Holistic Newborn Care: (Almost) Everything You Need to Know About Your Baby in the 4Th Trimester

Holistic Newborn Care: (Almost) Everything you need to know about your baby in the 4th trimester

©Tanya Wills and Manhattan Birth 2018

Support from Manhattan Birth after you give birth – attend with your baby! www.manhattanbirth.com to register

New Moms Support Group (8 weeks – join anytime) With Jenna Bourgeois Tuesdays 10:30-1:00 in Manhattan Wednesdays 10:30-1:00 in Prospect Heights BK *Ends with optional Infant CPR/Relief of Choking class

Mother Mentoring (an online support group for 6 weeks or ongoing) With Tanya Wills, CNM, IBCLC Ongoing – www.manhattanbirth.com/mother-mentoring

Comforting Touch for Babies (4 weeks offered bimonthly) Baby Massage class With Yiska Obadia-Gedal Thursdays 11:30-12:30 – see website for dates

Walking With Whitney Understanding your baby, her cues, and her development With Whitney Burke (Occupational Therapist and mom) Offered Monthly in Manhattan – see website for dates

Infant/Toddler CPR/Relief of Choking With Sarah Lovell Offered Monthly on Monday nights Private classes also available

Lactation Consultants Tanya Wills, CNM, IBCLC Yael Borensztein, RN, IBCLC Contact us through our website

Birth & Postpartum doulas also on our website

©Tanya Wills and Manhattan Birth 2018 Holistic Newborn Care

TABLE OF CONTENTS Title Page ...... 1 Support/Classes from Manhattan Birth for after your baby ...... 2 Table of Contents ...... 3 Introduction ...... 4 Cartoon ...... 5 Sanity Check – Our Alumni have a message for you ...... 7 How Things Change ...... 11 Where Does All the Time Go? ...... 12 Who Ya Gonna Call? Planning Support ...... 13 After The Birth, What a Family Needs ...... 14 Tips for Addressing the Baby Blues ...... 16 Your New Baby/Newborn Procedures ...... 19 Your New Baby (characteristics) ...... 20 Newborn Procedures ...... 22 Circumcision vs Breastfeeding ...... 23 Attachment Parenting/Comforting your Baby ...... 25 Attachment Parenting – The 7 Baby B’s ...... 26 The 5 S’s and Comforting your baby...... 29 Understanding your Newborn ...... 33 Infant States...... 35 Infant Cues ...... 36 March of Dimes – States of the Term Newborn ...... 37 Feeding Cues ...... 51 Diaper Counting Chart...... 52 The Benefits of Skin-To-Skin ...... 53 The Magical Hour...... 54 The Importance of Skin-to-skin Contact ...... 57 Understanding Newborn Sleep & Nighttime Parenting ...... 59 AAP Recommendations ...... 60 Sleep Tips from Elizabeth Pantly ...... 62 I Read All the Baby Sleep Books ...... 69 Co-Sleeping and Bedsharing ...... 72 ÓTanya Wills and Manhattan Birth 2018

Holistic Newborn Care

When Will my Baby Sleep Through the Night? ...... 84 Babywearing ...... 87 Benefits ...... 88 Choosing a Baby Carrier ...... 89 Carrier Descriptions ...... 91 Resources ...... 93 Postpartum Doulas ...... 94 Lactation Consultants (IBCLC’s) ...... 101 Pediatricians, etc...... 102 Reading and Research ...... 107

ÓTanya Wills and Manhattan Birth 2018

Sanity Check!

We asked our alumni to give you advice and they jumped at the chance. Here’s what they said.

Beyond: “Enjoy sleep while you can” and “Enjoy every moment with your baby”. What other parents are saying is NORMAL:

Endless frustration, perpetual bickering with spouse. All normal and take nothing personally.

The first parent to help should be maternal grandparent not paternal grandparent. A new mom will want the right to scream at them. It’s hard to do that with paternal grandma.

Trust themselves rather than anyone" should-ing" or "supposed to-ing" them. If something is working for their family at the moment and everyone is happy or getting it done then go with it. And every phase is just that...temporary and changeable.

If you feel sad or depressed after your baby is born, that is completely normal and you shouldn't feel bad about it - it doesn't mean that you don't appreciate parenthood or aren't a good parent. If you feel overwhelmingly sad or depressed, that is also completely normal - but please talk to your doctor or another expert you trust about it.

Everyone said it would get a lot easier once the baby starts smiling at around 6- 8 weeks. Everyone was right. Hang in there.

Try not to anticipate problems and take all advice with a grain of salt. Just because it works for many families does not mean that it is necessarily right for yours.

If you are planning to breastfeed, make sure you have support lined up in advance. New moms group, supportive husband, friends who breastfeed, etc.

People will tell you to "enjoy every moment". Those people are not as sleep- deprived as you. Resist the urge to kick them. Instead, ask them to change a diaper for you or make you lunch.

Also, trust your instincts - you know that baby better than anyone.

©Tanya Wills and Manhattan Birth 2018

Nursing is a full time job. It is different for everyone and all babies are different. It can be painful, tiresome, worrisome, rewarding and beautiful all at the same time. There will be nights/days when all you think you did was nurse the baby

You will get irritated with your significant other and they will not understand your hormones, night sweats, leakage, or your exhaustion.

You may not feel like yourself at times (or all the time for a while). It may feel like you never will again...but sure enough, you will!

I also felt like we got a new baby every 10 days. Just when we were high fiving each other about our routine (haha) it would change up. The best advice we were given is BABIES BE BABIES. We literally chanted it to each other like a mantra. Don't try to make them adults or dogs or like other people's babies.

When people visit in those first days don't feel you have to entertain them. Sit down and let them take care of you, giving birth is physically taxing and you may not realize it at first. Don't overdo it with guests either. Friends were over and real life kicked in with tar poops everywhere and baby crying. That's when I realized people were at my house too late and they were inside having fun while I was dealing with new baby and feeling very overwhelmed in the other room.

Even though you SWEAR your child will not have a pacifier, if it helps you get some rest, it won't make you the worst parent in the world.

We decided that no one was allowed to come and stay with us for two weeks. Some people love the additional help, but we knew we wouldn't need it and it made a world of difference to not have anyone there judging us. In fact, once my in-laws did show up my FIL laughed at me struggling with the ring sling (not cruelly a just because it was a sight) and I didn't even attempt to use it again for six weeks.

You will get pooped on. You will have a day where your baby squirts mustard colored poop all over everything. You will get puked on. You will eventually get to a point where dried spit up in your hair is not even disgusting. You will wonder if you will ever be sexual again. If breastfeeding, your breasts hardly feel like they "belong" to you anymore. Other, bigger kids will make you crazy - like STAY AWAY FROM MY BABY crazy. News stories about bad things happening to babies the same age as your baby will paralyze you with fear in a way previously unimaginable. You will second guess a lot of decisions, and realize that everything you thought you "knew" about parenting and all that judging of other parents before you had children of your own was all really dumb and that you don't know anything for sure, because YOUR kid is one of a kind. And just because everyone else says that one sleeping

©Tanya Wills and Manhattan Birth 2018

technique, feeding routine, etc worked for all their kids does NOT mean it will work for you. But don't worry, something will.

We also severely limited visitors especially during the first two weeks, and I do not regret that decision at all. It really helped us get our bearings as parents.

Our baby was on a pretty reliable three hour cycle from early on. We found that we could deal with visitors staying for one cycle (1-2 hours) but if they stayed longer than that it really impeded our ability to function. It cut too much into our ability to sleep or stay on top of critical chores like eating and laundry.

Oh yeah... Ignore the people who tell you to ignore the laundry. Your baby is going to produce a lot of laundry. You will probably need to do laundry preserve your sanity.

Also, I remember waking up a couple times in the middle of the night in a panic that the baby was in bed and I couldn't find her... when the baby was safe and sound in her crib. I've talked to a few other people who this has happened to... maybe common? Also I woke up in soaking wet sheets for about 4-5 weeks after I delivered. I had retained so much water I was sweating it out at night. Yuck. Also, you will leak breast milk EVERYWHERE, day and night.

Trust your own instincts over anything a doctor, nurse, "parenting expert," or parenting theory says you should do. Even if you don't feel like you have any idea what to do, remain calm and look inward. Baby chose you for a reason.

Don't panic about something "not going like it should" one day, such as baby not eating much, crying more than normal, etc. Every day is different, know that some days are just off.

There is a much touted "mommy-baby bond" that others talk about, but truthfully, not all experience, especially if you have a high needs baby. If you're not feeling a bond with baby, don't worry, many others don't and you're not doing anything wrong.

Even though you're in the thick of it and you're recognizing your life is forever changed, this phase will be over before you know it and you'll get back to a "normal" life of showering regularly, fixing your hair, wearing make-up, etc.

In the days after I delivered, Jeremiah said something that helped me a lot: the postpartum blues are real and they're just a part of the experience. Just try to maintain perspective when your emotions are seeming out of control and enjoy the ride as much as you can because that is part of bringing a baby into the world. Don't fight it,

©Tanya Wills and Manhattan Birth 2018

and don't let it make you feel like you're doing something wrong if you're blue or if your feelings of overwhelm send you into tears.

Also, it takes a little while to hit ground again. It will feel like your world has been turned upside down and that may be very scary, like you've lost yourself. But in time you will get to a new normal that just looks a little different than what you had before.

During those first few days after birth when people are visiting, (and when your hormones are all out of whack) you may cry profusely when people come and become extremely protective of your baby, even to the point of telling your husband to not let anyone ask to carry the baby. It sounds crazy but this totally happened to me when my very best friend came to visit when Emma was 3 days old. We laughed about it later, but it was such an intense and strong feeling!

It probably took at least 6 weeks if not longer before I stopped feeling like I was just watching someone else's child for them. I felt very little connection between my pregnancy and my baby. When he was born I felt mostly a strong sense of responsibility to him, but now at 5.5 months I really enjoy hanging out with him. It was (and still is) a process, and your relationship with your child has to develop just like any other relationship.

©Tanya Wills and Manhattan Birth 2018

Holistic Newborn Care

How things Change Getting Support

After the Birth, what a family needs By Gloria Lemay, midwife http://wisewomanwayofbirth.com/after-the-birth-what-a-family-needs/

“Let me know if I can help you in any way when the baby is born.” … “Just let me know if you need a hand.” … “Anything I can do, just give me a call.”

Most pregnant women get these statements from friends and family but shy away from making requests when they are up to their ears in dirty laundry, unmade beds, dust bunnies and countertops crowded with dirty dishes. The myth of “I’m fine, I’m doing great, new motherhood is wonderful, I can cope and my partner is the Rock of Gibraltar” is pervasive in postpartum land. If you’re too shy to ask for help and make straight requests of people, I suggest sending the following list out to your friends and family. These are the things I have found to be missing in every house with a new baby. It’s actually easy and fun for outsiders to remedy these problems for the new parents but there seems to be a lot of confusion about what’s wanted and needed…

1. Buy us toilet paper, milk and beautiful whole grain bread.

2. Buy us a new garbage can with a swing top lid and 6 pairs of black cotton underpants (women’s size____).

3. Make us a big supper salad with feta cheese, black Kalamata olives, toasted almonds, organic green crispy things and a nice homemade dressing on the side. Drop it off and leave right away. Or, buy us frozen lasagna, garlic bread, a bag of salad, a big jug of juice, and maybe some cookies to have for dessert. Drop it off and leave right away.

4. Come over about 2 in the afternoon, hold the baby while I have a hot shower, put me to bed with the baby and then fold all the piles of laundry that have been dumped on the couch, beds or in the room corners. If there’s no laundry to fold yet, do some.

5. Come over at l0 a.m., make me eggs, toast and a 1/2 grapefruit. Clean my fridge and throw out everything you are in doubt about. Don’t ask me about anything; just use your best judgment.

6. Put a sign on my door saying “Dear Friends and Family, Mom and baby need extra rest right now. Please come back in 7 days but phone first. All donations of casserole dinners would be most welcome. Thank you for caring about this family.”

7. Come over in your work clothes and vacuum and dust my house and then leave quietly. It’s tiring for me to chat and have tea with visitors but it will renew my soul to get some rest knowing I will wake up to clean, organized space.

8. Take my older kids for a really fun-filled afternoon to a park, zoo or Science World and feed them healthy food.

9. Come over and give my partner a two hour break to go out to a coffee shop, pub, hockey rink or some other r & r that will be a delight. Fold more laundry.

10. Make me a giant pot of vegetable soup and clean the kitchen completely afterwards. Take a big garbage bag and empty every trash basket in the house and reline with fresh bags.

These are the kindnesses that new families remember and appreciate forever. It’s easy to spend money on gifts but the things that really make a difference are the services for the body and soul described above. Most of your friends and family members don’t know what they can do that won’t be an intrusion. They also can’t devote 40 hours to supporting you but they would be thrilled to devote 4 hours. If you let 10 people help you out for 4 hours, you will have the 40 hours of rested, adult support you really need with a newborn in the house. There’s magic in the little prayer “I need help.” Tips for Addressing the Baby Blues By Lois Nightengale Taken from http://nightingalecenter.com/?p=78

1. Spend time with your baby! Remember how long you have been waiting to hold your precious angel.

2. Rest! Rest! Rest! Enjoy this time with your new baby. Let others wait on you. Enjoy being pampered for the first few days you are home (longer if you underwent a cesarean or other major complications).

