Category Archives: infant sleep strategies

Safe Winter Swaddling Strategies

When the weather gets colder, some parents think that they need to run out and buy a thick fleecy swaddle blanket or swaddle garment right away. Being too warm is a risk factor for SIDS, so it is worth making a thoughtful plan to swaddle safely in the winter months.  Here are some ideas about swaddling for the winter season:

  1. Your home doesn’t have to be super warm for a newborn, but they don’t regulate their temperature as well as older babies or adults.  An open window creating a breeze will cool them off too much if they are sleeping nearby, so drop the thermostat before you crack that window.
  2. We layer for comfort, so they can layer as well. Swaddling creates “neutral warmth”, the retained warmth of the baby’s body.  If you are concerned that your child is too warm, use a cotton onesie and a cotton flannel blanket, both reasonably breathable options.  The space between the layers can hold some warmth, so even though the fabrics are light, your child could be warm enough with just two light layers.
  3. Think he’s too hot?  Touch the back of his neck and behind his ears.  If he is sweaty there, then he is indeed too warm.  Use a lighter fabric for swaddling, or take off the onesie and re-swaddle in just a diaper.  If you live in a warmer locale or in an apartment with lots of heat, your baby might do much better in the summer-weight fabrics like muslin.  If the heat is unregulated and very warm, you may not be able to swaddle at all.  I used to live in a top-floor NYC apartment that allowed me to wear at tee shirt to bed in January!
  4. Think he’s too cold?  If your child’s face is cold, then that might be true.  Before you pop him into a fleece blanket or garment, think for a moment.  The fleece swaddle garments look so comfortable that they are tempting, but newborns will usually not cry when they are overheated, they just stay asleep.  The brain will try to get rid of excess heat but newborns don;t have the most effective temperature regulation wired into their brains at this early age.  A fleece pajama is loose compared with a fleece swaddle garment, and has less heat-holding fabric folds.

Be creative and thoughtful when you swaddle your newborn this season!

When to Stop Using the Infant Swing with Your Newborn

Weaning the swing can happen earlier than weaning swaddling.  Somewhere about 2.5 months old (adjust for prematurity if needed), many newborns no longer get more peaceful while swinging.  There will always be babies that prefer to be jiggled on your shoulder or in your lap from the beginning. There will also be babies a bit over 3 months old that only calm when snugly swaddled and swinging, firmly buckled in and fully reclined, of course.  If you are not talented in the blanket swaddling area, this is the time when you might want to try a swaddle garment.  It is unsafe to loosely swaddle a child when they are old enough to partially roll inside a swing.  If your child is so strong that he can undo a swaddle garment or a firm blanket swaddle, then swaddling in a swing is not for you.  You will just have to double-down on the shush/white noise, sucking and side/stomach calming.  I would also recommend the dream feed (my most popular blog post ever from January 2015) and be very careful not to put off naps until your child is over-tired.  More on that topic later this month.

When your baby is ready to wean swinging it may be as easy as shutting it off and putting him in the bassinet or a co-sleeper.  Wean a movement-loving baby by slowing the swing down for sleep for a few nights and then seeing if he can sleep in a non-moving swing.  If his sleep is still as long and as deep, then it could be time to put the swing on Craigslist or in the garage.

Don’t forget that the other S’s, especially shushing/white noise, may be even more important now for general calming and signaling bedtime.  This is not the time to dismantle your previously perfect newborn sleep routine.  Abandon all the signs and sounds that tell him things are quiet, safe and cozy at your own risk.  You may even add some more mature routines that can continue throughout childhood, like infant massage and story time.  Babies love to hear your rhythmic voice as you read “Goodnight Moon”.  I hope you like it too, since you will be reading it over and over…and over!

Baby Waking Up Early? Reset that Habitual Pattern Tonight

When infants and toddlers wake at 4 am, and it isn’t diapers, hunger, or illness, it is time to consider that this is a habitual sleep pattern.  Everyone is vulnerable to habitual waking, even adults.  The garbage pickup can trigger it, a spouse that rises early to go work out, etc.  You find yourself waking at the same time even if your partner changes his gym time.  Wide awake for no reason that you can see.  Babies and toddlers can also get stuck in a habit of waking early.  Since bedtime really starts right after breakfast, starting the day too early can shift nap and feeding schedules and destroy what used to be a great routine.  There are ways to fix this pattern, but it takes some awareness and some knowledge.

