Monday, 1 February 2016

Night waking

Initially babies require one or two feeds during the night. Most will barely wake to feed, do so efficiently and swiftly return to sleep. This physical reuirement gradually reduces to one night feed and then to sleeping through. Formula fed babies should be able to sleep through by about six to nine months. Breast fed babies often seek a night feed for longer. As long as night feeds can be completed without prolonged waking most mums will cope well.

Some mothers try to eliminate a feed by replacing it with water. While this may work in a few cases, replacing one "reward" with another does no eliminate the waking. Whether water, formula or breast feeds are given the infant is picked up, cuddled into mum and has a period of intense closeness which some come to rely on.
When you wish to eliminate a night feed it is more often successfull when done by a gradual reduction in either the volume of formula, or duration of breast feed. This way the child learns that there is less reason to wake. Consequently they start to sleep longer.

Not all night waking is about feeding. Some children seek the reassurance of a parent when they have had a bad dream. Night terrors affect children who have not had sufficent sleep in 24 hours or have had experiences which they found traumatic. Some are simply poor sleepers who tend to use night sleep as a period of "naps" and as a result they wake regularly throughout the night and the parent has to intervene to get the little one back to sleep. Some have developed the belief that they cannot return to sleep without parental intervention.

How parents should deal with night waking depends on the sleep history and the possible causes of the waking. This, along with looking at  the parental response helps in the development of a plan to eliminate these regular night wakings. As with many sleep difficulties it is not true that one remedy will work for every child. 

If you would like help to resolve your child's sleep difficulties contact us ;-


Friday, 29 January 2016

Ellie  A Case study

Ellie was 2 years 6months old. She was the older of two children. She had always slept without waking her parents, until the arrival of her baby brother. Although her parents had done some work to prepare her for the new arrival she was suddenly not at all keen to accept bed time. She had a good pre bed routine but now dad had to settle her if mum was feeding or caring for her baby brother. She did not like this at all, and the protests she set up were proving challenging. First she would try to delay bed time by wanting to wait until mum could take her to bed. Then, if mum was able to do this, she would expect mum to remain with her until she was asleep. She was not afraid of her room before, and had never had any difficulty in completing her pre bed routine and settling to sleep within a few minutes. Her brother was about 4 months old when I was asked if I could help mum improve this situation.

Although to begin with Ellie was doing her best to delay bed time, she was sleeping through the night, and initially her parents had thought this was her way of protesting at less time one to one with mum. They had gone along with things until the bed time delay had gone from half an hour to two to three hour,s before she would finally give in to sleep. At about this stage she was also waking through the night and demanding mum resettle her. Ellie could determinedly remain awake and chatty for two to three hours before she would allow her exhausted mum to return to her own room.

We talked about the changes Ellie was dealing with and how she had coped with each part of these changes. Previously dad had often been late home and had not had much to do with a pre bed routine. Dad was keen that she accept that he settle her and was a little concerned that she would not co-operate with him. We discussed his ideas of how to settle her and how much time this should take. We talked about the games she liked to play with dad and the differences between mum and dad's views of a good pre bed routine. We looked at practical aspects of Ellie's becoming more independent and how best to support that alongside her sleep patterns.

From sleep diaries it became clear that she was waking when her brother was being settled for the night, when he was fed through the night, and occasionally when Ellie needed to go to the toilet. We then had a long discussion about what we thought Ellie was feeling and thinking and how best to help her to accept her role as big sister.
Mum and dad were given strategies to use to help Ellie make appropriate decisions and feel involved in the process. It took a few weeks before Ellie started to protest less about bed time and to allow the settling process to be shortened.

As children grow and develop their own independence they become aware that they have few to no choices in life. The only control they have is over what they put in their mouths. This can result in picky eating for some. Giving a child some control of their day to day life can reap big rewards for parents as it also improves the child's view of fairness. Children can be given choices, usually between no more than two things. 

The choices offered should both be acceptable to the parents.
"Do you want to put on your socks or your pants first? " for example.  If the child is allowed to make choices through the day and the time comes when there is no choice, X has to be done, the parents can say "OK, you made a lot of choices today, now it's my turn. You have to ....." The child may protest but will see this as a fair action and usually will accept it.  A choice between more than two possibilities can be confusing at this age but having made a choice and having to live with the consequences of that decision is part and parcel of becoming an independent person.

Within a few weeks Ellie was much more settled and slept through the night without disturbing her parents. She accepted her pre bed routine with mum or dad and the household was happier and better rested.

