How To Treat Plagiocephaly

Maybe you’ve heard the term ‘flat head syndrome’, or perhaps you’ve seen a baby with a flat spot at the back of her head. Maybe your own baby’s head is beginning to look a bit flat in the back — don’t panic! Plagiocephaly, or Positional Plagiocephaly, is more common than one would think. In fact, almost half of all two month olds in the US have some form of Plagiocephaly, ranging from moderate to severe.

If your baby has flat head syndrome, don't panic! It's easy to treat Plagiocephaly with these tips...

What Is Plagiocephaly?

Babies grow at an extremely fast rate from birth, tripling their size in the first year, and their heads are no exception. To accommodate such a pace of growth, babies’ skulls remain “soft” with the cranial bones not yet fused. A baby’s unfused skull makes it easy to mold (how many babies have you seen born with a cone-shaped head?).

Positional Plagiocephaly, or flat head syndrome, can be present at birth (from cranial pressure in utero) or developed over time. Flat spots usually appear in the back or on either side, and are caused when a baby sleeps in the same position for a length of time.

The “Back Is Best” campaign, launched in the 1990s in an effort to combat SIDS, is largely responsible for the rise in Plagiocephaly in infants. With infants spending more time on their backs, Plagiocephaly has definitely become more common, but it’s not impossible to treat.

It’s important to note that cribs aren’t the only culprits here; bouncers, car seats and swings, anywhere your baby spends a significant amount of time laying, can all contribute to the development of Plagiocephaly.

How to Treat Plagiocephaly?

In most cases, your baby’s flat spots will resolve themselves in a matter of months. However, your should consult your pediatrician if you notice any flattening of your baby’s head. If you wait too long, your baby’s skull will grow less pliable over time, making it difficult to resolve.

If your baby has Positional Plagiocephaly, or flat spots caused by lying down, there are a variety of things you can do to help resolve the issue. Remember to ACT to help treat Plagiocephaly:

Alternate Positions

Make a concerted effort to vary the way you lie your baby in his crib — you’d be surprised how much your dominant hand/arm influences repetition! You should also reposition your baby’s head throughout the night, ensuring that he is sleeping on both sides (this will help with muscle development in the neck as well).

Carry Your Baby

If you’re trying to treat Plagiocephaly, or just trying to avoid it, one of the best things you can do is to hold your baby. These days there are a variety of baby carriers available, allowing you to carry your baby while having both hands free. Babywearing isn’t just beneficial for your little one’s head though, the benefits are varied and plentiful!

Tummy Time

Yes, the dreaded ‘T’ word. I honestly don’t know of many moms and babies who had a blast with tummy time in the early days, but it’s necessary. Not only does it give your little one’s noggin a break, but it strengthens the neck muscles, which are integral to appropriate and timely development.

Just remember, Plagiocephaly is relatively common, but there are plenty of things you can do to help your baby’s head remain beautifully round. If you’re still having trouble with sleeping arrangements, give me a call!

Crib Toys: Use Them or Lose Them?

Imagine you are drowning in a sea of toys, the Legos, Barbies, stuffed animals and stacking blocks slowly creeping past your chin. You’re wading through those toys, trying to get a secure footfall to climb from them, but the toy level continues rising until you’re head is almost covered.

Everywhere parents look, toys are being marketed to them or their children. Get the scoop on crib toys and whether or not you should buy them.

It’s every parent’s nightmare, and I’m sure this scenario has never happened, but the toy creep is one of parenting’s unsolved mysteries. You set out with good intentions and through the course of the year, birthdays and holidays add to the growing toy collection in your home.

Before you know it, you have toys in your car for entertainment, toys in your diaper bag, cribs toys strapped to the crib with plush toys creating a pillow top for the crib mattress — you even have special toys just for the bathroom. It happens to the best of us, but I want to talk about the toys that may be in your child’s bedroom or nursery, specifically crib toys.

Toys are educational, some are cute and cuddly, others sing songs and have flashing buttons for your child to interact with – in short, most toys marketed for babies these days have some educational value, which is great and I encourage you to use them with your baby…just not in the crib.

These days you can find crib toys including everything from a projector to a moving seascape that can be strapped to your child’s crib – they’re cool, they’re fun — but they don’t belong in the crib; cribs are for sleeping.

