Safe Sleep 101

I have started and re started this post and although I have been interrupted a million times I am determined to share  this important information.  

I summarized two great articles about the basics of safe sleep and prevention of SIDS (Sudden Infant Death Syndrome). The first is Recommendation for a Safe Sleep Environment by the American Academy of Pediatrics from October 2016. The second article was by by the Safe Sleep for Babies by the Canadian Association of Paediatrics.  I used this information to compile the following list of information.

As parents SIDS is a scary thought and it’s heartbreaking to even think of. As a sleep child consultant I feel my role is to educate the public on safe sleep.  Reducing your risk factors will add to your child's safety and your peace of mind while they are sleeping.

1. Babies should always sleep on their backs until the age of 1 year old. Once they start moving please let them sleep as they are but alway put them down on their backs.  

2. Room Sharing - allowing your child to be close for easy feedings, changing and the feeling of closeness up to 6 months to 1 year of age.

3. Alone - Always place your child to  sleep alone in an approved crib. The crib should include only your baby.

4. A firm approved mattress is also recommended.  A soft mattress could develop indentations that could be problematic to your child's health if they get trapped.

5. The mattress should be covered with a well fitting sheet (ideally a fitted sheet) and there should be nothing else in the crib.  This means NO bumpers, pillows, blankets, toys, stuffed animals or anything else that might suffocate, entrap or strangle the child.A wearable blanket is perfect for keeping your child warm as it reduces the risk of covering the baby’s head or causing entrapment.

6. Keep the bedroom dark. You might only have a nightlight for you to see by. Room darkening curtains are very helpful to create this environment.

7. Keep the room cool (18-20 celsius or 68-72 fahrenheit) and be careful not to overheat your child. Signs of overheating including sweating and/or the child’s chest feels hot to touch.  If your child falls asleep when you are out please also be careful using carseat and stroller covers as these can reduce airflow and increase the risk of overheating.

8. Avoid exposure to smoke or secondhand smoke during pregnancy and postpartum. Avoid drinking alcohol and using illicit drugs. It is especially important to not consume alcohol or drugs prior to bed sharing, as any impairment of the adult greatly increases the risk of SIDS.

9. Breastfeeding is recommended in reducing SIDS risk. This isn’t to say that bottle feeding is dangerous. I always say fed is best whatever the method. I have a formula fed and breastfed baby so fully understand both sides.

10. Using a soother has also been shown to reduce the risk of SIDS. This includes when a baby is sleeping and the pacifier falls out.  A pacifier should not be attached to a string or your child or propped to stay in your child's mouth as any of these can increase the risk of suffocation or strangulation.  If your child will not take a soother early on try again when your child is a little older. It is recommended to wait until breastfeeding is established before introducing a soother. Evidence is insufficient on the effects of thumbsucking and the reduction of SIDS.

11. Consistent prenatal care is an essential component of having a healthy baby as well as regular medical checks with your health care practitioner.

12. Immunize your child as per the guidelines.  This also reduces the chance of SIDS as many of these visits also include health checks and information on the well being of your baby.

13. Skin to skin contact is also important to relax the baby before putting them in the crib. I often did this in the morning when we woke up. It used to be my favourite time of day. Those moments were so special. But if you are about to fall asleep please place your baby in their crib. Another risk for SIDS are children sleeping on sleeping parents chests on chairs and couches.  

Here’s to safe sleep for you and your family.

Xx Alison

Summer Sleep Tips!

Summer is upon us here in the northern hemisphere….warmer temperatures, brighter mornings and evenings and no school….so often a less structured timetable.  Here are a few ways to help keep kids on a great routine for the summer holidays.

1. Make sure you have room darkening curtains/blinds. This not only makes bedtime easier but also keeps your child's room darker in the mornings to reduce the early wakings.

2. A noise machine - something constant to help drown out the outside noise coming in from the open windows. Those kids playing outside at 8pm and those chirping birds can be pretty loud in the morning.

