Archive for the ‘Safety’ Category

I received a question through my Ask Nicole e-mail address (asknicole [at] picknicksbrain [dot] com) this week. It came at the perfect time because I was contemplating what to write about for my blog posts this week (I try to post every Tuesday and Thursday and have a lot of ideas, but like to vary topics) and it was a good question. The gist of the question is whether it’s OK to put a 9-month old on his tummy to sleep.

First, Back to Sleep

It is highly recommended to place your baby on his back to sleep to reduce the risk of SIDS. If you haven’t already, please review the ten ways to reduce SIDS risk, one of which is to make sure baby sleeps on his back to sleep. Some parents are worried baby will choke on spit-up, but babies will automatically swallow fluids or turn to the side. The #1 way to reduce the risk of SIDS is to put baby “back to sleep”.

When can baby sleep on his tummy?

So, when can we put our babies on their tummy to sleep? Please note you should check with your pediatrician, first and foremost. I am not a doctor, but it is my understanding that once your baby can roll onto her tummy, it is OK to allow her to sleep that way and you do not need to worry about continuously flipping her back over. Dr. Sears’ website states “It does not mean that if your baby sleeps on her tummy she’s going to die of SIDS. Current SIDS rates are around one in a thousand babies; meaning that there’s a 99.9 percent chance your child will remain a healthy little girl regardless of her sleep position.”

Some babies start to roll and don’t like it and wake you up numerous times per night. That is never fun. I was lucky that once my son learned to roll that way, he actually slept better!

But, what about older babies?

Even though SIDS can happen anytime in the first year, the peak risk for SIDS is between 2 and 4 months old and 95% of all cases have occurred before 6 months, so that is probably less of a concern in a baby as old as 9 months old (the question at hand I mentioned at the beginning of this post). Many babies are rolling by 9 months old and likely would roll in their sleep, too.

Should you “force” tummy sleeping to get better sleep?

While encouraging your baby to sleep on his tummy when he hasn’t done it himself can work, it may be difficult to implement. It is best to develop a plan that you can 100% commit to and the #1 question to ask yourself when you consider a plan such as this, is whether you can stand at the crib and rub/pat his back for 2 hours. Of course, most babies probably will not take that long, but in most cases, if you had to visit this site, you do not have an “easy” sleeper and thus, certain methods may take a little longer than with other babies (especially in this case if he isn’t used to sleeping on his tummy). While some may drift off to sleep in 5-10 minutes, yours might take 30, 60 or 90 minutes. The #1 key is to be consistent with your plan, so make sure whatever you choose to do, you feel 100% committed you can stick with it for as long as it takes and then hope he doesn’t take that long. Of course, you will never know unless you try, either.

However, as with any method, you should be very careful not to create yet another sleep association that you will need to break. Don’t break one sleep association in exchange for another. That’s very important!

When did your baby start to sleep on his tummy?

In this post, I’ll talk about baby sleep pillows. When should you give a pillow to your baby? When can you give a pillow to your baby? What kind of pillow do you give your baby? What type of pillows can help with co-sleeping? What type of pillows can help with nursing?

When can you give your baby a pillow to sleep on?

The NICHHD recommends that you avoid pillows for babies under one year of age. They recommend never to place baby on a pillow to sleep or add pillows to the crib, either. This is to reduce the risk of SIDS. Here are other ways to reduce the risk of SIDS.

When should you give your baby a pillow to sleep?

There is no rule about needing to give your baby a pillow to sleep on. Yes, it’s more comfortable for us, adults, to sleep on a pillow. After all, it is one of our sleep associations. And, because we are bigger, a proper pillow supports our neck in such a way that our bodies can fully relax at night. Buy the wrong pillow and you can wake up with a cramped neck.

But, children are smaller and the wrong pillow when they are too young can be a bad idea. Not only can it increase the SIDS risk as I mentioned above, but baby can roll off if it doesn’t have side support. If baby is old enough to move around and the pillow is too large, the pillow might move on top of baby, making it dangerous for him. In addition, if your baby is pulling up, he can use the pillow as a launchpad out of the crib. No one wants that! He might be climbing out soon enough on his own. No need to give him props.

Therefore, I recommend avoiding a pillow for your baby until she is well into being a toddler over 2 years old. And, if she is content not to use a pillow at all, don’t even worry about it. My eldest son didn’t care to sleep on a pillow until he was close to 2 1/2 and then we gave him a very flat pillow.

