Ask The Expert: BabySleepRight

Last week I asked everyone to send me their sleep woes and I'd meet with a sleep expert, Luanne Bruneau of BabySleepRight, on your behalf to have her review the questions and provide some advice. She tackled your questions about a newborn, a one year old and a toddler below with information that will be valuable to many parents dealing with the same issues.

If you have something you'd like her to help you with, she offers free fifteen minute phone consultations or you can also pop onto her Facebook page for her biweekly Q&A. If you need more in-depth help, she can do that too!

Thanks to Baby Sleep Right for sponsoring this post and providing this advice free of charge to the parents who submitted questions.

INFANT

We are deep into the four month sleep regression ... *yawns* Any advice on how to help calm her in the middle of the night when we know she's not hungry and is just plain 'angry' to be awake would be amazing. Or how to stop her from pulling her soother out every three seconds and then crying? I tell her every day how fun it is to sleep - but apparently the reasoning skills of a four month old are lacking LOL

The four month sleep regression is when a baby’s sleep really starts to change. Until babies are a year old, parents should follow the safe sleep recommendations from Health Canada to reduce SIDS; keep them on a flat, firm surface on their backs unless they’ve been given a specific alternate recommendation from their paediatrician.

Developmental milestones, such as rolling, can affect a baby’s sleep even if she’s not actually flipping over. Many parents have also been swaddling their babies up until this point, where it is no longer safe, and the Moro Reflex often startles babies who are used to being secured in a swaddle. If she does start rolling and getting stuck on her belly, she may need rescuing until she can roll back on her own.

Once babies figure out how to roll back and forth on their own, it’s safe to let them sleep in the position they choose during the night. They may startle often for the first week or so as they adjust to sleeping without a swaddle however it’s best to give them a few moments to sort it out for themselves rather than going as soon as they cry out.

If she tries to soothe herself with the pacifier, but keeps getting angry and pulling it out, she could be hungry. Many babies go through a growth spurt around this age and cluster feed for a period of time until it passes.

Typically, babies this age should be able to get four to six hours of uninterrupted sleep at night, and should be able to last about two hours awake between sleep periods during the day. Putting her to bed earlier may help (between 6-8 p.m.), and ensuring she gets two to three naps a day that are in sync with her biological rhythms (the first around 9 a.m., the second between 12–2 p.m., and possibly a third in the late afternoon depending on how long she sleeps during her naps, around 3-3:30 p.m.). Just be sure she doesn’t nap much later than 4:30-5 p.m. if taking three daily naps or that may interfere with bedtime.
For more information about Baby Sleep Right services please visit the website and/or request a free fifteen minute phone consultation to get started.

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ONE YEAR OLD

I’m going back to work next month and my eleven month old has still never slept more than three hours in a row. He sleeps in bed with me still because he wakes every couple of hours and then nurses back to sleep - I feel like a human soother! I’m wondering if his sleep sack could be waking him as he gets tangled up in it and if I should try essential oils to help him sleep. I also have a five year old so I’m worried about him crying during the night during sleep training and waking my daughter.

It sounds like he has a strong feed-to-sleep association so it’s important to start teaching him to fall to sleep without nursing. If you don’t already have one, start a regular bedtime routine that you repeat in the same order every night, such as bath, brushing teeth, diaper, massage, and a story.

It’s okay to use essential oils if you want to at this stage, perhaps during a massage, as long as he doesn’t have any known sensitivities or dermatological concerns. There is some evidence to suggest that they may help, but this was done while two comparing groups who both made improvements to their sleep hygiene (routines), which is always key to good sleep habits. At the very least, it adds a calming element to the routine.

Make the routine peaceful and quiet and consistent, and do not have play time and do not feed him right before sleep. If he needs to eat before bedtime, feed just before bath time starts. Keep the routine thirty minutes so that he’s able to link the steps in it to sleep, and be sure all caregivers do it the same each time. He may need his bedtime moved earlier as well. He will likely be upset the first few times but if you are consistent he will start to change his sleep associations within about a week, and be in the habit by three weeks.