3. Bedtime routines - keep up with your bedtime routines. This acts as a reminder that it’s time for sleep.

4. Structure your day. I like to create  plan for our days… adding a little routine to our mornings, afternoon and evening. Even in summer I make sure my girls are up by 7:30am.

5. Keep night time clothes minimal - Try a summer sleep sack or light summer Pj’s. Babies have a hard time regulating their own temperature so be careful to keep light bedding. They can’t take off a  blanket when they are too hot.

6. Be sun and heat smart. Keep your kids out of the sun whenever possible, remember sunblock and to drink lots of water. Keeping kids hydrated in the heat is especially important. Dehydration or an uncomfortable sunburn might make it difficult for your child to sleep.

7. Don’t skip naps and quiet time.  Giving your child a chance each day to recharge and rest will also help create a better day. Summer can bring increased activities and thus recharging mid-day is so important. This will help you keep your schedule (#4).

8. The most important message is to enjoy the time with your kids. Summer is to be memorable. Go somewhere new with your kids and remember how much fun summer vacation was when you were little.

If you are needing help to navigate summer sleep please contact me at alison@cheekysleeper.com as i’d love to help you.

xx Alison

Nightmares!

I was recently asked on my facebook account the following questions.

“My 3 year old has recently started waking up once (at least) in the night. Most of the time, I think she is crying in her sleep. Is she having nightmares? She doesn’t seem phased by it in the morning but I would like to sleep through the night again! Any Suggestions?”

Nightmare will usually occur during REM Sleep and most nightmares will occur in the second part of the night when REM periods have lengthened. Nightmares are thought to have many triggers in children. These include:

• Illness – children can be prone to nightmares when they have fevers. This could also be as simple as they are too warm sleeping.

• Overtired  

• Having irregular sleep routines

• Developmental milestone – when they are conquering a new skill.

• Stress or Anxiety – something like moving, birth of a new sibling or some outside circumstance.

• A traumatic event.

Experts say anything can cause nightmares: a new television show or a scary story they overheard. The cause might not jump out at you but the following are a few simple tips to tips to get her back on track. 

1. Try getting her to bed even 10-15 minutes earlier for a couple of weeks. If she’s overtired she might just benefit from a couple extra minutes of sleep.

2. Try lighter Pajamas in case she is too warm. I will often go in and pull off my daughter’s heavier blanket once she’s asleep especially when she insists on wearing her warm fussy pj’s for bed

3. Teach an her an action in case she is waking up. – “Cuddle your pillow and say I know it’s over and I’m safe in my bed.” And go back to sleep.

4.  If she does wake you respond to her feelings and provide a big hug. Try not to over react to her fear by looking for monsters in her closet. Don’t show your anxiety or unhappiness with her waking.

5. Try adding something relaxing to your bedtime routine such as meditation, relaxing breathing or a warm bath.

6. It only takes repeating the same reaction like looking for a monster or a glass of water to create a habit or expectation in small humans so try to minimize the reward for night wakings.

7. Start a sleep diary for your child. See if you can see a pattern to her night wakings. What might be her trigger? Could it be a later bedtime, heat wave, watching something scary or even more disagreements with siblings?

8. Try talking about the nightmares when she is calm, relaxed and feeling safe. Asking if something might help her – extra night light or an extra special teddy. Something to make her feel safe at night.
9. Try ear plugs for yourself or alternate with your husband to allow you a better night's rest.
10. If your child is waking at approximately the same time each night try gently waking her slightly before her normal dream time to see if she will sleep through them. This is hard if you have to wake yourself but you might be able to get back to sleep more easily knowing she’s okay.
11. Remember dreaming is a good thing as it helps kids become more confident to deal with their problems. It helps them work through some of their worries.

I will mention Night Terrors. These occur earlier in sleep (1-2 hours after bedtime) with loud screams, eyes wide open and your child appears to look through you. Please get in touch with me - alison@cheekysleeper.com and I can provide additional pointers until I get a blog post up about these.

