning process as you each begin to get to know one another and find that groove for easy teamwork. It takes time for you as the parent or caregiver to suitably “read” baby’s cues and respond appropriately to those needs. And to develop the skills to best meet those needs with desirable results.

No two babies sleep the same way. You will know how much sleep your baby or toddler needs by reading the cues that tell you they are coping with their “awake” time comfortably and happily. When your child needs to sleep after a feed and play during the day, they will usually give you one or more cues.

So in turn, you need to give your baby and toddler your “cues” that it’s time to go to sleep. Reduce the surrounding stimulus and start the bedtime wind down mentally and physically. This ritual needs to be consistent so as there are no confusing “cues” if you are to have any success. Nothing elaborate or complicated and whatever you are comfortable doing to reassure and soothe your child to prepare for sleep.

There is no right or wrong way, it’s what works for you and your child and helps your child to self-regulate and manage their simple emotional needs.

Lastly be gentle on yourself. I have recently completed a parenting program called Circle of Security which is the latest evidence based research into developing a secure and loving attachment and relationship between the caregiver/parent and child.

There is no such thing as perfect parenting and neither is it desirable or healthy for the child.

It’s about understanding and responding to your child’s needs wherever possible, but taking charge when necessary. It’s about the parent being bigger, wiser, stronger and kind and responding to the feelings behind the behaviour not the behaviour itself.

The latest research says “good enough” parenting is all your child needs to feel secure, safe and loved.

The parents we work with every day, week and year, without exception, are all giving their kids 110% effort, love and support and doing their very best. This is good enough and your child is lucky to have you!

Research reference:
Circle of Security – Cooper, Hoffman, Marvin & Powell 2000

For copyright information go to; http://circleofsecurity.net/

The time has come to think about introducing solids into your baby’s diet, and for different reasons which may be relevant and suitable for your baby;

  • Your baby has come of age somewhere between 4-6 months where the additional nutrition other than milk feeds is a necessary next step for growth and development
  • Your baby is showing signs of needing the extra calories to grow eg. new night waking and hungry, his usual milk feed doesn’t sustain him for as long, showing interest in your eating,
  • For medical reasons your Paediatrician/GP has recommended you begin solids eg. diagnosed reflux, not tracking to expected growth/weights gains

You can find lots of information and advice on “Doctor Google” about this subject, some strong advocacy supporting exclusive breastfeeding until baby is 6 months old, and other health professionals who believe that introducing solids before 6 months better supports the immune system and lessens allergic sensitivity towards certain food groups. If your baby is bottle fed then this maybe a different consideration again, depending on weight gain, age and appetite. This may also be dependent on your baby’s development and strength in head and neck control, which will allow a more upright position for feeding, optimising digestion and new chewing skills.

I like to guide parents to relevant evidence based studies and recognised authorities on this subject, so that your decision is well informed and fits comfortably with your own parenting beliefs but most importantly, your child’s individual needs. You may choose to be well advised and guided by your trusted Health Professional.

Websites with interesting and diverse content regarding introduction of solids;

http://www.allergy.org.au/health-professionals/papers/ascia-infant-feeding-advice
http://www.eatforhealth.gov.au/news-media/translating-science-behind-eating-well-and-staying-healthy

So depending on when you introduce solids (I am an advocate of sometime before 6 months as a general rule) you will start with easily digested, iron fortified rice cereal which is also gentle on the immune system. This is a good initial training food to encourage your infant to use and coordinate different mouth and cheek muscles, the palate and tongue in a whole new way. This takes a bit of practice of course, and can be mixed with breast milk, formula or cooled boiled water (yuk with water, my opinion only) and followed by pureed fruits such as apple and pear, offering each food separately to develop baby’s bland and immature palate, and no added salt or sugar please! You may start with one meal per day probably with the mid-morning milk feed which is offered first with solids to follow approximately 10-20 mins later. This way if there is any reaction to certain foods it happens early in the day and can be readily addressed.

Introduction of these first solids may span first week to 10 days, progressing to offering twice a day and including pureed vegetables (such as pumpkin, carrot, sweet potato and zucchini). From around 6 months of age you can introduce yoghurt, pureed meats such as lamb/beef mince and avocado, mashed well and veggies and fruit can be prepared in a more chunky consistency than puree as long as baby is coping with chewing and swallowing.

After 6 months it is your decision (along with guidance from your health professional) as to when you introduce wheat based products, whole milk, egg yolk and egg white, cottage and ricotta cheese, fish and so on. You can certainly introduce cool boiled water with a Sippy cup from 6 months and you can give baby his solids about 30 mins before his milk feed (although he will probably like his milk feed first thing in the morning and last thing at night while he still toddler). He is probably moving towards cutting down his milk feeds to allow for the extra calories/nutrition. Try not to leave too much time between his solids and milk feed or you may find he is overeating. By 8 months or so you can give him light snacks say after his lunchtime sleep to keep the energy levels up til dinner time.

