Coffee Catchup 9th September with Dorothy Waide

OHbaby! Coffee Catchup - Palmerston North 9th September. Feel free to ask questions and Dorothy will reply when she can.

Could you recommend how to prepare my baby for a very long plane ride and how to best cope while on the plane. I'm flying with her alone and have a 14 hour and a 5 hour flight. We're taking the 14 hour at night in the hopes that she will sleep but i'm really worried how to survive such a long time with her on a plane alone.

Ok, one more: My baby really struggles with sleeping for more than 20 min during the day. She wakes up at a drop of a hat and won't go back to sleep. you mentioned picking them up and holding them firmly while cupping to get her back to sleep. Should i let her lay in her bassinet a while first and wait for her to attempt to self settle and risk her becoming totally wide awake or should i intervene when she first wakes and pick her up? Right now i put the dummy back in her mouth and rock her - sometimes it works and sometimes it doesn't.

Hi Dorothy, thank you for a lovely coffee group yesterday :-) My question I have is how do I develop a more consistent day sleep pattern with my nearly 10 week old? (I was the lady with the toddler and my baby in a purple wrap).
He has been pretty good at night lately going to bed in his bassinet somewhere between 10 and 11pm usually then waking for a feed and change around 3 or 4am, then going back down to around 7ish. During the day, however, he only seems to sleep for any length of time on me in the wrap or sometimes the pram (mountain buggy reclined). Using some of the techniques you showed us yesterday I managed to get one period of half an hour in the bassinet today, which is much longer than normal.
Rhett gets a bit of reflux (mainly silent I think - that's the one when they swallow it back down?)as well as just a general "fussiness" after some feeds - poss due to trapped wind. It does seem to be improving with age though. I also have the issue of having to work round a 5 1/2 yr old at school and a 2 1/2 yr old at home with me (except for daycare on Wed and Fri mornings). All 3 are boys and my 2 1/2 yr old is going through a very difficult phase!
I'd love to be able to get him to sleep in his bassinet for at least one of the sleeps as things like hanging out washing are harder in the wrap (also would allow some one on one with my toddler).
My husband is a shift worker with the pattern of 2 on, 2 off, 3 on 2 off, 2 on 3 off meaning I am solo parenting half the time.
Any advice/ suggestions would be much appreciated :-)
Many thanks

Hi Dorothy, I was the Chinese mum that asked about changing a toddler's routine when we are in China. She will be 17 months then. She goes to bed at 1930, and wakes between 6-7am. China is 5 hours behind, which means when we are there, she will get tired at 1430(chinese time) and wakes up between 1-2am. How should I deal with it? And also could you please share your note about traveling with babies that you mentioned at the catchup session?

One more question, my daughter is still sleeping in the same room with us, we are hoping to move her to her room soon-ish. Would you have any tips on how to do it please?

Thank you for such an informative session yesterday.

Hi Dorothy, I had the energetic 18month old, he was a very colicy baby.
I'm hoping my next 1 won't be, as well as demanding a feed all the time we co-slept up to
6 months as I heard if you go over that they can't break away as easy, is this true??
I'm wondering if this 1 is as demanding what activities I can give my toddler to do to keep him occupied while
I am busy feeding or nappy changing etc
Also routines with baby and 18month old do I try and get baby to sleep the hours
the 18 month old sleeps plus other times.

Edited by jolzieb - 11 September 2013 at 12:12pm

Hi Dorothy,

You talked about feeding 6+ babies milk first before their solids - which i try to do. However a lot of the times she falls asleep on the boob and then becomes hysterical when i try to feed her to follow up with the solids - because at that point she just wants to nap. How would you suggest i manage to give her the milk and solids feed?

Hi Dorothy, I am the mother with the 14 month old who is in the middle of dropping one of his two day naps, do you have any suggestions on how to do this? At the moment he is fine some days with only one sleep but on others if he is up earlier or hasn't had such a good sleep he definitely needs the second nap. Is there anything wrong with going from one to two and then back to one sleep again?Also when is the best time for the sleep? before lunch, after?

Hi you havent mentioned how old your baby is and how you are feeding so I have attached my notes on packing for a flight.   I would recommend that you let her sleep in your arms if you do not have a seat for her and I tend to close them down by placing a muslin or light cover over them.   