If she is tired the next day this could be an indication that she is losing too much sleep and it might be medical reason. If that is the case seeking assistance from your doctor would be recommended.

I hope this helps. 

Alison

What Happens During Sleep?

When I was studying to become to become a Paediatric Sleep Consultant I was blessed to virtually meet  a group of smart, fantastic, supportive, funny women. One of these women has written this excellent, educational article. I feel very lucky to have her permission to share her words with you.

"You know how good it feels to sleep well.  But do you know how amazing sleep really is?  If you could take a peek into what happens during sleep, you might be surprised at the complexity and the beauty of what goes on.  It would also give you a lot of insight into why little ones wake so often.  Let me explain.

You may have heard of REM sleep, which stands for rapid eye movement.  REM sleep is hugely important, but we'll get to that in a moment.  First comes a few stages of non-rapid eye movement, or NREM.  In NREM1, we’re still fairly aware of our surroundings.  This stage serves as the transition from waking to sleep.  Someone awakened from this stage might believe that they weren’t actually asleep.  We pass through this phase fairly quickly.

The second stage, NREM2, makes up most of an adult’s sleep.  It’s still a fairly light stage of sleep, but you’re becoming less aware of anything going on around you.  

During NREM3, heart rate and blood pressure drop; breathing becomes deep and even.  This is the deepest level of sleep, when cell growth and repair occur.  Energy is restored, key hormones are released.  We are least aware of external activity during this stage.  If awakened, you would feel extremely groggy.  Most of our deep sleep occurs during the first third of the night, making it the sleep your body is most likely to protect.

After NREM3, there is a return to stage 2 sleep, and then a period of REM--there it is!--when we are most likely to dream.  This stage is vital for learning and memory consolidation.  Adults experience about 25% of their sleep as REM sleep, but for a newborn this stage can account for as much as 75% of their sleep.  When you think about how fast their brains are growing, this makes a lot of sense.  

While in REM sleep, heart rate and breathing return to close to their waking rates, and the brain is incredibly active.  It is very easy to wake from REM sleep; in fact, adults may wake as many as 9 times throughout the night.  Normally we aren’t aware of these wakings since we return quickly to sleep.  These wakings are protective: they allow us to check on our surroundings, or to shift position so that we don’t become uncomfortable in one place for too long.  For babies, these awakenings also allow them to signal to their parents when they have a need.  If there’s no present need, baby might continue on to another cycle of NREM2, then more deep NREM3, repeating this light--to deep--to light--to dreaming trend through the night.  

Now pause for a moment here, and imagine with me that you’re in an unknown place.  Maybe you’re camping out in the open by yourself.  You’re not sure who else is around or what to expect through the night.  You can’t hold your eyes open for another moment though, and sleep overtakes you.

Would you sleep well?  Probably not.  Any foreign noise would put you on high alert.  A person walking by would startle you.  You would resist allowing your body to go into that deep stage of sleep; the wakings characteristic of REM sleep would give you frequent opportunities to make sure that you were still safe.  Rather than quickly settling back to sleep, you would scan your surroundings to make sure everything was still okay.

What allows us to sleep well when we’re at home and in our own bed?  We know what’s going on around us.  We know that we’re safe.  Because when you think about it, sleeping is an act of trust.  You’re incredibly vulnerable when you’re asleep.  As your environment stays the same night after night, you know that it’s okay to relax and let your guard down.  But if you woke during one of those points of lighter sleep one night and found that a light was mysteriously on in your home, you’d probably be concerned.  Things weren’t as you left them; instead of continuing to sleep you’d go investigate how this light happened to be on.  Note that the light didn’t wake you; it has no power to do that.  You came to a period of lighter sleep, woke, and noticed the light was on.