One way to know that your child is stuck in an early-waking groove is to notice that when they wake early, neither diapers, hunger or socialization are what they desperately need at that moment.   They aren’t longing for the closeness of nursing/bottles or the physical need for food that signals waking out of hunger.  They might not be seeking your attention very much at all; your baby is just awake and ready to play.

If you have a baby that actively protests a back to sleep message in the dark, you could have accidentally signaled to them over time that this is a great time to receive individual, undivided attention from you.  It is like “pillow talk” for people who can’t talk.  A quiet cuddle and looking into one another’s eyes without competition from siblings or iPhones might be such a treat to him that your baby may be looking forward to this night time love fest.  That is a different blog post entirely.

For a habitual waking issue, you need to use the wake-and-put-down method:  set your alarm an hour before the habitual wake-time, and go gently wake them up a little bit.  No talking, no cuddling, just a tiny rousing so that their sleep clock is re-set.  Do your best to get them right back to sleep (do only emergency diaper changes, no conversation and play) and onto a later wake time.  This can work as quickly as one night, according to the Baby Whisperer (that Baby Whisperer Solves All Your Problems book is a pretty good reference).

I agree with Dr. Karp, of The Happiest Baby Guide to Great Sleep fame, that if this reset plan doesn’t work then you have to consider that maybe your child’s bedtime is too early.  It also might be too late.  If it is too early, your child is waking because he just doesn’t need more sleep.  If his bedtime is too late, then you have a child who sleeps fitfully and wakes up to the slightest stimulation.  If you have ever  been out way past your normal range of bedtime the night before, you know that awful feeling.  You need and want sleep but you are wide awake.  Both of these authors share really helpful plans to change bedtime routines for early or late bedtimes.  My copies of their books are on the quick-reach shelf in my office.

It takes confidence and determination to execute the wake-and-put-down strategy and to move bedtimes around.  You may have to change the behavior of others in the home to dim lights and lower noise, set up a white noise machine or purposely get babies out in the sun during the early part of the day to reset their wake-sleep clock.  Unless you really like knowing when your newspaper is delivered and when your neighbors take a morning run, you may want to give these ideas a try!

Add Massage To Your Child’s Sleep Routine, And Both of You Could Sleep Better Tonight

Massage is a wonderful way to connect with your child, and it can be a great technique to send him off to sleep without tears or guilt.  After the books are read and the last feeding has finished, you can use a short and restful massage to relax him and assure him that it is time to go to sleep.

Dr. Harvey Karp writes about the fact that bedtime starts at breakfast:  having a calm and rewarding day in which a child feels that he received enough attention from loved ones, enough play and enough emotional support will allow him to cooperate with bedtime and separate at night with fewer issues.  Some days aren’t so blissful.  Commutes are too long, multi-tasking gets in the way of fun time, and children have their own mini-dramas in their own life at daycare or school.  One way to follow Dr. Karp’s advice to have daily “time-ins” and to support his feed-the-meter concept is to use a nighttime massage routine.  It can be something that both parties look forward to at the end of a busy day.

As a massage therapist, I teach parents custom routines that are flexible and easy to learn, but the very best massages are the kind in which both parent and child are relaxed and receptive.  Some children love back massage, some like foot and hand massage, and some relax best with a full-body treatment.  Your child’s reaction will tell you the direction to take.  The age and temperament of your child will dictate some of the choices of strokes and how long the massage takes.

A few suggestions:

  • use food-grade unscented oil until you are certain that your child’s skin is not sensitive to essential oils. Avoid lotions and oils that are synthetic.  You never know when they will lick their fingers, and if it isn’t of a quality that you would put on your food, it isn’t acceptable on your child’s skin either.
  • dim the lights, including computer/tablet/TV screens.  This isn’t the time to read the captions on your show.
  • you can use music or be quiet.  Not every child can relax with multi-sensory stimulation at bedtime. You can talk gently, or just smile and make eye contact.   Again, your child’s responses will tell you how to craft your massage environment.
  • use slow and rhythmic strokes for maximum relaxation.  If possible, try to have one stroke blend into the next without lifting both hands off your child.
  • use a full-arm, full-leg, or full-torso welcoming and finishing stroke.  It helps your child develop greater body awareness and is an elegant way to deliver your massage.
  • enjoy yourself; research has shown that the providers of massage also receive benefits such as greater oxytocin levels ( the brain neurochemical associated with attraction and attachment).
  • do not be surprised if your young infant (under 6 months) only tolerates a 15-20 minute massage, and then becomes fussy.  Massage can be a lot of stimulation for a young baby, and you will have to experiment with the quality and quantity of the strokes that bring your little one to bliss.  A brief massage may be just perfect for him!

