Sleep Coach’s Corner: Is There an Iron and Sleep Connection?

Today we’re taking a dive into research. More specifically, the correlation between iron levels and restless baby sleep. So, if you have a restless sleeper and nothing you’ve tried seems to work, read on.

Disclaimer: I am not a medical professional, nor do I claim to be one. The content in this blog is from a trusted authority but is speculative in nature.

Restless baby

In my decade as a sleep consultant, I’ve fielded hundreds of questions from tired parents. However, when parents come to me with a restless baby, I’m the one asking lots of questions. The reason why I ask so many questions is to help determine whether baby sleep or toddler sleep issues are because of dependency on a sleep prop or if there’s something else at work. (If you’re unfamiliar with the term sleep prop, it’s used to describe something a baby or toddler depends on to fall asleep, such as a pacifier, rocking, or breastfeeding.)

Sleep prop dependency is relatively easy to overcome and can usually be solved within a week or two of consistent bedtime routines. In fact, the majority of restless sleepers are traced back to sleep props causing disruption. However, every once in a while, I come across a restless baby sleep case without props to blame. Some babies and toddlers are just restless sleepers, just like children and adults who flail, toss, and turn in their sleep. This is where speculation comes in, so bear with me.

Sleep research

Yes, there’s such a thing as the World Sleep Congress. The World Sleep Congress is an annual gathering organized by the World Sleep Society, where researchers and scientists across the globe come to share research and studies on everything relating to sleep. And in 2019, I heard musings about a theory – scientists posit that there is a correlation between iron deficiency and restless sleep.

In fact, there are studies showing a correlation between iron deficiency and restless sleep in children dating back to 1969. You may already be familiar with Restless Leg Syndrome (RLS); perhaps you or someone in your family has RLS. If you’re reading this because your little one is a restless sleeper, they may suffer from periodic limb movements and involuntary movements during sleep.

Mayo Clinic linked RLS in children to a family history of the syndrome and iron deficiency in a 2005 study. And circling back to the 1969 study, researchers found that periodic limb movement lessened in 19 of 28 patients after receiving a serum containing iron. 

So, back to those restless sleepers. If you’ve got a restless baby, and nothing has worked to help them get a solid night of sleep, the research indicates that it may be worth asking your pediatrician to test iron levels. 

And, if you’re one of the many parents out there with a baby who is reliant on a sleep prop, or you simply need help coming up with a nap and bedtime schedule that works for your family, I’m here to help! Schedule your complimentary sleep assessment today!

Sleep Coach’s Corner: Sleep Training and Vomiting

If that title didn’t grab your attention, then I don’t know what will! Vomiting is one of those parenting experiences that nothing can really prepare you for. It’s scary and often distressing for everyone. And if you’re in the middle of sleep training, it can be stressful to know how to navigate it. Let’s take a look at how to handle things when your baby throws up during sleep training.

Why it happens

Intense crying and even coughing can trigger a baby’s gag reflex, causing them to vomit. When a baby is allowed to cry longer than usual, their increased mucus production can also contribute to triggering the gag reflex. I will note here that the Sleep Sense™ program that I use is not a “cry it out” sleep training program. The goal of sleep training is not to create additional stress for a tired family.

The simple way of explaining why some babies vomit during sleep training is that babies cry to communicate. Without language, their only method of communicating is through crying. When you change from rocking your baby to bed to calmly putting them into their crib, they’re confused, and they’ll let you know. As you remain firm in putting your baby to bed without rocking them to sleep (or feeding them to sleep), your baby will communicate their confusion through crying. This increased crying – whether in intensity or in the length of time – often triggers a baby’s gag reflex, resulting in them throwing up. 

Preparation is key

If you don’t do this already, now’s a great time to start; double or triple sheet your baby’s mattress with protective barriers in-between. This is great for nighttime diaper leaks as well, as it allows you to quickly and quietly strip the soiled sheet and get your baby back to bed. I also suggest having a change of clothing set out before bed or naptime, in addition to wipes for cleaning up, in the event a change is needed. 

Sleep training and vomiting: what to do

Now that you’re prepared, it’s time to discuss what to do when your baby vomits during sleep training. The first thing you need to do is to remain calm. Your baby is already feeling a bit of distress, so your goal is to exude calm as you go through the process of cleaning your little one up and getting them back down.