Those projectors? They’re sabatoging your efforts to put your child to sleep. The lights, the movement, all of that serves to stimulate your baby’s brain, rather than lull her to sleep.

While I do advocate the use of one security toy (or “lovey”) in the crib, once your child is old enough, I do not advocate the use of any other toys in the crib. Not only are toys, blankets, and other loose articles unsafe for your sleeping baby, they also communicate the opposite message of what you’re trying so hard to convey – cribs are for sleeping, not playing.

Think about it from your own perspective. If someone ushered you to a bed full of books you’ve wanted to read, movies you’ve been waiting to see, apps and gadgets, would you be sleeping in minutes or staying awake to enjoy all of your favorite things? The exposure to screens – TV, cell phones, tablets – before bedtime are the first things sleep specialists recommend doing away with when an adult comes in with sleep issues. Babies and children are no different.

Although baby toys are not the same as electronics with lighted screens, your baby will want to play with crib toys, stimulating his brain when he should be winding down for the day. Even if your little one is tired, those toys will keep him awake (like you checking Facebook “one last time” before you go to bed).

To reiterate, I am not against babies having toys, they just don’t belong in their crib. The only item I suggest having in the crib with your little one is the attachment or security object I mentioned earlier, as a way of soothing or providing comfort for your baby (I recommend that mom sleep with the object before introducing it to your little one’s crib so that her scent also serves to comfort).

Remember, not only is a bare crib a safe crib, it’s also conducive to healthy sleep!

When Illness Causes Baby Sleep Problems

You and your baby have finally mastered an amazing sleep routine and your little one has never slept better. Whammo! Your baby gets sick, you fall into bad sleep habits to comfort your little one, and the healthy sleep routine is out the door…or is it?

 

When illness causes baby sleep problems, keep the following tips in mind.

 

There is no need to completely throw away all of the amazing work you and your baby have done to ensure that sleep is happening in a healthy environment and in a routine manner. When illness causes baby sleep problems, keep some of the following tips in mind.

NIGHT WAKINGS

It’s a given that when a cold or illness strikes, the ‘Sleep Fairy’ goes on vacation. Think about how you sleep when you’re sick, and the level of discomfort you feel at nighttime — your baby is no different (except she can’t take Nyquil). So when illness causes baby sleep problems, anticipate night wakings, prepare yourself by having a plan for dealing with those wakings. Here’s the key — how you handle those wake-ups will make a big difference.

I’m also a parent, so I understand how tempting it is to go into the nursery when your little one is sick and do whatever you can to help assuage the discomfort by rocking or re-introducing a feed. Don’t do it. I’m not saying you’re not to comfort your little one, definitely go into the room, but don’t fall victim to all of the sleep props you’ve worked so hard to rid.

By all means, share a short cuddle with your little one, wipe her nose or offer some other type of comfort, but do not interfere with her sleep skills. Don’t rock her back to sleep, don’t feed her to sleep, don’t re-introduce any of the sleep props you eliminated (or start adding new ones!).

NIGHT FEEDS

The only time you should re-introduce nighttime feeds is if your pediatrician recommends it (IE your baby may need additional fluids due to his illness). Even then, you should only feed your little one at night for a few days, as in three days. Three days is my rule of thumb, any longer and you risk creating a new ‘routine’ for your baby, with him now waking each night expecting a feed long after the cold is gone.

MUSICAL ROOMS

I know it’s tempting, but please do not bring your baby into bed with you at night. I know, I know, you want to comfort your little one and be right by her side, but don’t do it. Routine, remember? Your baby needs to sleep in her room, in her crib (or whatever room or bed she usually sleeps in). If you feel the need to be by your child’s side while she’s sick, go to her.

That’s right, go to your baby’s natural sleep environment instead of uprooting him and bringing him into yours. Drag some cushions or an air mattress into your little one’s room and sleep in there for a night or two to monitor him.

Remember my rule of thumb? Do not spend more than three nights in your baby’s room, or else you may find yourself moving in permanently (and neither I nor you want that to happen).

What happens if everything falls apart? First of all, go easy on yourself, tending to a sick baby is not easy. Second, remember all of those healthy sleep skills and routines you and your baby worked so hard to achieve? You remember the structure, right? Well, get right back on the horse as soon as you and baby have come through the worst of it.

