Silent Reflux & Tongue Tie – The Real Reason for Unhappy Babies?

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Why are the simplest solutions often kept hidden from us when we become mothers? With my firstborn (my son, Jackson) I did as I was told and have many regrets these days that I didn’t trust my instincts over the advice of health professionals, friends and family. In those days I had no one to tell me otherwise.

With Lola, things changed, although the journey was very tough. When she was two weeks old the babymoon ended abruptly and she became an unhappy baby. Unhappy, that is, when she wasn’t with me. Her latch became poor, she fed very very frequently, and she hated being laid down- I was either carrying her, or bouncing her to sleep in a bouncy chair- she couldn’t sleep in a basket etc. By 10 weeks old she was finally diagnosed as having Gastro Oesophageal Reflux (the “silent” type- not so-called because of a silent newborn, far from it. The silence refers to the fact that baby doesn’t actually vomit) and a posterior tongue-tie, and the medical advice I received (and took) was to give her infant Gaviscon for the reflux, and a tongue-tie release.

One dose of Gaviscon later, my poor baby was completely constipated and in distress. That was stopped immediately. I carried her about and rocked or fed her to sleep or just to calm her- all the stuff we’re not “meant” to do.

The tongue-tie release was done professionally and compassionately at a private hospital with a peaceful paediatric wing, on the NHS! Lolly fed immediately after, but I couldn’t say I noticed a difference in her latch. In fact, I think it “regrew” if anything- at nearly two (and still feeding) she still has it to a degree, even though the TTR was “successful”. I went to La Leche League, local breastfeeding counsellors and actually got great help from a couple of my peer supporter-trained Hypnobirthing clients, and so we continued- we plodded on, from one day to the next. I wasn’t going to quit whatever happened, but I wanted to try and make the whole thing easier on us both.

Lola was not that “good” baby people like to coo over and pat you on the back for. People called her “clingy” and “hard work”, unlike my “good” baby, Jackson- it made me very protective of her. She made my Hypnobirthing work a real trial, even though I worked from home! I had gone back to work a week after she was born, feeling fine in myself, but obviously knowing nothing about how to bed-in and set up good breastfeeding habits! At 11 weeks old we tried osteopathy- and for the first time, someone else calmed her. Sue, a wonderful osteo who I now refer all of my clients to, laid her hands gently and respectfully on Lola and did some gentle manipulation on her skull and diaphragm. It was truly miraculous, Sue explaining what she was doing (very refreshing after having various health professionals just manhandle my precious baby without a word of explanation) and Lola relaxing and sleeping on the treatment table- lying down! After one more treatment the reflux was vastly improved- Lola never liked traditional tummy time (BabyCalm have a solution for these babies!) but she could at least have her nappy changed without getting distressed!

And then, after finally cracking (my mother in law often commented on how patient she thought I was with Lola) and bursting into tears while on the phone to one of my previous Hypnobirthing clients who is also a peer supporter and a lovely friend, she suggested I brought Lola over to her house as she had an idea.

I’d heard about slings, but had no real idea what they would be used for other than maybe taking your baby hiking?! Chris had always wanted a carrier, so he’d bought a BabyBjorn when Jackson was a baby. I’d stopped him using it because I always thought it looked entirely wrong for a baby to be supported by his crotch! So I went to my friend’s house and she showed me her collection (a library in fact!) of wraps and soft carriers. I was worried I wouldn’t know how to put one on so she reassured me that a Close Carrier would be a good thing to try “babywearing” out with and wouldn’t get me in a muddle. So, feeling silly, I let her show me how to get myself into this odd, jersey cotton contraption with metal D-rings either side of my hips, and she showed me how to lower Lolly in (who was characteristically malhumoured by now) and tighten it. “That tight?”, “Yes, and close enough to kiss”…

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The Close Caboo Carrier

Just as she did in the osteopathic clinic, Lola was calmed, instantly. I moved around a little, she nestled in, feeling closer to me than ever before (hence the product name I guess) and actually, she seemed happier than when actually being held. It’s like she should have been supplied with a sling at birth! It was honestly the missing ingredient! Since then we really turned a corner. I knew a marvellous way of helping her sleep, helping her stay calm so she fed more efficiently and therefore less frequently, keeping her safe and being able to get time to brush my teeth without listening to a screaming fit, not to mention being so much more mobile- I like to travel light, never been a handbag girl, so being able to go shopping without a pram (getting all of that “isn’t she a good baby!”, “oh how cute is she!” that she’d previously missed out on!) simply changed our lives. We used a couple of other types and still have a Connecta for the odd times I want to back carry her, and for all the carrying and feeling safe, secure and close to her mother, Lola is a very happy, sociable little girl- very much braver than her big brother too!

I passed this amazing knowledge on to my wonderful Hypnobirthing parents who come from all different walks of life, and like me, some of them never would have known about how the right sling can transform your everyday life. In time I read more, learned more, passed more knowledge on, to the point where I needed to make it official. Having spoken to Sarah a couple of times for professional advice before, the subject of BabyCalm came up, and Sarah suggested I train up as a teacher and help her and the other brilliant BabyCalm teachers rev up the Maternal Revolution. So I did! And amongst all of the amazing things that BabyCalm is, and does, I look at what we do and think, “if only it was around for my little Jackson and Lola, we could have had access to easier and simpler solutions to the problems we faced in those early days of their babyhood”.

By Melissa Wadey – Mother and BabyCalm & ToddlerCalm Teacher in Kent

Find out more about Melissa and her baby and toddler classes HERE.

Understanding and Helping the Toddler Who Won’t Sleep

Please note this is a collaborative post – for a list of authors please see the end of the article.

Every parent has despaired of their toddler’s night waking, no matter where the toddler sleeps and no matter the circumstances surrounding the desperation.  Although there is great disagreement regarding whether infants should be able to sleep through the night, the expectation that toddlers can and should sleep through the night without wakings parents is generally well accepted—with this expectation being what is presented as the “healthy” outcome by many health professionals.

Recent research however shows us how incorrect this expectation is as science tells us that it is normal for toddlers to wake at night well into their second year. Thus, to understand toddlers and what they need during nighttime care, we need to be sensitive to the “why” of their needs, abilities and experiences, and to look for “what” drives behaviours. The same concerns are important at bedtime. Knowing why a toddler is resistant to going to bed or unlikely to remain in bed when they wake at night is key to helping toddlers and parents create a healthy, happy sleep environment. Herein we offer some insight into the whys and whats of toddlerhood and then some practical suggestions about helping infants, and their parents, sleep.  

Toddler Sleep Around the World

One of the primary concerns that parents raise, especially in many Western cultures, is that toddlerhood is the time when independence must be learned and parental responsiveness may hinder this development.  Let us first assure you that the benefits of responsiveness to your child do not end in infancy, but rather that responsiveness to distress remains key to secure attachment and positive social and emotional outcomes for children (for a review, see Grusec, 2011).

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If you have been bed-sharing or co-sleeping, often parents worry that continuing this practice into toddlerhood will lead to negative outcomes for the child.  This is perpetuated by self-proclaimed “experts” who scare parents into believing they must take a hard line.  But is this supported?

