If the first thing that comes to mind when you think about infant sleep training is hours of endless, pitiful crying, then this is the blog for you. It may help to know that you’re not alone in thinking that sleep training is stressful for your baby. Still, it’s my goal to help you realize that the splashy headlines about sleep training do not apply to your situation. We’re talking about toxic stress and infant sleep training today. (more…)
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…)
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.”
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?
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.
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.
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.
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.
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.
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!
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.
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.
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.
Stop putting it off. I mean this in the nicest of ways, but if you keep saying you’ll get around to getting baby to sleep better, the reality is that you’re putting off the inevitable. And if your baby isn’t sleeping well, the longer you wait to make changes to their sleep routine, the harder those changes will be to make. In an effort to make things super easy for you, I’m throwing out four easy tips for getting baby to sleep better, that you can implement today. I mean, why do it tomorrow if you can do it today, right?
Tips for getting baby to sleep better
Keep it dark
Have you ever tried sleeping in the middle of the day? Unless you’ve outfitted your room, or are sneaking down to the basement for a quick nap, you’re going to be met with sunlight streaming in through the windows. Darkness is where it’s at, and as soon as you create a dark environment, the sooner your baby will understand that bedtime or naptime is coming.
Blackout shades or blinds are the easiest, and most inexpensive, fixes for a bright room; if you’re installing blinds, it’s imperative that you have them cut exact, or else you’ll have tiny beams of light cutting through the room like little lasers.
One thing many parents don’t think of is the light of the television or other electronics. Electronic screens emit blue light, which serves to keep baby (and you) alert and awake, opposite of your desired effect. The body needs darkness to trigger the release of melatonin, which aids in sleep, so turn off the electronics, or move to another room, at least an hour before baby’s bedtime.
Keep it cool
If you’re anything like me, your sinuses get dry and you become stuffy in the winter, when household heat is running constantly. And when I can’t breathe well, I don’t sleep well — it’s no different for babies. That feeling of snuggling into the warmth of your covers, body covered from the cool air of the room? So cozy! And babies love it, too.
Not only do babies sleep best in a cooler room — ideally between 65 and 70 degrees — it’s also safer for them. A hot room can increase your baby’s risk of SIDS, so keep the heat down and use a sleep sack or layered onesie to keep your baby core temperature up, making them comfortable while they sleep.
Keep it boring
Take a look around your nursery. Do you have bright prints on the walls? Maybe a mobile above the crib or hanging from the ceiling. How about one of those super cool, light-up faux aquariums that attach to the side of the crib? The reality is that all of these things are wonderful for stimulating your little one’s mind, but terrible for a quiet, comfortable sleep environment.
Instead, use your playroom, or a nook in your living room to create an area of stimulation for your baby, and try to keep all of the bright colors, lights and toys out of your nursery. Without much to look at, or play with, your baby will do what they’re meant to do in the nursery — sleep.
If you don’t already have one, consider adding a white noise machine to your nursery, to filter out the background noise of household activity or environmental noise. If you have other children, a white noise machine can be your baby’s sleep savior!
Keep it predictable
Think about how you perform when you have a set routine — you may even already practice a nightly bedtime routine. The truth is, babies respond extremely well with a consistent bedtime routine because they’re able to pick up on the cues.
Once you’ve taken them into the quiet of their nursery, perhaps reading them a book by a soft light, or giving them a warm bath, your baby starts to produce melatonin. Your baby’s body begins to relax, knowing that slumber is imminent, and they’re ready to welcome sleep.
While these tips for getting baby to sleep better are simple, and easy enough to begin implementing today, know that it will take some time for your baby to adjust to the changes. If you stay consistent, both you and your baby will reap the rewards of a healthy, restful night of sleep.
Whether you’ve been trying to conceive for a long time, or discovered you were unexpectedly…expecting, at some point your thoughts have turned to the nursery. What room to use, what crib should you pick out, bedding, decor, and then maybe, just maybe, you thought about something practical, such as a changing station (but not likely). If you want to save yourself some time, and some sleepless hours, you’ll follow my advice for creating the perfect nursery — and it has nothing to do with matching paint chips with potential themes.
Skip the fun stuff
I know, I know, you’ve always wanted to create a bright, colorful, themed nursery, and you have the Pinterest board to prove it. And while that nursery will likely photograph really well and look like a lively and happy place to be, it’s counterintuitive to your baby getting healthy sleep.