Most babies can stop night feedings by six months old, but I encourage you to check with your health care practitioner before you cease night feeding altogether. Without restorative sleep he will have a harder time focusing and learning during the day. Breastfeeding him multiple times throughout the night at this age also means he’s taking in less calories from solid food during day so there’s a slight chance that he could be iron deficient if he is waking up this often to feed. If this is the case, it’s been suggested that iron deficiency could interfere with seratonin production, a melatonin precursor, so talk to his doctor to be sure there are no underlying medical issues and that diet is not a concern.

Feeding him multiple times during the night will also mean he’s wetting his diaper more, which is another reason he may be waking up. This results in cold, wet diapers, which also reinforce night waking.  If he’s in bed with you, he should not be wearing a sleep sack as he may be overheating, which can be a cause of SIDS.  I also must refer you to Health Canada’s recommendations for safe sleep and reducing the risk of SIDS.

As for your daughter, talk to her ahead of time and explain that you are teaching her baby brother how to sleep and if she hears him at night, know that her parents are taking care of him. She doesn’t need to get up to check on him or let you know. Let her know that her big job during this transition is to go back to sleep if she hears him. Then be sure to praise her in the morning for being a big help!

For more information about Baby Sleep Right services please visit the website and/or request a free fifteen minute phone consultation to get started.

TODDLER

I was so spoiled and really had a great sleeper until around 18 months. Now we're at 20 months and he still goes down completely fine on his own; great bedtime routine, place in crib and walk away! Problem is he's now waking up anywhere between 10 p.m. and 3 a.m. and won't go back [to sleep] on his own; after an hour or so of shushing, soothing, etc. we've been giving in and bringing him in with us. Such a fail, I know, but with work it's so hard! Would love any tips and to know I'm not destroying him for life!!!

First of all, no, you’re definitely not destroying him for life! :)  I still ethically must refer you to Health Canada’s safe sleep recommendations.

If you and your partner choose to continue bedsharing, that is your family decision.  Of course, it is important to do things as safely as possible, and here are some recommendations for families who choose to bed share. If you want him to sleep on his own in his crib, then there are a number of sleep intervention methods that could be implemented.

The first thing to look at is if he’s going down for bed early enough. At 18 months he should be going to bed between 6-8 p.m. and sleeping 11-14 hours each night. Sleep is when babies grow and develop so it’s important that they get enough undisturbed sleep to do so. He doesn’t know what time it is when he’s waking so, when he does, it’s best to give him a few minutes to work things out on his own first. If he doesn’t settle, then you can go in calmly and practice the sleep intervention method you’ve chosen to settle him.

An hour of shushing and soothing is not too long for the first few days of a new routine, but if this has been going on for weeks, it’s not working at this point and it’s probably not the right method for him as it is likely causing frustration all around. Children can read body language and sense frustration, so if you’re frustrated, he will pick up on that. Similar to when a child falls, he looks to you for how to react; if you’re calm, he will calm more easily, if you’re upset, it may amplify his reaction.

It may be time to try a different intervention method. The key is to know that whichever one you choose, it will take at least a week to see results, and three weeks for it to become a habit.  So the most important thing is to choose an intervention method, follow it carefully, and have ALL caregivers be consistent during that time, even when it seems like you may be going backwards at some point.

For more information about Baby Sleep Right services please visit the website and/or request a free fifteen minute phone consultation to get started.


Luanne Bruneau established Baby Sleep Right in 2012 and was Atlantic Canada's first certified infant and child sleep consultant. She graduated from the University of Western Ontario with a B.Sc. in Genetics and an M.Sc. in Biology and is certified by the Family Sleep Institute (FSI) and a member of the International Association of Child Sleep Consultants. She is passionate about teaching families age appropriate behavioural intervention methods to help their children adopt healthier sleep habits according to their parenting style.

You can learn more about Baby Sleep Right's services by visiting their website and parents can request a free fifteen minute phone consultation to get started. You can also register for an upcoming Halifax workshop at Fiddleheads in Bedford on April 9 at 9 a.m. and Active Approach Chiropractic on May 6 at 2 p.m. Everyone is welcome to join the biweekly Sunday night Facebook Q&As as well.