3. Bring baby into your room or bed to minimize walking.

4. Avoid fixed or rigid schedules, they place undue stress on new mothers. Go with the baby’s flow and your own intuition.

5. Avoid overexertion, bothersome friends and relatives. Limit length and number of visits per day. (If uninvited guests find you in a robe they are less likely to over-stay their welcome).

6. Get up for short periods of time, some exercise is good. Do not overexert yourself. Fatigue and pain can exaggerate negative feelings. Notice when you are feeling weary.

7. Whenever your baby sleeps, rest or sleep yourself. (This is NOT the time to jump up and do those 40 chores you have been thinking about!)

8. Eat right. Have healthy snack foods on hand. Nutritious, easily prepared foods are helpful. (Send the donuts home with grandma). Make sure to eat some complex carbohydrates (bread, corn, rice, rye, potatoes, oats, whole- wheat crackers, etc.) every three hours to keep your blood sugar up.

9. Drink lots of fluids. Your body is healing, and if you are breast-feeding extra fluids are essential. Drink lots of water. Unsweetened juices are also terrific. Avoid caffeine, and empty calorie sodas. Avoid or conscientiously limit alcohol use.

10. Get help with the housework, meals and other children. Take friends up on their offers of: “If there’s anything I can do, just ask”. Don’t be afraid to ask!

11. Prioritize to conserve energy. Not all housework is equally important.

12. Thank your partner for all they are doing around the house, with meals or the older children. A little gratitude will go a long way during these days.

13. Hand squeezes, hugs and kisses between the two of you as new parents, to keep you both going.

14. Pamper yourself. Give yourself a facial, or a manicure. Condition your hair. Take a bath by yourself or with your baby. Read a frivolous book (you deserve it after months of studying only serious baby material.

15. Get outside. Enjoy the fresh air. Sit on the stoop in the early days. Later, take baby with you for a walk in a carrier. Don’t try to do too much too soon. Work up slowly. Listen to your body.

16. Surround yourself with other moms. Find groups of new mothers with whom you can talk and go do things with your babies. (Mother and baby exercise classes, park days, La Leche League, the hospital’s new Parents’ group, childbirth class reunions, your roommate in the hospital, babysitting co-ops, church, temple or synagogue groups, neighbors, or start your own group).

17. Learn relaxation techniques or meditation. Learn to make the most of the few quiet moments you have. (Remember the relation exercises from childbirth classes).

18. Focus on what you are doing. Concentrate on the present, this precious time goes by very fast.

19. Do fun things with your baby. (Baby gym classes, walks, dress him/her up in that “adorable” outfit, go to the park and feed the ducks, nature walks etc.)

20. Exercise with doctors’ approval. (Ask about specific exercises and how long you should wait to begin after delivery).

21. Be gentle with yourself, give yourself ample time to heal. The physical, hormonal and psychological recovery from pregnancy, labor and delivery may take longer than you had anticipated.

22. Take all advice with a grain of salt. Follow your own mothering intuition. You know what is best for your beautiful baby!!

Holistic Newborn Care

Your New Baby Newborn Procedures

Holistic Newborn Care

Attachment Parenting Comforting Your baby

Attachment Parenting: The 7 Baby B’s Taken from askdrsears.com

You can find more in The Baby Book by Dr. William Sears and Martha Sears, R.N.

1. Birth bonding The way baby and parents get started with one another helps the early attachment unfold. The days and weeks after birth are a sensitive period in which mothers and babies are uniquely primed to want to be close to one another. A close attachment after birth and beyond allows the natural, biological attachment-promoting behaviors of the infant and the intuitive, biological, caregiving qualities of the mother to come together. Both members of this biological pair get off to the right start at a time when the infant is most needy and the mother is most ready to nurture.

"What if something happens to prevent our immediate bonding?" Sometimes medical complications keep you and your baby apart for a while, but then catch-up bonding is what happens, starting as soon as possible. When the concept of bonding was first delivered onto the parenting scene twenty years ago, some people got it out of balance. The concept of human bonding being an absolute "critical period" or a "now-or-never" relationship was never intended. Birth bonding is not like instant glue that cements the mother-child relationship together forever. Bonding is a series of steps in your lifelong growing together with your child. Immediate bonding simply gives the parent- infant relationship a head start.

2. Breastfeeding Breastfeeding is an exercise in babyreading. Breastfeeding helps you read your baby's cues, her body language, which is the first step in getting to know your baby. Breastfeeding gives baby and mother a smart start in life. Breastmilk contains unique brain-building nutrients that cannot be manufactured or bought. Breastfeeding promotes the right chemistry between mother and baby by stimulating your body to produce prolactin and oxytocin, hormones that give your mothering a boost.

If, for some reason, you cannot breastfeed, you can still practice attachment parenting. Once again, it isn’t “all or nothing”.

3. Babywearing A baby learns a lot in the arms of a busy caregiver. Carried babies fuss less and spend more time in the state of quiet alertness, the behavior state in which babies learn most about their environment. Babywearing improves the sensitivity of the parents. Because your baby is so close to you, you get to know baby better. Closeness promotes familiarity.

4. Bedding close to baby Wherever all family members get the best night's sleep is the right arrangement for your individual family. Co-sleeping adds a nighttime touch that helps busy daytime parents reconnect with their infant at night. Since nighttime is scary time for little people, sleeping within close touching and nursing distance minimizes nighttime separation anxiety and helps baby learn that sleep is a pleasant state to enter and a fearless state to remain in.

5. Belief in the language value of your baby's cry A baby's cry is a signal designed for the survival of the baby and the development of the parents. Responding sensitively to your baby's cries builds trust. Babies trust that their caregivers will be responsive to their needs. Parents gradually learn to trust in their ability to appropriately meet their baby's needs. This raises the parent- child communication level up a notch. Tiny babies cry to communicate, not to manipulate.

6. Beware of baby trainers Attachment parenting teaches you how to be discerning of advice, especially those rigid and extreme parenting styles that teach you to watch a clock or a schedule instead of your baby; you know, the cry-it-out crowd. This "convenience" parenting is a short-term gain, but a long-term loss, and is not a wise investment. These more restrained styles of parenting create a distance between you and your baby and keep you from becoming an expert in your child.

7. Balance In your zeal to give so much to your baby, it's easy to neglect the needs of yourself and your marriage. As you will learn the key to putting balance in your parenting is being appropriately responsive to your baby – knowing when to say "yes" and when to say "no," and having the wisdom to say "yes" to yourself when you need help.

MORE ABOUT ATTACHMENT PARENTING AP is a starter style. There may be medical or family circumstances why you are unable to practice all of these baby B's. Attachment parenting implies first opening your mind and heart to the individual needs of your baby, and eventually you will develop the wisdom on how to make on-the-spot decisions on what works best for both you and your baby. Do the best you can with the resources you have – that's all your child will ever expect of you. These baby B's help parents and baby get off to the right start. Use these as starter tips to work out your own parenting style – one that fits the individual needs of your child and your family. Attachment parenting helps you develop your own personal parenting style.

AP is an approach, rather than a strict set of rules. It's actually the style that many parents use instinctively. Parenting is too individual and baby too complex for there to be only one way. The important point is to get connected to your baby, and the baby B's of attachment parenting help. Once connected, stick with what is working and modify what is not. You will ultimately develop your own parenting style that helps parent and baby find a way to fit – the little word that so economically describes the relationship between parent and baby.

AP is responsive parenting. By becoming sensitive to the cues of your infant, you learn to read your baby's level of need. Because baby trusts that his needs will be met and his language listened to, the infant trusts in his ability to give cues. As a result, baby becomes a better cue-giver, parents become better cue-readers, and the whole parent-child communication network becomes easier.

AP is a tool. Tools are things you use to complete a job. The better the tools, the easier and the better you can do the job. Notice we use the term "tools" rather than "steps." With tools you can pick and choose which of those fit your personal parent- child relationship. Steps imply that you have to use all the steps to get the job done. Think of attachment parenting as connecting tools, interactions with your infant that help you and your child get connected. Once connected, the whole parent-child relationship (discipline, healthcare, and plain old having fun with your child) becomes more natural and enjoyable. Consider AP a discipline tool. The better you know your child, the more your child trusts you, and the more effective your discipline will be. You will find it easier to discipline your child and your child will be easier to discipline.

Taken from https://happiestbaby.com/using-the-5-ss/

Dr. Harvey Karp – The Happiest Baby on the Block

The 5 S’s and some ways to comfort

All babies cry, and believe it or not, that’s actually a good thing. How else would we know if our helpless infants were cold, hungry, lonely or in pain.

During the first few months, babies fuss an average of 1.5 hours/day and 10% cry more than 3 hours/day (the medical definition of colic). That’s a whole lot of crying; and it doesn’t even include our crying!

Usually, this irritability starts churning around sundown and can go on for hours. No wonder it makes us exhausted, frustrated and concerned. Traditionally, parents have been encouraged to just keep their chins up and wait until the baby grows out of it. But, this is easier said than done!

Persistent crying – and the exhaustion it triggers in us – creates huge stress in families, include, marital conflict, maternal and paternal depression, obesity/ car accidents (people make poor decisions when stressed and overtired), SIDS and suffocation (tired parents fall asleep, baby in arm, on unsafe couches and beds). In addition to this human suffering, the national costs of the complications of infant crying and parental exhaustion total well over $1 billion dollars a year.

Most doctors say that colic is a mystery. That’s what I used to say, too, until 1981 when I learned about the Bushmen of the Kalahari Desert who can usually calm their fussy babies in under a minute!

The more I thought about it, the more it realized we could be as successful as the Bushmen, but only if we adopted two new ideas (described in The Happiest Baby on the Block book/DVD):

1) All babies are born 3 months early. Although newborn horses can run within an hour of birth, our mushy little babies need a virtual 4th trimester of womb sensations (soft touch, jiggly motion, snug holding, etc).

2) The symphony of rhythms fetuses experience every day before birth triggers a reflex that keeps babies relaxed. This calming reflex is a virtual off-switch for crying and on- switch for sleep.

The Bushmen are successful because they mimic the womb by carrying and rocking their babies 24 hours/day (and feeding them 3 times/hour!). Similarly, many parents in our community soothe their babies with weird womb-mimicking tricks, like car rides and vacuum cleaner noise. No wonder babies do best when held/rocked/shushed 12 hours a day. Does that sound like a lot? Actually, even 16 hours/day is a 40% cut back from the 24/7 embrace babies enjoy the months before birth. Smart parents around the world have invented many ways to calm babies and most are variations of 5 simple womb-like sensations I call the 5 S’s: Swaddle, Side-Stomach Position, Shush, Swing and Suck.

1St S- Swaddle

Swaddling imitates the snug packaging inside the womb and is the cornerstone of calming. It decreases startling and increases sleep. And, wrapped babies respond faster to the other 4 S’s and stay soothed longer because their arms can’t flail wildly.

Babies shouldn’t be swaddled all day, just during fussing and sleep. Wrap arms snug – straight at the side – but let the hips be loose and flexed. Use a large square blanket, but don’t overheat, cover your baby’s head or allow loose blankets.

Does your baby struggle against the swaddle? Just add the other S’s and within minutes he’ll be calm…and sleep better, too!

2nd S – Side or Stomach position

The back is the only safe position for sleeping but it’s the worst position for calming fussiness. This “S” can be activated by putting a baby on her side, on her stomach or over your shoulder.

3rd S – Shush

Contrary to myth, babies don’t need total silence. That’s why they’re so good at sleeping at noisy parties and basketball games! In the womb the sound of the blood flow is a shush louder than a vacuum cleaner.

But, not all white noise is created equal. Hissy fans and ocean sounds often fail because they lack the womb’s rumbly quality. The best way to imitate these magic sounds is with a white noise CD. CDs are better than sound machines because they’re so easy to use in the car or when travelling. And, my “Super-Soothing” Sleep Sounds CD has 6 unique, specially engineered sounds to quickly calm crying and boost sleep. (To calm crying – play it as loud as your baby; to promote sleep -play it as loud as a shower)

4th S – Swing

Womb life is jiggly (imagine your baby jiggling inside you when you walk down the stairs!). Slow rocking is fine for keeping babies calm, but to soothe crying mid-squawk, the motion needs to be fast and tiny. (My patients call this the “Jell-o head” jiggle.)

Always support the head/neck; keep your motions small (no more than 1 inch back and forth); and never, never, never shake your baby in anger or frustration. 5th S- Suck

Sucking is the icing on the cake of calming. Many fussy babies relax into a deep tranquility when they suck.

Other great calming techniques that imitate the womb include, delicious skin-to-skin contact; wearing your baby in a sling; warm baths; gentle massage.

The 5 S’s only work when they’re done exactly right. The calming reflex is just like the knee reflex that only works when you hit the knee exactly right (hit 1 inch too high or low and you’ll get no response).

All babies do better with swaddling and white noise, but try adding on the other S’s, too, to see what your baby prefers. If she doesn’t calm with the S’s, ask your doctor to make sure she isn’t ill. If there is no illness, she’ll likely calm after you review The Happiest Baby DVD to make sure you are doing the 5S’s right.

6th S – Sleep!

The keys to good sleep are swaddling and the white noise CD. Sound is like a comforting, teddy bear. Play it for all naps/nights as loud as a soft shower for at least the first year.