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Around the world, toddlers regularly sleep with their parents, and not just out of necessity.  In Bali, children regularly sleep with their mothers until the age of 3 (Diener, 2000).  Mayan children also share their mothers’ bed and often nurse throughout the night until 2-3 years of age (Morelli et al., 1992).  Among the Ifaluk of the South Pacific children sleep alongside their parents until about 3 years of age (Le, 2000).  In Japan, family members traditionally sleep in the same room, with many children even sharing their parents’ bed (Fukumizu et al., 2005).  In Sweden, approximately half of children aged 4-5 are bedsharing with their parents at least part of the time (Welles-Nystrom, 2005).  In Japan, children traditionally sleep with some adult (e.g., grandmother) until adolescence.

Even in North America, long-term outcomes associated with bedsharing outside of infancy support normal, healthy development (Barajas, Martin, Brooks-Gunn, & Hale, 2011).  Notably, at age 5 there were no cognitive or behavioural problems associated with bedsharing between the ages of 1 and 3 in a US sample of low-income families.  Being responsive or even bedsharing will not inhibit and likely promote your child’s independence or emotional growth.  Regardless of your sleep arrangements, the following sections should help you navigate your toddler’s sleep and help you all find solutions to any sleep problems you may encounter.

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Knowing your Toddler

Toddlers are often misunderstood as they try to meet their own needs and the needs and expectations of family and society. Toddlerhood is a time of emotional, biological and social change as the transition from babyhood to a new level of independence and growth occurs. A time matched only by adolescence in level of challenging developmental changes for your child and necessary challenges in childrearing for parents.

Why Sleeping Can be Hard

For toddlers, energy abounds. Toddlers want to ‘do it’ themselves; they love to show you , tell you, direct you and ask you; and most of all, they love your company. So why would a toddler want to walk away from the excitement of being with you to go to sleep? Well, they often don’t! Thus, they do not make or maintain that transition without support and guidance.  It is completely normal for toddlers to wake during the night.; they wake and may reach out for teddy, or something comforting with smells of mom; Toddlers may call out; termed “signalling”. Some toddlers signal once a week, others once a night or numerous times a night, or some not at all (Weinraub, Bender, Friedman, Susman, Knoke, Bradley, et al., 2012) .

A Waking Toddler is a common concern for parents, with research showing that over half of children over one are waking regularly (Scher, 2001) and at least one-third of all parents of toddlers report having a ‘significant problem’ with their child’s sleep (Armstrong, Quinn, & Dadds, 1994). So, worrying or being concerned about your toddlers’ sleep is not unusual. However, just as in infancy, guiding them toward settling and providing comfort at night can help them return to sleep without negative consequences. Not responding can leave toddlers anxious or unsettled.

Most importantly to remember, is a waking toddler is NOT being naughty; they are trying to communicate something with their behaviour.

Many parents respond to toddlers’ waking with discipline (Armstrong et al., 1994)—yet there is no indication that this is helpful in promoting sleep or positive development. Sure, sometimes it is ‘in code’ but with gentle kindness and a sense of someone being there for them, toddlers can find sleep.

Co-Authors

Tracy Cassels, University of British Columbia,www.evolutionaryparenting.com

Sarah Ockwell-Smith, babycalming.com

Wendy Middlemiss, University of North Texas

John Hoffman, uncommonjohn.wordpress.com

Kathleen Kendall-Tackett, Texas Tech University,http://www.uppitysciencechick.com/sleep.html

Helen Stevens, Safe Sleep Space

James McKenna, Mother-Baby Behavioral Sleep Laboratory, University of Notre Dame, www.cosleeping.nd.edu

References

Alfano, C.A., Ginsberg, G.S., & Kingergy, J.N. (2007).  Sleep-related problems among children and adolescents with anxiety disorders.  Journal of the American Academy of Child & Adolescent Psychiatry, 46, 224-232.

Barajas, R.G., Martin, A., Brooks-Gunn, J., & Hale, L. (2011).  Mother-child bed-sharing in toddlerhood and cognitive and behavioral outcomes.  Pediatrics, 128, e339-e347.

Cain, N. & Gradisar, M. (2010).  Electronic media use and sleep in school-aged children and adolescents: a review.  Sleep Medicine, 11, 735-742.

Cantor, J. (1998). “Mommy, I’m Scared”: How TV and Movies Frighten Children and What We Can Do to Protect Them. New York: Mariner.

Feshbach, N.D. (1987).  Parental empathy and child adjustment/maladjustment.  In N. Eisenberg & J. Strayer (Eds.) Empathy and Its Development (pp. 271-291).  Cambridge: Cambridge University Press.

Grusec, J.E. (2011).  Socialization processes in the family: social and emotional development.  Annual Review of Psychology, 62, 243-269.

Mindell, J.A., Telofski, L.S., Weigand, B., & Kurtz, E.S. (2009).  A nightly bedtime routine: impact on sleep in young children and maternal mood. Sleep, 32, 599-606.

Owens, J., Maxim, R., McGuinn, M., Nobile, C., Msall, M., & Alario, A. (1999).  Television-viewing habits and sleep disturbance in school children.  Pediatrics, 104, e27.

Smith, H.A. (2006). Parenting for primates. Cambridge, MA: Harvard University Press.

Thompson, D.A. & Christakis, D.A. (2005).  The association between television viewing and irregular sleep schedules among children less than 3 years of age.  Pediatrics, 116, 851-856.

Weinraub, M., Bender, R. H., Friedman, S. L., Susman, E. J., Knoke, B., Bradley, R., Houts, R., & Williams, J. (2012).  Patterns of developmental change in infants’ nighttime sleep awakenings from 6 through 36 months of age.  Developmental Psychology, 48, 1511-1528.

Welles-Nystrom, B. (2005).  Co-sleeping as a window into Swedish culture: considerations of  gender and health care. Scandinavian Journal of Caring Science, 19, 354-360.

Normal Baby Sleep – Do we have realistic expectations? (PART 2).

NOTE: This is a collaborative post – for an author listing please see the end of the post.

This is Part 2 of a 2 part post, to see part 1 click HERE.

 

“My child wakes up at 2am and is up for 1-2 hours!”

One of us remembers very clearly the first time her daughter ended up doing this.  At around 14 months, she woke up in the middle of the night and simply wasn’t ready to fall back asleep.  We nursed, we read, but nothing worked.  She insisted upon getting up and going to play, which she did for 2 hours before being ready to get back to sleep.  This continued regularly for a couple months.  And then as quickly as it started, it stopped and hasn’t happened again in over The “why” of this is relatively unknown—although researchers are continuing to explore the physiological underpinnings of sleep—but we do know that extended night wakings like these are experienced by many children until around 3 years of age (Weinraub, Bender, Friedman, Susman, Knoke, Bradley, et al., 2012).

