 Guest_77302 wrote:
hi Dorothy,
I have a fiver month old boy and for the past 2 months he is a chronic cat napper during the day only. if i manage to settle him (as soon as his back hits his cot he gets hysterical) he wakes after 20 minutes in a state. i have tried the cushing technique for a few days and it works to settle him but after 20 minutes i have had no luck he gets more and more worked up and thrashes about. I then have to pick him up and it is very hard to calm him (i use the cushing and pat technique) without nursing him. if i dont resort to the pram or car seat he would get about 1 hour sleep during the day. he is a very good night sleeper waking only once, however for the last two days i perservered with the cushing for 2 hours in his room and both night he would not go down at night and woke three times in the night.
his routine is wakes between 6.30-7 breast feed 7-7.30. walk at 8.30-9 for about an hour. feed 10.30. sleep 11.30-12. breast feed 2-2.30. sleep 3.30-4pm. feed 5.30-6pm. bed at 7. however he does not sleep so most of this ends up going out the door.
i have received numerous advice from consultants, plunket and books, from letting him cry, putting him down happy before he gets tired, making sure he is full, transfering him to the pram to keep him asleep, patting and leaving the room repeating several times. i appreciate any advice. |
Hi to really answer you question correctly I would need to have more informaiton so I am going to give you a general routine for a 5 month old baby to give you some guidelines and also my settling notes.
When you put him to bed you need to leave him to try and settle himself before you intervene with either the cushing or patting and sshing.
Rocking is one of the hardest things to break Ð depends on how quick or slow you want to work with breaking it. You could go back and do my 0-12 week settling program or just start with the settling notes I have added for you to look at.
Also you have not mentioned whether you have started solids Ð so I have also added these for you.
You need to do something consistently (80%) for ten days to see any changes and it could only be a small light at the end of a long tunnel, however this would be a start. I think also you may need some back up support Ð you could check out my email advice cost which comes with up to ten days support by email or text and phone calls at my discretion or you may like to look at my Dial Dorothy support package which gives you more back up support for a month.
Remember to not change things all the time but work with the same routine for ten days.
Suggest Routine for baby approx. 5 to 6 months
Feeding Routine
6 to 7 am Early Morning Milk
Nap 2 hours after getting up
9.30 to 10am Mid morning Baby rice mixed with milk
Milk
Nap 2 hours after getting up
1.00 to 1.30pm Midday Vegetables with a carb
base -kumara/yam
sweet potato or potato
Milk
Nap 2 hours after getting up
4.30pm to 5pm Evening Baby rice mixed with milk
Milk
Bath
Top up
Bed for the night
Approx time for a 5 month old to be up for their awake time is approx 1 ½ to 2 hours. Some babies are moving onto the 2 ½ hour up time but I think you need to start from somewhere and be consistent.
Introducing Solids
When to start
I am often asked about the best time to start a baby on solids. It really depends on the baby but is usually between four and six months. Although age is an important consideration you should also consider the growth of your baby. Your instincts as to your babyÕs needs, gained from watching and listening to your baby, are a good gauge too. If they have been happy and contented, are between 4 to 6 months and change to being unsettled or needy Ð this is normally a sign of being hungry.
Remember your desire for your baby to sleep through the night is not a reason to introduce your baby to solids before he/she is showing signs of readiness. After all, the cause of your babyÕs waking may have nothing to do with hunger.
What food to introduce first
The first food I introduce is baby rice. Why? Baby rice is gluten free and therefore most babies find it easy to digest.
What type of rice you choose to start with is a personal choice. I like to start with wholemeal rice or a mixture of wholemeal and white rice; using plain white baby rice as my last choice. With todayÕs focus on healthy eating, I believe it is a good idea to start the habits that you want your baby to continue with throughout their childhood and into adulthood.
Most babies can tolerate rice, however if you do have a SILENT reflux baby this may not be the right food to start with. Use another cereal such as oatmeal and blend it down to the appropriate consistency or start with another baby cereal that you can purchase over the counter.
Be aware that baby rice can also constipate some babies. To avoid this, you can add pureed prunes to his/her rice in the morning. Start with one teaspoon of puree pulp mixed with baby rice and increase if required.