Finger foods can be introduced around 9 months of age and make mealtimes fun by giving him different textured foods to feed himself, splashboards up! By 12 months of age he should be eating the same foods at mealtimes that the rest of the household enjoys.
It’s all good fun, and mealtimes will be pretty messy, I always give my bubs the opportunity to explore foods with their hands and this can sometimes create good diversion tactics as you get those spoonfuls into his mouth. It also helps them learn to start feeding themselves, because everything goes into those mouths!

But be mindful that with babies/toddlers, mealtimes need close supervision by an adult at all times to prevent any choking/gagging mishaps.

So strap on your plastic raincoat, a plastic sheet under the high chair, and many, strong washable bibs for junior because life is about to get very messy but a whole lot of fun!

Let’s wrap our small babies! It does help them sleep better and longer.

There are many different styles of swaddles and wraps to choose from all claiming to be the miracle you have been searching for, that elusive, settled, sleeping angel!

Today’s parents are inundated with so much conflicting advice and information from so many sources, little wonder you don’t know which course to follow and what products to purchase.

I have practised as a trained and qualified Mothercraft nurse for many years now and I have met sleep challenged babies every week (and just as many exhausted parents!).

Here are the reasons why I believe your little babies will settle better and longer when they are snugly wrapped and tucked into their beds.

  • Little babies from birth up until about 4 months of age still experience their startle (Moro) reflex and some find this more distracting and disruptive than others to deal with during their sleep periods. Whilst settling to sleep can be a challenge, (every day at least one unsettled period is the norm)  being  wrapped firmly with their hands and arms tucked away from their face will help them relax more quickly and stay settled longer. The art of wrapping is a “learnt” skill so when you are in hospital ask a Midwife to show you how and don’t  be afraid to practice under their guidance.
  • I have not met a baby from newborn to around 4-5 months of age  who doesn’t respond well to feeling contained and secure (emulating in utero) from a firm wrap when going to sleep. Just like when you cuddle them and hold them tight!
  • Being wrapped is a great sleep cue for baby, even though they sometimes look at you in abject horror when you put them down to do “the wrap”.  They already know the cue.This is usually the behaviour of babies who have for various reasons reached a stage of being very overtired and emotionally stretched, not unlike mum and dad!
  • And if babies are well wrapped they are more likely to settle faster and stay settled. How many times have you gone into baby who has woken after a short time (and you are trying to grit your teeth and be patient) and you can see little octopus hands waving around the cot and a long way from the dreamland.
  • I must admit if I had my way I would also love to tuck them in firmly to their cots or bassinets but not all the products on the market allow you to do this. But a little tip, you can roll up a cloth nappy or small towel and wedge one each side of the bed clothes into the side of the cot to create some firm tension and better outcomes, assisting your baby sleep patterns.
  • Please note that when your baby is starting to actively roll which is usually from around 4-5 months of age (guide only as each baby reached developmental milestones at different ages) then it is time to transition your  bub from the wrap to arms out. You can start with one arm so they get used to this exciting distraction and still go off to sleep, then the remaining arm. This is when those fabulous sleeping bags become useful particularly as now baby will be on the move around the cot. Take all the bed clothes out of the cot so there are no safety hazards and the sleeping bag will do the trick and keep them warm and safe. The sleeping bags available have different weights for different seasonal temperatures so you don’t have to worry if they become cold overnight. This supports the Sids and Kids research in terms of sleeping unencumbered without potential breathing hazards.

Personally I love the large stretchy cotton wraps that grow with your baby. They keep them secure and contained without uncomfortable constraints, and allow their hips to find a natural flexed position.  Again there are many versions of wraps available, emulating straight jackets that even Houdini couldn’t escape from, and these are great for mums who struggle with the skill of wrapping, so go for it. The zip up versions must certainly must work for some babies, I just haven’t met them yet!

So if you’re still having trouble with settling your bub, then it’s a wrap!

Your first baby is due in just a few short months and the preparation has begun. Setting up nursery, cots, clothes, bath, change table, pram and many dollars later…..scary thought? And lots of helpful suggestions from the girlfriends, family, Facebook friends…..the baby business is a booming business!

I am going to suggest that these shopping expeditions can become overwhelming and expensive and seriously not fun if you are not well prepared and well informed about what you will actually need. Some purchases will end up staying in the cupboard or will be used so briefly you will wonder why you let the sales person talk you into it!

Here is your “go to” checklist for your new baby which you can pack into your tote bag and head for the Baby warehouse (or online) confident and well informed. You can work this list within your budget and save money which can be spent wisely somewhere else along the way (like a massage or facial, won’t your husband be rapt!)

