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Babies Sleeping in Their Own Room, Sleep Longer

2:00

Many parents choose to have their newborn sleep in the same room as they do, so a common question is what is the right age to move baby into his or her own room? The answer may depend on who you ask. 

The American Academy of Pediatrics (APP) recommends that babies share their parents’ room – but not their bed- for at least 6 months and preferably, until their first birthday. The guidelines are meant to lower the risk of sudden infant death syndrome, or SIDS, which may occur while an infant is sleeping.

But if you are ready for your little one to sleep for longer periods of time, then a new study suggests moving your baby into his or her own room by 4 months of age.

For the study, Dr. Ian Paul, the chief of academic general pediatrics at Penn State College of Medicine. analyzed surveys from 230 first-time mothers. He found that babies slept for longer stretches if they didn't sleep in the same bedroom as their parents.

At 4 months, babies who slept alone had the longest stretches of uninterrupted sleep -- by about 45 minutes, on average -- though they slept about the same amount of time as babies who slept in their parents' rooms.

At 9 months, babies in their own rooms slept 40 minutes longer at night and over 20 minutes longer overall, compared with those who were still sharing a room with their parents. Those differences disappeared at 12 months but reappeared later. When the researchers followed up at 2½ years, toddlers who began sleeping alone by 9 months slept 45 minutes longer per night, though total sleep time was roughly the same.

As most parents can attest to, when a baby doesn’t sleep well it has an impact on the parents’ stress level and mental health. Paul notes that he believes the AAP recommendation is excessive and that most parents are ready for a room to themselves before 6 months to a year. "Most parents don't want their baby sleeping in their room until 1 year," Paul said. "I've got three of them myself."

Some experts also agree that moving an infant out of the parents' bedroom sooner could help babies sleep better before they develop separation anxiety, said Paul.

The difference in recommendations has led to tension between the two groups.

"This is important information," said Dr. Rachel Moon, a professor of pediatrics at the University of Virginia who co-authored the AAPs’ latest recommendation. "We don't have enough info about downstream effects about what we've recommended."

Moon, a SIDS researcher, cautioned in response to Paul's study that just because sleep is uninterrupted doesn't mean it's better. 

"We think that a lot of the problems with SIDS is that babies don't arouse," she said, adding that if babies sleep too deeply or for too long, some experts believe this could put them at risk.

Room sharing has been estimated to lower the risk of SIDS by as much as to 50%, according to the report Moon co-authored.

The researchers also found other differences between babies that slept in their own room and those that shared a room with their parents: Infants who slept in a room alone were also more likely to have a consistent bedtime routine, and they were more likely to go to bed by 8 p.m. Babies that shared a room were more likely to have something in their bed that shouldn’t be there, such as a blanket, pillow or stuffed animal, and were more likely to be brought into their parents’ bed sometime in the night. Both of which have been linked to sudden infant death, including by suffocation.

Instead of changing the guidelines, Moon said, doctors can use the new study to give better guidance to room-sharing parents who may be more likely to bring their baby into bed overnight, putting them at risk.

"If we know that this is happening, then we can do a better job of providing proactive guidance for families," she said.

If you’re still confused about when to move your little one into his or her room, talk with your pediatrician, for guidance, about any concerns or questions you have.

Story sources: Michael Nedelman, CNN http://www.cnn.com/2017/06/05/health/babies-room-sharing-study/index.html

 

Daily Dose

Good Sleep Habits For All Children

While we have been discussing infants sleep habits, a good night's sleep is equally important for children of all ages. It is important to focus on the sleeping half of children's lives, and the sleep habits of children have a direct impact on the adults who care for them. By starting off with good sleep habits in babies and teaching them how to sleep you will hopefully be blessed with a good sleeper, but many children will continue to have intermittent sleep issues.

Bedtime should be a pleasant part to the end of a busy day. As it gets dark your body secretes melatonin to signal the end of the day and the rest phase of our circadian rhythms. If you get overtired, your body secretes the hormone cortisol, to give you an energy burst, which may further contribute to bedtime problems. In other words, get your child to bed while still in the sleepy phase! Have a set bedtime and bedtime routine for children of all ages. Even teens require nine to 10 hours of sleep, so they should have a bedtime too. A good night's rest also contributes to your child's overall physical and emotional health. They will perform better in school, have less mood disturbances, and even experience less minor aches and pains like headaches and stomachaches. Wind down your evening with music, reading or a relaxing bath. Begin to dim the lights while getting your child to bed, as bright lights will signal the brain to stay alert so this will include turning off the TV and computer. Once every one gets into a good routine, maintain the habit. Good sleep habits are good for the entire family. That's your daily dose, we'll chat again soon.