There is no easy answer to how to deal with a baby on flight but I do keep to their routine as much as possible. As you are flying overnight ideally your baby will sleep most of the time.   

Dorothy
[FILE=uploads/45521/Packing_for_long_haul_flight_for_baby.docx]Packing_for_long_haul_flight_for_baby.docx

Hi you havent mentioned how old your baby is or how you feed her so my suggestions would be to offer her a breast feed approximately 15 mins before her nap and then put her in her cot wide awake with no props(this includes the dummy). Here are my settling and resettling notes. These notes are for babies over 12 weeks.
SELF-SETTLING TOOLS

•     Engulf Hold
•     Cupping and patting
•     Shushing

The ‘Engulf’ Hold
As the name suggests, this hold provides as much body contact as possible giving your baby the sense of being completely contained as if in the womb.

It positions your baby in such a way that you can initiate other settling techniques simultaneously. In addition, it also provides warmth, intimacy and the meditative beat of your heart.

Most mothers/fathers prefer using their dominant arm to support the baby’s body from underneath. Choose whichever side feels most natural to you.

Hold your baby so that her head is resting on the upper region of your non-dominant arm. For mothers, this ensures that their baby is not too close to the breast where she could be easily distracted by being close to their milk supply.

Draw your baby in close so that you are pressed tummy to tummy with your baby’s face nestled just below the top of your shoulder. Your palm will be on your baby’s bottom with her legs tucked up into your body and supported as such by your forearm.

With your non-dominant arm, reach around your baby’s shoulder and take hold of her arm to steady it, in other words to control the startle movement.

For this technique to be effective, there should be no eye contact or communication between you and your baby. Allow your own body to do the nurturing.


Patting and Cupping
Patting or cupping your baby’s bottom or lower body mimics your baby’s heartbeat and reassures your baby of your presence.

Patting is a rhythmic, firm and repetitive action done with your palm flat.

Cupping is a stronger action and is done with a cupped palm, incorporating both cupping and a short but gentle thrust forward of Baby’s body.

Both patting and cupping can be done in your arms or adapted for the cot.

Shushing
Shushing is a long, low sound, resembling air being released from a tyre. It should be loud enough so that your baby can hear it over her cry. It is thought that babies respond to shushing because it is similar to the sound that they experienced when in the womb.

Dummies (optional)
If you allow your baby to wind down before offering a dummy, it becomes a settling tool rather than a prop.

Props
Babies do not need to be rocked or walked around the block to encourage them to sleep. While movement may seem an obvious method to help soothe a baby to sleep, it becomes the hardest habit to break and interferes with self-settling. It is an unnecessarily labour-intensive approach that often delivers little reward.

Instead, imagine that your body takes the place of the cot in which your baby will eventually sleep independently; it makes sense that you remain stationary when settling her.

All props, including music, white noise, movement that cannot be done in a cot, dummies (when given straight away to a baby) create bad habits and interfere with a baby’s ability to learn self-settling.

Giving a dummy as a comfort tool is different from plugging a baby when they first go to bed (prop).

SLEEP, SETTLING AND RESETTLING
Much of your baby’s first 3 months was spent establishing feeding and sleeping rhythms. Her digestive system is still maturing and her sleep patterns are still evolving.

In the first 12 weeks your aim is to teach your baby, in a nurturing way, to settle and find sleep unaided and how to stay asleep.

How your baby’s sleep patterns evolve in the first 12 weeks will have depended on you and your household. Keep in mind that daytime rhythms will affect the night rhythms.

This routine is repeated throughout the day and night. With time, the amount of assistance with settling should decrease and eventually Baby will learn how to self-settle.

Once your baby learns how to settle and resettle, she will eventually be able to sleep anywhere.
You can’t spoil a baby at this age; they need lots of nurturing and reassurance.
Teaching good sleep habits requires TIME, ACCEPTANCE, CONSISTENCY and TRANQUILITY (TACT)

SLEEP CYCLES AND PATTERNS
It takes a minimum of 10 days to see changes (i.e. you are just looking for a dim light at the end of the tunnel at this stage) and the circadian sleep cycle takes at least 3 weeks of consistency. The changes do not happen over night but will happen over time.