Many times the wakings are brief and the child settles quickly. Other times settling takes longer. In either case, these wakings do not readily suggest your child has a sleep “problem”.  Increased night wakings, call-outs, and crying are common around 6 months of age or so, and again as infants near 2 years of age. These wakings may simply be one (of many) manifestations of separation anxiety experienced by the child—a normal change resulting from infants learning that they exist separately from their caregivers (for a review, see Middlemiss, 2004).Some argue that night wakings in toddlerhood are reflective of sleep problems, but these opinions are based on criteria that do not necessarily reflect the realities of infant sleep.  Several studies found that night waking is relatively common between age 12 and 24 months (Richman, 1981; Goodlin-Jones, Burnham, Gaylor, & Anders 2005; Scher, 2000; Weinraub et al., 2013).

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Thus, a parent’s perceptions about what constitutes a sleep problem may be triggered by either a disconnect between expectations of uninterrupted sleep and a toddler sleep pattern that arguably falls within the range of normal, or by the impact that night waking has on the parent’s quality of sleep and daily functioning (Loutzenhiser,  Ahlquist, & Hoffman 2012).  However, although changes in sleep patterns may be inconvenient and frustrating, they are normal occurrences in the context of a healthy parent-child relationship. When viewed as indicating problematic, rather than normal, sleep patterns that will come and go, oarents can experience greater stress and worry (Middlemiss, 2004). As we have learned from many parents, understanding that these night wakings are normal can go a long way to making them more bearable.

 

 “My child won’t go to sleep before 10 pm.”

It is not uncommon in our society to assume that infants and young children must be tired by 7 pm and asleep shortly thereafter.  In a posted lecture on infant sleep, Dr. Wendy Hall, a researcher at the University of British Columbia, suggested that no child should be put to sleep later than 9 pm.  Unfortunately, that’s just not the reality for many families and it’s not because parents are negligent in getting their infants to bed, but because some children simply have a different circadian rhythm or a later schedule may work for the family.  Some children will continue this pattern into their toddler years and beyond.

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Cross-cultural data on bedtimes for infants and toddlers shows that later bedtimes are actually quite frequent in predominantly Asian countries (Mindell, Sadeh, Wiegand, How, & Goh, 2010).  Whereas the mean bedtime for children in predominantly Caucasian countries was found to be 8:42 pm, it was a full hour later for predominantly Asian countries (with a mean at 9:44 pm), with the latest mean bedtime being 10:17 pm in Hong Kong.  Notably, the rising time was also significantly later in these countries.  A concurrent finding was that the vast majority of children in predominantly Asian countries sleep either in the parent’s bed or room. Thus children who sleep with their parents may naturally have a sleep schedule closer to their parents owing to the sleeping arrangements.

What is important to remember is that a late bedtime in and of itself is not a problem.  If it poses a problem for the family as a whole, then parents may want to adjust the bedtime routine (Mindell, Telofski, Weigand, & Kurtz, 2009) or start the routine earlier in small increments in order to gradually move to an earlier bedtime (Richman, 1981).

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 “My child sleeps less (or more) than the recommended amount no matter what I do!”

Most people have seen the “sleep guidelines” about how much sleep our children need at various stages.  Parents are told that newborns should sleep around 16-18 hours, that at two years of age, children require a total of 13 hours sleep, and so on.  When researchers explore questions of how long infants and children should sleep and what are healthy recommendations, the answers are not particularly clear and are often based on examining how much children are sleepingat different times in history (Matricciani, Olds, Blunden, Rigney, & Williams, 2012).

As parents it is important to remember that they arerecommendations. 

Each child is different and the recommendations may not fit every child.  Some will require much more sleep and some will require less.  If a child is truly sleep deprived, there will be noticeable signs.  Signs of sleep deprivation include rubbing eyes, looking dazed and not focusing on people or toys, becoming overly active late at night, and having a hard time waking up in the morning.  By paying attention to your child and his or her cues and behaviours, you will be able to tell if your child is getting enough sleep, regardless of the exact number of hours your child sleeps.  Sleep is important, but there are many ways to get it apart from one long, uninterrupted stretch.

*Interestingly, researchers are now telling us that waking in the middle of the night is common in adulthood and was viewed as normal in past eras—the “first sleep” lasted about 4 hours with an awake period in between followed by a “second sleep” of another four hours (for more details, see here and the book: At Day’s Close: Night in Times Past by Roger Ekirch (Norton 2005).

 

Co-Authors

Tracy Cassels, University of British Columbia,www.evolutionaryparenting.com

Sarah Ockwell-Smith, babycalming.com

Wendy Middlemiss, University of North Texas

John Hoffman, uncommonjohn.wordpress.com

Kathleen Kendall-Tackett, Texas Tech University,http://www.uppitysciencechick.com/sleep.html

Helen Stevens, Safe Sleep Space

James McKenna, Mother-Baby Behavioral Sleep Laboratory, University of Notre Dame, www.cosleeping.nd.edu

References:

Goodlin-Jones, B. L., Burnham, M. M., Gaylor, E. E., & Anders, T. F. (2001). Night waking, sleep-wake organization, and self-soothing in the first year of life. Journal of developmental and behavioral pediatrics: JDBP22(4), 226.

Loutzenhiser, L., Ahlquist, A., & Hoffman, J. (2011). Infant and maternal factors associated with maternal perceptions of infant sleep problems.Journal of Reproductive and Infant Psychology29(5), 460-471.

Matricciani, L. A., Olds, T. S., Blunden, S., Rigney, G., & Williams, M. T. (2012).  Never enough sleep: a brief history of sleep recommendations for children.  Pediatrics, 129, 548-556.

Middlemiss, W.  (2004). Infant sleep: a review of normative and problematic sleep and interventions.  Early Child Development and Care, 174, 99-122.

Mindell, J. A., Sadeh, A., Wiegand, B., How, T. H., & Goh, D. Y. T. (2010). Cross-cultural differences in infant and toddler sleep.  Sleep Medicine, 11, 274-280.

Normal Baby Sleep – What to Expect (feeding and development) PART 1.

NOTE. This is a collaborative post, for a list of authors please see the end of the post.

 

Infant sleep problems represent some of the most common concerns reported by parents of young children.  Ask any new parent and most will complain about lack of sleep. Many will also be worried that what they are experiencing isn’t “normal” and believe that their child has a problem that needs fixing.  So they search books, ask friends and family or even their doctors about what to do about a child’s problematic sleep patterns.  And to top it off, they feel immense anxiety and worry about them.

Part of the epidemic of parental angst about children’s sleep is that we live in a culture in which parents are repeatedly told that they need to worry about their child’s sleep, that there will be dire consequences if their child doesn’t get enough sleep. Another problem is that most new parents, having had little experience with children prior to having their own, have little awareness about what truly is “normal” when it comes to infant sleep

Simply being made aware of normal sleep patterns can help alleviate the stress and anxiety parents feel, leading to happier times for the entire family.

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So what is normal?

In this series of posts, we’ll tackle some of the more common sleep concerns parents have with the hope that they can see them as normal, developmental stages for their child.

 

“My child wakes every hour, all day and night, to feed”

Whether it’s every hour, or every two hours, or even three, parents are often concerned when their young infant is waking regularly for feedings.  This concern is not surprising given the focus on “sleeping through the night” that our culture pushes. But sleeping through the night is not biologically normal, especially for a breastfeeding baby.