Call me the fun police or a spoilsport, but the reality is that those nurseries with colorful characters, decorations and hanging mobiles only serve to provide stimulation, instead of a calm and restful atmosphere. Try to keep your baby’s nursery walls free from bright and/ or busy prints (blank walls are ideal), and keep to a muted color scheme, to ensure that your baby isn’t scanning the walls and decorations when they’re supposed to be sleeping. Don’t worry, there will be plenty of opportunities to decorate your little one’s bedroom in the future.
Perhaps one of the best investments you can make for your baby’s nursery, and likely one of the only items in there that will stay, long after the toddler years are gone, are blackout curtains, blinds or shades.
How well are you able to sleep with daylight pouring through the window? Probably not so well without a sleeping mask, but unfortunately, your baby doesn’t have that option. Creating a dark room for your baby will help them fall asleep without a lot of fuss, especially for those daytime naps and lengthy summer daylight hours. Your baby is already comfortable in the dark, having spent ten months in your wonderfully dark womb, so creating a sleep environment that mimics that is ideal.
The cooler the better
Not only do babies sleep best in a cooler room — ideally between 65 and 70 degrees — it’s also safer for them. A hot room can increase your baby’s risk of SIDS, so keep the room cool and use a sleep sack or onesie to keep your baby comfortable while they sleep.
Think Princess and the Pea
Just like the princess in Hans Christian Andersen’s famous fairy tale, your baby won’t be able to sleep well if they’re uncomfortable, and remember, they sleep most of the day. Put the money you’d planned to spend on nursery decorations towards a comfortable and safe crib mattress. For safety reasons, your baby’s mattress should be firm, as soft mattresses can pose a suffocation risk.
While you may be disappointed by your lack of nursery flair, I guarantee you’ll thank me once you bring your baby home and they’re sleeping soundly. If you’re unsure about your baby’s nursery, or have concerns about your little one’s sleep, please don’t hesitate to contact me.
Raising kids is a high-stakes responsibility, and in this age of social media and easy access to information about anything and everything, parents are easily overwhelmed with feelings of guilt and inadequacy. As a sleep consultant, I see this all the time from parents whose babies aren’t sleeping well. One of the other major contributors to the, “I’m doing something wrong,” sensation is separation anxiety; that oh-so-challenging part of a child’s life when they start to completely flip their lids whenever Mom’s not around.
The thought process, it would appear is one of…
Mommy’s not in the
Therefore, Mommy is somewhere
I would prefer to be there with
Make that happen, or mark my words, I shall raise the most unimaginable of And those ruckuses leave us, as parents, to wonder, “Am I doing something wrong?
After all, a well-adjusted child should probably feel reasonably safe when they’re separated from their parents for a little while, shouldn’t they? I mean, Beth from the office says her baby is perfectly content being left with her sitter, even overnight. And that one mom in your Facebook group said that her baby will happily play by herself for hours at a time, and actually takes her toys to her room occasionally in order to get a little ‘me’ time.”
About Separation Anxiety: Two things to keep in mind.
First, never compare yourself, or your child, to the mothers and babies described in the parenting groups on social media. Much like everything else on Facebook and Instagram, these experiences are almost always conveyed through the rosiest of lenses.
And second, separation anxiety is completely normal, expected, and a sign of a healthy attachment between parent and child.
So what is it, exactly?
Separation anxiety typically starts to occur around 6-8 months of age, when your little one starts to realize that things continue to exist, even when they’re not in sight. It’s a cognitive milestone known as “object permanence” which is defined as, “the understanding that objects continue to exist even when they cannot be observed.”
In other words, out of sight no longer means out of mind.
So as your baby begins to grasp this concept, they realize that if you, their favorite person in the whole world, are not there, you’re elsewhere. And, hey, wait a minute. If that’s the case, then you might not be coming back.
It’s kind of fascinating when you think about it, but it’s also a little heartbreaking. This realization, for a baby, is obviously cause for full-blown panic. The thought of a parent leaving and not returning causes anxiety in most grown-ups I know, so you can hardly expect an infant to take it with great decorum.
Anyways, that’s what happens in your little one’s brain when they suddenly start having a fit every time you leave the room. It’s normal, it’s natural, and it’s a sign that your little one is learning, and that they have a secure attachment to their parent. Awesome.