Remember sleeping is a learned behavior.

Self-Settling
I believe one of the most important skills 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.

When you go to bed you read a book, meditate, watch TV, or chat with your partner – a baby can only do one thing and that is cry. There is nothing unhealthy about a baby crying before going to sleep. As a parent, it can be difficult to listen to but as long your baby is happy and contented generally, crying is just part of life. Remember you are not leaving her there to cry it out; you are leaving her there to give her the ability to find her own sleep. You will not get anywhere by leaving your baby to cry for hours. You will succeed quicker by giving her space and then helping her find her sleep.

Self-settling is the key to establishing healthy sleep patterns. It gently teaches babies how to find sleep naturally, without the use of sleep aids, props or interference. It is about allowing your baby the ability to find her/his own sleep unaided. By stepping back and doing this you are giving her/him the ability and her/his right to find her/his own sleep.


It is that small window that occurs when your baby starts crying until the moment you intervene to help her find her sleep. This window initially may be for only a minute or two but as baby grows it increases until eventually she will be able to find sleep independently. It is a crucial step in Baby’s sleep development.

Self-settling does NOT involve leaving your baby to cry it out alone to finally fall asleep due to stress and exhaustion.

Settling Cycle
Little steps will get you there quicker than taking big steps then finding you are not able to stick with it. 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.

When putting your baby to bed you should do what I call ‘dump and run” i.e. put your baby in her cot and walk away and “do not hover like a helicopter”. 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.

Any insecurity that you may feel in practicing this ‘dump and run’ technique can be alleviated by the use of baby monitors. A monitor with movement, sound and/or camera will provide you with confidence whilst allowing your baby to have a calm environment to have their naps and nighttime sleep.

First Stage
Leave to cry up to 5 minutes STOP THINK and ACT – the ACT may be to leave your baby for another 5 minutes OR

•     Provide comfort with cupping/shushing.Option offer dummy. Remember this is to reassure and should be shorter than the crying time.
Then leave to cry up to 5 minutes, you may choose to do just 2 or 3 minutes here to begin with - STOP THINK and ACT

•     Provide comfort with cupping/shushing then patting and shushing. Option offer dummy.Stay in the room until your baby goes to sleep. At this stage if your baby does not go to sleep then you do have the option of picking her up and putting her to sleep in your arms (see engulfing notes).


Second Stage
Leave to cry for 10 minutes then STOP THINK and ACT- the ACT may be to leave her for another 5 minutes OR

➢     You may choose to do just 2 or 3 minutes here to begin with - STOP THINK and ACT
Provide comfort with cupping/shushing then patting and shushing. Option offer dummy.Stay in the room until your baby goes to sleep.

➢     Provide comfort with cupping/shushing. Remember this is to reassure and should be shorter than the crying time.
Leave to cry up to 5 minutes, - STOP THINK and ACT
Provide comfort with cupping/shushing then patting and shushing.Option offer dummy. Stay in the room until your baby goes to sleep.


Third Stage
Leave to cry up to 15 minutes then STOP THINK and ACT – the ACT may be to leave her for another 5 minutes OR

•     Provide comfort with cupping/shushing then patting and shushing. Option offer dummy.Stay in the room until your baby goes to sleep.   

•     Leave to cry up to 10 minutes, - STOP THINK and ACT
Provide comfort with cupping/shushing then patting and shushing.Option offer dummy. Stay in the room until your baby goes to sleep.   

Fourth Stage
Leave to cry up to 20 minutes STOP THINK and ACT
•     Provide comfort with cupping/shushing.Option offer dummy. Remember this is to reassure and should be shorter than the crying time.

Leave to cry up to 10 minutes, - STOP, THINK and ACT
Provide comfort with cupping/shushing then patting and shushing.Option offer dummy. Stay in the room until your baby goes to sleep.   

REMINDERS ON SETTLING
You need to take small steps so depending 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 cycle cup/pat/shush off to sleep.

Always try and settle in your baby in her cot. It’s harder to resettle her if you take 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 your baby to sleep – this is the hardest habit to break.

When comforting don’t talk or give your baby eye contact – both of these stimulate. Instead, you can use the shush noise and let your body talk to her. Also try and stand to the middle or bottom end of her body when comforting. Remember we all do end up giving eye contact it is human nature; however, try to avoid doing it as much as possible.