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Daily Dose

Bedtime!

1:30 to read

Bedtime….an important word for parents and for children. A recent study in Pediatrics just reinforces how important bedtimes for children may be.  The research shows that preschool children who had an earlier bedtime were less likely to become obese in their teenage years. 

The study involved nearly 1,000 children who were born in 1991 and whose parents recorded their bedtimes when they were 4.5 years old.  The researchers then looked at the growth data (height/weight) for these children when they were 15 years of age.

Interestingly, the pre-school children who were in bed by 8:00 p.m. had half the risk of becoming obese as a teenager compared to those children who went to bed after 9 pm. Specifically, of the children who went to bed by 8 pm, only 10 percent were obese as teens, while 16 percent of those who went to bed between 8 and 9 pm developed obesity, and 23 percent of those children   who had bedtimes after 9 pm developed teenage obesity. 

While there has been much research surrounding sleep and obesity (as well as behavior), this study provides even more evidence to the possible “protective effect” of early bedtime and bedtime routines for young children.  If getting to bed on time and earlier can in some way help stem the obesity tide, it would seem like an easy recommendation for many parents to follow.  

As a mother I was always a “fan” of schedules and bedtimes…and actually putting your child to bed at night is such a wonderful time of day. The routine of a bath, snuggles, some books ( with wishes for just one more) and more hugs and kisses is such a wonderful memory I have of my own 3 boys. It just seemed that everyone was happier (and I guess healthier) when we had early bedtimes. I remember I had a friend who always had her 3 young children fed, bathed and in bed by 7:00 p.m. every night..and in those pre cell phone days we did not dare call her house after that time!!  

I also think bedtime routines are important for younger children year round. While it is more difficult to have regular bedtimes for older children during the summer months, children under elementary school age (and maybe even older) really do benefit from continuing on the same bedtime schedule during the summer months.  I think if you told your middle school or teenager this “rule” there  might be mutiny….but I know as well as a working parent, it is much easier to have a routine even when the kids are out of school…they would totally disagree!

I am excited about this study and using it as another resource when discussing sleep habits and bedtime routines with my patients.  

Daily Dose

Crib Deaths

1:15 to read

Crib bumpers may cause deaths and should never be used!  A recent study in The Journal Pediatrics looked at the incidence of crib bumper related deaths from 1985- 2012.  The authors reviewed data from the U.S. Consumer Product Safety Commission (CPSC) and found that there were 3 times more bumper deaths reported in the last 7 years than the 3 previous time periods that had been reviewed. Bumper pads caused 48 suffocations of which “ 67% were due to the bumper alone and not clutter in the crib, and 33% of the deaths were due to wedgings between a bumper and another object in the crib”.  An additional 146 infants had sustained injuries from the bumpers, which included choking on the bumper ties or near suffocation.  

The study also looked at the number of CPSC reported deaths compared with those from the National Center for the Review and Prevention of Child Deaths, 2008- 2011. When using that data the total number of deaths increased to 77. 

While bumpers had been marketed to prevent a baby from falling out of a crib or to keep a baby’s arms or legs from getting stuck between the crib rails, in reality they cause injury and death.  In 2012 a national standard was revised which required that crib bumpers must be 2 inches in thickness or less.  At that time the thought was that “thinner bumpers” would be less likely to cause suffocation. But the recent study found that 3 of the deaths occurred in cribs that had thinner bumpers.   

According to Dr. N.J. Scheers, the lead author in the study, “these deaths are entirely preventable” if bumpers were not used and were not widely available.  But when flipping through a baby store catalog, or even shopping for cribs, parents  and grandparents) see beautiful cribs that are adorned with bumper pads!!  So, if they cause death why are they being sold?  Mixed messages are very hard for parents to understand. Concrete recommendations and guidelines save lives.  

Several cities and states have already banned the sale of crib bumpers and the CPSC is currently in the process of publishing new recommendations on how crib bumpers should be regulated. 

I don’t see the need for any more studies to show that bumper pads may cause deaths and injuries.  Clear guidelines from the AAP state, “bare cribs are the best”  and “all infants should be put to sleep on their backs”.  Save your money and your baby’s life…no bumpers.

Daily Dose

Back to Sleep Ads

1:30 to read

I am concerned that I have been seeing on line ads promoting “new” baby products in which an infant is shown sleeping on their tummy. In other words….not following AAP guidelines that all infants are placed on their back to fall asleep.  Their should be a “law” that you cannot shoot a picture for any product being advertised for an infant in which the baby is shown sleeping in the prone position. Seeing this photo may only confuse parents about correct sleep position for their baby, especially when many of the advertisements are for sleep related products. 