Which mealtime to introduce first
What time of day you start to introduce solids is entirely up to you and your baby. Some people recommend starting with lunch however this does not seem logical to me Ð when you introduce the second meal its not evenly balanced through the day. I take the following approach to introducing a mealtime schedule:
One meal
Start with either the midmorning feed 10.00am (breakfast) or the evening 5.00pm (dinner time).
Babies tend to be hungrier either at the morning or early evening feed, so by observing your baby you will work out which mealtime will work best for him/her.
Two Meals a Day
To graduate to two meals a day I introduce the opposite time from the first meal already introduced. For example, if I have started the baby off with breakfast then I choose dinner. At this stage, I again give baby rice. Baby rice is not going to make them fat and obese unless of course they are having oversized portions.
If your baby is disinterested with just eating rice then you may want to change the breakfast from rice to oatmeal, or you could introduce a small amount of fruit for the morning feed. The ratio I use here is 1 tablespoon of cereal to 1 teaspoon of fruit.
Third Meal of the Day
By this stage, your baby is enjoying breakfast and dinner. So, now introduce lunch around 2.00pm, making the meals evenly balanced throughout the day.
For me, the introduction of lunch coincides with the inclusion of vegetables in your babyÕs diet. You want your baby to enjoy vegetables so at this stage keep fruit to a minimum as if they get the taste of sweetness too early you may find it difficult to establish vegetables later on.
The Correct Amount of Food
I always measure food out in the beginning so I know exactly how much the baby is getting.
It is often suggested to start with one teaspoon of baby rice and then increase this amount, as the baby demands more. Based on my experience, I have found that the majority of babies I have established on solids are actually hungrier than that. Most want more than one teaspoon or even one tablespoon, so use any information as a guideline and go with what you think your baby needs. Also, your baby will clearly guide you Ð most babies will clench their lips firmly closed when they donÕt want anymore.
Should you introduce milk or solids first?
This is a much-debated subject, either way; milk remains an important part of a babyÕs diet. Once again I listen to the baby and go from there. The following are possible ways of introducing solids
¥ Solids first, milk second
¥ Milk first, solids second
¥ Part milk, first, solids second and finish off with more milk
I have found that a lot of sleeping issues with babies over the six-month plus age group is because they are filling up on milk and not eating enough solids. They are hungry and like us all, are unable to sleep well if not fully satisfied.
The reason why it is recommended that you give milk before solids is that your baby will drink less milk and therefore will miss out on much needed nutrients and fat from their milk intake. However I firmly believe that a hungry baby wants food and if you mix the milk (that they normally would drink) with rice then they are gaining additional calories, their hunger is being satisfied and the result is a happier baby. Plus you still have the option of offering him/her milk to finish off with at the end of the meal.
It is important to note that the amount of milk that a baby drinks varies from baby to baby and as long as they are happy and contented as well as weeing and pooing regularly then you should feel confident that he/she is getting the right mix.
Introducing New Foods
Apart from the cereal meals I tend to always introduce new foods mid day as you have the rest of the day for any reactions. Until they are well established on foods and are older I do not introduce new foods at the evening meal.
Fruits
When I introduce fruit it is always blended down with baby rice. This is for two reasons: one, fruit on its own doesnÕt fill their tummies and two, it can lead to the baby only liking sweet foods and therefore, offering vegetables can become a challenge.
I always offer cooked fruit versus raw fruit including bananas, which I bake before mashing. If offering prunes, I boil and then puree these, freezing in ice cubes or small amounts for future use.
Vegetables
The list below is intended as a guide to start and work through.
I suggest each new food is offered every day over a three-day period, before progressing onto the next food. Using this method, you can cook and puree enough to eat one day, keep enough in the fridge for the next day and freeze for thawing out for the third day.
You can freeze either in ice cube trays or on droplets on cooking paper using a flat tray, then once frozen put in plastic zip lock bags. If food is cooked, frozen and thawed, do not then re-freeze any unused food.