Sound helps good sleepers sleep even better. It keeps babies keep sleeping as they are weaned from swaddling at 4-5 months. And, it prevents sleep disturbances from mild hunger, disturbing noises and teething pain.

After 4 months, the 5 S’s may still work (even adults fall asleep rocking in a hammock and to the sound of rain), but the magic is no longer irresistible (shushing an irate 8- month-old I may make her even madder!).

Holistic Newborn Care

Understanding Your Newborn The Infant States of Being Newborn Behavior

INFANT STATES BIRTH to 6 MONTHS

CRYING • Tears • Muscle tension • Jerky movements • Rapid breathing • Color changes • Generally doesn’t respond quickly

IRRITABLE • Lots of movement • Sometimes fussy • Irregular breathing • Sensitive to body and surroundings • Eyes open, but not focused • Common before feeding

QUIET ALERT • Little body movement • Wants to play and interact • Eyes wide open • Requires energy and can • Steady, regular breathing make babies tired • Very responsive

DROWSY • Variable movement • Tired eyes • Irregular breathing • Delayed reaction time • Opens and closes eyes

LIGHT SLEEP (ACTIVE SLEEP) • Some movement • Rapid eye movement (REM) INCREASING INTENSITY • Irregular breathing • Easily awakened • Facial movement and startled

DEEP SLEEP (QUIET SLEEP) California • No body movement • Not easily • Regular breathing awakened • Bursts of sucking BEHAVIOR Campaign

Source: Brazelton, TB (1973) Neonatal Behavioral Assessment Scale. Clinics in Developmental Medicine, No. 50. JP Lippincott, Philadelphia. In collaboration with the UC Davis Human Lactation Center Infant

CUESBIRTH 6 MONTHS to

ENGAGEMENT DISENGAGEMENT “I want to be near you.” “I need something to be different.”

ENGAGEMENT CUES DISENGAGEMENT CUES • eyes open • turns or looks away • looks intently at your face • pushes away or arches back • follows your voice and face • cries • smiles • coughs • relaxes face • extends ﬁngers with a stiff hand • smooth body movements • yawns or falls asleep • feeding sounds • grimaces • rooting • has a glazed look

CAREGIVER/PARENT RESPONSE CAREGIVER/PARENT RESPONSE Time to play or feed (if baby shows Play detective and follow the cues to hunger cues). ﬁgure out what needs to be different. Remember, playing is hard work for baby and baby tires easily.

California WIC Program, California Department of Public Health This institution is an equal opportunity provider. Source : Kelly, Jean F. PhD; Zuckerman, Tracy PsyD; Rosenblatt, Shira PhD. HUMAN LACTATION CENTER Promoting First Relationships: A Relationship-Focused Early Intervention Approach. Infants & Young Children. 2008; 21 (4): 285-295. In collaboration with the UC Davis Human Lactation Center Perinatal Nursing Education Understanding the Behavior of Term Infants

States of the Term Newborn

State, also known as state of consciousness, Table 2. Sleep and Awake States powerfully influences the way infants respond at any given time. A state is a group of characteristic Sleep States Awake States behaviors and physiologic changes that recur Quiet sleep Drowsy together in a regular pattern (Brazelton & Nugent, 1996; Wolff, 1966). Active sleep Quiet alert Active alert Characteristic behaviors seen in individual states include: Crying • Body activity • Eye movements • Facial movements Significance of Infant States • Breathing pattern States provide a framework for observing and • Level of response to external understanding ways in which infants interact with and internal stimuli their caregivers. States are important in infant growth and development and in helping caregivers In addition to the different characteristic behaviors understand newborn behavior. that occur with each state, physiological changes in heart rate, blood flow, muscle tone, and EEG In each state, infants respond in a unique and patterns also occur. In the term infant who is not predictable manner–not chaotically, but in an monitored, caregivers rely on characteristic organized pattern. States allow infants to control behaviors to clinically assess the infant’s state. In how much and what kind of input they receive from term infants, state can readily be determined by their environments. Sleepy infants affect their using only characteristic behaviors. parents differently than alert or crying infants do. Infants who have long periods of wakefulness will Each state is organized into a pattern that differs have more frequent opportunities to interact with from any of the other states. States are divided into their parents than infants who sleep most of the sleep and awake states (Table 2). time.

States of the Term Newborn

Figure 1. Quiet Sleep (also called deep sleep)

Quiet sleep is restorative and anabolic. It is associated with an increase in cell mitosis and replication, lowered oxygen consumption, and the release of growth hormone. The threshold to sensory stimuli is very high during quiet sleep; only stimuli that are very intense and disturbing can arouse infants.

Characteristics Body Activity Nearly still, except for occasional startle or twitch.

Eye Movements None.

Facial Movements None, except for occasional sucking movement at regular intervals.

Breathing Pattern Smooth and regular.

Level of Response The infant’s threshold to stimuli is very high; only very intense and disturbing stimuli will arouse the infant.

Caregiving Caregivers trying to feed an infant who is in quiet sleep will probably find the experience frustrating. The infant will be unresponsive.

Feeding will be a more pleasant experience if nurses and parents respect the infant’s cycles and needs by waiting until the infant moves to a higher, more responsive state.

Even if caregivers use disturbing stimuli, chances are the infant will arouse only briefly, then become unresponsive as he or she returns to quiet sleep.

States of the Term Newborn

Figure 2. Active Sleep [also called light sleep or rapid eye movement (REM)sleep]

Active sleep is associated with processing and storing of information and has been linked to learning. It accounts for the highest proportion of newborn sleep and usually precedes wakening.

Characteristics Body Activity Some body movements.

Eye Movements Rapid eye movements (REM), fluttering of eyes beneath closed eyelids.

Facial Movements May smile and make brief fussy or crying sounds.

Breathing Pattern Irregular.

Level of Response In active sleep, infants are more responsive to internal stimuli (such as hunger) and external stimuli (such as handling) than they are in quiet sleep.

When stimuli occur, infants may remain in active sleep, return to quiet sleep, or arouse.

Caregiving Due to brief fussy or crying sounds during this state, caregivers who are not aware that these sounds normally occur may try to feed infants before they are ready to eat.

States of the Term Newborn

Figure 3. Drowsy

From the drowsy state, infants may return to sleep or awaken further.

Characteristics Body Activity Variable activity level with mild startles interspersed from time to time. Movements usually smooth.

Eye Movements Eyes occasionally open and close, are heavy-lidded or slit-like.

Facial Movements May have some facial movements. Often none, and face appears still.

Breathing Pattern Irregular.

Level of Response Infants react to sensory stimuli, although their responses are delayed. A change to quiet alert, active alert or crying after stimulation is frequently noted.

Caregiving To awaken infants, caregivers can provide something for infants to see, hear, or suck to arouse them to a more alert state.

If infants are left alone without stimuli, they may return to a sleep state.

States of the Term Newborn

Figure 4. Quiet Alert

During this state, infants are most attentive to their environment, focusing their attention on any stimuli that are present: nipple, voice, face, or moving objects.

Characteristics Body Activity Minimal.

Eye Movements Eyes brighten and widen.

Facial Movements Attentive appearance.

Breathing Pattern Regular.

Level of Response During this state, infants are most attentive to the environment, focusing attention on any stimuli present.

Caregiving In the first few hours after birth, many newborns experience a period of intense alertness before going into a long sleeping period.

As infants become older, they spend more and more time in this state.

Providing something for infants to see, hear, or suck will often maintain a quiet-alert state or help them enter a quiet- alert state from either a drowsy or active-alert state.

Infants in this state provide much pleasure and positive feedback to parents and other caregivers.

This is often a good time to feed the infant, especially if the mother is breastfeeding on an ad lib schedule.

States of the Term Newborn

Figure 5. Active Alert

During active alert, infants’ eyes are open, but their eyes and faces are not as bright as in quiet alert. Infants have more body activity in active alert than they do in quiet alert.

Characteristics Body Activity Variable activity level with mild startles interspersed from time to time. Movements usually smooth.

Eye Movements Eyes are open, with dull, glazed appearance.

Facial Movements May have some facial movements. Often none, and face appears still.

Breathing Pattern Irregular.

Level of Response Infants react to sensory stimuli, although responses are delayed. With stimulation, the infant may change to quiet alert or crying.

Caregiving Infants may have periods of fussiness and become increasingly sensitive to disturbing stimuli (hunger, fatigue, noise, excessive handling).

Infants may become more and more active and may change to a crying state.

Fatigue or caregiver interventions often interrupt this state, allowing infants to return to a drowsy or sleep state.

States of the Term Newborn

Figure 6. Crying

Crying is the infant state that presents the greatest challenge to the caregiver. This state is characterized by intense crying for at least 15 seconds.

Characteristics Body Activity Increased motor activity. Skin color darkens or changes to red or ruddy.

Eye Movements Eyes may be tightly closed or open.

Facial Movements Grimaces.

Breathing Pattern More irregular than in other states.

Level of Response Infants are extremely responsive to unpleasant external or internal stimuli.

Caregiving Crying is: • A communication signal. • A response to unpleasant stimuli from the environment. • A response to internal stimuli such as fatigue, hunger, or discomfort.

Crying tells the caregiver that the infant’s limits have been reached.

Sometimes infants can console themselves and return to active or quiet alert, drowsy, or a sleep state; at other times, they need help from caregivers.

States of the Term Newborn

State Modulation the infant or environment (Table 3). An important component of infant states is state modulation, which allows the infant to adapt to and Although states may seem like a continuous spect- interact with his or her environment by controlling rum from quiet sleep to crying, each state is qualita- sensory input and responses to caregivers and the tively specific with its unique internal organization environment. State modulation (Barnard, 1999) is of physiologic and behavioral characteristics and the ability of the infant to: level of central nervous system control. • Make smooth transitions between states. • Cycle between sleep states (see page 11). Most infants flow smoothly between states, as if • Arouse when appropriate (e.g., for feeding or moving up and down a ladder one step or occasion- playing). ally two steps at a time (Barnard, 1999; Nursing • Sustain sleep states. (Barnard, 1999) Child Assessment Training, 1978). However, not all infants flow smoothly between states. Some infants State modulation allows the infant to: tend to jump from one state to another. These in- • Adapt to his or her environment by controlling fants always seem to be sleeping or crying and sensory input and responses to the environ- spend little time in other states. ment. • Use state behaviors to guide caregiving. Caregivers can aid with state modulation by helping • Modify social interactions. (Barnard, 1999) an infant to become alert [see the reading “Infant During the early months of life, an important role of Behaviors, Reflexes and Cues”] or by soothing the caregivers is to help the infant with state-modula- infant. tion activities. An infant who is having difficulty with state modulation has problems regulating sens- Factors Influencing Infant State ory input and responses (Barnard, 1999). Infants Infant states are influenced by internal physiologic who cannot turn stimulation on or off may miss needs, external environment, stressful events, and important input or become overloaded by stimuli. pathologic conditions (Table 4) (Hack, 1987). Problems with state modulation may originate from

Table 3. Illustrative Infant and Environmental Factors That Affect State Modulation

Infant Factors Environmental Factors Temperament Noise Immaturity Vibration Pain Light Stress Temperature Maternal substance abuse Caregiver actions Illness

States of the Term Newborn

Table 4. Factors Influencing Infant State Factor Stimuli Effect of Stimuli

Touch Soothing and swaddling Reduces activity during active alert and crying

Handling (rubbing, stroking, Induces awakeness and activity holding)

Pain Increases awakeness and activity; inactive infants most sensitive to pain

Visual factors Pictures, objects, faces Induces quiet alert in drowsy, crying, or active-alert infants; quiet alert prolonged by interesting visual stimuli

Light/Dark Light Reduces active sleep; reduces level of activity in fussy or crying babies

Dark Increases quiet sleep

Auditory factors (sound) Variations in sound Increases activity

Rhythmic sound Reduces activity; more sleep, less crying

Continuous sound Reduces activity in crying and fussy babies; less active sleep, more quiet sleep

Proprioceptive factors (sensations Putting to shoulder and rocking Induces quiet alert in sleeping, related to movement of the body) in an upright position active-alert, and fussy babies

Environmental temperature Decreases Increases motor activity; decreases quiet sleep

Increases Increases sleep

continued on next page

States of the Term Newborn

Figure 4 continued Sucking Sucking on a pacifier or own Induces quiet alert in active-alert finger or hand and crying infants; inhibits head movements and peripheral vision

Stressful events Circumcision Increases fussy crying; shorter time to fall asleep; increases quiet sleep; effects may last several days

Repeated awakenings Longer wakefulness; more sleep after the deprivation period; fussiness

Internal physiologic needs Hunger Increases activity, active alert, and crying

Satiety Quiets, induces sleep

Need to stool Waking activity

Pathologic conditions Coma Complete absence of state cycles and definable sleep

Asphyxia Poor sleep-cycle development and state modulation; decreases active sleep; increases quiet sleep

Hydrocephalus or microcephalus Increases amounts of wakefulness with less sleep; poor or absent sleep-state organization

Maternal preeclampsia with Poor sleep-state organization; intrauterine growth restriction disorganized quiet sleep with irregular respirations

Jaundice Decreases quiet-awake periods; increases sleep-cycle duration and active sleep

Down syndrome Increases awakenings; decreases active sleep continued on next page

States of the Term Newborn

Figure 4 continued

Pathologic conditions (cont.) Biochemical disturbances Hyperirritability or decreased (hypoglycemia, hypocalcemia, wakefulness hypernatremia)

Drugs Meperidine (Demerol) and Decreases wakefulness, visual barbiturates alertness, and active-sleep spontaneous behaviors

Diazepam and barbiturates Increases a state that looks like quiet sleep; decreases active sleep

Heroin, methadone, and other Reduces quiet sleep; alters sleep opiates cycles; increases irritability, hyperactivity, and wakefulness

Cocaine and crack Increases irritability; rapid fluctuations in states; altered sleep patterns

Adapted from Hack, 1987.