You need to work within both your and your baby’s comfort zone. It is not about leaving her alone to cry until she is exhausted and goes to sleep, but it is about giving her space to find her sleep.

The crying isn’t to be crying at the top of her lungs for this length of time. your baby may start out loud and slowly reduce and also stop and start.

If the crying is constant at one level and goes for a long time then you need to reassure and see what is happening.

The crying time does depend on the cry but try not to go in under the time frame that you are working with - nothing is set in stone but you do have to push the boundaries to get results.

Do this settling up to 10 days – if it is not working then you need to reassess what you are doing. You may need to step back and allow her more time to find her sleep.

Resettling

This is how to get your baby to sleep and to enable her to stay asleep.

Resettling teaches babies how to progress from light to heavy sleep. This is essential to avoid the pitfalls of frequent waking and catnapping. In a sense, resettling is the second stage of teaching baby how to find sleep and does demand more time and patience than settling (TACT).

Most babies stir or wake when progressing from light to heavy sleep and this occurs anywhere between 20-45 minutes. In the beginning the idea is not to let your baby wake fully during this transition; a sleepy baby is easier to resettle than a wide-awake, crying baby.

Resettling is not about calming them down or staying until they just start to drift off, it is about staying with your baby until they go into a deep sleep.

However, as she grows you will need to step back and allow your baby the ability to try and resettle without any intervention.

The aim of resettling is to ensure your baby sleeps for not less than 1½ hours per sleep rhythm. Your baby can also sleep longer than 1-½ hours – ideally 2 to 2 ½ hour naps are what you are working towards.

Generally a baby who does not learn how to resettle will have short sleep cycles and wake during the night without the ability to fall back asleep on her own.

RESETTLING SUGGESTED CYCLE

First stage – you may choose to miss this stage and go onto the next stage.

Respond immediately.

To coax your baby into her deep sleep, place one hand over her chest (this is what I call ‘engulfing’ in the cot) and with the other hand begin the cupping action, offer dummy and then progress to gently patting and shushing her back to sleep. You can also turn your baby on her side facing away from you and then do the cupping action.

Remove hand from chest and then pat lighter, ending up patting the air. If your baby does not change her sleep pattern then leave the room. If your baby wakes then you need to repeat the process and stay with her until she goes back into a deep sleep.

Second stage

Leave to cry up to 5 minutes

Provide comfort by cupping/shushing then patting and shushing. Option offer dummy.Stay in the room until your baby goes to sleep. At this stage if she does not go to sleep then you do have the option of picking her up and putting her to sleep in your arms.

Third stage
Leave to cry up to 10 minutes

Provide comfort with cupping/shushing then patting and shushing. Option offer dummy.At this stage stay in the room until Baby goes to sleep.

Fourth stage
Leave to cry up to 15minutes STOP THINK and ACT

Provide comfort with cupping/shushing then patting and shushing.Option offer dummy. At this stage stay in the room until Baby goes to sleep.

Comfort - two ways of doing this, you stay in the room until your baby goes into a deep sleep and then you leave OR you can attempt to calm her down then leave and give your baby an appropriate time to see if she will resettle.

If your baby does not go back to sleep then you will need to stay with her until she goes into a deep sleep.

Always try and settle in her cot. It’s harder to resettle if you take her out of the cot, but trust me there will be times that you do this.

You can’t spoil a baby at this age; they need lots of nurturing and reassurance.

Do this settling up to 10 days – if it’s not working then you need to reassess what you are doing.

An example of resettling could be that your baby sleeps for 45 minutes wakes and it takes you another 45 minutes to coax them back into sleep and then they will sleep for another 45 minutes or less or sometimes more. Eventually over time your baby will not wake but continue to sleep through this wakeful period.

Waking Up
When your baby eventually wakes from sleeping, enter the room but avoid immediately picking her up. Instead reassure your baby with your voice, talking whilst opening the curtains. She will feel reassured with your presence.

This process is a subtle way of teaching your baby that her crying doesn’t automatically lead to her being a crucial opportunity to experience her own space and her own emotions, all the time knowing that you are coming to her.