Tuesday, 4 August 2015

Caring for your baby's skin

Taking care of baby’s skin
Skin is the largest body organ. It is our first defence against the elements and it is important that this effective barrier is maintained.  Some babies are noted to have dry skin from birth and a variety of tried and tested methods are suggested to help parents smooth the skin and avoid dryness.  Water is drying on the skin, and children with skin conditions are often given “emollients” to use in the bath or shower to reduce the drying effect of the water. 

Oilatum is one example of an emollient but there are others.
A tablespoon of porridge oats in a thin cloth soaked in the bath and squeezed out will make the baby’s bath water cloudy as it releases emollient into the bath water. This can be helpful without causing reactions on a sensitive baby’s skin. The same ingredients are used in the making of Aveeno skin care products.
Moisturising the skin surface is also advised by some. Again there are a variety of proprietary creams and ointments available. Some prefer to use naturally occurring substances to moisturise the skin.

Traditionally olive oil has been suggested to parents as a good way to improve their baby’s skin. While Olive oil is often used by adults there are a number of studies which demonstrate that olive oil is unable to be absorbed by skin as the molecules are too big to pass through the effective skin barrier.  Worse, frequent use of olive oil encourages the production of blackheads and whiteheads. 
Olive Oil iused twice daily on an adults skin has been demonstrated to thin the top layer of skin so what would prolonged use do to the more sensitive skin of a baby? 
Why is this?
Olive oil contains two acids. Linoleic acid, which, despite it’s name is good for skin, and oleic acid which has been demonstrated to thin the skin by destroying the top layer. Olive oil unfortunately contains a higher percentage of Oleic acid (the bad part) in comparison to Linoelic acid.

Baby massage is often done using Sunflower,  or  Grape seed oil.  Both are high in Linoleic acid and have molecules small enough to allow the skin to absorb them efficiently.

Nut oils have their proponents, but no health professional would advise the use of any nut oil on a child’s skin in case it provoked a reaction. Allergy to nuts is one of the most common allergies.

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Monday, 27 July 2015

Transition or Comfort Object

As an adult there are some smells which help us remember events or people and there are some smells which help us to relax. Many adults sleep best in a freshly laundered bed. Infants have a much more acute sense of smell than adults. Consequently when we want them to relax, or to go to sleep we should consider what smells might assist them.

We use swaddling to offer a sense of being held without the need for a parent to hold the little one. The firm constant, all over body pressure is comforting for newborns because they have always experienced firm physical boundaries before birth and often find it relaxing to have similar pressures afterwards.  As they grow and experience life they look for other comforting things like a regular routine which demonstrates what is expected of them.

Transition objects, a soft toy, a piece of material which smells of mum can be really useful and comforting to little ones. Introducing such an object at between 4 to 6 months can be very helpful for some babies. Choose a soft object which can be washed. Hold it between your body and your baby as you feed. This allows your "smell" to permeate the object which then goes with your little one for EVERY sleep. Put it where baby can smell it but be sure that this is not going to make your little one overheat. Putting it above baby's head, across from baby's face, or near baby's chin can be possibilities. The smell of mum means she must be close by. Closing your eyes and still being able to smell mum can be really reassuring. When you have recently washed this object hold it between you again so that you refresh the "mummy smell" before returning it to use.

Transition objects are things we have chosen for our children, they will choose their own when they
 are older. These work better for some children than others and some people believe the work best between 6 and 18 months when many little ones are more anxious about separation from mum.

When children become toddlers they will select something to carry with them or take to bed with them and this may continue to be the object you choose so long ago, or it may be something entirely different. If a soft toy which cannot be washed becomes the object of choice it can be freshened and any dust mites killed by wiping with a damp cloth and then putting it in a bag in the freezer for a few hours. It can then be returned to the child.

Contact us;-  email

Sunday, 26 July 2015

What should you expect from your child's sleep?

One of  the most common discussions amoungst new mums is the duration of their child's sleep. The "perfect" baby will wake to eat, play or interact for a short time, fall asleep easily and sleep through the night. This seems to be what many expect. Life unfortunately, is often not like that.

Your baby has come into the world with a sleep plan from your and your partners genes. You have an opportunity to build on that because the third part of sleep is in part learned by experience.
Most newborns do spend more time asleep than awake.Their brain is growing, "filing" the expereinces which occured during waking and "remembering" them. In part this is why routines are so important. When experiences happen regularly the child starts to understand the usual order of these, and to better understand what is expected of them.