Start over, and if you need support to get back on track, remember that I’m just a phone call away.

Swaddles and Baby Sleep

Swaddles. Swaddling has been around since ancient times (more specifically, the Paleolithic era), so it makes sense that questions surrounding swaddling are ones I receive frequently. Is a swaddle a sleep prop? How do you feel about swaddles? Simply put, I love swaddles. I think they are great for newborns and can help calm your baby, which is conducive to sleep.

I'm asked all of the time about my stance on swaddles. Swaddling is great for newborns, but weaning an older baby from the swaddle can be difficult.

Physiologically, swaddling helps combat your baby’s Moro or startle reflex by keeping flailing arms and legs secured. With her arms and legs secured, your baby is less likely to wake herself from a sleep by startling.

If you’re worried about your baby overheating, I suggest just keeping an eye on your little one. If your baby is becoming sweaty, either loosen your swaddle or switch to a lighter blanket for swaddling – cotton muslin is a light, breathable fabric that is great for swaddling.

While I’m all for swaddling newborns, I must point out that swaddles can become sleep props (for both you and your baby). Your baby gets used to being wrapped and associates it with sleep, so when she kicks out of her swaddle, or loosens the wrap, she’ll likely wake and need you to come re-wrap her.

As your baby grows, her relationship with the swaddle becomes more complex – she thinks she needs to be swaddled to sleep, but hates having her arms and legs trapped at the same time (contradictory, I know – wait until she reaches toddlerhood!). As your baby begins to experiment with her movement, it will become increasingly difficult to keep her swaddled.

I suggest transitioning away from a swaddle by the third month. To begin transitioning, start by swaddling from the waist down, leaving the arms free. Try a nap without a swaddle. Bedtime is often the easiest time to start transitioning from the swaddle because your little one is typically the most tired at this time of day. If you’re feeling up to the challenge, try going swaddle free at bedtime.

I know of a mom who was still swaddling her eight-month-old, sewing together four receiving blankets so that they would have a large enough blanket to swaddle their baby. Not only is it unsafe to swaddle a baby who is rolling on her own, but using a swaddle at this age is definitely a sleep prop. If you’re in this situation, you really want to lose the swaddle by going “cold turkey.”

I won’t sugarcoat it – it will be difficult for you to wean your baby from the swaddle when you’ve been using it for so long. The swaddle is now a sleep prop for your baby, and he is going to protest when you put him to bed without being wrapped tightly. But, both you and your baby will be better off once you’ve removed the swaddle for sleep.

If you absolutely can’t lose the swaddle overnight, I suggest using a transition object – the Zipadeezip. The Zipadeezip can help your little one transition from being tightly wrapped by being a safe, enclosed sleep garment. The Zipadeezip resembles a swaddle, but is quite a bit looser, allowing arm and leg movement (almost like a body sleeping bag, but not quite a sleep sack). I recommend using this if you want to ease your baby from the swaddle more slowly.

In a nutshell, I’m all for swaddling up to three months of age, after that I suggest removing the swaddle (for both safety and sleep association purposes). If you’ve tried weaning your little one from her swaddle but are still having difficulty, please give me a call and we can work out a strategy together.

8 Signs You’re Ready to Transition From Co-Sleeping

As a pediatric sleep consultant, I’m asked many of the same questions from tired parents everywhere (read: You’re not alone!). One of the most popular questions I’m asked pertains to co-sleeping. I’m often contacted by parents to help with transitionining their baby from co-sleeping to a crib. The short answer is yes, I can definitely help you with that!

Co-sleeping is a personal decision, and I work with families with a wide variety of sleeping arrangements. I’ve written a blog addressing concerns that some new or expecting parents have about co-sleeping, called Is Co-Sleeping Dangerous? Since I’m asked the question so often, I thought it would be fun to create a tongue-in-cheek list of 8 signs that you’re ready to transition from co-sleeping.

transition-from-cosleeping

You’re Now Going to Bed When Most People Eat Dinner

Your little one won’t sleep without the warm, snuggling embrace of mom, so you’re now on her schedule…which means you’re going to bed at 6pm and waking at 4am (because you can’t sleep 12 hours like she can). Oh, and you’re not a morning person, what’s a mom to do?