Now that you’re the epitome of calm, you need to change your baby. Move your little one to a clean area of the crib, clean them up, and change their clothing. In case you missed it, you are not removing your little one from the crib. Use a gentle tone and touch to soothe your baby and reassure them that they’re okay.

With baby cleaned up, you need to strip the crib. Beginning at the corner closest to the vomit, remove the top sheet and protective barrier and start rolling it on itself until you have enough space to move your baby onto the fresh sheet. Roll the remainder of the soiled sheet and remove it from the crib. 

With your baby and their crib cleaned up, give them a quick cuddle, some soothing words, and then retreat to your chair if you’re remaining in the room. 

I will reiterate that it can take up to two weeks for your baby to adapt to their new, consistent sleep routine. While it’s distressing to see your baby cry until they vomit, they’ll eventually settle into the routine once they understand the sleep cues you’re giving them. After a few days of consistent sleep training, your baby will understand the cues that let them know precisely what will happen, leading up to a nap or bedtime. 

Hang in there tired parents! As always, if you’re struggling to find a sleep routine that sticks, or you need help creating a healthy sleep routine, give me a call. I’ve helped hundreds of Philadelphia area families – and families across the globe – get the sleep they need.

Infant Sleep Training in the Limelight: Gift of Sleep in the Philadelphia Inquirer

Adorable baby sleeping in blue bassinet with canopy at night. Little boy in pajamas taking a nap in dark room with crib lamp and toy bear. Bed time for kids. Bedroom and nursery interior.

Apart from the fact that many of my former clients call me the “Sleep Whisperer,” I don’t like to toot my own horn (but yes, I’m really good at showing you how to sleep train your baby). However, when a major publication contacts me for an interview, I get a little giddy! In case you missed it, I and a couple of other certified pediatric sleep consultants were interviewed for a Philadelphia Inquirer piece about infant sleep training and more.

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Holidays and Healthy Sleep

In the blink of an eye, the holiday season is here again, and I know that I have many nervous parents wondering how they’re going to stay on top of the busy season and keep their little ones well-rested and healthy. I’m here to tell you that it likely won’t be perfect, but with a bit of planning and foresight, you can help your baby stay on some semblance of a sleep schedule. (more…)

A Bedtime Reading Routine is Beneficial for Babies

The first five years of a child’s life are explosive in terms of their overall development and will set the stage for the person they will become. By age three, your toddler’s brain is 80% the size of an adult’s and reaches 90% of its potential size at age five. According to First Things First, “The early years are the best opportunity for a child’s brain to develop the connections they need to be healthy, capable, successful adults. The connections needed for many important, higher-level abilities like motivation, self-regulation, problem solving and communication are formed in these early years – or not formed.”

bedtime reading routine babies (more…)

Tips for Dealing With The Time Change and Daylight Savings for Children

Daylight savings time is coming up this weekend. Most parents don’t mind it so much in the fall when they gain an extra hour, but it sends fear through people’s bones when they hear they are going to have to lose an hour of sleep! Every year I get a TON of questions asking for the best way to handle daylight savings time and children’s sleep. So here it is: (more…)

5 Common Myths About Sleep Training

Parenting can be a sensitive topic, and the advice is not in short supply. From the time you celebrate your baby shower to your first visitors in the hospital, you’re bombarded with “advice” on how to parent your baby. And likely, from the moment your baby is born, you’ll be asked how your baby is sleeping, even before your baby has had an opportunity to find their rhythm. So, as an ode to all of the awful and unsolicited advice new parents receive, I’m going to discuss five common myths about sleep training.

myths

Your first week or two of being a parent inevitably blessed you with the most beautiful, peaceful baby who slept most of the hours in the day. You likely didn’t heed the advice of well-meaning friends and family who told you to sleep when your baby slept and took in every moment of your adorable sleeping beauty. And then your baby flipped days and nights and began to be awake more. Now you panicked and began scouring the internet for suggestions on how to get your baby to a.) sleep at night (like the rest of the human world), and b.) sleep longer. And in the process surfing the web for information, and checking out books on baby sleep, and getting well-meaning advice from friends, family, and strangers, you discovered that the wealth of information you were being given was conflicting, making you more confused than when you first began your research. Take a deep breath, put the bad advice, books, notes, printouts, and bookmarks aside and read on while I debunk common myths about sleep training.