Sleep Cycles Periods of active sleep and quiet sleep alternate in a Figure 7. Periods of Active Sleep and Quiet fixed pattern. A sleep cycle is the time from a per- Sleep in the Term Infant iod of active sleep, through a period of quiet sleep, to the beginning of the next active sleep period (Barnard, 1999). Infants spend approximately 60% of sleep time in active sleep and 40% in quiet sleep (Figure 7) (Barnard, 1999; Nursing Child Assessment Training, 1978). 60% active sleep The average length of a sleep cycle in term infants is 50-80 minutes. During a sleep cycle, infants spend 35-60 minutes in active sleep and 15-20 40% minutes in quiet sleep (Figure 8) (Barnard, 1999; quiet sleep Nursing Child Assessment Training, 1978). For example, a sleep cycle might last 60 minutes, with infants spending 15 minutes in quiet sleep and the remaining time in active sleep. At the end of a sleep cycle, infants either begin another sleep cycle or start to arouse.

States of the Term Newborn

Figure 8. Minutes of Active Sleep and Quiet awake, and the states become more organized Sleep in a Sleep Cycle of the Term Infant (Holditch-Davis, 1998).

Co-Sleeping Co-sleeping, where the infant is in the same bed or room with parents, is the focus of recent research and is controversial. Because of the risk of suffoca- 35-60 minutes tion and injury, the American Academy of Pediatrics in active sleep (AAP) opposes co-sleeping where the infant is in the same bed with adults. The Consumer Product Safety Commission (CPSC) and National Institute of Child Health and Human Development (NICHD) 15-20 also do not support co-sleeping. The AAP acknowl- minutes in edges that the CPSC opposes bed sharing by an in- quiet sleep fant and an adult but recognizes that a significant portion of the U.S. population practices bed sharing between mother and infant to facilitate breastfeeding and that it is common for the father to also be in the bed. Sleep and Awake Patterns As newborns grow and mature, their sleep and Advocates of same-bed sharing cite benefits for awake patterns change (Table 5 on next page). The breastfeeding, cultural continuation, close infant total amount of sleep per 24 hours does not change monitoring, and other potential physiological bene- significantly over the first year. The major change is fits being studied. Co-sleeping advocates advise in the organization of sleep and in consolidation of against co-sleeping for families who smoke. sleep into nighttime hours, with increased awake time during the day. The information about sleep states in this module is based on research with infants who are in separate Development of sleep and awake states during beds (i.e., are not co-sleeping). infancy reflects central nervous system (CNS) maturation and is important for growth, develop- In 2000, the AAP Task Force on Infant Sleep Posi- ment, and learning. With maturation of the CNS, the tion and Sudden Infant Death Syndrome (SIDS) infant is able to increasingly inhibit smooth muscle concluded that there was insufficient evidence to movements, reduce generalized responses, improve conclude that bed sharing under carefully controlled habituation, and develop increased attention ability. conditions is clearly either hazardous or safe. Table Quiet periods become longer during both sleep and 6 on page 14 presents highlights from the AAP guidance on co-sleeping.

States of the Term Newborn

Table 5. Changes in Sleep and Awake Patterns During Early Infancy

• The infant sleeps 14 hours per day by 1 month. • The total amount of sleep decreases to about 13 hours per day by 12 months. • Decrease in sleep is accompanied by a steady increase in the amount of wakefulness. • Awake times during daytime hours increase as the infant is able to put together two or more sleep cycles. • The duration of individual sleep periods increases. • The infant consolidates sleep periods into nighttime hours. • The percentage of active sleep decreases, and the percentage of quiet sleep increases. • Increased length of sleep at night is not related to the initiation of solid foods.

Adapted from Barnard, 1999.

Assessment of Infant States • Does the infant seem to move smoothly from Learning to identify the state of an infant is a skill one state to another, or does the infant jump that most nurses find relatively easy to acquire with from a sleep state, to crying, to drowsy? a little practice. Nurses can practice state identification with infants in the delivery, nursery, or post- With a little experience, identification of an infant’s partum areas. state becomes an automatic response so whenever the nurse is working with an infant, she or he can Initially, nurses will need to make a conscious effort anticipate the way the infant may respond and what to assess an infant’s state. They will need to ask activities may be most appropriate with the infant at themselves the following: that time.

• In what state is the infant as I approach the Video Clips and Cases bassinet and before the infant is handled? Return to the online module “Understanding the • How does the infant’s state change while be- Behavior of Term Infants” to view videos and cases ing touched, diapered, and/or bathed? related to this reading. • In what state is the infant while the mother or father is holding or feeding the infant, or when the infant is returned to the bassinet?

States of the Term Newborn

Table 6. Guidance on Co-Sleeping from the American Academy of Pediatrics In 2000, the AAP Task Force on Infant Sleep Position and Sudden Infant Death Syndrome (SIDS) concluded that there was insufficient evidence to conclude that bed sharing under carefully controlled conditions is clearly either hazardous or safe. This table presents highlights from the AAP guidance on co-sleeping.

• As an alternative to bed sharing, parents may consider placing the infant’s crib near the parents’ bed to allow for more convenient breastfeeding and parent contact.

• Mothers who choose to have their infants sleep in their beds to breastfeed should follow these guidelines: – Ensure that the infant is in a nonprone sleep position. – Avoid soft surfaces and loose covers. – To prevent entrapment, position the bed away from the wall and other furniture and avoid beds that present entrapment possibilities, such as two side-by-side mattresses.

• Adults other than parents, children, or siblings should avoid bed sharing with an infant.

• Parents who choose to bed share with their infant should not smoke or use sub- stances such as alcohol or drugs that may impair their arousal.

• Overheating should be avoided. The infant should be lightly clothed and should not feel hot to the touch. The bedroom temperature should be kept comfortable for a lightly clothed adult.

• Some daily tummy time while the infant is awake and observed is recommended to encourage development and to help prevent flat spots on the occiput. To help prevent positional plagiocephaly, caregivers may place the infant to sleep with the head to one side for a week or so and then change to the other. Periodically changing the infant’s orientation to outside activity (e.g., the door of the room) will encourage the infant to change head position.

• Devices to maintain sleep position or to reduce the risk of rebreathing are not recommended, because none has been tested sufficiently to show efficacy or safety.

• Electronic cardiac and respiratory monitors may be of value for home monitoring of selected infants who have extreme cardiorespiratory instability. However, there is no evidence that such home monitoring decreases the incidence of SIDS.

Adapted from AAP, 2000.

Holistic Newborn Care

The Benefits of Skin-to-Skin Contact with your Newborn

The Magical Hour

The First Hour After Birth: A Baby’s 9 Instinctive Stages

The first hours after birth are a developmentally distinct time for a baby and there are well-documented short and long-term physical and psychological advantages when a baby is held skin-to-skin during this time.

When a baby is in skin-to-skin contact after birth there are nine observable newborn stages, happening in a specific order, that are innate and instinctive for the baby. Within each of these stages, there are a variety of actions the baby may demonstrate.

Stage 1: The Birth Cry The first stage is the birth cry. This distinctive cry occurs immediately after birth as the baby’s lungs expand.

Stage 2: Relaxation The second stage is the relaxation stage. During the relaxation stage, the newborn exhibits no mouth movements and the hands are relaxed. This stage usually begins when the birth cry has stopped. The baby is skin-to-skin with the mother and covered with a warm, dry towel or blanket.

Stage 3: Awakening The third stage is the awakening stage. During this stage the newborn exhibits small thrusts of movement in the head and shoulders. This stage usually begins about 3 minutes after birth. The newborn in the awakening stage may exhibit head movements, open his eyes, show some mouth activity and might move his shoulders.

Stage 4: Activity The fourth stage is the activity stage. During this stage, the newborn begins to make increased mouthing and sucking movements as the rooting reflex becomes more obvious. This stage usually begins about 8 minutes after birth.

Stage 5: Rest At any point, the baby may rest. The baby may have periods of resting between periods of activity throughout the first hour or so after birth.

Stage 6: Crawling The sixth stage is the crawling stage. The baby approaches the breast during this stage with short periods of action that result in reaching the breast and nipple. This stage usually begins about 35 minutes after birth.

Kajsa Brimdyr, PhD, CLC Healthy Children Project 327 Quaker Meeting House Road East Sandwich, MA 02537, (508) 888 8044

The Magical Hour

Stage 7: Familiarization The seventh stage is called familiarization. During this stage, the newborn becomes acquainted with the mother by licking the nipple and touching and massaging her breast. This stage usually begins around 45 minutes after birth and could last for 20 minutes or more.

Stage 8: Suckling The eighth stage is suckling. During this stage, the newborn takes the nipple, self- attaches and suckles. This early experience of learning to breastfeed usually begins about an hour after birth. If the mother has had analgesia/anesthesia during labor, it may take more time with skin-to-skin for the baby to complete the stages and begin suckling.

Stage 9: Sleep The final stage is sleep. The baby and sometimes the mother fall into a restful sleep. Babies usually fall asleep about 1! to 2 hours after birth.

Benefits for Babies: Regardless of how you are feeding your baby, your baby can benefit from skin-to- skin contact.

• Babies are warmer. • Babies are calmer. • Babies can hear their mother’s heartbeat. • Heart and breathing rates are normalized. • Milk supply may be improved. Other family members can hold and bond with babies through skin-to-skin holding too!

What To Do in the First Hour with Mother You and your baby are covered with a blanket. The baby’s head stays out. The baby is naked and not wrapped. You and your baby will rest skin-to-skin for an hour or two after birth. This is a special time for you and your baby. Necessary procedures and checks are done with the mother and baby skin-to-skin.

If there are medical reasons that keep you and your baby from skin-to-skin holding right after birth, start as soon as possible.

If you are on medications or anything that might impair your strength or ability to stay awake when holding the baby, be sure someone else can help you care for the baby and hold the baby skin-to-skin. Kajsa Brimdyr, PhD, CLC Healthy Children Project 327 Quaker Meeting House Road East Sandwich, MA 02537, (508) 888 8044

The Importance of Skin to Skin Contact 8/21/14 10:56 AM

The Importance of Skin to Skin Contact There are now a multitude of studies that show that mothers and babies should be together, skin to skin (baby naked, not wrapped in a blanket) immediately after birth, as well as later. The baby is happier, the baby’s temperature is more stable and more normal, the baby’s heart and breathing rates are more stable and more normal, and the baby’s blood sugar is more elevated. Not only that, skin to skin contact immediately after birth allows the baby to be colonized by the same bacteria as the mother. This, plus breastfeeding, are thought to be important in the prevention of allergic diseases. When a baby is put into an incubator, his skin and gut are often colonized by bacteria different from his mother’s.

We now know that this is true not only for the baby born at term and in good health, but also even for the premature baby. Skin to skin contact and Kangaroo Mother Care can contribute much to the care of the premature baby. Even babies on oxygen can be cared for skin to skin, and this helps reduce their need for extra oxygen, and keeps them more stable in other ways as well (See www.kangaroomothercare.com) (See the information sheet Breastfeeding the Premature Baby).

To appreciate the importance of keeping mother and baby skin to skin for as long as possible in these first few weeks of life (not just at feedings) it might help to understand that a human baby, like any mammal, has a natural habitat: in close contact with the mother (or father). When a baby or any mammal is taken out of this natural habitat, it shows all the physiologic signs of being under significant stress. A baby not in close contact with his mother (or father) by distance (under a heat lamp or in an incubator) or swaddled in a blanket, may become too sleepy or lethargic or becomes disassociated altogether or cry and protest in despair. When a baby is swaddled it cannot interact with his mother, the way nature intended. With skin to skin contact, the mother and the baby exchange sensory information that stimulates and elicits “baby” behaviour: rooting and searching the breast, staying calm, breathing more naturally, staying warm, maintaining his body temperature and maintaining his blood sugar.

From the point of view of breastfeeding, babies who are kept skin to skin with the mother immediately after birth for at least an hour, are more likely to latch on without any help and they are more likely to latch on well, especially if the mother did not receive medication during the labour or birth. As mentioned in the information sheet Breastfeeding—Starting out Right, a baby who latches on well gets milk more easily than a baby who latches on less well. See the video clips of young babies (less than 48 hours old) breastfeeding at the website nbci.ca. When a baby latches on well, the mother is less likely to be sore. When a mother’s milk is abundant, the baby can take the breast poorly and still get lots of milk, though the feedings may then be long or frequent or both, and the mother is more prone to develop problems such as blocked ducts and mastitis. In the first few days, however, the mother does have enough milk, but because it is not abundant, as nature intended, the baby needs a good latch in order to get that milk. Yes, the milk is there even if someone has proved to you with the big pump that there isn’t any. How much does or does not come out in the pump proves nothing—it is irrelevant. Many mothers with abundant milk supplies have difficulty expressing or pumping more than a small amount of milk. Also note, you can’t tell by squeezing the breast whether there is enough milk in there or not. And a good latch is important to help the baby get the milk that is available. If the baby does not latch on well, the mother may be sore, and if the baby does not get milk well, the baby will want to be on the breast for long periods of time worsening the soreness.

