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Archive for April, 2009

As a first time parents, I was desperately trying to figure out what my newborn son needed. What did his cries mean? I came across a great DVD that explains what your newborn’s cries mean- “Dunstant Baby” I rented it from the library. This DVD taught you how to recognize if your baby was crying because he was hungry, tired, had gas, or was board/ need a change. The DVD shows a number of babies make these particular cries so it is very helpful to see the different cries actually produced. My son Cooper definitely made these cries. The most helpful cries were the ones for hunger, tired, and gas. It helped me to follow my son’s lead when it come to feeding him and following his hunger cues. I was on a baby wise feeding schedule, but if my son let out a cry for hunger “neh” I made sure I fed him. It helped me to not over feed him because there would be times he would cry, but it would be for other reasons such as tiredness, and I would just put him down for a nap at that point.

Here is a quick clip of the DVD from utube: http://www.youtube.com/watch?v=9Ehv5m9gnu0

Here is what Wikipedia writes about the program:

Between 0-3 months, infants make what Dunstan calls sound reflexes.[2] According to Dunstan, we all have reflexes, like sneezes, hiccups, and burps, that all have a recognizable pattern when sound is added to the reflex. There are other reflexes that all babies experience, and when sound is added to these, a distinct, preemptive “cry” will occur before the infant breaks into what Dunstan calls the hysterical cry. Dunstan claims that these preemptive cries can indicate what the infant requires (e.g., food, comfort, sleep, etc.), and they escalate to the hysterical cry if they are not answered. As the infant matures past 3 months in vocalization, the sound reflexes become replaced with more elaborate babbling.

According to Dunstan, the five universal words (or sound reflexes) used by infants are[3]:

Neh—I’m hungry – An infant uses the sound reflex “Neh” to communicate its hunger. The sound is produced when the sucking reflex is triggered, and the tongue is pushed up on the roof of the mouth.
Owh—I’m sleepy – An infant uses the sound reflex “Owh” to communicate that they are tired. The sound is produced much like an audible yawn.
Heh—I’m experiencing discomfort – An infant uses the sound reflex “Heh” to communicate stress, discomfort, or perhaps that it needs a fresh diaper. The sound is produced by a response to a skin reflex, such as feeling sweat or itchiness in the bum.
Eairh—I have lower gas – An infant uses the sound reflex “Eairh” to communicate they have flatulence or an upset stomach. The sound is produced when trapped air from a belch that is unable to release and travels to the stomach where the muscles of the intestine tighten to force the air bubble out. Often, this sound will indicate that a bowel movement is in progress, and the infant will bend its knees, bringing the legs toward the torso. This leg movement assists in the ongoing process.
Eh—I have gas – An infant uses the sound reflex “Eh” to communicate that it needs to be burped. The sound is produced when a large bubble of trapped air is caught in the chest, and the reflex is trying to release this out of the mouth.
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I have used many of the baby wise principals with my son. I have followed a lot of the advice they have given about feeding schedules. They have worked really well so far. I exclusively breastfeed Cooper until he was almost 5 months old. My son is now 7 months old and I am still breastfeeding and have not lost my milk supply. I should also add that Cooper has always been in the 50 %ile for weight and 90-95 %ile for height.

Common Issues with Baby Wise and Breastfeeding

I have hear the common issues that people have when it comes to babywise- “you can decrease you milk supply or lose it all together if you follow babywise and your child may have failure to thrive. After following a feeding schedule that is similar to the one they suggest in baby wise, I can understand why that might happen. People misinterpret how to implement baby wise while they are breast feeding which results in low milk supply (or loose ability to nurse) and children who fail to thrive. I wanted to give some helpful suggestions to make sure this does not happen to you!

Don’t feed by the clock- this type of feeding schedule is not baby wise. Baby wise is a parent-directed feeding schedule. This type of feeding schedule has designated feeding times, but also allows for some variation due to child’s hunger. For instants, let’s say you’re feeding schedule looked something like this- 7am, 10am, 1pm, 4pm, 7pm, 10pm. If you child is suppose to eat at 10am but is crying and fussy at 9:50 should you make them wait an additional 10 minutes to eat- no, that is hyper scheduling! The schedule serves as a guide line for when to feed and how to schedule naps. It helps you as a parent know when to expect your child to be hungry. This was great when my son was a newborn. I knew if he was crying around a scheduled feeding time he was most likely hungry.  But if he was crying and he had just eaten a hour prior, he most likely was not hungry and perhaps he was tired or had gas. Babywise gave this diagram to help drive home the point to not feed only by the clock:

Hunger Cue + Clock + Parent Assessment = Feeding Time

Feed More Frequently During Growth Spurts- During a growth spurt, you will need to feed your baby more frequently if you are nursing. This will help stimulate your breasts to start producing more milk. If you fail to follow your child’s hunger cues, you could damage your milk supply. The result is less milk and a fussy, underfeed baby. If you were feeding on a 3- hour schedule, consider moving back to a 2.5 hour schedule to fit in an extra feeding. Remember to follow your child’s hunger cue’s and feed your baby when she is hungry. Growth spurts really don’t last longer than a few days, a week at most. Yes your schedule will be a little messed up for a few days. Don’t fear, after the growth spurt is over, you little one will return to the previous schedule fairly easy.

Add a feeding- Once your child is on a 4-hour schedule, that means you will only need to feed your little one 4 times a day. Your schedule might look like this- 7am, 11am, 3pm, 7pm. For some breastfeeding mom’s 4 feedings is not enough. Baby wise recognizes this and writes, “Your baby will maintain four to six liquid feeding in a 24- hour period, three of which will be supplemented by babyfood.” Some moms can nurse 4 times and maintain milk supply but others cannot. If you are on a 4 hour schedule, how do you fit in the 6 feedings to maintain milk supply? You can add the late night feeding (dreamfeed), this is the feeding you usually give to your child after they have been asleep around 10/11pm before you go to sleep. You could also try cluster feeding in the evening since your milk supply is lower at night any way. Your schedule might look like this- 7am, 11am, 3pm, 5pm, 7pm, with an optional late night feeding at 10/11pm. Once your baby is older and will stay awake longer, they may not be on a perfect 4 hour eat, wake, sleep cycle. NOTE: if you see your milk supply dipping, just add an additional feeding.  Shorten the length between feeding to accomplish this.

Pump: Once your little one is sleeping through the night and no longer taking the late night feeding (dreamfeed) you may only be breastfeeding 4 times a day. I tried doing that, but my milk supply started to dip. I added a 5 feeding, but I pump this feeding right before I go to sleep between 10/11pm. I save the milk that I pump and use it in his cereal for the next day. Once I added the 5 feeding back with pumping, I was able to maintain a healthy milk supply.

Here is what my feeding schedule looks like with my 7 month old currently:

  • 7am Breastfeed/ breakfast
  • 10am nap (1.5 hours)
  • 11:30 breastfeed/ lunch
  • 2:30 nap (1.5 hours)
  • 4:00 breastfeed
  • 6:00 Dinner
  • 7:00 Breastfeed
  • 10/11:00 Pump (save breast milk for cereal next day)

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My son who is now 7 months old started waking up an hour early for about the past 3 weeks. He does not do this consistently. I was looking over my notes and it seems that he has been waking between 5:45-6:30 but occasionally sleeping in until 7am (which seems to happen mostly on weekends). I should add that I have dark out blinds in his room and a white noise machine running all night long.

Here’s my theory for why he is waking an hour early:

First, it is getting lighter sooner. I think this is setting off a natural alarm clock in Cooper that says, “rise and shine”. Unfortunate for Chris and I because our alarm clock says, “no thanks we need another hour”. I have tired to darken the room even more than it was, but there is still a faint bit of daylight creeping through, enough to make it appear to not be night but morning. The hormone that signals sleep, melatonin starts to decrease in the early morning hours, causing us to have lighter sleep. Sunlight also decreases the amount of melatonin that we produce.

Second, our neighbors above us (we live in a condo) have been waking up early in the morning it seems. I hear them somewhere between 5am and 6am. I can hear their footsteps and water running. Occasionally, I might even hear their dog tramping across the floor or let out a bark. They are not being overly loud, but the noises are enough to stir me awake. (I am a light sleeper to begin with.)

Conclusion: I think I am just going to have to accept the fact that Cooper is waking at 6am. I cannot not tell God to make the day light come up an hour later and I cannot tell my neighbors above us to wake up later. This just means that Chris and I need to go to bed an hour earlier at night and wake up at 6am instead of 7am. Oh well!