At the time of birth, a baby’s stomach can only hold a teaspoon’s worth of milk, meaning that he or she will need to feed frequently to meet the many demands for energy that accompany this period of growth.   Although the stomach grows relatively quickly, the fat and protein content in human breastmilk is much lower than in the milk of other mammals and thus infants are required to feed often, resulting in greater night wakings (Ball, 2003; Ball, 2009).

Human breastmilk, being designed for infants who need to feed on cue day and night, is easily and quickly digested.  Formula, however, is typically made from the breastmilk of another species – cows – and is higher in fat while also containing myriad additives which make it more difficult, and thus slower, to digest.  This can affect infant sleep, resulting in unnaturally deeper infant sleep (more time spent in stage 3-4) (Butte, Jensen, Moon, Glaze, & Frost Jr., 1992), a stage of sleep from which it is most difficult to arouse to terminate breathing pauses (especially for arousal deficient infants), thereby potentially diminishing the infant’s capacity to maintain sufficient oxygen.  Even so, formula use does not necessarily provide parents with more sleep overall (Doan, Gardiner, Gay, & Lee, 2007).

Infants whose primary source of energy is breastmilk will often wake frequently to nurse, something that is essential for the breastfeeding relationship to continue (Ball, 2009). However, regardless of feeding status, many infants wake regularly during the night (Weinraub, Bender, Friedman, Susman, Knoke, Bradley, et al., 2012).  Waking through the night is normal and biologically adaptive.  In fact, though it is often reported that sleep patterns consolidate in the second year, the pattern differs in breastfed children.

Breastfeeding moms may wake more often, but report greater total sleep.  For example in a study following breastfed children for 2 years, it was found that these children continued to wake frequently throughout the second year of life, a pattern more in line with cultures in which co-sleeping and full-term (aka “extended”)  breastfeeding are more common (Elias, Nicolson, Bora, & Johnston, 1986).

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Night wakings serve to protect the infant.

Night wakings have been reported as being more common in infants who bedshare with a parent, yet the wakings and bedsharing (when done safely) may actually protect the infant from SIDS (Mosko, Richard, & McKenna, 1997; Mosko, Richard, McKenna, & Drummond, 1996).  The critical period for SIDS is up to 8 months of age (with the peak at 2-3 months) and night wakings may serve as a protective mechanism.  In fact, if we look at parenting historically and cross-culturally, frequent night-wakings coupled with co-sleeping and breastfeeding are the norm for which we should be comparing other infant sleep behaviours.

 

“My child was sleeping through the night and suddenly it’s stopped.”

Imagine you’ve been waking regularly with night feeds and arousals, but as time passes they are decreasing.  Then you realize you’re now sleeping in nice, long chunks.  Hours of sleep all at once!  And it’s wonderful.  Then suddenly, as quickly as it came, it’s gone.  Your wonderful, sleeping-through-the-night child is suddenly waking again.  This experience, which is a reality for many, can cause frustration and despair accompanied by the feeling that you’ve done something wrong, or that you must do something get their uninterrupted sleep back again.

But here’s the thing: You didn’t do anything.  A return to night waking after periods of sleeping through the night is entirely normal.  Many children’s sleep will cycle like this for a while.  In fact, researchers looking at sleep patterns have found that often between 6 and 12 months, infants who had previously been sleeping long stretches suddenly start to wake more frequently at night (Scher, 1991; Scher, 2001).  In fact, in one long-term study looking at child sleep between 3 and 42 months found that there was no stability in night wakings or even sleep duration during this time (Scher, Epstein, & Tirosh, 2004).

What causes the change in sleeping pattern?

There are likely a variety of reasons, unique to each child.  For some, it may be a growth spurt or teething.  For others, it may be a cognitive leap that has them buzzing more so than usual or the appearance of separation anxiety.  Just recently a study reported that babies tend to wake more often when they are learning to crawl.   And for some, we may never know the actual reason.  But as children age and each develops a circadian rhythm, they will go through cycles of sleep – some more convenient for parents than others.  Parents need to be aware that these changes are entirely normal, even though they can be frustrating. Hopefully once you know that changes are to be expected, you can be better prepared or at least not add anxiety to the sleep disruptions you are forced to deal with once again.

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For Part 2 of this post please CLICK HERE.

Co-Authors

Tracy Cassels, University of British Columbia,www.evolutionaryparenting.com

Sarah Ockwell-Smith, babycalming.com

Wendy Middlemiss, University of North Texas

John Hoffman, uncommonjohn.wordpress.com

Kathleen Kendall-Tackett, Texas Tech University,http://www.uppitysciencechick.com/sleep.html

Helen Stevens, Safe Sleep Space

James McKenna, Mother-Baby Behavioral Sleep Laboratory, University of Notre Dame, www.cosleeping.nd.edu

References

Ball, H. L. (2003).  Breastfeeding, bed-sharing, and infant sleep.  Birth, 30, 181-188.

Ball, H. L. (2009).  Bed-sharing and co-sleeping: research overview.  NCT New Digest, 48, 22-27.

Ball, H.L, & Volpe, L.W. (2013).  Sudden Infant Death Syndrome (SIDS) risk reduction and infant sleep location –Moving the discussion forward. Social Science & Medicine 79, 84-91

Butte, N. F., Jensen, C. L., Moon, J. K., Glaze, D. G., & Frost Jr., J. D. (1992).  Sleep organization and energy expenditure of breast-fed and formula-fed infants.  Pediatric Research, 32, 514-519.

How to Cope When Your Baby Has Separation Anxiety (AKA The Clingy Baby!)

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I remember it well. Just as you come out of the new parent fog, your baby sleeps a little more at night, you begin to think that ‘at last I might have this parenting thing sussed’, perhaps you’re about to go back to work, or consider leaving your baby for your first post baby night away…….and then it happens, all of a sudden your baby regresses back to newborn behaviour, your smiling, ‘happy to go to anybody’ little bundle is only happy in your arms. You can no longer even have a wee alone, the second you leave the room you hear your little one wail, if they’re mobile they crawl into the bathroom after you, clinging at your legs desperate for you to pick them up.

cryingWhat went wrong?

What did you do to create such a clingy baby?

Why is your little one so lacking in confidence that they need to be glued to you 24/7?

Why do they cry so much unless they are close to you?

It’s your fault……you must have done something wrong surely?

Only you didn’t, in fact you did everything right! Separation anxiety (AKA the baby who screams unless superglued to you) is a GOOD sign, yes I did say that, no I’m not insane – it’s a sign you’ve done a great job! In fact it’s one of the best signs you can see to show that you have raised a psychologically healthy, completely normal infant.

So why is it a good thing? To put it briefly when your baby is born they have no idea that they are a separate entity to you, as far as your baby is concerned you and he are one , in fact you may as well be your baby’s arm or leg, he sees you as such an integral part of your being. It takes quite a while for your little one to work out that you aren’t joined at the hip, that he is a separate being to you. This knowledge happens at around 6 to 18 months, peaking at around the 9 to 10 month stage.  It shows your baby is clever, intelligent and totally, totally normal and it shows you have done a great job as a mother, you see it is an indication that your little one has formed a secure attachment to you.