Always measure large tablespoons and remember good hygiene around preparation and cooking. Use the water that food has been boiled in/steamed with to puree your vegetables (except potato).
Babies will get bored very quickly with the same flavours so work through a range of flavours. If your baby does not like something remember to reintroduce it again a little later, perhaps making sure it is not as strong in flavour as the last time.
I do not mix vegetables with fruit, however if you are having great difficulty with getting your baby to eat vegetables, then adding a little fruit to sweeten them can be useful. Remember though to reduce the fruit from the vegetable gradually so your baby does not become reliant on eating vegetables only mixed with fruit.
Take extra care with certain foods
Bananas, apples, avocados, carrots, potatoes can all have an effect on reflux babies so when introducing these foods do so in the middle of the day, that way you can better monitor their effect. Also start with a small amount of the new food blended into established foods that you know your baby is okay with.
In light of increasing concerns over food allergies, there is an array of advice about when to introduce certain foods into a babyÕs diet. Opinions differ from one medical practitioner to another so itÕs best to do your research. When you make the decision to introduce a particular food to your baby at the appropriate age recommendation, my advice would be to start with a small amount blended with other foods that you know your baby can tolerate. If there is no adverse reaction, then slowly increase the amount each time that food is given.
If your baby does have an adverse reaction (hives, swelling around the mouth or vomiting) then seek immediate medical advice.
Food Allergy is an immune system response. It occurs when the body mistakes an ingredient in food (usually a protein) as harmful and creates a defense system (antibodies) to fight it. The food allergy symptoms develop when the antibodies are batthing the food invading their body.
Food Intolerance is a digestive system response rather than a food allergy response. It occurs when something in a food irrates a baby/childÕs digestive system or when a baby/child is unable to properly digest or breakdown the food. Most common intolerance is the lactose found in milk and dairy products.
The Drink Debate
You can offer sips of water throughout the day to babies over six months, but remember they only need a little water to quench their thirst.
Juice
Babies do not need to have juice. In fact, I would avoid introducing it into to their diet at all. Many kindergartenÕs and schoolÕs now operate a water only policy so sticking with water at home is not only healthier but it makes for an easier transition to preschool/school later on.
If you are going to introduce juice, I recommend not doing so until at least the 18-month mark.
Baby-Led Weaning
This has actually been around for a long time. I teach my mothers that once their baby is sitting in their highchair and eating three meals a day that whatever purees you are giving your baby then you should offer them the finger food (cooked) so that they learn texture, taste and smell.
I find that babies that have both purees and finger food are happy and contented as while they are experimenting with finger food their hunger is being met with the purees.
For the evening meal if you donÕt have the time to cook fresh food, then offer the puree as a spread on a rice cake, cruskit or toast.
Life-long healthy eating
As you can see, I tend to stick with vegetables for as long as possible when starting out solids and I do not offer three course meals. If you think about it as an adult meal, their first course is veggies and the second course is milk. So, if you decide to offer a pudding then you are actually offering your baby three-course meals. Focus on offering your baby fresh healthy meals that do not include juices or puddings and you are well on the way to teaching your child life-long healthy eating habits.
Sleep Cycles and Patterns
It takes a minimum of ten days to see changes and the circadian sleep cycle change takes at least three weeks of consistency.
Sleeping routines
Sleeping is a learned behavior and this applies to resettling during the night.
Teaching good sleep habits requires TIME, ACCEPTANCE, CONSISTENCY and TRANQUILITY (TACT).
Settling
I believe one of the most important skill that parents can teach babies is that of self-settling. It teaches babies how to gain control over their emotional state and this in turn leads to them developing their emotional backbone as they grow. It does not happen overnight and needs to be taught in a nurturing way.
Basically when you go to bed you read a book, mediate, watch TV, or chat to your partner Ð a baby can only do one thing and that is cry. It is actually healthy for a baby to cry before going to sleep. ItÕs difficult to listen to and as long as they are happy and contented it is part of life. Remember you are not leaving him/her there to cry it out you are leaving him/her there to give him/her the ability to find his/her own sleep. You will not get anywhere by leaving him/her to cry for hours, you will succeed quicker by giving him/her space and then helping him/her find his sleep.