Future Action: Since we are moving to Texas in a month, the time zone will change and we will be an hour behind Maryland time. This might be the chance for me to get Cooper back to waking at 7am. I will be in a quieter house with no condo neighbors and the time change will make it easier for me to just shift his schedule.

There are many reasons your little one could be waking early in the mornings

  • might need less sleep– check my post about the average amount of sleep your infant should be getting daily. It could be that your child is older and now requires less sleep at night or during the day. If your baby is getting too much daytime sleep, it could be causing him to wake early. Or if you little one is sleeping too long at night, they could be waking up.  https://blogginaboutbabies.wordpress.com/2009/04/08/sleep-requirements-for-infants/
  • morning nap is to close to nighttime sleep- if you don’t keep your baby up long enough in the morning, your little one could be confusing the first nap of the day as part of his nighttime sleep. Try extending his wake time between the time he wakes from nighttime sleep to the first nap.
  • afternoon nap is to close to nighttime sleep- the last nap of the day or the afternoon nap if you are down to two naps is to close to nighttime sleep, this could also cause your child to possibly wake up early.
  • hunger- your child could be going through a growth spurt or just need more food. Try feeding him more solids or offering bottles/ nursing more frequently during the day to prevent him from waking early in the morning. You can also try to offer a later dinner that has more carbohydrates to keep him fuller longer. You can also do a late night feeding (some people call this a dream feed). A late night feeding is when you feed your baby after already being asleep for the night between 10-11pm. This might help to hold his hunger out longer in the morning.
  • needs a longer awake time- you might try keeping your child up longer in between naps and nighttime sleep. Your child may not be tired enough to sleep for a longer stretch. If you adjust their awake time, they may sleep longer. See my post on infant schedules, it includes average awake times for infants. https://blogginaboutbabies.wordpress.com/2009/04/16/infant-schedules/
  • overtired/ overstimulated- if you child has been not sleeping well and may have had a lot of disruptions to his sleep, then that too could cause him to wake early. Try to get your baby to bed during their “sleep window” before they become overtired/ overstimulated. Stay as consistent with your schedule as possible too- this helps to get your little on back on track. See my post on sleep windows https://blogginaboutbabies.wordpress.com/2009/04/23/sleep-windows-get-them-to-bed-before-its-too-late/
  • too bright in bedroom- the room may be to bright in the morning. Invest in some darkening blinds or put cardboard up to block the light.
  • too noisy- invest in a good quality sound machine/ white noise machine, run a fan, or play soft music in the background to block out external noises from loud neighbors, your own home, or outside.
  • room temperature is too hot or too cold– make sure to dress your baby appropriately for bed. If they are either too hot or too cold they will wake more easily, especially in the morning when melatonin, the hormone that helps us to sleep, is wearing off.

Some kids are just early birds

If your child wakes up happy, you have tried all the suggestions above, and you have seen no improvement, then you might just have to accept the fact that your child is waking early. Some children just wake early. Just adjust their schedule as needed to accommodate the earlier wake time.

Other Resources About Early Risers

Note: many of the ideas were pulled from Good Night, Sleep Tight p. 98-100 and the internet resources provided

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I am a relatively new mom. My son is 7 months old. For the most part, my son has been a pretty good sleeper. He is a touchy sleeper though and he needs things just right in order to get some sleep. I discovered he needs it very dark to sleep so we invested in some dark drapes to cover the windows. We also live in a condo and the noise from our neighbors wakes him. We invested in a sound machine and that helps to drown out most of the background noise. When my son was under 6 months old, we swaddled him. The swaddling helped him to sleep longer and keep himself from jerking his body awake. At 4.5 months old we would still swaddle him, but leave one arm out. This allowed him to suck on his fingers if he woke up early so he could self-sooth himself back to sleep. Then at 6 months old we transferred him from a swaddle to a sleep sac because he started to roll over and he needed both of his arms so he would not get stuck. We also have a fan in his room to keep it cool one warm days. My son will wake early from a nap if he is too hot or cold. We would just layer him with more clothes in the dead of winter so he would stay warm.

What if you travel?