Last century several prominent psychologists spent a long term researching attachment theory, I’m going to be a bit lazy here and fill you in via YouTube

THIS is also a wonderful (in depth) summary of the origins of ‘Attachment Theory’ – in short the significantly important work of these researchers led us to the understanding we have today – that the beginnings of true independence and confidence in children stem from a secure attachment to the mother (or substitute mother figure) in infancy.

One of the best measures of ‘secure attachment’ is a very young child who is comfortable (to explore the world) in the presence of her mother and very upset when her mother leaves – the only problem is in our detachment parenting culture this is not seen as normal, it is seen as undesirable and ‘clingy’ behaviour, in many cases it is seen as a failing – a failing for the parents to ‘detach’ and grow a confident child. This couldn’t be further from the truth, just as the incorrect assumption made by society that “in order to create a confident independent child we must push them out into the world so they can learn we are not always there” is grossly incorrect too. True independence is not learnt through rewards, punishments and force, true independence stems from a loving, secure relationship with caregivers at a young age.

So then, back to your clingy 9 month old. Rather than being a cause for concern that you’ve done something wrong and will have a shy, clingy child living with you until their 30s, actually what his ‘clingy’ behaviour could be interpreted as is a way of him congratulating you “you did good mum!”. All of that considered I appreciate it would be nice to have a wee by yourself once in a while, so here’s a few ideas to help you to cope during the peak separation anxiety period whilst fostering the all important attachment your little one has created and allowing detachment at his or her pace.

hugsad1. Empathy – Understand what your baby is going through, understand that this is a normal phase of development, albeit a scary one, for them to pass through, they are not trying to manipulate you or “wind you around their finger”, if you parent with empathy during separation anxiety not only will your child be more empathic and confident themselves when they are grown, ultimately parenting will be easier and more rewarding for you too.

2. Understanding – Not just from you, but from those close to you. Despite research into attachment theory being prevalent in the 50s and 60s (the era our parents were most often born) the results of this research didn’t really filter down into mainstream parenting, thus our parents probably parented in an entirely different way that involved us “needing to learn to be independent”. It’s hard parenting in a way different to your own parents, particularly when they (and health visitors of a similar age) offer us advice along the likes of “Just leave him to cry a little bit, it won’t kill him, he has to learn he can’t have everything his own way all of the time.”

3. Consider the timing for your return to work – Many mothers book their return to work at around 7 to 10 months, thinking that their babies won’t be tiny any more, will probably be weaned onto solids and thus not so needy of the mother, in fact this is probably one of the worst times a mum can return to work, but it is so common! Consider the possibility of pushing back your return to work by a month or two if possible.

4. If you do have to return to work, consider the impact of attachment on your child, it has long been suggested that one on one care in a home setting from a nanny or childminder is psychologically more healthy  for a baby, it allows the child and caregiver to foster a good bond and to help the baby to cope with separation anxiety in a way that will lead them to be more confident as a child.  Attachment Childcare UK is a wonderful organisation that offers a free listing of childcare professionals who subscribe to the principles of attachment theory.

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Consider postponing a move to the nursery or out of the parental bed. We all know 6 months is the recommended minimum to keep our babies in our bedroom in order to reduce SIDS risks, keeping your baby in with you for a little longer can also help them to cope with separation anxiety too.

6. Build secure attachments with other people – Pretty much covered in point 4 above, but the secure attachment doesn’t just have to be with mum, it can be with dad, granny, grandad, babysitter, nanny or childminder! You just need to build the secure attachment before separation anxiety exists

7. Help your child to feel as ‘close’ to you as possible, some parents give their child an item of their clothing to hug, a muslin spritzed with their perfume or even a photograph of themselves to carry around. Some even record their voices, talking to their little one or singing a lullaby.

8. Donald Winnicott spoke widely about ‘transitional objects’, or what you and I would know as ‘comfort objects’. Teddy bears, dummies, blankets, ‘lovies’ or any other object which a child can use to transition from complete dependence to relative independence from you.  First Mummy or Daddy sleeps with the comforter to transfer all their comforting scents onto the comforter. When introduced to your baby/toddler,the comforter helps to create a cosy safe environment for your little one to drift off to sleep whilst still feeling the closeness of you. Just make sure you have more than one in case one gets lost!

 

9. Try to keep the rest of your life as constant as possible, nine months is not the greatest time to go on holiday for instance, or start a trial session at nursery or the gym crèche.

10. Be kind on yourself whilst your baby is experiencing separation anxiety. This is the real key, the key to surviving this period is you.  You can’t do much to speed your baby through this stage, nor can you stop them from feeling totally normal feelings, but what you can do is change how you respond. In order to respond with compassion for your baby you need to nurture yourself. Sleep when you can, enlist help from people your baby already has a secure attachment with, even if it is just for them to sit cuddling your baby for an hour whilst you soak in the bath, ask people to prepare meals for you, consider temporarily employing a cleaner or somebody to do your washing and ironing for you (using our local laundarettes service wash was a Godsend for me during this phase with my children!). Find something that helps you to mentally relax – yoga, relaxation CDs, running, reading a good book and know that “this too will pass”.

The easiest way to survive separation anxiety is with the help of your family and friends, this is the key – as summed up so well by the father of attachment theory – Bowlby – himself:

“Just as children are absolutely dependent on their parents for sustenance, so in all but the most primitive communities, are parents, especially their mothers, dependent on a greater society for economic provision. If a community values its children it must cherish their parents.” (John Bowlby, 1951)

Sarah (Mum to Four, Parenting Author and Founder of BabyCalm Ltd)

You can read more of Sarah’s articles HERE.

Why You Should Celebrate International Babywearing Week – Guest Post by Babywearing UK

Many thanks to Victoria Ward from Babywearing UK for this guest blog post:

 

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Celebrate International Babywearing Week Oct 8-14th, 2012

Every year, families around the world get together to celebrate ‘International Babywearing Week‘. What is it, you might ask? And why the need to celebrate what is actually something simple: carrying your child? Is there anything novel about that?

For thousands of years, women carried their babies everywhere: in the house, at work, outside… It was the best – and possibly the only way – to keep them safe and warm. Then it became usual to place babies in various contraptions away from their mothers – from buggies to car seats, rocking chairs, cots, even walkers. As usual with these things, you might have noticed that the tide is turning. More and more parents (re)-discover that it is practical and convenient to carry their baby. And it is actually a good thing.

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Above image Copyright Calin Bleu

Parents can be at a loss to understand their newborn. Why is he fussing? Is he hungry, tired, does he need a clean nappy? Carrying your baby close helps you understand his signs much quicker, establishing the early foundations of communication and satisfying his needs before he gets to the full-on cries. A much nicer experience for the whole family.