  • Bassinet /and or cot – most mums prefer their newborn sleep beside their bed for the first 6months, so a bassinet is probably the way to go, then transfer to a cot when you are comfortable to do so. Don’t get a bassinet that rocks, moves easily or squeaks! This becomes very annoying when you are trying to get baby to sleep and your bub gets used to swaying, rocking beds. The imminent transfer of your baby to a cot arrives and well it doesn’t sway and rock, a challenge you don’t need. And please look for good well ventilated structure, furniture that adheres to Australian safety standards, all cotton bedding, and firm flat mattresses.
  • Change table nearby wherever possible and practical, at a good height for parents lumbar health (you’ll be spending some time standing in this position for months to come!), storage shelves for nappies, creams and stuff, multiple wraps, cloth nappies for general use (like the odd vomit) and any other items that require easy and quick access.
  • Pram. This seems to be quite a complex and well researched acquisition, particularly as the “on trend” range to choose from are pretty expensive. When you are considering your choices, keep in mind it needs to be practical. Will it suit a newborn as well as an older baby needing to sit up? Will it fit through normal doorways, supermarket entrances, and tuck in neatly somewhere in coffee shops? Is it light enough for you to collapse and lift into the boot of your car? Is it manoeuvrable and easy to drive over footpaths, steps and rough surfaces? Adjustable handles? Just a few things to consider…
  • Car capsule/seat. Needs to adhere to Australian safety standards. Can the capsule be transported from the car to house so as not to disturb sleeping baby? This can be a real winner in the early days. And practice getting capsule in and out of the care before baby arrives…
  • Baby clothes. Depends on season of birth. And you will probably be given heaps as gifts…but could be varies sizing so I think a starter pack of approx. 6 x cotton all in ones (0000’s and triple 0’s) 3 of each, with a zip up the front as a preference instead of studs, 6 x button through cotton singlets (they don’t ride up their little bodies), 6 x little newborn bibs, cotton socks, at least 4 x stretch cotton wraps (better to be on the big side as easier to wrap snugly and stretch cotton is much more effective) cotton bed blankets that can tuck in and all can be machine washed easily. Muslin wraps are very handy for all purpose use but I find them ineffective when trying to snugly wrap a baby for sleep. Baby towel for bathing x 2. And there is going to be lots of washing at least one extra load a day and you will wonder how such a little person can generate so much washing! Inside drying rack could be very handy for bad weather and fast drying inside.
  • Stuff. Disposable newborn nappies, baby wipes, cotton wool balls and perhaps even some sterile saline water capsules for sticky eyes. Creams for the bottom, my suggestion is Bepanthen for actual nappy rash and a barrier cream such as Sudocrem or Desitin for general use with each nappy change. Baby shampoo and/or baby bath wash for all purpose, there are many on the market, pure and fragrance free. Good old Sorbelene for the after bath massage and moisturise, can’t beat it and it is inexpensive.
  • Baby bath. It really doesn’t have to be too slick to start with as your baby will grow out of it pretty quickly. Just a simple inexpensive plastic baby bath that can be easily drained at a sink and easily filled at the tap or with a jug. Preferably near a change table or you can set up baby bathing on a bench in the kitchen near the sink, very practical.
  • A baby bouncer or chair for general use, sitting in after a feed, safe transfer around the house so baby can come with you and watch while you hang out the washing and he can watch you preparing meals.
  • And yes I do suggest in the “just in case” emergency list, that you purchase a couple of newborn dummies, a couple of small BPA free plastic wide necked feeding bottles and newborn teats (my firm preference is the brand Pidgeon). Of course you may never need them but just in case you do, at say 3am, then you have them in the cupboard! Oh and a small supply of formula…

Who said shopping wasn’t fun…especially when you can target the right shops with your list and not waste precious coffee/rest time!

I hope this is a helpful guide in preparing a workable nursery for you and your baby.

Recently the topical subject of “controlled comforting” for sleep challenged babies was highlighted in mainstream media…again. It was supported by a study by researchers at the Murdoch Children’s Research Institute in Melbourne which followed 225 children aged 6 who were involved in an earlier behavioural sleep study as infants.

http://www.mcri.edu.au/news/2010/march/’controlled-crying’.aspx

Parents with babies and sleep problems were offered several different interventions including controlled comforting. This is a contemporary version of the dated controlled crying techniques without the rigid timed intervals.

There are also gentler more responsive techniques such as parental presence where the mum or dad “camps out” in the baby’s room. But this study showed that the more rigid techniques to teach baby to self soothe and self-settle did no harm to these children later in life and significantly improved the parent’s quality of life and associated maternal depression.

Babies will cry. This is the only way they can communicate to we mere mortals that there is something not right in their world and needs to be responded to…..and sometimes they just cry for no good reason. I wish they could pass us a note with their issues it would make it so much easier.

During my home visits where mum and dad have reached the end of their rope, and their precious little darling has brought the household to its sleep deprived knees, there is usually a reason why this little tiny person is unhappy and unsettled for extended periods outside normal expectations.

It’s fair to say that a sleep deprived household can impact everyone’s ability to enjoy each other and the daily ritual of living a normal life. We all live a sameness and busy daily routine as adults as we are creatures of habit.

As parents you need to decide what works best for your child and aligns with your comfort levels and parenting beliefs. Don’t worry too much about what other friends and family think or advise. It’s about what works for you and your family.

So back to crying babies. They can be helped to change from poor sleeping patterns to better meet their sleep needs so that they are happy and relaxed when awake.

Parents try so hard to make perfect parenting decisions every day. And there is no such thing as a perfect parent or a perfect baby for that matter.