To recap, skin to skin contact immediately after birth, which lasts for at least an hour (and should continue for as many hours as possible throughout the day and night for the first number of weeks) has the following

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positive effects. The baby:

Is more likely to latch on Is more likely to latch on well Maintains his body temperature normal better even than in an incubator Maintains his heart rate, respiratory rate and blood pressure normal Has higher blood sugar Is less likely to cry Is more likely to breastfeed exclusively and breastfeed longer Will indicate to his mother when he is ready to feed

There is no reason that the vast majority of babies cannot be skin to skin with the mother immediately after birth for at least an hour. Hospital routines, such as weighing the baby, should not take precedence.

The baby should be dried off and put on the mother. Nobody should be pushing the baby to do anything; nobody should be trying to help the baby latch on during this time. The baby may be placed vertically on the mother’s abdomen and chest and be left to find his way to the breast, while mother supports him if necessary. The mother, of course, may make some attempts to help the baby, and this should not be discouraged. This is baby’s first journey in the outside world and the mother and baby should just be left in peace to enjoy each other’s company. (The mother and baby should not be left alone, however, especially if the mother has received medication, and it is important that not only the mother’s partner, but also a nurse, midwife, doula or physician stay with them—occasionally, some babies do need medical help and someone qualified should be there “just in case”). The eye drops and the injection of vitamin K can wait a couple of hours. By the way, immediate skin to skin contact can also be done after cæsarean section, even while the mother is getting stitched up, unless there are medical reasons which prevent it.

Studies have shown that even premature babies, as small as 1200 g (2 lb 10 oz) are more stable metabolically (including the level of their blood sugars) and breathe better if they are skin to skin immediately after birth. Skin to skin contact is quite compatible with other measures taken to keep the baby healthy. Of course, if the baby is quite sick, the baby’s health must not be compromised, but any premature baby who is not suffering from respiratory distress syndrome can be skin to skin with the mother immediately after birth. Indeed, in the premature baby, as in the full term baby, skin to skin contact may decrease rapid breathing into the normal range.

Even if the baby does not latch on during the first hour or two, skin to skin contact is important for the baby and the mother for all the other reasons mentioned.

If the baby does not take the breast right away, do not panic. There is almost never any rush, especially in the full term healthy baby. One of the most harmful approaches to feeding the newborn has been the bizarre notion that babies must feed every three hours. Babies should feed when they show signs of being ready, and keeping a baby next to his mother will make it obvious to her when the baby is ready. There is actually not a stitch of proof that babies must feed every three hours or by any schedule, but based on such a notion, many babies are being pushed into the breast simply because three hours have passed. The baby who is not yet interested in feeding may object strenuously, and thus is pushed even more, resulting, in many cases, in baby refusing the breast because we want to make sure they take the breast. And it gets worse. If the baby keeps objecting to being pushed into the breast and gets more and more upset, then the “obvious next step” is to give a supplement. And it is obvious where we are headed (see the information sheet When a Baby Has Not

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Holistic Newborn Care

Understanding Newborn Sleep

American Academy of Pediatrics Announces New Safe Sleep Recommendations to Protect Against SIDS, Sleep-Related Infant Deaths 10/24/2016 https://www.aap.org/en-us/about-the-aap/aap-press-room/pages/american-academy-of-pediatrics- announces-new-safe-sleep-recommendations-to-protect-against-sids.aspx

San Francisco, CA -- Infants should sleep in the same bedroom as their parents – but on a separate surface, such as a crib or bassinet, and never on a couch, armchair or soft surface -- to decrease the risks of sleep-related deaths, according to a new policy statement released by the American Academy of Pediatrics.

Recommendations call for infants to share their parents' bedroom for at least the first six months and, optimally, for the first year of life, based on the latest evidence.

The policy statement and an accompanying technical report will be released Monday, Oct. 24, at the AAP National Conference & Exhibition in San Francisco. The report, to be published in the November 2016 issue of Pediatrics (online Oct. 24), includes new evidence that supports skin-to-skin care for newborn infants; addresses the use of bedside and in-bed sleepers; and adds to recommendations on how to create a safe sleep environment.

"We know that parents may be overwhelmed with a new baby in the home, and we want to provide them with clear and simple guidance on how and where to put their infant to sleep," said Rachel Moon, MD, FAAP, lead author of the report. "Parents should never place the baby on a sofa, couch, or cushioned chair, either alone or sleeping with another person. We know that these surfaces are extremely hazardous."

Approximately 3,500 infants die annually in the United States from sleep-related deaths, including sudden infant death syndrome (SIDS); ill-defined deaths; and accidental suffocation and strangulation. The number of infant deaths initially decreased in the 1990s after a national safe sleep campaign, but has plateaued in recent years.

AAP recommendations on creating a safe sleep environment include:

• Place the baby on his or her back on a firm sleep surface such as a crib or bassinet with a tight-fitting sheet. • Avoid use of soft bedding, including crib bumpers, blankets, pillows and soft toys. The crib should be bare. • Share a bedroom with parents, but not the same sleeping surface, preferably until the baby turns 1 but at least for the first six months. Room-sharing decreases the risk of SIDS by as much as 50 percent. • Avoid baby's exposure to smoke, alcohol and illicit drugs.

Skin-to-skin care is recommended, regardless of feeding or delivery method, immediately following birth for at least an hour as soon as the mother is medically stable and awake, according to the report.

Breastfeeding is also recommended as adding protection against SIDS. After feeding, the AAP encourages parents to move the baby to his or her separate sleeping space, preferably a crib or bassinet in the parents' bedroom.

"If you are feeding your baby and think that there's even the slightest possibility that you may fall asleep, feed your baby on your bed, rather than a sofa or cushioned chair," said Lori Feldman- Winter, MD, FAAP, member of the Task Force on SIDS and co-author of the report.

"If you do fall asleep, as soon as you wake up be sure to move the baby to his or her own bed," she said.

"There should be no pillows, sheets, blankets or other items that could obstruct the infant's breathing or cause overheating."

While infants are at heightened risk for SIDS between the ages 1 and 4 months, new evidence shows that soft bedding continues to pose hazards to babies who are 4 months and older.

Other recommendations include:

• Offer a pacifier at nap time and bedtime. • Do not use home monitors or commercial devices, including wedges or positioners, marketed to reduce the risk of SIDS. • Infants should receive all recommended vaccinations. • Supervised, awake tummy time is recommended daily to facilitate development.

The AAP recommends that doctors have open and nonjudgmental conversations with families about their sleep practices. Media outlets and advertisers may also play a role in educating parents by following safe sleep recommendations when presenting images and messages to the public.

"We want to share this information in a way that doesn't scare parents but helps to explain the real risks posed by an unsafe sleep environment," Dr. Moon said. "We know that we can keep a baby safer without spending a lot of money on home monitoring gadgets but through simple precautionary measures."

Your Roadmap to Inspire Peaceful Newborn Sleep

Watch, Listen, and Learn Have Realistic 1 How Baby Communicates 2 Expectations

FACT: Sleep periods can be as short as 20 Respect the Span of minutes or as long as 4 “Happily Awake Time” Learn to Read Your fve hours. There is no 3 Baby’s Sleepy Signals “day” or “night” to Baby! Diferentiate between Sleeping 5 Noises and Awake Noises Use Pink-Hued 6 White Noise APPROACHING DREAMLAND FACT: By keeping nights dark and Set Your Baby’s quiet, and days bright and happy, Ensure Adequate 7 Biological Clock you can help 8 Daily Naps Baby’s internal clock to mature.

Understand and Respect Your 9 Baby’s Sucking Reﬂex Help Your Baby Make 5 SHEEP FROM 10 Friends With the Bassinet

STORYVILLE

Give Baby a Chance to Swaddle at the Right Time, 12 Fall Asleep Unaided 11 in the Right Way 3 WINKS TO LULLABY TOWN Provide Motion for Develop a Hint of 13 Peaceful Sleep 14 Bedtime Routine

FACT: White noise, quiet and dim lights, your voice, a lullaby are elements of inducing sleep.

Tune Out the Criticism and Be 15 True to Yourself and Baby!

The No-Cry Sleep Solution for Newborns By Bestselling Author of the No-Cry Solution Series, Elizabeth Pantley AVAILABLE WHEREVER BOOKS ARE SOLD 5 Easy Ways to Help Your Newborn Sleep Better Newborn Newborn sleep problems are common – but it’s a mystery. Babies in the womb sleep up to twenty hours per day. Sleep Newborns know how to sleep, but we unknowingly get in the way of their natural process. Here are ways to help your baby get more sweet dreams.

Elizabeth Pantley, Author The No-Cry Sleep Solution for Newborns

1 Don’t Exceed Baby’s “Happily Awake Span”

Newborns can only last forty-five minutes to an hour between sleep sessions. By three months of age this can extend to two or three hours, maximum. If your baby is awake longer than biology allows he’ll be fussier and cry more, plus find it harder to fall asleep.

2 Learn your Baby’s Sleepy Signals Your newborn will give you signals when she’s tired. If you miss the signs, your baby will quickly become overtired. On the flip side, a baby who isn’t tired will reject efforts to get her to sleep. Look for that perfect sleepy moment. Babies share a few common signs of tiredness, such as losing interest in people and toys and making slower movements.

3 Correctly Identify Sleeping Sounds and Motions Newborns grunt, coo, twitch, and shift position during sleep. These noises and movements don’t always signal awakening. Rushing to pick your baby up during these occurrences can actually wake her up! So, take a pause to observe and listen. If your baby is sleeping – let her sleep!

4 Use White Noise to Mask Baby-waking Sounds The use of quiet, rumbly white noise can soothe your baby and mask any outside sounds that wake him. Find a sound that you enjoy, too, since your baby may enjoy these sleepy sounds up through toddlerhood.

5 Feed your Newborn Frequently – Day and Night.

Your baby doesn’t have a day/night body clock, so sleep and feedings occur throughout a 24-hour period. Your newborn’s teaspoon-sized stomach doesn’t last long without food. Newborns can’t sleep when they’re hungry and will keep waking up until they’re fed. It’s better to respond to feeding cues quickly so you can both get back to the important job of sleeping.

For more articles visit NoCrySolution.com Four Ways that White Noise The Magic Works its Magic of The right kind of background noise is a perfect sleep aid for most newborns because it is effective in a variety of White Noise ways. Whether your baby is an easy sleeper or a more challenged sleeper, white noise can be helpful to your little one in four different ways:

Elizabeth Pantley, Author The No-Cry Sleep Solution for Newborns

1 A gentle sound can be effective at soothing Baby to sleep.

The simple, repetitive “Shhh Shhh” sound helps to calm a baby because it mimics mother’s heartbeat. When a baby hears these types of sounds it allows him to focus on those, and then he can center himself and relax or fall asleep.

2 The sound masks harsh noises that startle your baby awake. A steady hum of background noise can help to block out sharp sudden sounds. White noise, played just loud enough (but not too loud), softens the edges of these sharp sounds.

You don’t want to have to always tiptoe around a sleeping baby, and the sounds of the house, like talking or soft footsteps, are actually soothing, as babies love to hear the sounds of the village as they sleep. However, sharp sounds like dishes clinking, a phone ringing, dogs barking, or older siblings shouting can be intrusive sounds that wake your sleeping newborn. Having white noise playing can mask these baby-waking noises.

3 White noise sounds can act as a bridge between sleep cycles. White noise can cover many disruptive sounds that happen during naps or in the middle of the night. When your baby is having a brief awakening between sleep cycles and hears these noises, they can gain his attention and bring him fully awake. White noise can help your baby move seamlessly through sleep cycles (when hunger doesn't interfere) so that your baby has a longer nap or fewer night wakings.

4 A sound used frequently creates a consistent cue. When your baby hears this specific sound she knows it’s time to sleep. When you routinely use the sounds as soon as you notice signs of tiredness, your baby comes to recognize it as sleeping music. Add some warm milk and a cuddle to easily lull your baby to sleep.

White noise is conducive to sleep, but unhelpful during awake times. Turn the white noise off as soon as your baby is awake. This keeps the sound exclusive to sleep and allows your infant to hear the sounds of the world when she is awake and alert.

For more articles visit NoCrySolution.com Newborn Babie and Sleep

“Although it would be nice to lay your litle bundle down at bedtime and no hear fom him until morning, this is no a realiﬆic goal for a tiny baby...”

I Read All The Baby Sleep Books | HuffPost 2/25/18, 8(03 PM I Read All The Baby Sleep Books Ava Neyer

I went on Amazon and bought all the top books on baby sleep and development. I read through them all, as well as several blogs and sleep websites. I gathered lots of advice.

You shouldn’t sleep train at all, before a year, before 6 months, or before 4 months, but if you wait too late, your baby will never be able to sleep without you. College-aged children never need to be nursed, rocked, helped to sleep, so don’t worry about any bad habits. Nursing, rocking, singing, swaddling, etc. to sleep are all bad habits and should be stopped immediately. White noise will help them fall asleep. White noise, heartbeart sounds, etc., don’t work. Naps should only be taken in the bed, never in a swing, carseat, stroller, or when worn. Letting them sleep in the carseat or swing will damage their skulls. If your baby has trouble falling asleep in the bed, put them in a swing, carseat, stroller, or wear them.