Settling Cycle
Below is the ideal settling cycle that I suggest you use, however as long as you do 2 lots of 5 minutes to begin with then that is okay. I work on the principle that it takes most babies/toddlers 20 minutes to wind down before going to sleep and adjust this for each individual as well.
Bed ÐÒDump and runÓ i.e., put in cot and walk away and Òdo not hover like a helicopter.Ó Walk out of the room and shut the door. Remember a dark room creates calmness and also signals time to go to sleep. Light is for playtime and dark is for sleeping.
1st Stage
Cry up to 5 minutes STOP THINK and ACT (the act will be probably to leave him/her for another 5)
Cry up to 5 minutes STOP THINK and ACT
Comfort ssh and pat off to sleep Ð
Then the next stage will be
Cry up to 10
Comfort - ssh and pat Ð this is to reassure and not to stop crying and should be shorter than the crying time
Cry up to 10
Comfort - ssh and pat and off to sleep
Then the next stage will be
Cry up to 15
Comfort - ssh and pat Ð this is to reassure and not to stop crying and should be shorter than the crying time
Cry up to 15
Comfort - ssh and pat and off to sleep Ð
Then the next stage will be
Cry up to 20 STOP THINK and ACT
Comfort - ssh pat and off to sleep Ð
Then the next stage will be
Cry up to 20 STOP THINK and ACT
Comfort ssh and pat Ð this is to reassure and not to stop crying and should be shorter than the crying time
Cry up to 20 STOP THINK and ACT
Comfort Ð ssh and pat off to sleep
The last stage you will find that he/she will be asleep by the end of the 20 minutes wind down.
Also the crying isnÕt to be crying at the top of his/her lungs for this length of time. The baby will start of loud and slowly reduce and also stop and start. If its constant at one level and goes for a long time then you need to reassure and see what is happening.
The crying time can and will be built up to 20 to 30 minutes especially on the first cry and then intervene. Also the time frame does depend on the cry and also how you are feeling - nothing is set in stone but you do have to push the boundaries to get results.
Do this settling up to ten days Ð if its not working then you need to address what you are doing.
Always try and settle in his/her cot. Its harder to resettle if you take him/her out of the cot, but trust me there will be times that you will do this.
Try not to use movement as a calming tool or to put the baby to sleep Ð this is the hardest habit to break.
The crying time does depend on the cry but try not to go in under the time frame that you are working with. You need to work within your comfort zone and also the babyÕsÕs comfort zone. It is not about leaving him/her alone to cry until he/she is exhausted and goes to sleep, but it is about giving The baby space to find his sleep.
When comforting do not talk or give the baby eye contact Ð both of these stimulate Ð you can use the ssh ssh noise and let your body talk to him/her. Also try and stand to the bottom end of the cot when comforting. If you do talk to him/her keep the verbalization to a limit so in other words try not and have a full conversation with him/her.
You need to take small stepping stones so dependent on how you feel you can do the full cycle above or start with doing two lots of crying and at the end of the second pat off to sleep.
Do this settling up to ten days Ð if its not working then you need to re look at what you are doing.
Comfort
When you go in and comfort The baby try and do something that works for you both. So when you go in if he/she is annoyed you are there then step back and leave him/her and then re try settling him/her. In the beginning you can stay in the room to do this. I would suggest sitting in the chair or lying on the bed. Babies/toddlers mimic us so my suggestion is to lie on the bed and pretend to go to sleep Ð he will follow your steps.
Cuddly Toy
ItÕs a good ideal to give the baby a cuddly toy or blanket (snuggly) so that he/she can find comfort with it.
Patting
I put one hand on the babyÕsÕs chest and with the other hand pat his/her bottom. Two types of patting Ð normal pat, which you try first and then if that doesnÕt work, do the second one. The second one when patting gives him/her very slight movement rather like jiggling and also you can use the ssh ssh noise. Or you can sing to him/her but whatever you do make it consistent. The patting should be in rhythm with their heartbeat.