1. If you let your baby sleep too much during the day, it will keep them up at night.

Unlikely, but it does occur on a rare occasion. Now, if your little one is sleeping through the day and not getting a wink of sleep at night, you may need to take a look at daytime napping, but again, “sleeping too much” is rarely the case. In fact, newborns need a lot of sleep, and I don’t recommend that your baby be awake for more than 2-2 1/2 hours at a time if they’re under six months of age. For newborns, that number is closer to 45 minutes to an hour.

You might be surprised to hear that overtiredness often keeps babies awake at night because it goes against what we think we know about sleep. The reality is that an overtired baby has missed falling asleep when they were tired, and their bodies are cycling back into wakefulness.

2. Sleeping is a natural development and can’t be taught.

Yes-ish. Everyone cycles through sleep stages through the night, waking and falling back asleep each night. You likely don’t remember waking because you already know how to slip right back into your next sleep cycle. However, babies can take some time to learn how to smoothly transition between sleep cycles.

If you’re in the habit of nursing or rocking your baby to sleep, your little one can become dependent on that motion or routine to fall asleep — we’ll call it a sleep crutch. As your baby cycles through sleep stages during the night, they wake and don’t know how to get themselves back to sleep without being nursed or rocked, so they cry out for you. Part of sleep training is teaching your baby how to fall asleep independently.

3. Babies will naturally dictate their sleep schedule.

In a perfect world, babies would regulate their own sleep needs and always be well-rested; unfortunately, this is not the case. Much like the constant care babies need with diapers and feeding, they rely on their caregivers to help them develop healthy sleep habits. Left unregulated, babies’ sleep cycles would become erratic; missing a sleep cycle by just 30 minutes can cause cortisol levels to elevate which is when we experience cranky babies who are overtired.

Read more about identifying baby sleep signals

4. Sleep training is stressful for the baby and can affect the parent-child attachment.

This is just not true. In fact, you may have consulted the American Academy of Pediatrics (AAP) for information about safe sleep practices, a source I’m sure you trust. Well, a 2016 study conducted by the AAP found that “Both graduated extinction and bedtime fading provide significant sleep benefits above control, yet convey no adverse stress responses or long-term effects on parent-child attachment or child emotions and behavior.” And, both parents and babies slept better through the night — win-win!

5. Babies are not “designed” to sleep through the night.

Babies don’t come with manuals, so I’m not sure who dictated what babies are or are not “designed” for — sheesh! What I can tell you is that trusting your child’s physiology to dictate their sleep schedule, their eating habits or their behavior is a recipe for disaster.

Look, you’re obviously reading this for a reason — most likely because you’d like your baby to sleep better. I’m here to tell you that I can help you and your baby develop healthy, independent sleep habits that will have the entire family getting restful nights of sleep. When you’re ready to get started, give me a call to see how I can work with your family to guide you to healthy sleep.

The Four-Month Sleep Regression

Google the phrase “sleep regression.” C’mon, I dare you. What do you see? A lot of articles with words like dreaded, survive, beat in the titles. Like anything, something simple can quickly become alarming when put into a negative context — much like sleep regression in babies. The reality is that the four-month sleep regression isn’t a regression at all. How about that?

4 month sleep regression

 

The word itself is alarming as it typically denotes taking a step back or as the dictionary says, “a return to a former or less developed state.” Nothing could be further from the truth. Let’s take a look.

What sleep regression isn’t

There’s a tendency to label any rough nights (or days) a baby has as a sleep regression, which just isn’t the case. The reality is that babies undergo a tremendous amount of physical, mental and emotional growth and development in their first year of life, which often affects sleep and understandably so. Teething is often the culprit, as are growth spurts and other developmental milestones. It’s happening because your baby is developing and moving forward not backward.

Sleep stages

To better understand what is going on with your 4-month old, it helps to have an understanding of sleep, in general. Sleep is comprised of four stages which, when combined, make up the human sleep cycle and is repeated throughout our slumber.

Stage 1

This is the stage when you’re just drifting off, maybe you’re losing your place in your book or your eyes are closing to the sound of the television — stage one is a snoozing stage.

