Tag Archives: Infant/Toddler Sleep

Feeling Clueless? Reading Your Baby’s Cues

By Meri Levy, MFT

father babyPeople have a physiological reaction to the sound of a baby crying. Our hearts pound, our blood pressure rises, and we start to sweat. This reaction causes most of us to try to stop the crying, regardless of how tired, irritable, or hungry we might be ourselves. And that’s a good thing. It’s how our babies learn to trust that their needs will be met and that the world is a safe place.

But sometimes (often!) new parents wonder what the baby is trying to say? What does the baby need? We run around randomly, trying different remedies: jiggling the baby, rocking the baby, changing her diaper, offering a breast or the bottle, or a pacifier. And sometimes the baby still cries. We desperately want to eliminate the cause of the crying, and we become frustrated, angry or guilty when we fail.

I faced this situation with my first child, Benjamin. I never knew what he wanted. He seemed to be constantly fussing, and I was never very good at calming him (and I did not feel calm myself). My second child, Elijah, always wanted to eat, so it was easier to consistently meet his needs. But I had not really improved my ability to read a baby’s signals.

With my third child, Emma, I hoped and prayed she would never (or rarely) cry, so I wouldn’t feel quite so inadequate again. But in the meantime, I picked up a copy of Secrets of the Baby Whisperer by Tracy Hogg. I had heard her on a talk show, and she claimed she get babies to sleep through the night, on their own, without letting them cry. This was a secret I wanted in on.

What I got from the book was very different from what I expected. The book is not for everyone. The author is not an advocate of “attachment parenting,” for example. But regardless of your parenting philosophy, The Baby Whisperer has a lot of good information about caring for your baby in a respectful way. She focuses on honoring your baby’s individuality, understanding how babies communicate, and learning how to meet their individual needs.

The book prompted me to stop when Emma began to cry, and to really listen and observe her, rather than jumping in and trying to “rescue” her without knowing what she was asking for. When I figured out what she was saying to me, I was in a much better position to meet her needs.

Here are some of the body language cues discussed in the book that I have found helpful:

Tiredness:

    • Yawning;
    • Moving head from side to side;
    • Flailing, uncoordinated arms, clawing at face;
    • Strong, uncoordinated kicking;
    • Bloodshot eyes.

Overstimulation/overtiredness, same as above, plus:

    • Turns away from objects and faces;
    • “Seven-mile stare.”

Hunger:

    • Turning head to one side and craning neck back with an open mouth;
    • Bringing hands to mouth, trying to suck them;
    • Pursing lips;
    • Curling tongue at sides.

Coldness:

    • Quivering bottom lip;
    • Extremities turning bluish;
    • Mottled skin;
    • Goose pimples;

Pain/gas:

  • Silent screaming, then gasp and audible wail
  • Grimacing, often scrunched up face
  • Arms shaking, slight tremor
  • Rigid torso
  • Legs pulled up to chest

What I discovered, from observing Emma more closely and choosing how to respond to her body language and cries, is that frequently what I used to interpret as hunger or gas was in fact tiredness or overstimulation. What happens if you feed a tired baby who isn’t hungry is that frequently she may get gas and be overtired and more difficult to put to sleep.

The goal is not to stop all crying. Babies cry to express themselves, and even a “perfect” parent, if such a thing existed, couldn’t prevent all crying. Nor should you, necessarily; your baby may benefit from having a chance occasionally to self-soothe, which is an important skill as your baby grows older. For subsequent children, this skill is learned by necessity because parents can’t always respond immediately. But by learning to read your baby’s cues, you can avoid some frustration for yourself and have the confidence to know you are doing the best you can for your baby.

Helping Your Baby Sleep Better

Gentle Tips for Helping Your Baby Sleep Through the Night

By Meri Levy, MFT, CLE

It’s a very rare new mom who isn’t exhausted much of the time. Newborns don’t sleep the way adults do, and it can be a very difficult transition for new parents to adapt to their newborn’s sleeping patterns, and sometimes an even harder one to eventually adapt their baby’s sleep schedule to one that allows Mom and Dad to get a good night’s sleep.