But, as many of us know, it also means that leaving them with a sitter or dropping them off at day care can be an absolute horror show.
But what we really want to know, or at least what I really wanted to know when it happened with my children, isn’t “What’s causing this?” What I wanted to know was, “How do I prevent it?”
Well, the truth is, you probably wouldn’t want to if you could. I mean, really, wouldn’t you be just a little devastated if you left your child with a stranger and they were just completely OK with it? “Bye Mom! See you at dinner!
Don’t worry about me. You guys have fun!”
I’m guessing that would actually be significantly more troubling than some tears and howling.
But we obviously want to keep things at a happy medium, and if you’re struggling with a child who’s pitching an absolute fit every time you try to run an errand or head out for date night, I’ve got some suggestions to take the edge off until this phase runs its course.
1. Lead by Example
Your little one follows your cues, so if you’re not willing to let her out of your sight, they probably, albeit un- consciously, feel like they’re not safe if you’re not in the room. So designate a room where they can explore a little and play without your direct supervision. It’s a small adjustment, but it has a tremendous effect.
2. Don’t Avoid It
Learning about separation and reunion is an important milestone, so don’t just take the path of least resistance and stay with your child 24/7 until they’re seven years old. (It happens. Believe me.) Let them know that it’s okay for them to get upset when you leave and reassure them that you’ll always come back when you do. If there are some tears around it, that’s alright. This is an important concept that they need to get on board with.
3. Start Slow
Once your little one has started to demonstrate the understanding that they’ll be spending some time with someone besides a parent, make it a short outing. Don’t plan on dinner and a movie or an overnighter for the first few attempts.
4. Start With Someone Familiar
Kids typically do a little better being left with a grandparent or family friend who they’ve already spent some time with, and who they’ve grown to trust a little, so call in a favor, put some wine in the fridge, and plan to spend at least an hour away from the house for the first few attempts.
5. Stick Around for a While
After your sitter, parent, friend, or whoever is watching your little one arrives, plan to hang around for a half hour or so. Seeing that this is someone you’re familiar with will go a long way in reassuring your child that they’re “good people” and worthy of their trust.
6. Face the Music
Many of us have, at least once, attempted to distract our toddlers and then sneak out the door without saying goodbye. After all, it’s the goodbye that provokes the reaction, right? But even if it provokes some tears, it’s important for your child to understand that you’re going to leave sometimes, and that you’ll be back when you say you will.
7. Establish a Routine
Much like bedtime, a solid, predictable goodbye routine helps your little one recognize and accept the situation. A set number of kisses and hugs, a memorable key phrase, and a clear indication of when you’ll be back should be just the right balance of short and reassuring.
8. Speak in Terms They’ll Understand
Instead of telling them how long you’ll be gone, tell them when you’ll be back in regards to their schedule. After nap time, before bed, after dinner, before bath time, and so on.
Nothing is going to prevent your child from getting a little bit upset when you leave, (And as I said before, thank the stars for that, because if they didn’t, oh your poor heart,) but you can definitely keep the fuss to a minimum.
Now, I should add here that these techniques are suggested for kids who are dealing with ordinary, everyday separation anxiety. There is also a condition called Separation Anxiety Disorder which is obviously more serious and warrants a trip to your pediatrician if you suspect your little one might be afflicted with it.
But for run-of-the-mill fit-pitching when you try to leave the house for an hour or two, these tips should go a long way towards remedying the problem. Be consistent, supportive, assertive, and calm. Before long, your child will understand the concept of you leaving and coming back.
In fact, this concept that will also come in handy when you start to leave them alone in high school.
“I’m leaving for the night, but rest assured, I’m coming back. So you just remember that before you invite your rowdy friends over.”
But until then, if you feel like your little one’s separation anxiety has led to some not so great sleep habits…I’m here to help. A FREE Sleep Assessment call is just a click away. SCHEDULE A CALL WITH JENNIFER
With the holidays approaching, many new parents who have recently gotten their babies sleeping on a schedule are worried that they might regress a little over the holidays.
And I can assure you, those fears could not be more well-founded.
Between the travel, the excitement, the constant attention and then travel all over again, the holidays are the single easiest way to throw all of your hard work out with the wrapping paper and turkey bones.
But I’m happy to tell you that it doesn’t have to be that way! With some strategic planning and an iron will, you can keep that carefully orchestrated routine running just the way you did at home.