It is important to your child to have regular routines. For this reason it is very useful to see baby's day as a 12 hour stretch with built in opportunities to nap. Night time is also then a 12 hour period when sleep is the most important thing.
For example ;- if your child spontaneously wakes at 7am on a regular basis, then they should be in bed ready to sleep at 7pm.
Sadly it does not always follow that come 7pm they will fall asleep and sleep through the night.

Sleeping through the night without waking for a feed, a comforting cuddle, or help to get back to sleep happens at different ages and stages. In general, many infants sleep through the night from about 6 months. Breast fed babies may still wake for a single "through the night feed" at 9 months but, this is usually accomplished quickly, with the little one being sleepy and not requring prolonged attention.
 By the time a little one is a year old they should not physically require a feed between parents bed and wake time.

If you would like help and support to improve your child's sleep
Contact us

Monday, 6 July 2015

Treasure baskets for children who can sit unsupported.

Playing and taking risks are important learning opportunities. Elinor Goldschmied developed the idea of using selected ordinary objects to stimulate learning through play. Treasure baskets are collections of household objects which are cleaned regularly, and provide sensory experiences for children who are too young to get around by themselves and explore the environment. They can of course be adapted for older children too.

The idea is that using a strong, durable, flat bottomed basket, preferably not plastic, with no handles, and putting in a variety of household objects, improves play and provides an interesting learning esperience. Offering differences in texture weight and shape which can be offered to baby to explore while an adult is present, teaches small children about the environment while they play. Of course the child will explore these obects with their mouths as well as hands but as long as an adult is present there should be no difficulty with this. One could offer a rich variety of different baskets;-

Touch  :- different textures, weights and shapes, prickly, smooth.

Smell :- different scents      
Sight :- colour shape length shiny dull
Natural objects :-  shell, pebbles, loofah, pumice, feather
Wooden objects :- Curtain rings, napkin holder, egg cup, clothes pegs, spoons
Metal objects  :-    spoons, tins, measuring bowls, funnel, keys
Natural materials :- nail brush, back brush, cosmetic brush, little baskets,
Leather, rubber, tennis ball, wallet, purse, teddy, spectacle case

Plastic is not recommended as it is always smooth, has no smell and no taste. There is little variety except in shape and form.

Baskets should  be treated with respect. Broken objects should be thrown away and all things should be regularly cleaned. Your imagination is the only limit in filling a basket. Having the opportunity to explore these things twice a week keeps the play fresh and interesting. A baby may choose to play with just one object or to explore a few. The adult should be watching, but not talking, allowing plenty of time for baby to investigate the whole basket. This could be 45 minutes to an hour. If you feel that something is not safe, of course intervene.

Toys today are often plastic and smooth to the touch. How do you know what prickly is if you have never felt it? Remember that baby is also experiencing temperature. Cold metal, warmer wood, tastes differ too, salty, sweet, sour, the more experience your little one has the more confident they become about exploring their environment.

Older children might enjoy a "dressing up" basket. Again, only your imagination limits the experience you offer. Treasure baskets for older children are a good "rainy day" fall back and if they are produced in rotation they remain interesting to children of every age.

Thursday, 20 March 2014

Health Warning about Baby Wearing

Baby wearing has been gaining in popularity over the last few years as a good way to maintain closeness and reassure your baby while leaving you with hands free for other things. This practice has been something both mum and baby enjoy but recently there have been a number of babies who have died while mum was out walking with her baby "safe" in a fabric sling.

The slings concerned are the soft fabric ones which do not have frames and are designed to carry baby in a lying down position rather than being held upright. The greatest risk, it is suggested, is to premature babies or babies with a low birth weight, babies from a multiple birth or babies with respiratory conditions.
The suffocation risks are linked to incorrect positioning of baby;-

1) Either the baby is in the C position with their chin tucked into the chest blocking their airway.
2) The baby's nose and mouth is covered by the fabric itself.

Over the past 20 years 13 babies have died in the USA while being carried in a sling. 12 of them were less than four months old. The majority were premature or were experiencing breathing problems or had a cold.

The safety advice is as follows;-
Be sure your sling is tight
The adult "wearing baby" should be able to look down and see their baby's face.
The adult can kiss baby's face by tipping their head forward.
The baby should never be curled up so their chin is forced onto their chest as this restricts breathing.

The simple mnemonic is TICKS
In view at all times
Close enough to kiss
Keep chin off chest
Support back