We have traveled quite a bit with my son and I also have to take him to a friend’s house once a week where he takes one of his naps. It use to be that when he napped any where else other than his room, his naps were terrible. I was lucky if he would nap for 45 minutes. After some advise from some friends, I started to get smart about traveling with my son. First, I take his crib sheet because it has the sent of home on it. I would just place the crib sheet over the pack ‘n play mattress. I brought the sound machine to help drown out the background noise and create a familiar sounding environment for him. I made sure to bring his swaddle or sleep sac along, but I made sure I did not wash it right before we left in order to keep the familiar sent. To darken the room, I brought a large sheet to drape over the window. If the sheet would not drape over the window, I would drape receiving blankets on the four sides of the pack ‘n play to keep some of the light from directly shining on him.

Sleep Sack http://www.toysrus.com/product/index.jsp?productId=2610669

Swaddle http://www.toysrus.com/product/index.jsp?productId=2265543

White Noise/ Sound Machine http://www.amazon.com/Marpac-SleepMate-980A-Electro-Mechanical-Conditioner/dp/B000KUHFGM/ref=pd_bbs_sr_2?ie=UTF8&s=hpc&qid=1240856752&sr=8-2

Pack ‘n Play (travel lite crib) http://www.toysrus.com/product/index.jsp?productId=2959499

If you have another suggestions for creating a good sleep environment both at home or when you travel, please leave a comment!

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Just like it is good to establish a good bedtime routine, it is just as important to establish a good morning routine. In Kim West’s book Good Night, Sleep Tight she discusses a good part of a morning routine should be a “dramatic wake-up”. A dramatic wake-up should signal to your child that the day has started and it is different than waking in the middle of the night. To establish a “dramatic wake-up” try opening the blinds, turn on the bight over head light, and signing a happy song.

Why is this important? You want your child to know the difference between day and night. This helps to establish the difference clearly. If you have to go into their room during the night, you are are not going to sign a song and turn on a bright light. At night you keep as little stimulation from occurring as possible. The morning is the time to arouse and stimulate your child, helping them to set their natural alarm clocks. This is particularly important with newborns who are very sleepy. Many newborns have their day and nights confused- this helps to distinguish the difference.

It might also be helpful if you allow daddy to do the dramatic wake-up. This gives daddy the one-on-one time with baby and it does not require nursing (if nursing). Daddy can sing and talk to the baby while mommy either readies herself to breastfeed or perhaps is preparing the bottle. If you baby is not starving, you can also include a diaper change and change out of pajamas. Young infants tend to wake in the morning crying from hunger, you might have to delay the diaper change and clothing change until after the feeding. Another suggestion, try feeding your child in a well lit room that is not in the nursery in the morning. This will also help to establish the start of the day. Keep the day time feeding out of the nursery and all nighttime feeding in the nursery.

Here is what we do with our son for a “dramatic wake-up”

Dad goes in his room, turns on the light, opens the windows, and talks and plays with Cooper for a minute or two. Daddy then brings Cooper into our bedroom so that I can breastfeed him. After I finish feeding him, I put him on the potty (we do infant potty training), change his diaper, and put on a outfit for the day. We do this routine pretty much every day. Notice that daddy gets to get him up and I feed him. We share the responsibility and it gives us each quality one-on-one time with your son.

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In the book Good Night, Sleep Tight Kim West writes about sleep windows. A sleep window is the time your child would naturally go to sleep. If you time it right, your child’s body starts to produce melatonin, which is a hormone that helps induce sleep. If you keep your child up past this precious sleep window, they stop producing melatonin and start producing cortisol, a stress-related hormone that will eventually overstimulate your child, thus creating a second wind. “He will be more agitated, more difficult to console, more likely to need a lot more of your time and energy to help him wind down again and get to sleep.”

If he naturally falls asleep around 7pm and you keep him up until 8pm, he will most like not sleep well. He’ll have a hard time falling asleep and even staying asleep. He may wake several times in the night and maybe even wake earlier than normal in the morning before he is well rested. “This cycle can lead to poor naps the next day, which will lead to an overtired baby at bedtime, which leads to poor nighttime sleep.”

It is important that you learn your child’s sleep cues. Every child is different, but here are a few common sleep cues: “rubbing eyes, yawning, becoming less active, maybe a little listless.” Don’t wait until your child is fussing and crying, almost always at this point you have waited to long and your child is overstimulated/ overtired.

“If you have trouble detecting your child’s signals, keep one eye on him and another on the clock. Try going into a quiet, dimly lit room and engaging in a very gentle activity when you think nap time or bedtime is approaching. The signs may then appear.” For me, I will take my son into his bedroom and turn off all the light and only turn on the reading lamp and we read a story. If he will sit calmly in my lap, then I know it is time for sleep. Try taking your child to his room and reading a story, doing infant massage, sing soft songs together, or lay on the floor and talk to you child. Just keep the activity simple and quiet.