You Get Nothing Completed Throughout the Day (or Night)

Those early 3-4 naps a day times are rough on co-sleeping moms. You have time to put a load of laundry in, but no time to dry and fold it because naptimes call.

You’re Both a Human Pacifier AND An All Night Buffet

You’ve given up sleeping in a nighty because your little one has an all-access pass to your breasts. You’re exhausted from waking multiple times throughout the night from the tugging sensation of a nursling, who’s both suckling for comfort AND for nourishment…ALL NIGHT LONG.

You Find Strange Things in Your Bed

Bed-sharing parents share their sacred space to keep their little ones feeling secure and comfortable while they sleep. However, you may be ready to transition your preschooler when you begin finding strange things tucked underneath the pillow…like a wrench. True story.

You’re Being Kicked From Within AND Without

If you bed-share, you’re used to shuffling around the bed with your little one’s movements, removing stray little appendages as they work their way over your face and across your body throughout the night. But when you’re pregnant, and are beginning to get kicked by in-utero and by your bed-sharing little one, it may be time to transition to make room for baby.

You’re Shopping for a Larger Bed

Your bedroom is small, so a queen-sized bed is the largest you should really go, but you need more room to accommodate the family. You can invest in a king-size bed that will be a tight fit in your bedroom, or you can finally transition your toddler/preschooler to their own room.

Your Bedroom Looks Like a Summer Camp Cabin

Your little one has outgrown your bed, or you now have a baby sharing the bed with you, so you add a small mattress so your child can sleep on the floor. At this point your bedroom now resembles a sleepaway camp cabin or a squatter’s den, with both you and your partner tripping on your way to the bathroom in the middle of the night.

You’ve Developed Ninja-like Skills

In an effort to have a little alone time with your partner, you lay down with your baby to get her to sleep. Once her breathing has settled and she’s entered the world of dreams, you stealthily swap a pillow or plush toy for your body, maneuvering out of the bed and creeping out of the room like a ninja in the night.

All kidding aside, just as weaning a baby from bottle or breast can be difficult, I understand that it can often be challenging to transition a little one from co-sleeping to crib. If you’re struggling with the transition, give me a call so that I can guide you through the process.

Baby Waking Too Early?

You’ve finally gotten into a groove, the whole house is sleeping great at night. Getting eight glorious hours of sleep has allowed to stay up past 9pm with your partner, enjoying some kid-free time. Just as you’re beginning to get really comfortable with this routine, you hear a cry. It’s 5:30am. As the days go on, your little one begins waking earlier and earlier, and you find yourself setting the timer on the coffee maker for 4:30am. Your baby is waking too early.

Morning wake time is getting earlier by the day and your baby is waking too early. These 5 tips will help you turn your early riser into a great sleeper.

If you’ve just begun The Sleep Sense Program, you’re used to your baby waking too early; early waking is pretty normal in the first couple of weeks, as your little one learns how to consolidate sleep. Don’t worry, the early mornings will become later as your little one becomes a master at sleeping.

If you’ve been working on transitioning your little one from being an early riser – with no success – give these 5 tips a try:

1. Make sure the room is dark enough.

I’ve stressed the importance of keeping the nursery dark for naps and bedtime, but you also want to make sure that the room is dark enough to facilitate sleep. You may need to adjust your window coverings with the changing seasons, as summer brings early daylight – a change in the lighting in the room, no matter how slight, may be enough to stimulate a wake up. My advice is too ensure that the room is as dark at 5:00am as it is at 3:00am.

2. Implement white noise.

Environmental noise is one of the top culprits of sleep disruption. Remember those early sunlight hours I was just referencing? Well, the birds will be up with the sun and they can get pretty noisy (so can the garbage truck that rolls by at 5:30am).

While I recommend investing in a white noise machine, you can easily use a fan to help block out any errant noises.

3. Remain steadfast with your minimum wake time.

Pick a minimum wake up time (for me it’s 7:00am) and stick to it. It’s amazing how the time can creep up on you when you relax your minimum, allowing for ten early minutes. Before you know it, those ten minutes turn into twenty minutes, and then an entire half hour earlier. Pick your minimum and stick with it.