For your child, this world is a great big unknown.  The way they learn that it’s safe to fall asleep and stay asleep is to know that nothing will change through the night as they reach those frequent periods of REM sleep.  If mom was there as baby fell asleep, waking up during the night to find mom missing would be just as unsettling to baby as finding a light on in the middle of the night would be to you.  This is why consistency is such a big part of sleep for little ones.  If you rely on feeding your baby to sleep each night, each time your baby wakes during the night she’ll need that feeding in order to fall back to sleep again.  How she falls asleep at bedtime is how she needs to return to sleep through the night.  That consistency builds her trust that it’s safe to sleep.  Remember though, that babies spend more time in REM sleep than adults do, and that it’s normal for them to wake often throughout the night.  Committing to helping your baby fall asleep at bedtime means committing to helping your baby return to sleep.  Night after night after night.

The challenge is, no one can keep up with this.  Not without losing your sanity, that is.  We weren’t made to continue to face interrupted sleep without end.  While caring for your newborn at night is part of being a parent, your baby is capable of sleeping for longer stretches by 2-3 months of age, and generally through the night by 6 months of age.  But when your baby’s trust hinges on you being there every time sleep begins (at bedtime) or restarts (through the night), it becomes a black hole that you can never fill.  You simply can’t respond so consistently that your baby decides to stop waking.  

This is why we teach independent sleep.  By providing your baby with a consistent bedtime routine, you build predictability for your little one.  He learns to expect what comes next: sleep.  When we allow our little ones to drift off to sleep on their own, there are no surprises in the middle of the night.  When our daytime interactions have shown baby that we are responsive and they can trust us, that trust translates into a greater ability to fall asleep at night, knowing that we have provided for them.

Will your baby still wake you at night from time to time?  Of course.  It’s developmentally appropriate for babies to continue to wake occasionally throughout the first year.  Learning to roll, crawl, pull to stand, and walk all have a good chance of waking your baby, as he gets to a light stage of sleep and thinks, “I want to practice that new thing that I learned!”  Illness and leaky diapers will often be the cause of your baby summoning you from your bed.  But know that the effort you’ve put into making your actions responsive and predictable to your baby makes a difference.  You’ve taught your baby that surrendering to sleep is a good and pleasant thing, and she can trust you.  

Sweet dreams!" - credit to Sarah Christian, Once Upon A Bedtime.

How Did I Get Here

How Did I Get Here...

I am the owner and founder of Cheeky Sleeper- Sleep Consultants Ltd. I named my company after my own Cheeky Sleepers, ages 2 and 4. They are the reason I started my business, went back to school and the reason I am who I am today.

As a new parent, sleep was at the top of my mind all the time. My first daughter was a scheduled eater - she woke every 3-4 hours every single night until I started to teach/coach her to sleep through the night at 10 months. I have clear memories of sleeping on the floor outside her room for 3 nights as she cried and cried. After a couple of nights of crying she got it and has been a good but cheeky sleeper at bedtime. We've now made it through teething, nap transitions, giving up soothers, moving, travel, an absent parent and the arrival of a sibling.

To be honest, I don't have clear memories of sleep training my youngest. I clearly remember the sleepless nights when she was young, bottle night feeding her at 6 months while sitting in a chair next to her crib.  Magically at 8 months old, my husband got her to sleep through the night while I was in the hospital for a few nights. Now two she loves to go to bed but is always a little cheeky at nap time.

Neither journey has been easy but I get to see the rewards... everyday two happy, well rested little girls. My kids are amazing, full of joy, very active and love being sisters.  

After the arrival of my youngest, my passion for my career in Human Resources dwindled. I love to talk and share my experiences as a parent with others. It wasn't till I heard a Paediatric Sleep Consultant (a fellow Family Sleep Institute (FSI) grad) speak that I had a moment it dawned on me that I should become a sleep consultant. I have always wanted my own business and I am delighted it will be as a sleep consultant. I started my education with Family Sleep Institute in September 2016 and graduated in March 2017. I love learning, talking and coaching parents through sleep training.

I hope to make this site and my blog a resources to share and educate parents.

Thank you for coming on this journey with me and I look forward to share my knowledge with you.

xx alison