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Your Baby

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

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.

Your Teen

Teens Getting Less and Less Sleep

2:00

Today’s American teens are getting a whole lot less sleep than they did in the 90s according to a new study. Too little sleep makes focusing difficult and depletes one’s energy. As a result, school performance often suffers and unhealthy and/or unwise decisions are much easier to make.

Just 63 percent of 15-year-olds reported getting seven or more hours of sleep a night in 2012. That number is down from 72 percent in 1991, according to the study.

Between the ages of 13 and 18, teens getting 7 hours or more of sleep a night plummets. At 13, roughly two-thirds of teens get at least seven hours of sleep a night; by 18 that percentage drops to about one-third.

"After age 16, the majority are not meeting the recommended guidelines," said study author Katherine Keyes, an assistant professor of epidemiology at Columbia University's Mailman School of Public Health in New York City.

Why is it so important that teens get enough sleep? A lack of sleep can impact just about every part of their life. Hormones are escalating, social interactions are fragile, school demands are heightened, self-image is developing and many begin testing boundaries with parents, teachers and each other. It can be a rugged time for teens and those around them.

For the study, researchers from Columbia University looked at sleep data from a national survey of more than 270,000 teens from 1991 to 2012. Each year, teens reported how often they got seven or more hours of sleep, as well as how often they got less sleep than they need.

The most recent recommendation from the National Sleep Foundation says teens aged 14 to 17 need eight to 10 hours a night and people aged 18 to 25 need seven to nine hours.

The largest declines in those getting enough sleep occurred between 1991 through 2000; then the problem plateaued, Keyes said.

Researchers also found that girls were less likely to get an adequate amount of sleep compared to boys.

So what’s causing the decline? There a several theories about what may be contributing to this downward slide in teen sleep.

Keyes did not have access to information about the teens' use of electronic media, a factor often blamed for lack of sleep as teens text, check social media, play video games and work on laptops late into the night. However, that might be a factor, she said.

"On an individual level, excessive use of technology may impair an adolescent's ability to sleep," Keyes said.

Caffeine may also be a culprit. It’s estimated that about 30 percent of adolescents report consuming energy drinks which are packed with caffeine. Many teens drink specialty coffees as well.

Another issue may be early school start times. Some sleep disorder experts believe that starting school – even an hour later- could help teens get more valuable sleep. Starting school, for instance at 8:30 a.m., is an approach favored by the American Academy of Pediatrics.

Other studies have noted that a lack of sleep is linked with many other teen health problems including obesity, car accidents, depression and a drop in school performance.

When kids are younger, parents are more likely to set limits on bedtime behavior as well as bedtimes. Once kids reach their teens, some of those limits may get a little lax, but this is the time when they are needed most.

Parents still have the authority to set a bedtime and require that computers, tablets and phones are off at least an hour before bedtime. Many kids (and adults) are addicted to their smartphones, so it’s a tough rule to set; it takes a strong commitment and a good example for it to work.

Lack of sleep is hard on everyone, but teens really need the extra help to stay healthy and function well in school. It has such a big impact not only on their present but for their future as well.

Source: Kathleen Doheny, http://www.webmd.com/children/news/20150216/us-teens-getting-less-sleep-than-ever

Daily Dose

Pregnancy & Sleep

1:15 to read

Why is it that as you get further into your pregnancy you sleep less?  I am sure that it is just a factor of being “bigger” and as one mother said to me, “having another human inhabit your body”. It is often hard to find a comfortable position to sleep in, and even if you do, the baby may not want to stop moving when it is your bedtime.

But, I also really think this is all in God’s plan to get a mother (and father who often says his wife keeps him up) ready to be new parents. It is just foreshadowing of the weeks to come when you bring that newborn home from the hospital.  You have already learned to “survive” with less sleep.

The first few weeks at home with that most precious baby is really just about survival. I don’t care what you read or how many classes you take...there really are no “rules” or “tricks” to get thru the first 6-8 weeks of being a new (or seasoned) parent.  

I tell my parents the only “rule” is that the baby MUST sleep on their BACK..other than that try to do the feed, play, sleep routine that you think will just happen, but know at times your baby just does not want to go to sleep when you want them to!! They are not abnormal and you are not a “bad” parent.....they are just newborns with developing brains and sleep cycles. I promise, this too shall pass and longer sleep cycles will come.