4. Take a look at your bedtime.

Many parents are taken aback when I tell them to move their child’s bedtime earlier. The fear is that moving bedtime earlier will create an earlier wake time. The reality is that their child is very likely waking early due to overtiredness. Try moving your baby’s bedtime just 30 minutes earlier and see if it makes a difference in his morning wake time.

Much like sleep training, you need to give your baby time to adjust to changes in her sleep schedule. If you put her to bed early one night, and don’t see any change in her wake time, don’t give up! Allow two weeks before trying something different.

5. Be aware of sleep associations.

Does your baby get fed as soon as he wakes up? If your baby loves to nurse, and nursing has played a large role in his sleep associations, he could be waking early because he’s looking forward to nursing.

Just like bedtime, it may help to put a little distance between wake time and first feed (or whatever your baby is anticipating first thing in the morning). Change a diaper, sing a little song or dance and then transition to nursing/feeding. Having a short break between waking and feeding can help break the association.

Hang in there and remember that you’re doing a great job! If you need more suggestions or a customized plan for you and your little one, please give me a call.

Help Your Newborn Sleep Longer

You’ve welcomed your newborn into the world, brought her home and are now navigating the ins and outs of new parenthood. You begin to ponder the ‘wisdom’ from well-meaning friends and family; they’ll tell you that sleep is a thing of the past now that you have a newborn, and that the words newborn and sleep are not, in any way, connected. You find yourself wondering if sleep deprivation really is a right of passage into parenthood.

newborn-sleep-longer

 

I’m not here to tell you that you won’t have sleepless nights, but I can tell you that it’s never too early to begin laying the foundation for healthy sleep habits with your newborn. Understanding newborn sleep patterns, and ways you can work with your new baby to help her sleep for longer stretches of time, is the first step toward a lifetime of healthy sleep for both your child and yourself.

Establishing a simple bedtime routine early can yield a big payoff in the months to come: sleep! Helping your newborn develop sleep skills, and learn to sleep for longer periods of time, is the key to establishing healthy practices. I’m going to tell you a little secret: the first step towards establishing newborn sleep habits is to put your little one down awake. Yes, awake.

You can begin by putting your baby into her crib in a drowsy state, but the goal is to work towards putting your newborn to bed in an increasingly wakeful state. Keep working on this for a few weeks, each time putting her down more wakeful than the previous night. Once you are able to put your baby to bed wide-awake, she is in a position to get herself to sleep on her own, paving the way towards longer stretches of nighttime sleep.

What about night feeds, you ask? If your baby has slept for a 4-5 hour period without eating, she’s proven that she is capable of sleeping longer without a feed. Once your baby is able to go to sleep on her own and sleep for a longer stretch of time, hold her to that standard; you know she can do it, so give her the opportunity to put those sleep skills to use!

If you find your baby waking an hour and a half in, but she’s proven that she can sleep for four to five hours in the past, don’t rush in. Is she really hungry, or is she simply transitioning between sleep cycles? Your first instinct will be to rush into your newborn’s room at the first sounds of fussing, but make yourself pause; wait five minutes to see if she can get herself back to sleep.

This pause is crucial to the development of your baby’s sleep habits – if you don’t allow her to practice the skills you’ve been working on, she won’t have the opportunity to execute the techniques she’s learned.

You’ll know that your hard work is paying off when the initial nighttime stretch of sleep is longer than others throughout the course of the night. It’s typical for the first period of nighttime sleep to last between four and five hours, with shorter stretches for the remainder of the night. You’ll find that the first block of nighttime sleep lengthens over time, with shorter stretches towards the early morning hours. Don’t be alarmed, this is a great sign! This sleep pattern is the consolidation of nighttime sleep process. The initial, longer stretch of sleep is what you are working on developing and making longer.

Questions? Please don’t hesitate to call or email me with questions about newborn sleep habits.

7 Baby Sleep Tips

As a sleep consultant, I am constantly asked for baby sleep tips: what is the secret to getting your baby to sleep through the night? The reality is that there is not one secret, or one way, to get your baby to sleep through the night. Teaching your baby healthy sleep habits is the best foundation for getting your little one to sleep through the night. These baby sleep tips will help you set the foundation for healthy sleep habits and a good night’s rest!