Newborns are used to being lulled to sleep by Mom’s voice and activity during the day while in utero, and can be more active at night (remember those kicks waking you up at 3am?). So at first, it isn’t uncommon for the baby to have days and nights reversed. But don’t worry too much. Humans are diurnal creatures by nature (active during daylight hours) and there’s not much you need to do except expose your baby to daylight during the day for the baby to adapt to sleeping at night. Although it may feel like a long time coming…

Another way you can help your baby to distinguish day from night is to spend plenty of time holding your baby and interacting during the day when the baby is alert, and avoiding eye contact and being more businesslike about feeding and changing during the middle of the night. Regardless of how adorable your baby is in the wee hours, if you save your quality interaction for the daytime hours, your baby will sleep more consistently at night.

Most babies are not ready to sleep more than a few hours at a stretch until they are at least three months old and weigh 12lbs or more. Some babies will start to sleep longer intervals on their own around this time. If you have questions about whether your baby can go without feedings for longer than three to four hours, discuss your concerns with your pediatrician.

After four months or so, the decision of whether to feed and change the baby during the night is a controversial one. Ask 10 parenting experts at what age your baby could be sleeping through the night, and you’re bound to get 11 answers! So, this can be one of the hardest decisions new parents must make: at what age do I want to encourage my baby to sleep through the night, and how far am I willing to go to make that happen?

Factors to consider when making this decision include your pediatrician’s advice, your parenting philosophy, how badly you need more sleep (which depends on your sensitivity to stress), and how often your baby is waking during the night. One Mom may be content to sleep with her baby and feed continuously throughout the night for a year or so. Another may not be able to sleep well at all with her baby, have a baby that wakes every two hours to feed, and desperately needs more sleep to function well. Only you can make that decision. If you’re doing well with the way your baby sleeps at night, this article isn’t for you – yet. But if your baby’s sleep pattern changes or you decide it’s time for a change, you may want to consider some tips for encouraging your baby to sleep through the night.

If you will not want to continue feeding your baby throughout the night for many months, it’s a good idea to get into the habit early of putting your baby to bed at least partly awake. Just as you would wake up upset if you fell asleep with a pillow and woke to find it gone, your baby can be startled if he or she falls asleep at your breast or in your arms and wakes up alone. So putting the baby to bed in the same way he or she will need to fall back to sleep in the middle of the night is a good idea to encourage the baby to sleep through the night when he or she is ready. That doesn’t mean you can never nurse your baby to sleep, but at least some of the time, put the baby to bed when he or she is sleepy but partly awake. The earlier you start this, the easier it may be for the baby to transition to falling asleep out of your arms.

If you do decide to help your baby along in the process of sleeping through the night, it may be difficult to do this with the baby in your bed or even in your room. Studies show that cosleeping mothers and babies impact each other extensively during the night. Up until three months, the baby’s stirring and waking rouse the mother. But after four months, frequently the sounds or sensations of the mother stirring rouse the baby, who then wakes up to feed. So the first step is establishing the baby in a safe crib in a room where he or she can’t hear every move that Mom makes. Sometimes this, in and of itself, can cause the baby to start sleeping through the night.

The second thing that you can do, if moving the baby to his or her own room isn’t enough, is to begin consistently putting the baby down to sleep when sleepy but still awake. That means when you’re feeding during the night and the baby starts to nod off, burp him for a minute to rouse him a bit, and try to make sure you put him back to bed before he is fully asleep. Another aspect to this is feeding the baby only enough to satisfy but not fill her up. In the early days you wanted to get as much milk as possible into the baby to encourage her to sleep longer. But when you are trying to help your baby sleep through the night, it is a good idea to have smaller feedings in the middle of the night, so he eats more during the day and gets used to meeting his caloric needs then.

Once your baby is only taking small feedings at night and can fall back to sleep in his crib on his own, he is more likely to give up the nighttime feedings entirely. And if he doesn’t, you are in a better position to encourage him to give up the night feedings than if he was feeding a lot at night (and therefore hungry) and falling asleep in your arms.

Whether you allow your baby to fuss or cry for a period of time with or without you in the room is something you need to decide in consultation with your pediatrician. It is a very difficult decision for any parent to let their baby fuss along in his crib, but some babies will not learn to sleep on their own without expressing some protest. If you do let your baby cry, it is OK to soothe him or her at regular intervals, but you should not “give in” and pick the baby up. If you do, you are teaching your baby to cry for longer periods of time in expectation that you will eventually come and pick them up. So you need to be really prepared for how you want to handle what comes up and stick to your plan.