So, if you are awake one night toward the end of your pregnancy and reading this, look at the bright side.  Your body is just getting you even more prepared to be a “great” parent....you already know how to survive with interrupted and less sleep.      

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Back to School, Back to Sleep!

Daily Dose

Getting Your Baby to Sleep!

1:30 to read

Did you know one of the biggest Google internet searches for parents revolves around “how do I get my baby to sleep?”  I guess that any new parent in the middle of the night is online searching for “THE ANSWER”, so of course you “Google it”!

Now that we are grandparents and the baby is about 6 weeks old (although technically she is a week old, as she was 5 weeks early) my son is also looking for answers on the internet to that same question....how to make her sleep, so I can too! He even asked me if their was “magic” to this?

If only there was an answer on Google or in any book. It just takes time and every baby is different.   I guess there are some babies that sleep through the night from the time they get home from the hospital, but I have never seen one.  I think some parents just forget that at some time or another they were up at night with a newborn.

A newborn baby does not understand circadian rhythm and they are really not “trying” to keep parents up at night.  It takes weeks for a newborn to even begin to have some “routine” to their day and I try never to use the word “schedule” when discussing a newborn.  A baby is not a robot, they do not eat every 3 hours and then sleep for 3 more before eating again. They are “little people” and their tummies sometimes need to eat in 2 hours and then later it may be 3 hours before another feeding.  Don’t you sometimes eat an early lunch one day and a later lunch the next? 

But by trying to awaken the baby throughout the day and offering a feeding every 2-3 hours you will hopefully notice after several weeks that your baby is eating more often during the day and suddenly may thrill you and sleep 4 hours at night. it just takes time....YOU cannot make it happen.  I tease new parents that awakening a newborn during the day and prayer is about all you can do....all babies do eventually sleep, but it may not be right after you get them home from the hospital...think several months (as in 2-4) and you will be happy if it happens sooner.

Lastly, with all of the tech in the room, don’t pick up your baby in the middle of the night if they are just “squirming” around. Babies are notoriously loud sleepers and if they are not crying let them be and you may be surprised that they arouse and went back to sleep. If your baby cries you absolutely go get them and console them and feed them too if it is time. An infant should not be left to cry. 

This too shall pass and sleep will come, but there will be new stages down the road that will keep parents up at night, of that you can be assured. Comes with the territory.

Daily Dose

The Dangers of Co-Sleeping With Your Baby

New parents are sleep deprived and even when being very careful, may roll over in their sleep or push a your-baby up against the wall or side of bed and cause accidental suffocation.With new data just published in this month's Pediatrics on the increase in deaths in infants related to accidental suffocation and strangulation in bed, it points out once again the dangers of co-sleeping. The "back to sleep" campaign that began in the mid-1990s after studies showed that children who slept in the supine position had a decreased incidence of SIDS. Since that time we have seen such a significant decrease in infant deaths related to SIDS.

It is seldom that I even have to re-iterate supine sleeping, as most parents seem to realize the risks associated with tummy sleeping. There is an occasional parent that thinks their child "sleeps better on their tummy" but the inherent risks far outweigh the risks of prone sleeping. This latest article and analysis of data shows that a new group of sudden unexpected infant deaths is now on the rise, and seems to be related to suffocation often secondary to an adult rolling on top of an infant or due to an infant who becomes entrapped between the bed and mattress or wall. These infants have all been co-sleeping with an adult on a mattress, couch, or even a waterbed. The American Academy of Pediatrics recommends that newborns sleep in their parents rooms, but in a bassinet or port-a-crib, and not in the parent's bed. New parents are sleep deprived and even when being very careful, may roll over in their sleep or push a your-baby up against the wall or side of bed and cause accidental suffocation. The rates of accidental suffocation have quadrupled in the last 10 years. We all want to be the best parent possible. If you have a newborn you know that there is nothing better than snuggling with your your-baby. But once cuddled, put your your-baby down to sleep on a firm mattress, in their own bed, without other pillows or blankets in their bed. The new tag line should be "back to sleep in their own bed!" That's your daily dose, we'll chat again tomorrow. More Information: Rise in Infant Suffocations Tied to Bed-Sharing

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