Personal Experiences: My son is currently having trouble sleeping. I suspect that he is overtired and I am missing his sleep windows. We had a lot of disruptions to his schedule last week. He had a cold, we had a home inspection (because we are selling our home) that cut a nap short, we were out late at a friends house, cut a nap short for church on Sunday. I think that all these disruptions added up. I did not see the signs at first, but a good friend of mind helped me to see that he was probable overtired. Then I pulled Kim West’s book out and it hit home. I started to really watch for his sleep cues. For my son, his eye lids get really pink and you can see the veins in them. If he yawns, I may have already been to late. So I watched for the sleep cues today, but his naps were still pretty poor, which is most like a results of poor nighttime sleep the night before. I imagine if I do it again another day, his naps will improve. He has also been waking up around 5am when his wake time is 7am. I know this is due to missing his sleep window and becoming overstimulated/ overtired. His bedtime is 7pm, but we were not always diligent about getting him to be at 7pm. I should have known better because it has backfired! So tonight, I made sure he was in bed before 7pm so he would have plenty of time to fall asleep. Another thing to note, because he was so overtired today, I went back to rocking him before naps and bedtime. I did not let him fall asleep in my arms. I only did this to help him relax since he was so overstimulate from a weeks worth of poor sleep. I am hoping that tomorrow I will start to see the benefits of getting my son down for his naps and bedtime during his “Sleep window” and staying as consistent as possible! UPDATE 4/27/08: My son is back to taking his solid 2-2 hour naps a day and getting 11-12 hours of sleep a night. It took about 2 days of being consistent with timing his sleep windows and watching his tired cues, but he is back to sleeping well! He is not longer overtired and has been in a great mood!

Quotations are from Good Night, Sleep Tight by Kim West p. 33-35

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There are various reasons that babies refuse to nurse. I am in the mist of my son refusing to nurse. It can be really frustrating. As they get older, they are  more aware of their surroundings and less focused on nursing. I noticed that nursing became more difficult once my son Cooper turned 4.5 months old. It can be so frustrating, especially when he totally refuses to nurse at times. According the the book The Nursing Mothers Companion, nursing refusal/ strikes usually only last a few days but can sometimes last as long as two weeks.

Here are some strategies I have used. Some of these strategies come from the book The Nursing Mothers Companion and other strategies are ones that I have personally tired and work.

  1. Try to change positions, nurse in a quite, dark room.
  2. pump and express your milk if you baby refuses to take nurse- to keep milk supply up
  3. try nursing with skin-to-skin contact
  4. nurse when baby is sleepy- this will help prevent him from becoming distracted
  5. nurse more frequently- to keep milk supply up
  6. try to determine if your milk supply is too low- if this is the case- you will have to do something to help correct this problem
  7. swaddle your baby before feeding- this helps to keep them from thrashing about and more focuses on nursing
  8. drape a colorful cloth or scarf over your shoulder for your baby to look at

Other Things to Consider

  • If your baby is young, 0-3 months, and is fussy and has greenish poop, your child may have a food alergy (something you ate) or colic. Discuss this with your doctor or lactation specialist.
  • Thrush- a yeast infection that can be passed from mom to baby. Baby may be fussy at the breast. They will have a white coating around the lips and cheek and may be more gassy than normal. There might be bright red dotting around your babies genitals and your nipples. Consult your doctor to discuss proper treatment for you and your baby.
  • Menstruating- this can cause your milk supply to decrease and the flavor of the milk to change.  See my post for more suggestions https://blogginaboutbabies.wordpress.com/2009/04/20/milk-supply-during-menstruation/
  • Illness- common cold and ear infections can make nursing difficult
  • Perfume- baby may not like the smell of the perfume you are wearing
  • supplemental bottle- sometimes if you supplement with a bottle, your milk supply will decrease, thus making the baby less interested in nursing.
  • teething- this can make a baby uncomfortable while nursing

More Resources

http://www.llli.org/NB/NBNovDec92p173.html

http://www.kellymom.com/bf/concerns/baby/back-to-breast.html

http://www.breastfeedingbasics.com/html/nursing_strike.shtml

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