In my own case, only one of my three kids was so challenging during the night that I eventually needed to let him cry it out — he was waking every 45 minutes at night to have his pacifier put back in his mouth and I was about to totally lose it! (An aside – he was the kid who most needed limits in all areas of life). It was a tough few nights, after weaning him off the pacifier during the day first, but he did learn to get himself back to sleep after only a few days. And I loved him so much more that first morning when I had had a full night’s sleep — 7:30pm to 7am. And interestingly, he’s been the best sleeper of the three consistently since that time. He’s only one who never complains of difficulty falling asleep, even at 21 years old!

It can be very challenging making decisions of how to work with your baby around sleep. Remember, there’s no one perfect way to parent, and every baby is different.

Safe Sleep Choices

By Meri Levy, MFT, CLE

Regardless of where you stand on the issue of bed-sharing versus cribs, there are safe ways and unsafe ways to put your baby to sleep. Here are some tips to help your baby sleep safely with or without you.

Crib Safety

The Problem: Over 9,000 children are brought to hospitals each year due to injuries suffered in cribs. An average of 54 children per year die from crib injuries.

How to Keep Safe: Avoid used cribs with corner post extensions, ill-fitting mattresses, wide slats, or other features that can cause injury. If you are not sure if a used crib is safe, don?t use it!

Features to Beware of:

    • Corner posts should not be higher than the end panels on the crib. Children’s clothing can get caught on extended corner posts and pose a strangulation hazard.
    • Space between slats must be less than 2 3/8″ and no slats should be missing.
    • All screws, bolts and hardware must be in place and tight to prevent the crib from collapsing.
    • Mattress must fit snugly so that two adult fingers cannot fit between the mattress and the crib side.
    • Do not use cribs with cutout designs in end panels. Child can strangle due to entrapment.

 

Crib Safety Tips:

  • Never put infants to sleep on fluffy, plush surfaces such as sheepskins, quilts, comforters or pillows.
  • Never fasten a pacifier around a baby’s neck
  • Never hang any object from a string where a baby could become caught it in and strangle
  • Never leave a child in the crib with the side rail lowered.
  • Remove crib gyms and mobiles when baby is able to push up on hands and knees
  • Keep drapes, ribbons, blind cords and wall hangings out of child’s reach
  • Make sure crib sheets fit securely. If they come loose, they can pose a strangulation hazard
  • Always put your infant to sleep on his or her back, unless your doctor directs otherwise

Safe Bed-Sharing

The problem:

The Consumer Product Safety Commission has warned parents against bed-sharing due to the risks presented by adult bedding and the concern that parents may roll over on their babies.

How to Keep Safe:

Make sure that your bed is a safe sleeping environment for a baby, and never allow a smoker or an adult who is impaired by drugs, alcohol or medications to sleep with your baby.

Bed-Sharing Safety Tips:

  • Always place your infant on its back to sleep. Do not use anything to prop or hold your baby in place.
  • Be careful when using certain medications, drugs or alcohol. If you or your partner are taking any substance that makes you drowsy, it is best to place baby in a crib next to your bed, to avoid the risk of mistakenly smothering your baby.
  • Avoid using fluffy pillows, stuffed toys, plastics and loose bedding, which pose a suffocation hazard. Place the baby on a firm flat surface which is covered by a tight fitting sheet ? even for naps.

Other tips for safe sleeping:

  • Do not let anyone smoke around your baby. Second-hand smoke affects normal infant breathing and can cause respiratory and other medical problems. Do not bedshare if you are a smoker.
  • Do not put baby to sleep on sofas, recliners, waterbeds, futons, or beanbags, even for naps.
  • Avoid overheating your baby. Your baby should be lightly clothed for sleep, and the temperature of your home should be kept comfortable for a lightly clothed adult. Your baby should not feel hot or moist to the touch.

For more information on safe sleeping, contact the Contra Costa SIDS Program at 925-313-6254. For more information on crib safety, contact The Danny Foundation at 1-800-833-2669.

Information for this article was provided by the Contra Costa SIDS Program and The Danny Foundation.