Stage 2

This is the stage that is considered entering into an actual sleep state. If you wake from this second stage, you definitely realize that you’d been sleeping just moments before.

Stage 3

If sleep was a competitive sport, stage three would be just beneath the level of greatness — you want to reach this place, it’s great for your body, but you still have more work to do.

Stage 4

Nirvana. In stage four of the sleep cycle, you hit REM sleep and your brain begins to recoup from the day — this is the state of dreams.

Newborn sleep stages

Your newborn only cycles through two sleep stages for the first few months of their life — stage three and stage four or REM sleep, the two deepest cycles. New parents should take in this time as it’s when their baby will be sleeping the soundest with no outside help.

What happens around month 4

Around month three or four — as your baby is developing — your baby begins to expand their sleep cycles into the four stages. When this happens, your baby transitions from spending half of their sleep time in REM to only a quarter. And with more time spent in lighter sleep stages, there’s more opportunity for your baby to wake.

Where problems arise is when parents see this as a regression in sleep — the reality is that this is the time that your baby is developing and learning how to transition throughout the stages of sleep they’ll be cycling for the remainder of their lives and it’s a big change! There will be a disruption of sorts in the sleep cycle as your baby learns how to smoothly transition between sleep stages. As adults, we typically slide through the sleep stages effortlessly, without even remembering waking between — your baby hasn’t developed that skill yet, which is why they’re waking more at this time.

Remove the props

Up until this time, you may have been swaddling your baby for sleep or using a pacifier to calm them at bedtimes and nap-times. Now that they’re spending more time in a lighter sleep, they’re going to notice that the pacifier has dropped from their mouth when they cycle between stages, or they’ll notice that their little body isn’t wrapped snuggly and their startle reflex may wake them. This is the time when you want to remove sleep props so that your little one doesn’t begin to form sleep associations (that can easily become sleep disruptors).

Create the perfect environment

This is the time you want to perfect your baby’s sleep environment, if you haven’t already. Make sure that the room is cool and dark without any distractions — you want to create a space that allows your baby to focus on transitioning through sleep stages and resting, not becoming alert and wanting to play.

 

If you reframe how you view what is commonly known as the four-month sleep regression and instead view it as yet another opportunity for your baby to grow, you’ll be in great shape to get through this phase. And if you feel you need support, don’t hesitate to contact me! I offer a free 15-minute evaluation so I can get to know the specifics about your little one’s situation, so book a call now and we can move forward as soon as you’re ready to get your little one sleeping through the night!

 

How to Drop to One Nap

Just when it seems you’ve gotten into a comfortable rhythm of morning and afternoon naps, your baby’s sleep behavior begins to change, and you start to wonder what’s causing the disruption. Are you sitting down? The culprit may be that your baby…needs less sleep. There, I said it. It’s entirely possible that the changes you’re witnessing are signs that your baby is ready to transition to one nap a day.

Drop One Nap

Signs your baby is ready

Before you begin panicking — and I get it, those naptime hours were the times you got to relax a little and focus on things you needed to accomplish — make sure your baby really is ready to transition from two naps to one.

You may find that your baby is completely rocking their morning nap, and then struggling to go down in the afternoon. Or maybe your little one struggles to go down for their afternoon nap two or three days in a row, and then completely conks out for their afternoon nap on the fourth day. The rule of thumb here is that if your baby is struggling to go down for their afternoon nap the majority of the days in a week, it’s a good sign that they’re ready to transition to one nap.

Another sign that your baby is ready to transition to one nap is if they’re rocking both their morning and afternoon naps, and then wide awake when bedtime rolls around. If your baby is taking an hour or more past their usual bedtime to settle into sleep, it’s a good sign that they’re ready to drop a nap.

Because developmental milestones happen often, and can typically cause changes in sleep, you want to make sure that your child’s disrupted sleep pattern lasts at least two weeks before deciding to transition to a single nap per day. While the two week period may be difficult, it’s worth knowing whether or not it’s time to make a change (rather than having to backtrack later). And on that note, once you’re sure your baby’s sleep issues aren’t due to a growth spurt, make sure that you’re committed to transitioning to one nap, because you definitely do not want to waver here — it’s confusing for baby and more work for you — so stick to it.