7-BABY-SLEEP-TIPS

 

#1 WATCH THE WAKING HOURS

Sleep begets sleep, so ensuring that your baby or toddler is napping well during the day helps prevent overtiredness. Overtiredness is a sleep killer, making naps and nighttime sleep difficult for your little one. Let’s take a quick look at how long your child should be awake between naps throughout the day:

NEWBORNS (0-12 weeks): 45 minutes of awake time

3-5 MONTHS: 1 1/2 – 2 hours of awake time

6-8 MONTHS: 2-3 hours of awake time

9-12 MONTHS: 3-4 hours of awake time

13 MONTHS to 2 1/2 YEARS: 5-6 hours of awake time

The key to great naps is ensuring that your little on is put down before she gets overtired. Once you’ve mastered nap times, you’ll find that bedtime will be a smooth process.

#2 DON’T BE AFRAID OF THE DARK

It’s no secret that humans, adults and children, sleep better in a dark environment. Make your child’s room as dark as possible, using blackout shades or curtains, to create a dark and cozy environment conducive to sleep. Be mindful of any ambient light you may have in the room, such as digital alarm clocks or night lights, as these items can possibly disrupt sleep.

#3 BE PREDICTABLE

Babies and toddlers thrive with the predictability of set routines and schedules. Establishing nap and bedtime routines aids greatly in creating healthy sleep habits. Keep your child’s bedtime routine predictable as well, lasting no longer than 30 minutes. Establishing these routines signals sleep for your little one. Here is an example of a typical bedtime routine:

  • Bath (5 minutes)
  • Put on pajamas (5 minutes)
  • Nurse or bottle-feed (10 minutes)
  • Read a book (10 minutes)

The keys to establishing your baby’s bedtime routine is ensuring that a.) it happens at the same time each night (or within a 30 minute window), and b.) the routine follows the same order each night (predictability, remember?). Remember that bedtime is a time of quiet, devoid of any stimulation, so be boring. If your little one throws a blanket or stuffed animal from their crib, or stands up, quietly replace the item and leave the room — no talking!

#4 FEED AFTER NAPS, NOT BEFORE

A vast majority of babies and toddlers have difficulty sleeping because they associate feeding with sleep. Unknowingly, you’ve created an association that makes your little one think that she needs to nurse or have a bottle before she can fall asleep. By feeding your little one after nap time, you can break this association.

NOTE: This tip pertains to naps only; your little one needs a full tummy at bedtime to prevent night wakings.

#5 SAME PLACE, SAME TIME

As I’ve stated, routine and predictability are the secrets to establishing healthy sleep habits for your baby or toddler. Place your child to bed in the same place each day for both nap and bedtimes. If your child is with a caregiver during the day, create a similar sleep environment to establish familiarity. Keep nap and bedtimes on a set schedule (or within the same 30 minute window) to establish a predictable routine.

#6 TRY THE 1, 2, 3 SYSTEM

Night wakings can be one of the most difficult obstacles to overcome with babies and sleep. When your baby begins to fuss, try to wait before running in to tend to her.

The first day, wait one minute before going into the nursery, two minutes the second day, three minutes the third day, and so on. The purpose of this is to allow your baby time to self-soothe back to sleep. Everyone wakes briefly at the end of each 45 minute sleep cycle, including babies, and the 1, 2, 3 system helps you teach your baby what you already know — how to transition between sleep cycles.

#7 TAKE FIVE

Once you’ve gone through your baby’s nap or bedtime routine, be mindful of the final five minutes of the routine. The last five minutes of your child’s sleep routine should be calm and quiet, setting the tone for sleep. This means no tickle fights and no television (ticklefights are perfect for when your little one wakes!).

These baby sleep tips are often all that is needed to get your child to sleep, and sleep well. If you find that you’re still struggling after implementing these tips, I’m available to give you guidance.

White Noise Machines, Babies, and Nurseries

You’ve just gotten your fussy baby down for a nap, and your neighbor decides to mow the lawn. Or, the mailman rings the bell for you to sign for a package…just as you had gotten your little to sleep. Better still are the early morning wake-ups, caused by the garbage truck or overzealous birds in the summertime. It could even be as benign as you putting dishes away in the evening, or peeking your head in to check on your baby before heading in for the night. If you have a baby with bionic hearing, or is an extremely light sleeper, read on.

white-noise-babies

 

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