Put the baby in a nursery, bed in your room, in your bed. Co-sleeping is the best way to get sleep, except that it can kill your baby, so never ever do it. If your baby doesn’t die, you will need to bedshare until college.

Use the same cues as night: cut lights, keep the house quiet and still. Differentiate naps from nightly sleep by leaving the lights on and making a regular amount of noise. Keep the room warm, but not too warm. Swaddle the baby tightly, but not too tightly. Put them on their back to sleep, but don’t let them be on their backs too long or they will be developmentally delayed. Give them a pacifier to reduce SIDS. Be careful about pacifiers because they can cause nursing problems and stop your baby from sleeping soundly. If your baby sleeps too soundly, they’ll die of SIDS.

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Don’t let your baby sleep too long, except when they’ve been napping too much, then you should wake them. Never wake a sleeping baby. Any baby problem can be solved by putting them to bed earlier, even if they are waking up too early. If your baby wakes up too early, put them to bed later or cut out a nap. Don’t let them nap after 5 pm. Sleep begets sleep, so try to get your child to sleep as much as possible. Put the baby to bed awake but drowsy. Don’t wake the baby if it fell asleep while nursing.

You should start a routine and keep track of everything. Not just when they sleep and how long, but how long it has been between sleep, how many naps they’ve had per day, and what you were doing before they slept. Have a set time per day that you put them to bed. Don’t watch the clock. Put them on a schedule. Scheduling will make your life impossible because they will constantly be thrown off of it and you will become a prisoner in your home.

Using CIO will make them think they’ve been abandoned and will be eaten by a lion shortly. It also causes brain damage. Not getting enough sleep will cause behavior and mental problems, so be sure to put them to sleep by any means necessary, especially CIO, which is the most effective form. Extinction CIO is cruel beyond belief and the only thing that truly works because parents are a distraction. The Sleep Lady Shuffle and Ferber method are really CIO in disguise or Controlled Crying and so much better than Extinction. All three of these will prevent your child from ever bonding with you in a healthy way. Bedsharing and gentler forms of settling will cause your child to become too dependent on you.

Topping the baby off before bed will help prevent night wakings. When babies wake at night, it isn’t because they are hungry. If the baby wants to nurse to sleep, press on the baby’s chin to close its mouth. Don’t stop the baby from nursing when asleep because that doesn’t cause a bad habit. Be wary of night feeds. If you respond too quickly with food or comfort, your baby is

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manipulating you. Babies can’t manipulate. Babies older than six months can manipulate.

Sleep when the baby sleeps. Clean when the baby cleans. Don’t worry. Stress causes your baby stress and a stressed baby won’t sleep.

This post originally appeared on Reddit.

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https://www.huffingtonpost.com/ava-neyer/i-read-all-the-baby-sleep-advice-books_b_3143253.html Page 3 of 3 Safe Sleeep Smart Steps To Safer Bedsharing Meet all seven and you can sleep sweet

No Smoking 1 In the home or outside

Sober Parents 2 No Alcohol cough No Drowsy Meds 77 A Rhyme for Sleep Tme Nursing Mother 3 Day & Night Sing to “Row, Row, Row Your Boat” Healthy Baby 4 Full Term No smoke sober mom Baby at your breat.

Healthy baby on his back.

Keep him lightly dresed. 5 Baby On Back Not too sof a bed. No Sweat Watch the cords and gaps. 6 No Swaddle Keep the covers off his head For your nights and naps.

Sweet Sleep Safe Surface available at 7 store.llli.org No super-soft mattress, no extra pillows, no toys, no heavy covers Clear of strings and cords Pack the cracks: use rolled towels or baby blankets Cover the baby, not the head llli.org Co-Sleeping: Yes, No, Sometimes? Taken from askdrsears.com

Co-Sleeping Is Not Necessarily Bad Our first three babies were easy sleepers. We felt no need or desire to have them share our bed. Besides, I was a new member of the medical profession whose party line was that sleeping with babies was weird and even dangerous. Then along came our fourth child, Hayden, born in 1978, whose birth changed our lives and our attitudes about sleep.

Co-Sleeping: Yes Were it not for Hayden, many of our books might never have been written. Hayden hated her crib. Finally one night, out of sheer exhaustion my wife, Martha, brought Hayden into our bed. From that night on we all slept better. We slept so happily together that we did it for four years, until the next baby was born!

Soon after we ventured into this “daring” sleeping arrangement, I consulted baby books for advice. Big mistake! They all preached the same old tired theme: Don’t take your baby into your bed. Martha said, “I don’t care what the books say, I’m tired and I need some sleep!” We initially had to get over all those worries and warnings about manipulation and terminal nighttime dependency. You’re probably familiar with the long litany of “you’ll-be-sorry” reasons. Well, we are not sorry; we’re happy. Hayden opened up a new whole wonderful nighttime world for us that we now want to share with you.

Sleeping with Hayden opened our hearts and minds to the fact that there are many nighttime parenting styles, and parents need to be sensible and use whatever arrangement gets all family members the best night’s sleep. Over the next sixteen years we slept with four more of our babies (one at a time). While it’s nice to now have the bed to ourselves, we have these special nighttime connection memories.

Not an unusual custom At first we thought we were doing something unusual, but we soon discovered that many other parents slept with their babies, too. They just don’t tell their doctors or in-laws about it. In social settings, when the subject of sleep came up, we admitted that we slept with our babies. Other parents would secretly “confess” that they did, too. Why should parents have to be so hush-hush about this nighttime parenting practice and made to feel they are doing something strange? Most parents throughout the world sleep with their infants. Why is this beautiful custom taboo in our society? How could a culture be so educated in other things, yet be so misguided in parenting styles?

Co-Sleeping: What to call it Sleeping with your baby has various labels: The earthy term “family bed,” while appealing to many, is a turn-off to parents who imagine a pile of kids squeezed into a small bed with dad and the family dog perched precariously on the mattress edge. “Co-sleeping” sounds more like what adults do. “Bed-sharing” is the term frequently used in medical writings. I prefer the term “sleep- sharing” because, as you will learn, a baby shares more than just bed space. An infant and mother sleeping side by side share lots of interactions that are safe and healthy.

A mindset more than a place to sleep Sharing sleep involves more than a decision about where your baby sleeps. It is a mindset, one in which parents are flexible enough to shift nighttime parenting styles as circumstances change. Every family goes through nocturnal juggling acts at different stages of children’s development. Sharing sleep reflects an attitude of acceptance of your baby as a little person with big needs. Your infant trusts that you, his parents, will continually be available during the night, as you are during the day. Sharing sleep in our culture also requires that you trust your intuition about parenting your individual baby instead of unquestionably accepting the norms of American society. Accepting and respecting your baby’s needs can help you recognize that you are not spoiling your baby or letting him manipulate you when you welcome him into your bed.

What I noticed about co-sleeping In the early years of sleeping with our babies, I watched the sleep-sharing pair nestled next to me. I truly began to believe that a special connection occurs between the sleep-sharing pair that has to be good for baby. Was it brain waves, motion, or just something mysterious in the air that occurs between two people during nighttime touch? I couldn’t help feeling there was something good and healthful about this arrangement. Specifically, I noticed these special connections:

• Martha and baby naturally slept on their sides, belly-to-belly facing each other. Even if they started out at a distance, baby would naturally gravitate toward Martha, their heads facing each other, sort of a breath away. Most of the sleep-sharing mothers I have interviewed spend most of their night naturally sleeping on their backs or sides (as do their babies), positions that give mother and baby easier access to each other for breastfeeding. Other researchers have recently reported the prevalence of the face-to-face position during sleep-sharing (Mosko and McKenna 1994). When I noticed this face-to-face, almost nose- to-nose position, I wondered if the respiratory gasses from mother’s nose might affect baby’s breathing, and there is some experimental evidence to support this. Could there be sensors in a baby’s nose that detect mother’s breath, so that she is acting like a pacemaker or breathing stimulus?

Researchers have discovered that the lining of the nose is rich in receptors that may affect breathing, though their exact function is unknown. Perhaps mother’s breath and/or smell stimulates some of these receptors, and thus affects baby’s breathing. One of the main gases in an exhaled breath is carbon dioxide, which acts as a respiratory stimulant. Researchers have recently measured the exhaled air coming from a mother’s nose while sleeping with her baby. They confirmed this logical suspicion that the closer baby is to mother’s nose, the higher is the carbon dioxide concentration of the exhaled air, and the concentration of carbon dioxide between the face-to-face pair is possibly just the right amount to stimulate breathing.

• As I watched the sleeping pair, I was intrigued by the harmony in their breathing. When Martha took a deep breath, baby took a deep breath. When I draped our tiny babies skin- to-skin over my chest, (a touch I dubbed “the warm fuzzy”), I noticed their breathing would synchronize with the rise and fall of my chest.

• The sleep-sharing pair is often, but not always, in sleep harmony with each other. Martha would often enter a state of light sleep a few seconds before our babies did. They would gravitate toward one another, and Martha, by some internal sensor, would turn toward baby and nurse or touch her, and the pair would peacefully drift back to sleep, often without either member awakening. Also, there seemed to be occasional simultaneous arousal. When Martha or the baby would stir the other would also move. After spending hours watching these sleeping beauties, I was certain that each member of the sleep- sharing pair affects the sleep patterns of the other, yet I could only speculate how. Perhaps these mutual arousals allow mother and baby to “practice” waking up in response to a life-threatening event. (If SIDS is a defect in arousability from sleep, perhaps this practice would help baby’s sleep arousability mature.)

• Then there was the “reach-out-and-touch-someone observation.” The baby would extend an arm, touch Martha, take a deep breath and resettle.

• I was amazed by how much interaction went on between Martha and our babies when they shared sleep. One would wiggle and the other would wiggle. Martha, even without awakening, would reach out and touch the baby who would move a bit in response to her touch. She would periodically semi-awaken to check on the baby, rearrange the covers, and then drift easily back to sleep. It seemed that baby and mother spent a lot of time during the night checking on the presence of each other. I did not miss the hours of sleep I gave up to study this fascinating relationship.

Our son, Dr. Jim, an avid sailor, offers a father’s viewpoint on co-sleeping sensitivity: “People often ask me how a sailor gets any sleep when ocean racing solo. While sleeping, the lone sailor puts the boat on autopilot. Because the sailor is so in tune with his boat, if the wind shifts so that something is not quite right with the boat, the sailor will wake up.”

In essence, the sleep-sharing pair seemed to enjoy a mutual awareness without a mutual disturbance.

Our experiments In 1992 we set up equipment in our bedroom to study eight-week-old Lauren’s breathing while she slept in two different arrangements. One night Lauren and Martha slept together in the same bed, as they were used to doing. The next night, Lauren slept alone in our bed and Martha slept in an adjacent room. Lauren was wired to a computer that recorded her electrocardiogram, her breathing movements, the airflow from her nose, and her blood oxygen level. The instrumentation was painless and didn’t appear to disturb her sleep. Martha nursed Lauren down to sleep in both arrangements and sensitively responded to her during the nighttime as needed. (The equipment was designed to detect only Lauren’s physiologic changes during sleep. The equipment did not pick up Martha’s signals.) Martha nursed Lauren down to sleep in both arrangements and sensitively responded to Lauren’s nighttime needs. A technician and I observed and recorded the information. The data was analyzed by computer and interpreted by a pediatric pulmonologist who was “blind” to the situation—that is, he didn’t know whether the data he was analyzing came from the shared-sleeping or the solo-sleeping arrangement.

Our study revealed that Lauren breathed better when sleeping next to Martha than when sleeping alone. Her breathing and her heart rate were more regular during shared sleep, and there were fewer “dips,” low points in respiration and blood oxygen from stop-breathing episodes. On the night Lauren slept with Martha, there were no dips in her blood oxygen. On the night Lauren slept alone, there were 132 dips. The results were similar in a second infant, whose parents generously allowed us into their bedroom. We studied Lauren and the other infant again at five months. As expected, the physiological differences between shared and solo sleep were less pronounced at five months than at two months.

In 1993 I was invited to present our sleep-sharing research to the 11th International Apnea of Infancy Conference, since this was the first study of sleep-sharing in the natural home environment (Sears, 1993). Certainly our studies would not stand up to scientific scrutiny, mainly because we only studied two babies. We didn’t intend them to; it would be presumptuous to draw sweeping conclusions from studies in only two babies. We meant this only to be a pilot study. But we learned that with the availability of new microtechnology and in-home, nonintrusive monitoring, my belief about the protective effects of sharing sleep was a testable hypothesis. I hoped this preliminary study would stimulate other SIDS researchers to scientifically study the physiological effects of sharing sleep in a natural home environment.

Co-sleeping research The physiological effects of sleep-sharing are finally being studied in sleep laboratories that are set up to mimic, as much as possible, the home bedroom. Over the past few years, nearly a million dollars of government research money has been devoted to sleep-sharing research. These studies have all been done on mothers and infants ranging from two to five months in age. Here are the preliminary findings based on mother-infant pairs studied in the sleep-sharing arrangement versus the solitary-sleeping arrangement:

1. Sleep-sharing pairs showed more synchronous arousals than when sleeping separately. When one member of the pair stirred, coughed, or changed sleeping stages, the other member also changed, often without awakening.