 

The “back to sleep” campaign which started in 1994 has served to reduce the incidence of SIDS by over 50%. I have been fortunate in that I have not had a patient of mine die from SIDS since the recommendations for sleep position were changed. Unfortunately, when looking at data, 30% of SIDS cases report that the baby was found in the prone (tummy) position.  

 

So, if a sleep deprived new parent is surfing the net for products related to infant sleep, and then sees a baby on their tummy, they may think “maybe that is the trick “ to get my baby to sleep, never realizing the huge risk they are taking. Many a parent has come in to my office and said “ I think my baby sleeps better on their tummy”, which immediately puts a look of horror on my face!! “WHAT…I thought we had discussed that your baby must sleep on their back until they are rolling over on their own.” Some of the parents do reply, “my ……told me it was okay.” In this case do not listen to anyone about tummy sleeping!!! Discuss car seats, high chairs, pacifier options or whatever else instead….and choose which works for you. Sleep position is non negotiable. 

 

With that being said, I realize that between 4 - 7 months many babies will roll over during sleep even when placed on their backs. It is a developmental milestone for babies to roll and you cannot put a brick on them. I would “guesstimate” that about 25% of the babies I see will ultimately prefer to sleep on their tummies, but they are all out of their swaddle and then roll over after being put down on their back. I also get many videos showing me a baby in their crib who is in the act of rolling over, with a nervous parent running in turning them back over, only to have the child roll right back to their tummy. You could spend the entire night “flipping the baby” over!

 

Remember, back sleeping only, in a crib with just baby and no bumpers or toys….you will have plenty of time for other stuff in the crib when they are bigger.

Daily Dose

Kids & Bedtimes

1.30 to read

As the summer winds down, my office is bust with back to school check-ups.  During these exams, I find myself asking a lot of questions related to a child’s sleep routines. Over the years I have always asked about sleep, and for so many  parents it is one of their main concerns.  

But what I have noticed is it seems children are going to bed later and later. I know the summer months are less scheduled for many families and children tend to get out of routines, but never the less, when I routinely ask, “during the school year what time does your child go to bed at night?” I am surprised by some of the answers.  And I am not talking about teens either, this is mainly the 5-13 year old set. (I do think teens need bedtime guidelines as well, that is a different discussion). 

As a working parent I totally understand and empathize with how busy the evenings are. I tell new parents that the evening hours between 6-9 pm are often the “witching hours” for newborns but I also see these same “crazy hours”  for most families once their children get to be school aged. (is this why cocktail hour was invented?)  It is the time of day for after school activities, homework to be done, dinners to be cooked and children to be bathed. Add in bedtime stories and/or reading by your child and it is CRAZY....but even so children need to have bedtimes appropriate for their ages.

Hearing that 5 year olds go to bed at 9 pm or that 10 year olds are up until 10 or 11 pm not only makes me tired but worries me as well that these children are not getting enough sleep. And the statement from frazzled parents, “they just won’t go to bed” makes me know just how important early good sleep habits are. Bedtime is a statement not a question!

While some children are just natural sleepers, others can be more difficult, but I am convinced that early good sleep habits help all children to be better and more independent sleepers.  Self soothing begins in infancy, but self calming and sleeping in your own bed is an important milestone as well. A child who awakens every night and ends up sleeping in their parents bed is disrupting both their sleep and their parents, which leads to irritable, unfocused and tired children and adults.

So, this seems to be a good time to re-look at bedtimes and adjust accordingly for your child’s age.  Once you get a good routine going, good habits are easy to continue.  

 

Daily Dose

A Better Night's Sleep

1:15 to read

What is it about sleep and parenting? Babies never sleep enough and teenagers sleep too much!! Why can’t “we” get this right? While sleep patterns definitely do change with the age of the child, good sleep habits can begin in infancy and continue throughout adolescence.

Even from the beginning,  you should try to teach your child to fall asleep on their own and to self-console by either sucking on their fingers or a pacifier. But remember, this sleep thing is new and babies really do have to learn how to do this.  Think of it as if you were teaching your child to read, it doesn’t happen overnight, but evolves with practice, patience and repetition. Sleep is the same way.

After the early years of teaching your child to fall asleep on their own, the toddler, preschool, and elementary years are usually fairly easy to establish good sleep patterns if you follow a routine, with a set bedtime, reading to your child before bed and hugs and kisses and lights out. This is the age for occasional nightmares, or fears, but also for regular nights of uninterrupted sleep.