The extra cuddles and closeness give the baby just the reassurance he needs to transition from the womb to the outside world. It can be bright and noisy out there but snuggled up against mummy or daddy’s chest, it’s alright. The closeness allows baby to sense his parents’ reactions much better and gradually makes sense of his experiences.

If you have to be separated from your baby for work or other reasons, carrying him closely in a baby sling while you are with him – perhaps on the way to nursery – is a good way to catch up on closeness. It is also true for working fathers who might not be able to see their little one as much as they want during the week. A baby sling is not just for parents: try lending a baby carrier to your childminder and show her how you use it. She will be able to comfort your baby throughout the day even if she has other children to care for.

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Above image copyright Moby Wrap

‘Babywearing’ is not just for newborns and babies. There are numerous child carriers who have been designed to fit toddlers. They allow you to carry your child right up to about 20kg (45lb). You can help him catch a nap on your back in the middle of a busy day, or encourage him to walk independently knowing that if he gets too tired, you can pop him on your back. A baby sling is a good way to keep young children safe in busy surroundings – at the market or when you’re travelling on public transport for example. Perched on your back, they have a good view of their surroundings (probably less scary that if they were much lower on the ground, surrounded by what must surely seem like giants!).

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Above Image: Copyright. Connecta Baby Carrier.

So why celebrate International Babywearing Week? Because parents all around the world are choosing to parent their children a different way, a way that suits the whole family. Because carrying their baby or their toddler in a comfortable baby carrier allows parents to live the life they want to live with their child.

To find a babywearing event near you visit: www.babywearing.co.uk

 

A Guest blog by Victoria Ward from Babywearing UK.

Love Bombing – A Guest Blog by Oliver James

This blog post has been written by Oliver James, psychologist, Guardian columnist and author. His books include ‘Affluenza’ and ‘How Not to F*** Them Up’.

Here Oliver describes the subject matter of his latest book ‘Love Bombing: Reset Your Child’s Emotional Thermostat’ – having had the benefit of trying Oliver’s Love Bombing technique with my own son (see THIS POST) I can heartily recommend this book if you are struggling with your child’s behaviour.

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Nine year old Tim hated himself, he told his mum Marianne he was ‘rubbish’ at everything and became more threatening towards his talented older sister.

Marianne was at her wits’ end, having tried everything suggested by her son’s GP and teacher, including a stricter punishment regime. My advice was to try the opposite – a technique called Love Bombing.

It entails giving your child a very intense, condensed experience of feeling completely loved and completely in control. It works best with children aged three to the onset of puberty and can be applied to depressive children such as Tim, as well as classic cases of attention deficit hyperactivity disorder, or when a child is aggressively defiant. It also works well for shyness or academic underachievement. But there does not have to be any ‘problem’, it would improve the well-being of both parent and child in almost every case – over 100 parents have done it (put ‘love bombing oliver james’ into google to see thousands of threads).

Interestingly, a significant number of the parents who found it useful had used strict routines with their babies or toddlers. They reported feeling that the Love Bombing seemed to reset their child’s emotional thermostats as well as enabling them to parent in a more loving and effective fashion (for a more detailed account click HERE and for my view that strict routines with babies are harmful click HERE).

The child is told that they are going to have a period when they can do whatever they like, within reason. during this time, they have the exclusive attention of a parent. the child is in charge of where they go and what they do, including meals and bedtimes, and told he or she is loved, along with lots of cuddles, as often as possible. The period can be 48 hours, a single day or shorter bursts. Whatever the duration, the experience needs to be rekindled daily for half an hour for lasting effects.

Perhaps surprisingly, children are more willing to accept boundaries afterwards. the opposite of stricter discipline is often what is required when a child is playing up. they are feeling needy and deprived, loveless and powerless. Give them an intense period of feeling loved and in control, and the neediness and anger dissolve.

Almost all the arents who have done it report a more biddable, calmer child. parents who have been sucked into a nagging, niggling pattern become more authoritative.

Marianne took Tim away for 48 hours to a hotel. he chose it and they spent time watching TV and messing about. a week later she said, ‘it definitely worked. so far we haven’t had any major unhappiness.’ eighteen months on, the self-loathing was extinguished. tim recalled, ‘the best bit was just being alone with my mum.’

As part of a professional couple Marianne could afford a hotel. but dozens of parents have found ways of doing love bombing that require little or no cost.

It might sound like just spending ‘quality time’. this is something entirely different. Going that extra mile into the love bombing zone can save you a huge amount of grief – and it can be a whole lot of fun.

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To learn more about Oliver’s Love Bombing technique visit www.lovebombing.info.

Oliver will be speaking about Love Bombing at the BabyCalm & ToddlerCalm 2013 International Conference next year, for more information or if you would like to book a ticket visit the conference website HERE.

‘Love Bombing: Reset Your Child’s Emotional Thermostat’ is published by Karnac Bookson Friday 28th September 2012, £9.99

Breaking News: New Study does NOT show ‘Sleep Training Babies Causes no Lasting Damage’

The study opens with this paragraph:

“Behavioral techniques effectively reduce infant sleep problems and associated maternal depression in the short- to medium-term (4–16 months’ postintervention). Despite their effectiveness, theoretical concerns persist about long-term harm on children’s emotional development, stress regulation, mental health, and the child-parent relationship. “

Behavioral sleep techniques did not cause long-lasting harms or benefits to child, child-parent, or maternal outcomes. Parents and health professionals can feel comfortable about using these techniques to reduce the population burden of infant sleep problems and maternal depression.”

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Potential Methodology Issues Not addressed in the Study:

