Some valuable information on Co-Sleeping and Breastfeeding

One of our alert readers directed us to this article on the virtues of co-sleeping especially when breastfeeding.  And we say: if it works for you, then go for it.  Just please, please, please follow the basic rules that we outlined earlier: no gap between the headboard and mattress; no excess of bedding; no exceedingly soft surfaces; baby positioned to sleep on her back.

Another thing with all of the recommendations that Denise and I make here: if you don't view sleep as an issue, then it's not an issue.  So, if you, your bedpartner and your child are all comfortable and are not experiencing daytime fatigue and all feel that the amount of sleep that each of you is getting is adequate, then you don't have a problem.  If you have a problem (frequent awakenings during the night unrelated to feeding an infant; excessive daytime sleepiness; infant with slow growth), then the co-sleeping situation should be examined to see if changing it changes the issues.

As opposed to Gisele Bundchen dictated that all mothers should always breastfeed their babies for at least a year and every mom who either failed at breastfeeding or returned to a job outside of the home freaked out, we, the Sleep Tech Moms, recognize that there is a unique solution for sleep for every family and that there are as many iterations of sleeping as there are families.  And while, as sleep techs, we are always prepared to glue wires all over the head of anyone who sits still long enough for us to do so, we are aware that the sterile environment of the lab is not necessarily how people sleep in their homes.

So there.

New info on SIDS

So, we inadvertantly (well, at least unintentionally) opened a small can of baby worms with our last post.  Here is a VERRRRY academic article on SIDS that is quite thorough in its analysis.  And, if you skip through most of the parts with the really big words and any part that says "pathophysiologically" or "biomarkers" or what have you and skip to the summary, there you will find that the author has listed out the risk factors for SIDS.  As with so many diseases and disorders of infancy, Being Born Poor is the worst thing that a baby can do.  Being Born Poor and to a mother who smoked during pregnancy and into a household where there is tobacco smoke and in which baby is put to sleep lying on his belly or on a couch is even worse.  So, while co-sleeping is mentioned, it's not the devil that our last post may have been interpreted to say it is.

Another separate post on co-sleeping will follow, however, it is our feeling that the best place for newborn babies (less than 12 weeks) is in the parent(s)'s room in a separate spot for baby (e.g., bassinet, baby basket, etc.)  Apparently, it is no longer considered safe to do as Trixie did with her Little Ones, which is to put them in their car seats.  Here is an article published in the journal Pediatrics in 2009 that showed lower oxygen levels for two day old infants placed in car seats versus beds.  While the study isn't controlled all that well, the evidence here does suggest that sleeping long-term in a car seat is not ideal.  A brief review of the chat rooms out there showed that many parents do use the car seat, especially when dealing with reflux.

Finally, if you do decide to bring Baby into your bed, remember to make sure that there is no loose bedding (pillows, covers, the Sunday Times) that could cover Baby's face.  Check that there isn't a Baby-size gap between the headboard and the mattress.  Place Baby on her back, preferably on the mattress, and never on anything too soft (like a comforter.)

And always remember to discuss sleep with your pediatrician!

No, No Newbies!

DO NOT let your newborn infant sleep with you in your bed!  The voice in your head telling you not to is not a paranoid voice, it is a sensible voice, eked out from millennia of evolutionary progress.  Put your newborn in her car-seat thingy and set it on the floor next to your bed or put him in a laundry basket on HIS BACK next to your bed but DO NOT sleep with your infant in your bed.  Especially not with your and your equally sleep-deprived partner.  It seems sort of dangerous because it is sort of dangerous.  And yes, sleeping in the parental bed is a CAUSE of Sudden Infant Death Syndrome.  The baby can be in your room, in arm's reach, and NOT in your bed.
Here is what the Mayo Clinic has to say on the subject of SIDS.

Again, we are sleep techs and understand sleep deprivation.  Please, please put your infant to sleep somewhere other than your bed.

Dr. Dennis Rocks!

We are chagrined that we didn't post this link earlier:
Dr. Dennis Rosen weighs in on study in the journal Pediatrics

We have said it before and we will say it again: turn off the teevee!  Television is stimulating to kids, even if they appear zoned out.  There is no reason to have a television set in a young child's bedroom (and we are against television in anyone's bedroom since bedrooms are for sleeping (and possibly for canoodling, but this is sleep therapy, not sex therapy, so we won't go there.))

Recently, Trixie's pre-schooler has fallen asleep while Trixie read to him in his bed.  While this may be because Trixie is really boring and chose excerpts from a medical textbook to read, it still is really a lovely thing to have your child curl into you and be lulled to sleep by the sound of your voice.