If itÕs the time you are patting the baby to sleep then once he/she is asleep remove your hand from his/her chest, then it he/she doesnÕt wake then pat lighter until you think you can stop and then leave the room. If the baby wakes again you need to redo the whole cycle.
Getting Up
When you go to pick the baby up from his/her cot whether it is after a nap or in the mornings, open up his/her room before picking him/her up. This encourages the baby to play or lie in his/her cot and also he/she will learn that when you walk into the room you are not going to pick him/her up straight away. I always chat to my babies when I go into the room and while opening up the room. I also use this time to put away clothes etc.
Resettling Suggested Cycle
This is not an easy one to write as I know that you need to do it during the night - SO most importantly we need to resettle in his/her room and not intervene too early or too late. The time frames are guidelines only and you need to do something that you can work with and not give up because it becomes too hard. Yes, you can leave him/her to cry it out for Òx Òamount of hours for ÒxÓ amount of days but I donÕt believe in this. My approach will take longer or maybe not, but its to be done with nurturing and working within everyoneÕs boundaries.
Wakes during the night Ð STOP, LISTEN AND ACT
The act will be probably to leave him/her for an appropriate time 5 to 30 minutes (the longer time will be something that you extend to as time goes by)
Then again STOP, LISTEN and ACT
If the crying is off and on then you may leave him/her longer, if the crying is full pitch and he/she hasnÕt stopped to take a breath then you will go in and comfort.
Comfort two ways of doing this, you stay in there until he/she goes into a deep sleep and then you leave OR you can attempt to calm him/her down and leave and then give him/her an appropriate time to see if he/she will resettle. IF he/she doesnÕt go back to sleep then you go in and stay with him/her until he/she goes into a deep sleep.
The time frame that you leave the baby is something that you all need to be comfortable with and work together.
Always try and settle in his/her cot. Its harder to resettle if you take them out of the cot, but trust me there will be times that you do this.
Try not to use movement as a calming tool or to put him/her to sleep Ð this is the hardest habit to break.
You canÕt spoil a baby at this age; they need lots of nurturing and reassurance.
The crying time does depend on the cry but eventually try not to go in under 20 minutes and it also depends on you. You need to work within your comfort zone and also the babyÕsÕs comfort zone. It is not about leaving him/her alone to cry until he/she is exhausted and goes to sleep, but it is about giving him/her space to find his/her sleep.
When comforting donÕt talk or give the baby eye contact Ð both of these stimulate Ð you can use the ssh ssh noise and let your body talk to him/her. Also try and stand to the bottom end of the cot when comforting.
You need to take small stepping stones so dependent on how you feel you can do the full cycle above or start with doing two lots of crying and at the end of the second pat off to sleep.
Do this settling up to ten days Ð if its not working then you need to re look at what you are doing.
Most babies wake up after going to sleep and its usually between 20 to 45 minutes. They have different levels of sleep and the two most talked about are their light sleep and then their deep sleep.
If he wakes after 45 minutes when he/she goes from his/her light to heavy sleep then its important to do a full resettle during the day and during the night to do a partial resettle. At this stage get in quickly donÕt leave him/her too long to resettle, as it is harder to resettle an awake baby than a baby stirring. As time goes on though you will need to step back and let him/her resettle himself/herself but I normally do this once I am comfortable with the going to bed routine.
Why they Wake in the Night
Some babies/toddlers wake during the night as they go through their different developmental stages or experience anxiety separation. He could be over stimulated which again would result in night waking.
Night waking can also be due to sleep deprivation so its important she starts to learn to sleep during the day for a decent time frame.
There is one theory that night waking or early morning waking is due to babies/toddlers looking for that first milk feed of the morning. Its like they are Ôexcited/crazyÕ to have that sucking time. Sucking is also their away of comforting themselves and need or use this to resettle during the night.
If you take away the first milk feed of the morning and replace with solids then after a few days (maybe up to 10) they will wake a little later in the morning or not so much at night because the ÔsuckingÕ on the milk has gone and at the same time they learn to find different ways of self settling.
Some believe itÕs a kind of ÔmaturingÕ or moving onto their next milestones going from ÒsuckingÓ to eating food and drinking from cups.
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