What kind of pillow can you give your baby for sleep?

If you are going to give your baby or toddler a pillow to sleep on, make sure it’s small and flat such that it will be better for her neck support. They make small pillows just for babies. Here are just a few:

• For babies who need to be at an incline (e.g. those with reflux), you can try this wedge pillow. It safely keeps baby at an incline.
• For help positioning younger babies on their back (also guards against SIDS), I used the Close & Secure Sleeper, but for something more inexpensive, you can try a Head-N-Back Sleep Positioner. These positioners also help with co-sleeping.
• You can buy toddler pillows like Mr. Bobbles’ Blankets pillows or sets that come with a pillow. They also have these cool travel neck pillows, now.

Baby Nursing Pillows

Using a pillow while nursing is a life-saver! It saves your wrist with support and makes it so much easier in those early days. When baby is older and can support his own head, it helps to have your hands free, especially if you have a toddler. I used to read to one and nurse the other.

I used a Boppy for both of my children, but I saw this Leachco Cuddle-U Nursing Pillow and thought it looked really cool and the reviews were really good! I have also heard good things about the My Brest Friend Pillow.

When did you start using a baby sleep pillow? Which one?

In Part 1 of this series I discussed why it’s a good idea to sleep train your baby and the bedtime routine, your first step. Now I will discuss the various methods to help your child learn how to fall asleep without your “help”.

Co-Sleeping

Co-sleeping is not a “sleep training method”, but I wanted to talk about a way you can sleep train your baby but still co-sleep. Remember, sleep training is not cry-it-out (CIO). You can sleep train without letting your baby cry. Co-sleeping works for many families without any special steps taken, but for some it’s difficult due to the fact their baby wants to nurse all night. Nursing may or may not be the challenge for the mother, but perhaps the fact she can’t go right back to sleep during or after nursing. And, maybe mom and dad want to continue co-sleeping, but not nurse all night.

In some cases, nursing while co-sleeping has become the baby’s sleep association and the key is to break that association. But, how do you do it without letting the baby cry, yet still sleep in the family bed? The key to this dilemma is to help your baby learn to fall asleep without nursing. You will want to move nursing away from the final moment your baby falls asleep, but without replacing one sleep association (e.g. nursing to sleep) for another (e.g. rocking your baby). I include pacifiers as a sleep association. I am not a big fan of pacifiers but know plenty of people who use them and have no problems. But, others become frustrated they are replacing the pacifier 8-10 times per night. At this point, the pacifier has become a hindrance more than a help, so be very careful not to replace nursing with a pacifier. Once baby learns how to fall asleep without nursing, (s)he can start to learn to go BACK to sleep throughout the night, which is true of all sleep associations. This method will take a lot of patience, determination and committment on the parents’ parts, but with consistency, it can work.

Co-sleeping Safety

I would be remiss if I didn’t talk about co-sleeping safety. It gets a bad rep sometimes, but when done properly, it can be perfectly safe. If you feel nervous you are going to roll on top of the baby, an Arm’s Reach Co-Sleeper or The First Years Close & Secure Sleeper are great options. Dr. Sears’ website has more tips including put baby next to mom, not between mom and dad, sleep in a large queen or king-size bed, and don’t sleep on a too-cushion-y surface where you might roll over too easily (e.g. waterbed or couch), among other tips. He makes sure to mention not to sleep with your baby if you are severely sleep-deprived where you might be less aware of your baby. Ironically, I would think this is when most people do start to sleep with their baby (if they didn’t plan to from the get-go like me).

When co-sleeping isn’t working

There may be another reason or multiple reasons co-sleeping is difficult for your family. If it’s not working for you, that’s okay. It works for some, but not all. This is not a reflection on you as a parent. Some people are too nervous and don’t sleep well due to worry. I’d say that makes you a caring parent. Some people just can’t go right back to sleep. You have no control over that. Some babies are very active, waking you up all hours of the night. Whatever the reason, if it’s not working for you, don’t let guilt drive you to more and more sleep deprivation, which can lead to unhappiness, stress, and depression. Once you feel ready, you may want to transition your baby out of the family bed. As I always say, well-rested babies make happy babies and well-rested parents make happy parents and happy parents make better parents.

Continue to Part 3 of this series where I discuss the “fading” approach.