How to transition to one nap

While the steps to transitioning your baby from two naps to one may look incredibly easy, realize that the transition will happen over time — as much as you may want to, do not rush the process.

Begin by pushing your baby’s morning nap a half hour later every three days, until naptime is at 12:30pm. Know that this transition can take anywhere between 4-6 weeks, so be patient and trust the process. If you don’t rush, you’re more likely to commit to this schedule change, and everyone will be happy.

I know, I know, pushing your baby’s naptime back is no easy feat, now that they’re firmly into a sleep schedule. To make things a little easier, try to avoid going for car rides or walks with the stroller during your baby’s usual naptime, to prevent them from falling asleep (and derailing their transition’s progress). Try engaging your little one in a physical activity during their typical naptime, to try to distract them from their fatigue. If need be, give your baby a piece of fruit to give them just enough pep to make it until their newer, later naptime.

You may also find it helpful to temporarily move up your baby’s bedtime, just until they adjust to their new schedule. Don’t worry if you encounter inconsistencies on your baby’s part along the way, it’s important that you remain consistent, and their little body will follow along shortly.

If you hit a rough spot in your baby’s nap transition, just think of how much freer you’ll be once your baby is down to one, middle-of-the-day nap — it’s so worth it!

If you’re having difficulty transitioning your little one down to one nap a day, feel free to reach out to me to see if you can benefit from my help.

Does Teething Affect My Baby’s Sleep?

Teething symptoms in babies is much debated — just ask your pediatrician…and then poll your friends. Some pediatricians will say that an elevated temperature is not a sign or symptom of teething, but ask parents of multiple children and they’ll tell you otherwise. A quick internet search will yield results listing a handful of baby teething symptoms, but what you rarely see listed is disturbed sleep patterns.

Teething Sleep

Timing of teething

Many of my clients often feel that their baby has just gotten the hang of a healthy sleep routine when it’s suddenly derailed. And if this sleep regression happens between the ages of 4 and 7 or 8 months, teething typically gets the blame.

Teething symptoms

The American Academy of Pediatrics (AAP) — a good source of answers to all of your baby questions — does concede that teething in babies may be accompanied by some not-so-fun side effects; it’s interesting to note that their listing of signs and symptoms of teething is preceded by the following statement:  “Teething occasionally may cause….” Notice the word in italics. The reality of many parents with teething babies is much different than an occasional symptom or associated discomfort, and you’ve likely experienced anecdotes from both sides — not a single symptom or side-effect, or a completely miserable, drooling baby.

The AAP’s official stance is that teething may — occasionally — cause and/ or be accompanied by mild irritability and crying in your baby (no surprise there because, ouch.). Your baby may also exhibit a low grade temperature — not exceeding 101 degrees Fahrenheit — excessive drooling, a desire to chew on something hard, and have swollen, tender gums.

Teething and sleep

What the AAP doesn’t mention is that your baby’s sleep may be disrupted during this uncomfortable period. It stands to reason that, if your baby is experiencing the uncomfortable symptoms associated with teething, those symptoms won’t simply disappear during naptime and nighttime. And, as any good parent does, you want to do whatever you can to take away any of your baby’s pain or discomfort, by any means possible. Am I right?

The truth is that teething can disrupt your baby’s sleep, but it can also derail any progress you’ve made with sleep training, if you suddenly decide to run in at the sound of the first wimper. Now, I’m not saying you should leave your baby to cry when they’re in pain, but you shouldn’t use teething as an excuse to fall back into bad sleep habits, either.

According to a Parents.com article, parents may give their baby Tylenol to help reduce teething pain. However, the article warns that, while teething can cause sleep disruptions, a change in behavior — a disinterest in playing or inability to be distracted — can be a sign of something other than teething. In essence, teething isn’t so painful that your baby should be crying incessantly; if this is the case, you need to call your pediatrician.

As you would at any other time, give your baby some time to calm themself when they awake from sleep crying. I’m not saying to completely ignore a baby in distress, but don’t disregard the pause just because your baby is teething. Allowing your baby to work through the discomfort and self-soothe will ensure that they’re getting the sleep they need for their growing body, tooth buds and all!

Is your little one having trouble falling asleep and staying asleep and you are sure it’s more than teething?  Let’s chat! Please reach out to me!  Visit me HERE and get in touch for a complimentary sleep assessment.