2. Each member of the pair tended to often, but not always, be in the same stage of sleep for longer periods if they slept together.

3. Sleep-sharing babies spent less time in each cycle of deep sleep. Lest mothers worry they will get less deep sleep; preliminary studies showed that sleep-sharing mothers didn’t get less total deep sleep.

4. Sleep-sharing infants aroused more often and spent more time breastfeeding than solitary sleepers, yet the sleep-sharing mothers did not report awakening more frequently.

5. Sleep-sharing infants tended to sleep more often on their backs or sides and less often on their tummies, a factor that could itself lower the SIDS risk.

6. A lot of mutual touch and interaction occurs between the sleep-sharers. What one does affects the nighttime behavior of the other. Even though these studies are being conducted in sleep laboratories instead of the natural home environment, it’s likely that within a few years enough mother-infant pairs will be studied to scientifically validate what insightful mothers have long known: something good and healthful occurs when mothers and babies share sleep.

Stories from co-sleeping parents: I have selected the following quotes from my gallery of medical testimonies from my “consultants.” These are professional mothers who have lots of intuition. Many are also pediatric nurses. Some of these mothers slept with their babies for fear of SIDS. These savvy women know babies.

“During the first six months of Leah’s life, I noticed some dramatic differences in her sleeping when I wasn’t sleeping next to her. In the morning I would often get up while she was still sleeping. Since I had the monitor on, I would hear loud and irregular breathing patterns rather than the quiet and regular breathing patterns she had when we slept together. There was a definite change in her breathing patterns after I would get out of bed. I think that I actually helped her breathe. Maybe I was her pacemaker. I also noticed that when she was five-months-old and I would get out of bed that after a while she would roll over onto her belly. She never rolled onto her belly when I slept next to her. She was always on her side or back.”

“When my baby slept with me, I noticed there were times when he would stop breathing. I would wait, and wait, and wait and no breath would come. When I felt I had waited long enough, I would take a deep breath. At that very instant, so would Zach! Hearing my breathing actually stimulated his breathing impulses.”

“Our newborn was on a monitor and slept in a cradle next to our bed. One night I heard her gasping. I know baby noises, and these weren’t normal noises. As soon as I picked her up and put her next to me in bed, she breathed regularly. My pediatrician told me I was just a nervous mother. If her breathing didn’t wake her up, it wasn’t a problem. He told me it was my problem, and if I moved her out of our room I wouldn’t hear her. I kept badgering pediatricians to study her and indeed they found she had apnea eighteen percent of the time. When she slept with me I noticed a difference. She breathed with me. My doctor still thought I was a nervous, crazy woman, and said she would be fine if I would just leave her alone.”

“When my baby was three-months-old I went back to work part-time in the evenings. She became fussy and cried most of the time I was gone. By the time she went to sleep, she had worked herself into such a hysterical state that she cried herself to sleep. I feel that messed up her breathing. I would come home from work and put my ear down next to her crib, and I couldn’t hear her breathing. Every seven or eight seconds she would take one or two gasps, and that’s all I could hear. As soon as I picked her up and lay down with her on my bed, she started breathing more calmly and regularly again. She continued this panicky breathing in her crib at night for about a month. After that, I quit work and slept with her every night. That was my husband’s idea. My friends told me to let her cry it out and that she had to learn to sleep by herself. The panicky breathing that I heard when she slept alone in the crib was not the sleep that I wanted her to learn.”

“My baby usually sleeps with me, but sometimes he sleeps alone. When he sleeps alone he wakes up after a short while afraid. I believe that it is the afraidness that causes SIDS.”

“My baby had a cold for a couple of weeks and one night she woke up in her crib gasping and struggling to breathe. Her breathing seemed obstructed, but after ten minutes she was fine. I took her to the doctor the next day, and he reassured me, ‘There’s never a warning sign of SIDS. There is never a precursor.’ I wondered, “Is that because most babies are in cribs and no one witnesses the warning signs?”

“My baby had a breathing problem at night and seizures that were diagnosed as Sandifers Syndrome with reflux and a seizure disorder. The sleep study at one university hospital was done while baby was sleeping alone in a crib, and showed irregular breathing. I told the doctor that she normally slept with me, but he said it would make no difference and that he wanted to treat her with medication and put her on a heart monitor. She was now four months of age. I got a second opinion at another university hospital, where I asked them to do the same study while she slept with me. It showed normal results and the doctors advised me to stop the monitor and that nothing further needed to be done.”

“Our baby would breathe like a choo-choo train when sleeping alone. When I would go over and touch him, he would breathe normally. When I took him into our bed, he would breathe normally.”

“I don’t want to sound psychic, but I know we are on the same brain wave when we sleep together. We seem to be in perfect nighttime harmony. He nurses at night and I don’t even wake up. Because of this, my life is so much easier than with my first baby.”

“At first I thought sleeping with your baby was nuts. Then our ten-week-old infant was diagnosed with gastroesophageal reflux . I realized I couldn’t let him cry at night. It would be dangerous because crying brings on the reflux. So I slept with him, and he cried less. Now I’m so used to his breathing patterns that I wake up shortly before he does or when his breathing patterns change.” “Because we had two relatives who lost babies to SIDS, we monitored our first baby, and he slept with me. I recognized when his breathing rhythm changed. My husband and I would wake up seconds before the monitor went off. When I tapped and stroked him, he would start to breathe again.”

“With my first baby, for fear of spoiling, I didn’t let her sleep with me (now I know differently), but she slept within inches of me in a bassinet next to my bed. When she was three-and-a-half- months-old, I transferred her to a crib in her own room. That night I awoke in the middle of the night with a panicky feeling that I had to get to her. I found her not breathing. I gave her a shake and she started breathing. Evaluation at a children’s hospital showed that she had frequent periods of apnea, from ten to fifty a night, and we hadn’t even been aware of this. Then she went on a monitor, and our life revolved around the monitor. I was still afraid to sleep with her in my bed, because at that time the monitors didn’t have a disconnect alarm, and I was afraid I would disconnect the monitor and wouldn’t hear it if she had an apnea period. On many nights the alarm would go off every ten minutes to an hour. When she was around four-months, in desperation to get some sleep, I would sleep with her on my chest in a reclining chair. On those nights, we all slept better and there were no alarms. Even when we were sleeping separately, many times I would awaken immediately before the apnea alarm went off. I believe I had a connection to her. I felt a need to have her close to me. I think breastfeeding her and holding her a lot during the day helped give me that connection.”

“Our baby has asthma, and I notice that if he sleeps in our bed his breathing is more regular and not as fast as when he sleeps alone. My husband has found he can also affect Nathaniel’s breathing by pulling him close to his chest with a big “bear hug cuddle” and breathing slow and deep. This has become part of our asthma plan. Not only has it helped Nathaniel have more restful nights and require less medication, but my husband and I have more restful nights as well.”

“Each of our five children slept in our bed until two-and-a-half to three- and-a-half-years-of-age, when they chose to move out. I noticed that they all slept with their faces toward mine and if I turned my face away from theirs, they’d awaken. I truly believe that babies and mothers breathe in synchrony, and when one stirs, so does the other. It always seems like I awaken with our babies, not after them. I believe this breathing connection is responsible for it.”

“I slept with all six of my babies, and I think their breathing was more regular when they slept next to me. When I watched them sleep alone in the crib, their breathing seemed more irregular.”

“Our sleep cycles seem to be in tune. I wake up a few seconds before she does.”

“If it weren’t for our daughter, we never would have considered sleep- sharing. During our childbirth classes the instructor mentioned, ‘You might think about sharing sleep with your baby.’ My husband and I looked at each other and said, ‘That sounds liberal. No way, thank you. She will have her own bed in her own room.’ One afternoon when our baby was twenty-days-old, the high winds in our house caused the door to her bedroom to slam loudly. I thought she’d be scared, so I quickly went in to check on her. I found her gray, ashen, limp, and not breathing. I thought she was gone—I’m a paramedic. I grabbed her and she started breathing. After studying several nights of monitor tracings, the doctors concluded that ‘she had numerous episodes of periodic breathing like a 34 or 35-week premature baby.”

“Sort of on the sly, my doctor said, ‘You might consider sleeping with her and nursing her at night while lying next to her. All our babies slept in our bed until they were twelve-to fifteen-months-old, and I’ve heard that a mother’s presence regulates a baby’s heartbeat.’ I then said to my husband, ‘Between my childbirth instructor, my La Leche League leader, Dr. Sears’ books, and now my pediatrician, maybe we should rethink this matter.”

“She slept in our bed the next ten months, monitored only by me. To my knowledge, she never had any more breathing difficulties. When people would say, ‘Oh, she sleeps with you?’ and give me a put-down look, I would simply say, ‘Our doctor says it’s best because it helps her regulate her breathing.’ In my college classes, I get so angry when people equate sleeping with your baby with ‘doing something different.’ It’s natural, like a mother holding a baby. I wish they wouldn’t try to make it such a liberal thing. I can’t express to you how strongly I feel it made a difference. Our next baby will sleep with us.”

From the preceding evidence it seems that separate sleeping is not only unnatural, but may even be dangerous for some babies. Put new research findings together with the intuition of wise parents and you wonder whether sleep-sharing could not only make a psychological difference but also a physiological difference to babies. Each year more and more studies are confirming what savvy parents have long suspected: sharing sleep is not only safe, but also healthy for their babies. Thus, I leave it to parents to consider the following: If there were fewer cribs, would there be fewer crib deaths?

7 benefits of co-sleeping There is no right or wrong place for baby to sleep. Wherever all family members sleep the best is the right arrangement for you. Remember, over half the world’s population sleeps with their baby, and more and more parents in the U.S. are sharing sleep with their little one. Here’s why:

1. Babies sleep better Sleepsharing babies usually go to sleep and stay asleep better. Being parented to sleep at the breast of mother or in the arms of father creates a healthy go-to-sleep attitude. Baby learns that going to sleep is a pleasant state to enter (one of our goals of nighttime parenting).

Babies stay asleep Put yourself in the sleep pattern of baby. As baby passes from deep sleep into light sleep, he enters a vulnerable period for nightwaking, a transition state that may occur as often as every hour and from which it is difficult for baby to resettle on his own into a deep sleep. You are a familiar attachment person whom baby can touch, smell, and hear. Your presence conveys an “It’s OK to go back to sleep” message. Feeling no worry, baby peacefully drifts through this vulnerable period of nightwaking and reenters deep sleep. If baby does awaken, she is sometimes able to resettle herself because you are right there. A familiar touch, perhaps a few minutes’ feed, and you comfort baby back into deep sleep without either member of the sleep- sharing pair fully awakening. Many babies need help going back to sleep because of a developmental quirk called object or person permanence. When something or someone is out of sight, it is out of mind. Most babies less than a year old do not have the ability to think of mother as existing somewhere else. When babies awaken alone in a crib, they become frightened and often unable to resettle back into deep sleep. Because of this separation anxiety, they learn that sleep is a fearful state to remain in (not one of our goals of nighttime parenting).

2. Mothers sleep better Many mothers and infants are able to achieve nighttime harmony: babies and mothers get their sleep cycles in sync with one another. Martha notes: “I would automatically awaken seconds before my baby would. When the baby started to squirm, I would lay on a comforting hand and she would drift back to sleep. Sometimes I did this automatically and I didn’t even wake up.”

Contrast co-sleeping with the crib and nursery scene. The separate sleeper awakens – alone and behind bars. He is out of touch. He first squirms and whimpers. Still out of touch. Separation anxiety sets in, baby becomes scared, and the cry escalates into an all-out wail or plea for help. This piercing cry awakens even the most long distance mother, who jumps up (sometimes out of the state of deep sleep, which is what leads to most nighttime exhaustion), and staggers reluctantly down the hall. By the time mother reaches the baby, baby is wide awake and upset, mother is wide awake and upset, and the comforting that follows becomes a reluctant duty rather than an automatic nurturant response. It takes longer to resettle an upset solo sleeper than it does a half-asleep baby who is sleeping within arm’s reach of mother. Once baby does fall asleep, mother is still wide-awake and too upset to resettle easily. If, however, the baby is sleeping next to mother and they have their sleep cycles in sync, most mothers and babies can quickly resettle without either member of the co-sleeping pair fully awakening. Being awakened suddenly and completely from a state of deep sleep to attend to a hungry or frightened baby is what leads to sleep-deprived parents and fearful babies.

3. Breastfeeding is easier Most veteran breastfeeding mothers have, for survival, learned that sharing sleep makes breastfeeding easier. Breastfeeding mothers find it easier than bottle-feeding mothers to get their sleep cycles in sync with their babies. They often wake up just before the babies awaken for a feeding. By being there and anticipating the feeding, mother can breastfeed baby back to a deep sleep before baby (and often mother) fully awakens.

A mother who had achieved nighttime-nursing harmony with her baby shared the following story with us: “About thirty seconds before my baby wakes up for a feeding, my sleep seems to lighten and I almost wake up. By being able to anticipate his feeding, I usually can start breastfeeding him just as he begins to squirm and reach for the nipple. Getting him to suck immediately keeps him from fully waking up, and then we both drift back into a deep sleep right after feeding.”

Mothers who experience daytime breastfeeding difficulties report that breastfeeding becomes easier when they sleep next to their babies at night and lie down with baby and nap nurse during the day. We believe baby senses that mother is more relaxed, and her milk-producing hormones work better when she is relaxed or sleeping.