There are two major impediments to your little one’s sleep over the holidays. One is travel and the other is family and friends, so I just want to tackle both of those topics individually.
First off, travel.
If you’re thinking about starting sleep training your little one, but you’ve got to take a trip in a few weeks, my suggestion is to put off the training until you get back. (Although if you’re looking for an excuse to cancel your trip, not wanting to throw your baby’s sleep schedule out of whack is a pretty good one. Just sayin’!)
If you’ve already started, not to worry. Taking a trip typically won’t help your little one sleep better, but if you can maintain some semblance of normalcy until the end of your trip, you and baby should be ready to get back to business as soon as you get home.
If you’re driving to your destination, a clever trick is to schedule your driving time over baby’s naps. Car naps aren’t ideal, but compared to no naps at all, they’re the lesser of two evils by a mile. So if at all possible, get on the road right around the time that baby would normally be taking their first nap.
If you’re really committed, you might even look for some parks, tourist attractions, or other outdoor activities that are on your route where you can stop when baby gets up. It’s a great chance to get out into the sunshine and fresh air, which will make that next nap that much easier.
If you’re flying, well, my heart goes out to you.
It’s no secret that planes and babies just don’t seem to like each other, so I suggest (and this is the only time you’ll hear me say this) that you do whatever gets you through the flight with a minimum amount of fuss. Hand out snacks, let them play with your phone, and otherwise let them do anything they want to do.
The truth is, if they don’t want to sleep on the plane, they’re just not going to, so don’t try to force it. It will just result in a lot of frustration for both of you. (And, most likely, the passengers around you.)
Alright! So you’ve arrived, and hopefully you’ve managed to maintain some degree of sanity. Now, I’m sorry to say, comes the hard part.
Because in the car or on the plane, everybody is on your side, right? Keeping baby quiet and relaxed, and hopefully asleep, is just what everyone is rooting for.
But now that you’re at Grandma and Grandpa’s place, it’s just the opposite. Everyone wants baby awake so they can see them, play with them, take a thousand pictures, and get them ridiculously overstimulated. And it’s exceptionally difficult to tell all of these friends and family members that you’re putting an end to the fun because baby needs to get to sleep.
So if you need permission to be the bad guy, I’m giving it to you right here and now. Don’t negotiate, don’t make exceptions, and don’t feel bad about it. Firmly explain to anyone who’s giving you the “I’ll just sneak in a take a quick peek,” routine that baby’s in the middle of sleep training and you’re not taking any chances of them waking up. Let them know when baby will be getting up and tell them to hang around, come back, or catch you the next time. Or better yet, tell people in advance when to expect some baby time based on baby’s schedule.
I know it sounds harsh, but the alternative is an almost immediate backslide right back into day one. Baby misses a nap, gets all fired up because of all the new faces and activity, then overtiredness kicks in, cortisol production goes up, and the next nap is ruined, which results in more overtiredness which derails nighttime sleep, and before you know it, you’re headed home and it seems like baby did nothing but cry the entire trip.
I’m not even slightly exaggerating. It happens that quickly.
So OK, you’ve steeled your nerves and let everyone know that you’re not budging on baby’s schedule. She took her naps at the right times, and now it’s time for bed. The only catch is that, with all of the company staying at the house, there’s only one room for you and baby.
No problem, right? Bed sharing for a few nights isn’t the end of the world, after all.
I wish I could make it that easy for you, but again, you want to make this as little of a deviation from the normal routine as possible, and babies can develop a real affinity for co-sleeping in as little as one night.
So this may sound a little unorthodox, but if you’re sharing a room, what I suggest is simple.
Make it into two rooms.
I’m not saying you need to bust out the lumber and drywall, but I do suggest hanging a blanket, setting up a dressing screen, or, yes, I’m going to go ahead and say it, put baby in the closet.
That sounds crazy, I know, but really, a decent sized closet is a great place for baby to sleep. It’s dark, it’s quiet, she won’t be distracted by being able to see you, and people accidentally walking in and out of the room are much less likely to distract her.
And while we’re on the subject of “no exceptions,” that rule extends to all other sleep props. You might be tempted to slip baby a pacifier or rock her to sleep if she’s disturbing the rest of the house, but baby is going to latch on to that really, really quickly, and chances are you’ll be waking up every hour or two, rocking baby back to sleep or putting her pacifier back in, which is going to end up disturbing everyone a lot worse than a half hour of crying at 7:00 at night.