  • Sleep problems were ‘parent reported’, at 7mths a questionnaire was given with the question “Over the last 2 weeks has your child’s sleep generally been a problem for you?” 47% of respondents answered ‘yes’ and thus became eligible for trial inclusion. The ‘problem’ was not elaborated upon and I would have liked to have seen more questioning to ascertain exactly what the problems were, what had been tried until that point, what information the parents had received and what support had they received up until that point in those first important 7months as this time period could have a big effect.
  • The sample (out of those reported sleep problems) was selected by the researchers, I can find no mention of how they were selected and what other criteria was looked into in terms of the infant’s/family history/psychological wellbeing until that point.
  • Parents must have been open to the idea of sleep training to agree enrollment in the study, would this therefore mean that their opinions/beliefs were reflected in other parenting practices?
  • Training was carried out on babies 8-10months of age so cannot be applied to any infants younger than this. It also does not tell us the effects of training on older children/toddlers.
  • Parents were able to choose the type of sleep training used – either gradual extinction (what you and I know as controlled crying) or gradual withdrawal (parent starting out sitting with child and moving further away but involving no crying) – though no distinction was made between the type of sleep training used and later impact in the results.
  • Control/Intervention group allocation was blinded only to researchers not parents (understandably it would be tricky to be blinded to parents – but I wonder how knowledge that they were in the intervention group affected parental perception).
  • The control group visited the same nurses and were free to ask for sleep advice, but the nurses in these control groups were not trained to offer specific sleep training advice, however what advice did they give? Pretty much any parent I know could give controlled crying instructions without special training, do we know that they didn’t give similar advice to the intervention group? I cannot find this information out and to me from this point in the study loses all credibility for me – Do we know what the control group did sleep wise? We know they reported that they had had a problem with their child’s sleep in order to enter the study, so it’s pretty likely that they would want to do *something* – were they followed up and questioned and asked exactly what they did do? Again I can find no mention – How do we know that a large majority of the control group DIDN’T sleep train?
  • Outcomes were measure by cortisol samples, taken at 6yrs of age (why on earth would they take them at 6year of age?! I find this very confusing and not at all relevant? From what I can see the first follow up – and potential cortisol testing was at 10 months, yet the concerns over stress to infants from sleep training is during and in the immediate aftermath of the training, a sample taken 2 months up to 5 years later seems bizarre? Where is the cortisol sample DURING and IMMEDIATELY after the training? This is the one that matters IMO).
  • Child emotional questionnaires and ‘quality of life’ questionnaires were parent reported (and occasionally child reported) – meaning that parents filled in the questionnaires giving their own opinions. We know questionnaire reporting is notoriously unreliable with two main factors – 1) wanting to tell the investigator what they want to hear and 2) sticking to ‘middle of the road’ answers, i will add in 3) here – what parent will want to report that they feel their child has an emotional/behavioural difficulty? Especially not when they have been enrolled into a trial looking into the effects their early parenting may have had upon these. I find it very hard to determine whether the measures of psychological wellbeing were all parent reported as the results are very vague, but if I were to make an assumption I would guess that the majority were parent reported. Child reporting surely would include bias – what child would say negative things about their parents in front of said parents?
  • In terms of parenting style (and thus I presume eluding to bonding too?) the researchers appear to feel that “authoritative parenting” (high warmth, high control) is optimal parenting whereas what they call permissive parenting (high warmth, low control) is sub-optimal. I would argue that having “high control” over children is NOT optimal parenting, or indeed respectful parenting and am not convinced at all that highly controlling parents are those exhibiting the most healthy parenting style. I would like to see how they define “high and low control” and look to see how many initial “permissive parents” morphed into “authoritative parents” from the intervention group as a result of the training undertaken, this information though is not provided.
  • Nearly a third of the sample were lost to follow up (31%) – that’s a BIG number and a major limitation – what if they didn’t agree/respond to follow up because they found the intervention traumatic/it didn’t work for them/it went against their instinct?

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Perhaps the most interesting part of this research is this:

“There was no evidence that a population based targeted intervention that effectively reduced parent-reported sleep problems and maternal depression during infancy had long-lasting harmful or beneficial effects on child, childparent, or maternal outcomes by 6 years of age. Thus, this trial indicates that behavioral techniques are safe to use in the long-term to at least 5 years.”

Read that again, I’m pretty certain I dispute their claim that it has no long lasting harmful effects given the parental reporting, strange timing of cortisol testing, lack of information on what techniques the control group used, promotion of authoritative/controlling parenting as the optimum type, lack of information of life before 7 months of age (or in fact not much about life afterwards aside from financial questioning – what about childcare for a start) and lack of in-depth information about bonding (why no Ainsworth ‘Strange Situation’ type testing?). No the most interesting part to me is even with all of the above limitations in mind this research tells us there are NO LASTING BENEFITS to sleep training……Now which paper picked up on that then?! No, thought not.

So what DOES the research tell us?

  • There is still NO evidence that shows controlled crying under 8 months of age has no ill effects
  • The results did NOT differentiate between the different types of sleep training used (e.g: No Cry V Crying related options) in the results, therefore we do not know about the individual methods and their outcomes, only ‘sleep training’ as a broad label of many different types of training.
  • That sleep training does NOT have lasting positive effects on a child’s sleep behaviour
  • That nearly 50% of parents still have problems with their baby’s sleep by 7months of age (hey, perhaps that’s because it is NORMAL infant sleep and our expectations are incorrect)
  • That 31% of parents for some reason did not agree to follow up with the researchers
  • That parents tell researchers that they did not feel that sleep training affected their child negatively (tell me something new).
  • That controlled crying DOES work in the short term (I don’t think this has ever been disputed?).
  • That concerns over the effect of controlled crying on babies are still very valid, particularly in light of the recent Middlemiss study (that measured cortisol levels DURING training, not 5yrs later!) – A good summary of the concerns of sleep training can be read HERE.
  • That a whole lot more health professionals and  ‘baby experts’ are going to use this as arsenal to tell parents that there are no concerns with sleep training involving baby crying, that it’s a good thing to do, even if it feels wrong to them, as parents, to do it.

Sigh………..

Sarah (Founder of BabyCalm)

You can read more of Sarah’s articles HERE.

 

Reference:

Price. A, Wake. M, Ukoumunne. O and Hiscock. H. ‘Five-Year Follow-up of Harms and Benefits of Behavioral Infant Sleep Intervention: Randomized Trial’ Pediatrics;  September 10, 2012;

To Swaddle or not to Swaddle?

Is any issue more emotive in the babycare world at the moment?

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Emotive in general, but also a point that I am asked to comment on at least once per week in response to questions from, mostly, potential BabyCalm teachers – concerned that BabyCalm “advocate swaddling”. My answer is always “BabyCalm don’t advocate anything! That’s not what we do – we’re all about empowering parents and in order to truly empower we must allow the parent to make his or her own informed choice – and sometimes that choice may be something that makes our heart sing, othertimes it may be something that makes us uncomfortable – BUT – and it’s a big but! – we have to learn that our feelings must stay that – OUR feelings.”

So, what’s the deal with swaddling and BabyCalm?

In short we present the idea of swaddling to parents as one of many, many ways that they can soothe their baby (and those of you who have attended a BabyCalm class will know how little of it is taken up with soothing techniques – in short it’s the smallest part of what we do!) and it is just that “presented”. As with any other method we present we always disccuss the pros and cons of the technique and we help parents to know how to do it safely, with the minimal amount of risks as possible – be that dummy use, bedsharing, babywearing or swaddling. I am always concerned when somebody says “That’s dangerous – never do it” (FSIDs and bedsharing anyone?) or “That interrrupts feeding – never do it” because things are NEVER that cut and dried………..sure most things in life have risks, but most have benefits too and ways to reduce those risks.

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What would you suggest in this scenario? A mum with a 6 week old baby who confesses to you she’s not coping, her baby is very fretful and sleeps fitfully. She is at the end of her tether, she admits that the exhaustion and lack of sleep she’s experiencing is now affecting her bonding with her baby, she’s desperate. She also tells you that she is happily formula feeding, baby is in her own cot (and she wants it to stay that way) and babywearing isn’t for her. She’s tried swaddling and it really seems to help, she’s using a fleece blanket and pulling it really tight all around the baby. This scenario is precisely when swaddling can be a God send – this scenario is the norm in the UK, outside of the AP bubble of breastfeeding, bedsharing and babywearing………..but, this scenario is when swaddling can be dangerous and why we still teach swaddling in BabyCalm, we teach how to reduce those risks as much as possible.