With the tweens and teens and hormone changes of adolescence comes a new sleep clock that is set to stay up too late and not wake up in the morning. Even teens need a good nights rest, so a bedtime should be encouraged and enforced unless there is a test of special event. There is not a reason I can think of for teens to be up past 11 pm on a school night, homework should be finished, and all of the accessories such as cell phone, computer and all other electronic gear put up before bed. The older you get the more you understand a good night’s sleep , but someone has to teach the basics along the way and before you know it the whole house will be on that schedule too. That's your daily dose for today.  We'll chat again tomorrow. Send your question to Dr. Sue now!

Daily Dose

How To Prevents SIDS

1:15 to read

A new study on swaddling and sudden infant death (SIDS) was just published this week in the journal Pediatrics. Not surprisingly, it found that infants who were swaddled and placed on their sides or stomach had a higher incidence of SIDS. It has been routinely recommended for more than 15 years that all babies sleep on their backs and since that time the incidence of SIDS has been dramatically reduced.  Unfortunately not everyone follows the AAP recommendation. 

While it has been known that tummy sleeping has been associated with SIDS this meta analysis looked at data which was gathered over two decades and from 3 different global sites. The review found that infants who were swaddled and placed on their sides were almost twice as likely to experience SIDS and the risk of SIDS did double in those babies who were swaddled and placed on their stomachs.  

I discuss swaddling with all of my patients as there are so many different swaddle blankets available.  Actually, one of the first things a newborn nurse seems to teach a new parent is how to swaddle their baby.  While swaddling has been promoted to aid in calming a newborn as well as to help their sleep, the recommendation that the baby be placed on their back in their crib continues..  Many a baby looks like a little burrito….. rolled up in the swaddle and then being placed on their back in the crib.

But is seems from this study that some babies were being swaddled and then placed on their side to sleep. Unfortunately, even a newborn may squirm enough that they then move from their side into the prone position.  Older infants who are swaddled may actually roll from their back to their tummies, even while swaddled. While the association between swaddling and SIDS remains unclear, I think this is a good reason to start getting a baby out of a swaddle once they are rolling. So around the 3 month mark I start having parents loosen the swaddle and try to just lay the baby on their back without being swaddled.

Let me re-iterate, this article does not confirm an association between swaddling and SIDS.  I do think it is a good reminder for putting a baby, “back to sleep” and once they are rolling “ditching” the swaddle seems to make even more sense. Once less thing to worry about, right?

 

Daily Dose

Fear Of The Dark

1.30 to read

Just about every child goes through a phase when they become afraid of the dark. It is interesting to see a toddler who happily goes to bed in their crib in complete darkness turn into a two-year-old who is afraid of shadows and monsters in a dark room.

How does that happen, seemingly overnight? Actually fear is a normal part of development, and is usually seen in children around two to three years of age. Fears develop when a child is old enough to have an imagination, but is not yet old enough to distinguish fantasy from reality. Try telling your three-year-old “that ghosts aren’t real” and to “just go to sleep”, and I guarantee you will lose that discussion. Fear of the dark is called “nyctophobia” and is amazingly common. Even as an adult, my worries and anxieties seem to be worse in the middle of the night in the darkness, than the same issues are during daylight hours. A toddler has a very active imagination, which is also influenced by things that they see and hear throughout the day. Television shows and videos that they have watched or books that they have read may seem innocent enough during the day but may be a scary memory at night. When a child goes to bed, even after a lovely, calming bedtime routine, there are few distractions to keep their minds occupied and their young brains go into high gear in a dark room. The shadows are definitely a witch that they saw in a movie, or the noise in the hallway is a “bad guy”.  They are very real and VERY SCARY. The best way to conquer fear is to discuss a child’s fears with them. Talk about things that seem to make them afraid and turn off the TVs and stimulating videos. Draw pictures of the scary thoughts and then have a party to throw them away. By empowering them to talk about their fears will often help children feel better. Teach them about positive self talk, with phrases such as” I am not afraid, it is just dark” or “I am not alone, Mommy and Daddy are in the other room”. Another strategy that worked in our house was the “bedtime box”. We decorated a shoebox and filled it with things to help make our boys feel safe and able to handle their fears. In the box were a flashlight, extra batteries (for the “what if the batteries go out” discussion), a magic wand and monster dust to sprinkle in the room (glitter), and their favorite books. They knew this box was there every night if they needed it. Children will also often want a night-light and some may even want the lights on for a while, but let them feel like they are in control. Lastly, there are lots of books to read with your children about being afraid of the dark. Take a trip to the library and ask the librarian for suggestions. A few of our favorites were “The Dark, Dark Night” and “Can’t You Sleep Little Bear”. Children’s fear of the dark usually resolves around four to five years of age as their magical thinking matures. That’s your daily dose, we’ll chat again soon. Send your question to Dr. Sue! More Information: The Dark, Dark Night (Amazon.com) More Information: Can’t You Sleep Little Bear (Amazon.com)

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