Now, on a serious note, I find the biggest reason that parents give in on these points is, quite simply, because they’re embarrassed. There’s a house full of eyes and they’re all focused on the new baby, and by association, the new parent.
The feeling that everyone is making judgments about how you’re parenting is nearly overwhelming in these family gatherings, but in those moments, remember what’s really important here.
Your baby, your family, and their health and well-being.
There may well be a few people who feel a bit jaded because you put baby to bed just when they got in the door, and your mother might tell you that putting your baby in the closet for the night is ridiculous, but remember you’re doing this for a very noble cause. Perhaps the most noble cause there is.
So stand tall and remember that you’re a superhero, defending sleep for those who are too small to defend it for themselves. If you want to wear a cape and give yourself a cool superhero name, you go right ahead. WonderMom, UberMama, The Somnum Inducere, if you’re feeling really fancy. Just remember that, like any superhero, you may be misunderstood by the masses.
Safe sleep guidelines is a topic that I never tire of sharing, and it’s important to follow the American Academy of Pediatrics (AAP) research-backed suggestions. The AAP recently revised their safe sleep guidelines, and I thought it would be great to take a moment to share those with you, as well as to take a look at how those guidelines have changed over the years.
Back is best
In 1992, the AAP instructed parents to lie their infants on their backs to sleep, which resulted in an overall decrease in the occurrences of Sudden Infant Death Syndrome (SIDS) across the country. But while SIDS deaths decreased, infant death by suffocation, entrapment and asphyxia rose, prompting the AAP to revisit and further explain their safe sleep guidelines.
What is a safe sleep environment?
The American Academy of Pediatrics again changed their safe sleep guidelines in 2011, this time with an emphasis on the explanation and demonstration of safe sleep environments for infants. The AAP made three additional safe sleep recommendations, to reduce the overall occurrence of infant deaths, including SIDS related deaths. Those recommendations included:
Breastfeeding is recommended and is associated with a reduced risk of SIDS.
Infants should be immunized. Evidence suggests that immunization reduces the risk of SIDS by 50 percent.
Bumper pads should not be used in cribs. There is no evidence that bumper pads prevent injuries, and there is a potential risk of suffocation, strangulation or entrapment.
Further recommendations included:
Always place your baby on his or her back for every sleep time.
Always use a firm sleep surface. Car seats and other sitting devices are not recommended for routine sleep.
The baby should sleep in the same room as the parents, but not in the same bed (room-sharing without bed-sharing).
Keep soft objects or loose bedding out of the crib. This includes pillows, blankets, and bumper pads.
Wedges and positioners should not be used.
Pregnant woman should receive regular prenatal care.
Don’t smoke during pregnancy or after birth.
Breastfeeding is recommended.
Offer a pacifier at nap time and bedtime.
Avoid covering the infant’s head or overheating.
Do not use home monitors or commercial devices marketed to reduce the risk of SIDS.
Infants should receive all recommended vaccinations.
Supervised, awake tummy time is recommended daily to facilitate development and minimize the occurrence of positional plagiocephaly (flat heads).
So, what’s different between 2011’s AAP safe sleep guidelines and those recently released? The AAP now recommends that infants share the same bedroom as their parents, or room share, for at least the first six months of an infant’s life, and ideally, the first year. This comes as a result of new research findings, showing a decrease in sleep-related infant deaths in those infants room-sharing with their parents. The AAP also included the recommendation of immediate skin-to-skin time after birth, regardless of feeding or birth type, for a minimum of one hour, as soon as the mother is “medically stable and awake.”
Breastfeeding is still recommended, and the AAP urges parents to move babies to their [separate] sleep space as soon as feeding is completed, to further reduce the risk of accidental death [should a mother or father fall asleep while holding the baby].
While these recommendations are not hugely different from what they have been, they do further explain ideal safe sleep conditions, back by research showing a reduced rate of infant mortality. In addition, AAP is urging doctors to have more in-depth conversations about infant sleep environments with new and expecting parents, in an effort to communicate ideal safe sleep environments and field any questions parents may have.
If you have any questions about your baby’s sleep environment, I am available to review and make recommendations for the safest sleep environment for your little one.