4. It’s contemporary parenting Co-sleeping is even more relevant in today’s busy lifestyles. As more and more mothers, out of necessity, are separated from their baby during the day, sleeping with their baby at night allows them to reconnect and make up for missed touch time during the day. As a nighttime perk, the relaxing hormones that are produced in response to baby nursing relax a mother and help her wind down from the tension of a busy day’s work.

5. Babies thrive better Over the past thirty years of observing co-sleeping families in our pediatric practice, we have noticed one medical benefit that stands out; these babies thrive . “Thriving” means not only getting bigger, but also growing to your full potential, emotionally, physically, and intellectually. Perhaps it’s the extra touch that stimulates development, or perhaps the extra feedings (yes, co- sleeping infants breastfeed more often than solo sleepers).

6. Parents and infants become more connected Remember that becoming connected is the basis of parenting, and one of your early goals of parenting. In our office, we keep a file entitled “Kids Who Turned Out Well, What Their Parents Did.” We have noticed that infants who sleep with their parents (some or all of the time during those early formative years) not only thrive better, but infants and parents are more connected.

7. Reduces the risk of SIDS New research is showing what parents the world over have long suspected: infants who sleep safely nestled next to parents are less likely to succumb to the tragedy of SIDS. Yet, because SIDS is so rare (.5 to 1 case per 1,000 infants), this worry should not be a reason to sleep with your baby. (For in depth information on the science of co-sleeping and the experiments showing how sleep benefits a baby’s nighttime physiology.

Co-sleeping does not always work and some parents simply do not want to sleep with their baby. Co-sleeping is an optional attachment tool. You are not bad parents if you don’t sleep with your baby. Try it. If it’s working and you enjoy it, continue. If not, try other sleeping arrangements (an alternative is the sidecar arrangement: place a crib or Arm’s Reach® Co-Sleeper® adjacent to your bed).

New parents often worry that their child will get so used to sleeping with them that he may never want to leave their bed. Yes, if you’re used to sleeping first-class, you are reluctant to be downgraded. Like weaning from the breast, infants do wean from your bed (usually sometime around two years of age). Keep in mind that co-sleeping may be the arrangement that is designed for the safety and security of babies. The time in your arms, at your breast, and in your bed is a very short time in the total life of your child, yet the memories of love and availability last a lifetime.

Co-sleeping and SIDS Since research suggests that infants at risk of SIDS have a diminished arousal response during sleep, it seems logical that anything that increases the infant’s arousability from sleep or the mother’s awareness of her infant during sleep may decrease the risk of SIDS. That’s exactly what sleeping with your baby can do. Here are the vital roles a sleep-sharing mother plays:

DR. SEARS SIDS HYPOTHESIS: I believe that in most cases SIDS is a sleep disorder, primarily a disorder of arousal and breathing control during sleep. All the elements of natural mothering, especially breastfeeding and sharing sleep, benefit the infant’s breathing control and increase the mutual awareness between mother and infant so that their arousability is increased and the risk of SIDS decreased.

Mother acts as pacemaker A major part of my sleep-sharing hypothesis is that mother can act as a breathing pacemaker for her baby. Picture what happens when mother and baby sleep side by side. Mother acts like a breathing pacemaker for her baby during sleep. Together they develop what we call “sleep harmony.” Both members of the sleeping pair have simultaneous sleep stages, perhaps not perfectly attuned and not all night long, but close enough that they are mutually aware of each others presence without disturbing each others sleep. Because of this mutual sensitivity, as baby normally cycles from deep sleep into light sleep, the presence of the mother raises baby’s arousability and awareness. As previously discussed the lack of arousability or ascending out of deep sleep may characterize infants at risk for SIDS. Countless times a mother has said to me, “I automatically awaken just before my baby starts to stir and I nurse her back to sleep. Usually neither of us fully awakens, and we both quickly drift back to sleep.”

While watching Martha sleep next to our babies, I noticed how frequently she would attend to our infant’s nighttime needs, often without even waking up. Several times throughout the night she would adjust baby’s covers, nurse, or do whatever seemed right for baby’s well-being. This sleeping arrangement does not imply that a mother should think of herself as a lifeguard, keeping watch every sleeping hour, day and night, for six months or feel that she is an inadequate parent if she chooses not to do so. This attitude puts fear into and takes the joy out of nighttime parenting. I’m simply talking about forgetting cultural norms and doing what comes naturally. Don’t feel that you must never let your baby sleep alone or that you must go to bed early with baby every night. Remember that SIDS is a relatively uncommon occurrence, not a nightly threat to your baby’s life.

Mother fills in a missing ingredient In the early months, much of a baby’s night is spent in active sleep—the state in which babies are most easily aroused. As we discussed previously, this state may “protect” the infant against stop- breathing episodes. From one to six months, the time of primary concern about SIDS, the percentage of active sleep decreases, and quiet, or deeper, sleep increases. More deep sleep means that babies start to sleep through the night. That’s the good news. The concern, however, is that as baby learns to sleep deeper, it is more difficult for him to arouse when there is an apnea episode, and the risk of SIDS increases. By six months, the baby’s cardiopulmonary regulating system has matured enough that the breathing centers in the brain are better able to restart breathing, even in deep sleep. But there is a vulnerable period between one and six months when the sleep is deepening, yet the compensatory mechanisms are not yet mature. During the time baby is at risk, mother fills in. In fact, mother sleeps like a baby until the baby is mature enough to sleep like an adult. That warm body next to baby acts as a breathing pacemaker, sort of reminding baby to breathe, until the baby’s self-start mechanisms can handle the job on their own When Will My Baby Sleep Through the Night!? You Want the Good News or the Bad News First? | progressiveparentingnetwork 8/17/14 9:09 PM

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When Will My Baby Sleep Through the Night!? You Want the Good News or the Bad News First?

by Gena on May 17, 2014 in Co-Sleeping, newborn care, Parenting

Photo Via API Click here for great info

Babies and children have needs at night just as they do during the day; from hunger, loneliness, and fear, to feeling too hot or too  cold. They rely on parents to soothe them and help them regulate their intense emotions.

The GOOD News is babies are not meant to sleep through the night because it’s not safe for them to. The BAD news is babies are not meant to sleep through the night because it’s not safe for them to. So here is the ugly truth, being a parent is hard. There is no getting around it. For about the first five years of their lives MOST children will not sleep through the entire night. There I said it and I wish more people would. Being a parent doesn’t nor should it end when you go to sleep. Our children need us and like fire fighters we need to expect that they will need us at any time of day, and we should be prepared. Unlike fire fighters we don’t have to get dressed before we have to put out a fire/night terror. And hey isn’t that in the job description as a parent any way? Sleep is important and without it some of us can get tired, even cranky, which can lead to frustration and when you are all of these things it’s easy to make decisions you may not have made had you been well rested.

“Parents who are frustrated with frequent waking or who are sleep deprived may be tempted to try sleep training techniques that  recommend letting a baby cry in an effort to “teach” him to “self-soothe”. New research suggests that these techniques can have detrimental physiological effects on the baby by increasing the stress hormone cortisol in the brain, with potential long term effects to emotional regulation, sleep patterns and behavior. An infant is not neurologically or developmentally capable of calming or soothing himself to sleep in a way that is healthy. The part of the brain that helps with self-soothing isn’t well developed until the child is two and a half to three years of age. Until that time, a child depends on his parents to help him calm down and learn to regulate his intense feelings.” -API

We Haven’t Always Slept Alone!

“It’s important to note that infant solitary sleep is a relatively new practice that has evolved in the western world only within the last 100 years. Recently, there have been efforts by various medical and professional organizations to discourage parents from sleeping with

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their children for fear that it contributes to an increase in Sudden Infant Death Syndrome (SIDS). However, new research demonstrates that co-sleeping, when practiced by informed parents, can be safe and beneficial. In fact, many cultures where parents routinely sleep with their children report some of the lowest SIDS rates. In some of these cultures SIDS is non-existent. API encourages parents to respond to their children’s needs at night just as they do during the day. Parents are also encouraged to explore the variety of different sleeping arrangements, and to choose the approach that best allows them to be responsive at night. Individual babies’ sleep patterns and needs vary a great deal. Remain flexible and understand that it is developmentally appropriate and normal for babies to wake up during the night to feed and seek contact.”-API

Many of our generation cried ourselves to sleep as infants and sleep for most adults now is a major issue.

Do you know how you were parented at night? My husband and I recently discovered our Cry It Out pasts.

I believe HOW we were brought up has a little to do with how we raise our babies.

Shared sleeping arrangements allow parents to pay attention to infants’ signaling which  helps the infant learn to regulate emotional responses. According to Dr. Sears: ” Nightwaking has developmental benefits. Sleep researchers believe that babies sleep “smarter” than adults do. They theorize that light sleep helps the brain develop because the brain doesn’t rest during REM sleep. In fact, blood flow to the brain nearly doubles during REM sleep. (This increased blood flow is particularly evident in the area of the brain that automatically controls breathing.) During REM sleep the body increases its manufacture of certain nerve proteins, the building blocks of the brain. Learning is also thought to occur during the active stage of sleep. The brain may use this time to process information acquired while awake, storing what is beneficial to the individual and discarding what is not. Some sleep researchers believe that REM sleeps acts to auto-stimulate the developing brain, providing beneficial imagery that promotes mental development. During the light sleep stage, the higher centers of the brain keep operating, yet during deep sleep these higher brain centers shut off and the baby functions on her lower brain centers. It is possible that during this stage of rapid brain growth (babies’ brains grow to nearly seventy percent of adult volume during the first two years) the brain needs to continue functioning during sleep in order to develop. It is interesting to note that premature babies spend even more of their sleep time (approximately 90 percent) in REM sleep, perhaps to accelerate their brain growth. As you can see, the period of life when humans sleep the most and the brain is developing the most rapidly is also the time when they have the most active sleep.”

With my kids sleep history the above means my kids are going to be super geniuses! While getting little sleep is no laughing matter, it s a part of early parenthood. I recently discovered that the word sacrifice in it’s origin means to make something sacred. Our early parenting years, as hard as they may be, in the end IS sacred and the loss of sleep that I had been so used to, up until my decision to have a baby is worth this very very sacred time in their and our lives. OKAY OKAY you say, but WHEN is my baby going to SLEEP THROUGH THE NIGHT? More “bad” news…no one can say because babies are all so different from one another. Keep in mind the size of your babies tummy. You are saying, “Stomach?! Sleep?! What are you talking about?!” When your baby is born their tummy is about the size of a marble and even at three months it’s the size of a ping pong ball. In the first three months, tiny babies seldom sleep for more than four-hour stretches without needing a feeding. Then from three to six months, most babies begin to settle. Thank goodness!. They are awake for longer stretches during the day and some may sleep five-hour stretches at night. Between three to six months, expect one or two nightwakings. You will also see the period of deep sleep lengthen. The vulnerable periods for nightwaking decrease and babies are able to enter deep sleep more quickly. Dr. Sears calls this “sleep maturity”. BUT MY FRIENDS KIDS SLEEP THROUGH THE NIGHT. LIES!!!! (mostly) Please remember that your baby’s sleep habits are more about your baby’s temperament rather than how you parent at night. The ugly truth is that other parents usually exaggerate how long their baby sleeps, as if this makes you a good parent, it doesn’t. It is NOT your fault baby wakes up. But they DO wake up. WHEN your baby reaches “sleep maturity” unfortunately, varies. now bear in mind even WHEN they achieve this “sleep maturity around the last half of the first year, they STILL wake up. WHY!?!? You say rubbing your eyes and yawning. Well painful stuff like teething pain, and colds pop up. When your little ones start doing big kid stuff like sitting, crawling, and walking, your baby will “practice” these new skills in their sleep. Then between one and two years of age, when your baby starts to sleep through the above-mentioned wake-up stimuli, other causes of nightwaking occur, such as separation anxiety and nightmares. BUT WHAT ABOUT YOU?! So now you know, but sleep is still important for you. In the http://progressiveparentingnetwork.com/when-will-my-baby-sleep-through-the-night-you-want-the-good-news-or-the-bad-news-first-2/ Page 2 of 4 When Will My Baby Sleep Through the Night!? You Want the Good News or the Bad News First? | progressiveparentingnetwork 8/17/14 9:09 PM

early days of parenting, even before baby is born, set up your own village that it will take to raise this baby. Ask for help. There are plenty of folks in your life willing to play with or just look adoringly after your baby while you get some sleep. Having grandma or a best friend hold your child for four hours while you get your Sleep Maturity on can be a life saver. Consider registering for a post partum doula in those first few days and weeks after baby is born. IT’S NOT ABOUT BEING PERFECT We did a series on Attachment Parenting on our radio show. These shows were emotionally moving for me. I always say I am not an expert & as it turns out, I am most certainly not an expert, these shows have helped me reconnect, pause and strive to be a better mom. There is no such thing as a perfect parent. That’s not my goal. Personally I just want to do better for my children. I want to be responsible and I want to be kind. That’s it. AP isn’t about being perfect. It’s about finding out that there are different ways to parent, the information I get from API has helped me understand that the things I’ve done instinctually are backed up by science and common sense. I am grateful to API and if you are too please feel free to be as generous as possible and give back.

Ensure Safe Sleep, Physically and Emotionally CLICK HERE TO LISTEN TO BROADCAST

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