Save the tube time for when you are doing something important, like surfing the Internets or updating your Facebook profile.  Bedtime is not screen-time.

That's the Way the Cookie Crumbles

So, Denise walks into work last night and is confronted with a four year old, who, according to his mother, will not go to sleep, will not go to sleep without the television on, is being worked up for ADHD (did we mention that this child is FOUR YEARS OLD?) and will not stay in his own bed.  Denise introduces herself to Little Jakey (not his real name) and notices cookie crumbs all around the cherub's mouth and on the bed.  Not JUST cookie crumbs, mind you: these are OREO crumbs.  Which are made of chocolate.  Which is like giving a four year old, who is coming to a HOSPITAL for a SLEEP TEST, a double espresso.  Denise is able to get Jakey to go to bed with lights out and TV OFF at 9:15 (despite protestations from Mom.)  Jakey sleeps through the night with very few awakenings: a normal sleep study.  Mom also noted that, at home, Jakey is put to bed at 8PM and is awakened at 7AM.  For this kiddo, that is too much sleep.  Pushing bedtime back by an hour should assure that Jakey will sleep through the night.  Additionally, at home, when Jakey awakens, he goes into the parents' bed and is allowed to stay because THEY ARE TOO TIRED TO PUT HIM BACK IN HIS BED.  Newsflash: he ain't gonna go on his own, sistah.

So, what have we learned here?

• Oreos are only to be eaten by the Sleep Technologists, who are very hungry.
• It is OK to be a parent and to say things like "I am turning the TV off now" and "I am going to put you back in your bed now."  Especially when the child in question is FOUR YEARS OLD!
• If a child is exhibiting symptoms of hyperactivity, cut back on the sugar.
• A child's bedtime is not predicated on when the parent is tired of the child; it is predicated on when the child is tired.

What you'll do on your Summer Vacation

If you are lucky enough to have a vacation scheduled this summer, here are some things to remember when you take your Little Darlings along.  If you have figured out how to have a vacation without dragging the LD's with you, please let us know.

If your child's sleep schedule changes while you are on vacation (whether it's a time zone change or a later bedtime or addition of naps on the beach or any other change), you will pay for it when you get back home.  So, don't expect your child to automatically resume a pre-vacation bedtime routine just because you have to go to work on Monday.  No, no, no.

If, for example, you allowed those cherubs to stay up late and, in turn, sleep in late, you will need to reestablish the routine sleep schedule when you return home.  Bad news here: it may take a week or two of gradually moving the clock back and it will depend on just how lenient you were while on vacation.  If your kiddos usually go to bed by, say, 9PM with a wake-up time of 7AM and, during your week at the Cape, they stayed up until 11:30 and then slept until 9AM, you need to move the whole schedule back two hours.  This will not go over well and you should not try to do it all at once.  However, allowing them to stay up and then yanking them out of bed to go off to camp or child care at the usual early rising time will backfire on both of you in a big way.

The best thing to do is to avoid changing the usual sleep-wake times by too much while you are on vacation.  The less change there is, the easier it will be to get the critters back on routine when you get home.  Which we know may be easier said than done.

Just keep in mind that if you get home from a week away only to find that your kids are miserable and even more disagreeable than usual, you may want to check on the bedtimes.

And don't forget the sunscreen!

Art imitates life. Again.

Denise worked with another patient last week: an adolescent male with ADHD and difficulty initiating and maintaining sleep.  As she always does, since she is perfect, Denise reminded the patient and parent that there should be no chocolate or caffeine consumption prior to lights out and that lights out would be at 10PM.  The patient's father was aghast, since the patient would not, could not, will not go to bed before 1AM.  Sleep Lab rules, Denise said, in the nicest way imaginable.  Let's try it this way for tonight.

A little later, Denise returns to the patient's room only to find crumbs that look suspiciously like CHOCOLATE littering the bed.  Oh, says the patient, I had my nightly CHOCOLATE POP TART.  Um, what was it about "no chocolate" that you didn't understand?  And, Trixie would like to point out, Pop Tarts are the work of the devil and contain nothing but chemicals and high fructose corn syrup, which are bad for you.

Anyhoo, after applying the usual 1000 electrodes and sensors to the patient, Denise prepares the patient for lights out.  And this boy, with his chocolate Pop Tarts and ADHD and inability to fall asleep before 1AM, gets out his cell phone and his iTouch and his Nintendo DS and prepares to fall asleep as he usually does: that is, by NOT sleeping and by STIMULATING his brain with all of this electronic paraphernalia.  So, Denise, bless her heart, turns all of the stuff to the OFF position and leaves the patient and his father sulking.

Lo and behold, the patient was asleep within FIFTEEN MINUTES.  Yet another cure for the Sleep Tech Moms.