Think of another scenario – Mum of a 6wk old baby who confesses to you she’s not coping, her baby is very fretful and sleeps fitfully. She is at the end of her tether, she admits that the exhaustion and lack of sleep she’s experiencing is now affecting her bonding with her baby, she’s desperate. She is breastfeeding and open to suggestions of babywearing, bedsharing and co-bathing…..what would you suggest here? would it be different to the above? Of course it would! but……..what if this mum’s informed choice was *still* to swaddle rather than bedshare/babywear/cobath/skin to skin? is that your position to tell her what NOT to do? even though she’s thoroughly considered the pros and cons and made her decision – most definitely NOT!

In my opinion telling somebody NOT to swaddle – ever, is just as bad as telling them to ALWAYS swaddle, as certain baby experts might! Frankly it is none of our business what parents do and I’m always shocked that some in this profession think that it is by passing on their own strong feelings (often backed by hunches and opinion, not evidence) to vulnerable new parents. This is NOT letting the parent make an informed choice!

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So what are the pros and cons of swaddling? What does current research and our own anecdotal opinion tell us?

PROS

  1. Swaddling can help promote new sleep cycles/less waking.
  2. Swaddling can help prevent prolonged crying. (but see 8 below!)
  3. Swaddling can help breastfeeding when a baby has flailing hands making latch difficult (but see 2 below!)
  4. Swaddling can help a baby to not accidentally scratch his face
  5. Swaddling can stop loose blankets going on top of the babies face
  6. Swaddling can prevent a baby from rolling onto his tummy during sleep.
  7. Swaddling Can give parents a technique to calm their baby and thus time to calm themselves, this is heightened for parents who make the choice to formula feed and not bedshare/babywear etc..
  8. Swaddling can help a baby feel ‘held’ and perhaps as if still in utero.

CONS

  1. Swaddling can lead parents to miss baby’s early hunger cues
  2. Swaddling can inhibit breastfeeding, particularly in the early days
  3. Swaddled babies cannot suckle on their own hands as they may have done in utero
  4. There is an increased risk of SIDs shown in studies when babies placed to sleep on stomach swaddled
  5. Swaddling can cause hip dysplasia if babies are swaddled too tightly over hips
  6. Swaddling can cause respiratory compression if babies are swaddled too tightly over chest
  7. Swaddling has been linked to less arousability, if the swaddling was not started until 3months of age.
  8. Swaddling prevents a baby’s freedom of movement and expression.

If a parent would still like to swaddle their baby after considering the above, how best to do so as safely as possible?

When Swaddling Always Remember:

  1. Never swaddle over a baby’s head or near their face
  2. Never swaddle a baby who is ill/has a fever
  3. Ensure the baby does not overheat – only swaddle with a breathable/thin fabric
  4. Only swaddle until a baby can roll **
  5. Always place a swaddled baby to sleep on their back
  6. Do not swaddle tightly across the chest
  7. Do not swaddle tightly around the hips/legs. Legs should be free to “froggy up”
  8. Begin swaddling well before 3 months of age, if breastfeeding only once feeding established and never in the first few hours postpartum (in the hospital!) when skin to skin is necessary!

** The American Academy of Paediatrics recommends swaddling for babies 0-14weeks only.

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I’m being a bit lazy here as it’s the first day of school summer holidays and I want to take my kids out on a picnic – so here’s a great summary of up to date swaddling evidence.

So what’s BabyCalm’s position on swaddling? To be honest we don’t really have one! other than we are committed to letting parents make their own choices and helping them to have the information they need to do so. For some swaddling is an amazing tool, for others it’s quite the reverse! There is no “one size fits all approach” when it comes to new parents and babies and *THAT* is our position!

Sarah (Founder of BabyCalm)

“Why don’t you ever put that poor baby down?” and How to Deal with Babywearing Negativity.

A huge thanks to Anne McEwan from Natural Mamas for this guest post:

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Carrying your child in a sling has many well documented benefits yet it often seems that society is still playing catch up. Parents using slings report negative reactions from friends, family and even complete strangers. Being told that a choice you are making for your child is wrong can be hard, especially if it is a choice that feels so right for you.

Why the negativity? 

When deciding how to deal with negativity to your choice to carry your child in a sling – or any parenting choice- it can be useful to consider why they feel the need to express the negativity in the first place. The vast majority of comments fall into these two categories:

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1) That is not what I did/would do and I feel judged by you or think you are crazy 
Regardless of whether you intend to judge someone else for not carrying their child, some people will allow their own insecurities to coax them into putting down your choice. Remarks from these people are often phrased in a ‘I could never do that’ or ‘It never harmed mine to go in a buggy’ way.

2) Lack of understanding 
Just very simply a lack of understanding as to why you would want to carry your child. Sometimes people react with ridicule to something that they have not encountered before as a way to hide their lack of knowledge. ‘Look at that woman with two heads’ or ‘can you not afford a pushchair’ are ways in which this can be expressed.

What can you do? 

The first thing you can do when you are approached in a way which feels negative to you is to examine whether it was meant to cause upset, is a misunderstanding or someone suffering from a case of foot in mouth syndrome.

It is possible for someone to say something which was meant in a very innocent way but which comes across as negative to you. By taking a step back and asking yourself whether you are being over sensitive you can gain an extra insight into the situation rather than going into defensive mode straight away.

If you have established that it was not merely an innocent remark you can then decide whether and how you want to respond. A teenager passing in the street may not be worthy of any response since it does not matter what they think of you, whilst a negative remark from a family member can have a much bigger impact.

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Tried and tested responses
These are some tried and tested responses to negative remarks. Choose the one that suits you and your situation best or have fun making up your own!

‘I love carrying him it makes both of us happy.’ 
The truth and nothing but the truth. So many reasons to carry but this is the most important of all and really it is also one that people should just be able to accept.

‘Carrying her is so easy. I wish slings like this had been as easily accessible when you had your babies.’ 
This one is great for those who you feel may have wished they had carried their children. It works in two ways. One, it gives an excellent non emotive reason for carrying and two, it empathises with them and expresses a wish that they would have been able to do the same.

‘I am sure carrying him has made him so much more confident, just look at how he loves to play with his train. Do you mind looking after him while I go and make a drink.’ 
If you feel that the person expressing the negativity is worried that they will not get to interact with your child in the way they had imagined, this can be a good way to redirect their attention. Please note that using this technique with a child who will scream when you leave their sight is probably counter productive…

‘Do you know I burn a lot more calories carrying her. It is great exercise and my back has never been stronger.’ 
A concern for the carriers back is often borne from an inability to understand how a soft sling distributes the weight evenly over your body. They imagine themselves carrying a child as heavy as yours and simply cannot imagine being able to do so.

‘Have you seen his latest trick? He can blow bubbles.’
Sometimes it is not worth your breath arguing or trying to explain. Focusing the attention on your gorgeous baby can then be the least confrontational way to move forward. After all, regardless of what they think, you are doing what you believe is best for your baby and as his parent you are in the ultimate position to make those decisions.

For some great independent advice on slings and babywearing see www.slingguide.co.uk 

Anne McEwan – Babywearing consultant and educator.
www.naturalmamas.co.uk The home of natural parenting.