Ten Problems That Cause Parents to Abandon Happiest Baby on the Block

Learning to use The Happiest Baby on the Block 5 S’s can be tricky.  In addition to teaching group classes, I also teach parents privately to help them get the techniques down correctly and answer all of their questions on the spot.  I meet parents who have watched the DVD or read the book but still struggle to get the amazing results they see/read about.  Here are the biggest problems/mistakes that parents encounter when they try to use THBOTB:

  1. The Loose Swaddle.  New parents can be hesitant to use a firm swaddle, thinking that since their baby is still crying, he is crying because he hates being restrained. Why Some Newborns Look Like They Hate To Be Swaddled This is usually not the case, as newborns generally love deep pressure that simulates the womb, and parents that I work with are far more likely to do a too-loose swaddle than a too-tight swaddle.  In fact, I have never yet seen a parent that I have personally trained do a swaddle so tight that I had to gently intervene.  A loose swaddle is an asphyxiation risk when it comes undone and the fabric covers the nose and mouth.  It also allows a baby’s arms to fly up and startle a newborn, leading to more screaming.  Preemies are swaddled with their arms up to increase calm alertness and they are monitored 24/7.  Huge difference.
  2. The Too-Hot Swaddle.   Using the fleece swaddle garment in a warm apartment will sedate your child.  It looks like it works perfectly.  But newborns cannot sweat away excess heat, and if a baby is sweating, their ears and neck are warm and damp, then they need to be swaddled in something cooler.  Being overheated is a risk factor for SIDS, so if you have no A/C and your baby is too hot even with a muslin swaddle, you need to remove it.  A hot baby is a baby at risk.
  3.  Too Slow and Too Gentle Swinging.  The magic of the Swinging “S” is in the small but faster head movements that stimulate a baby’s vestibular (balance) system.  Completely different from shaken baby syndrome, this jiggling movement is calming.  Slow swing is not going to be able to stimulate a newborn’s balance system correctly.  Parents are often afraid that they will harm their baby, but if they are taught well, that little neck and brain are completely safe.
  4. Stomach/Side Positioning Errors.  This “S” is another way to dampen down the startle reflex,  so correct positioning is key.  The little secret of this move?  Every baby’s balance sense is  a little different, and yours may prefer stomach instead of side positioning to calm them, or she might need a little more of a side turn to feel “just right”.
  5. Pacifier Abandonment Out of Fear.  Many new parents are anxious that their child not become addicted to pacifiers like toddlers they see walking around town.  They are also worried that it will deform their teeth.  Well, newborns have no teeth to deform, and addiction to pacifiers is created when older children have no other ways of calming themselves down.  Parents that make a conscious plan to wean pacifier use after 6 months, well before growing cognitive skills and long-term use create a habitual need, should be OK.  Teaching a newborn to use a pacifier is easy when you get the one that fits their mouth shape and you use THBOTB training technique.  The 5 S’s can be done without a pacifier, but rejecting it out of fear is different than using different techniques for sucking.  For more information, see Prevent Pacifier Addiction With A Focus on Building Self-Calming Without Plastic
  6. Ignoring the Layer Cake Concept of the 5 S’s.  There are some babies that calm with just a swaddle and a shush.  But most need the full-on 5 S’s.  I meet more of those because parents call me when they are frantic for sleep and have tried maybe 2 or 3 of the S’s and given up.  Needing all 5 moves is not a sign of a problem.  The problem is likely that your baby is normal, has a sensitive or spirited temperament, and is right in the stage for maximal newborn crying (2-10 weeks).  Ignore this at your (sleep’s) peril.
  7. The Too-Quiet Shush.  Babies quickly calm to the right volume and pitch of shushing, but parents sometimes think that the loud shushing needed to calm them initially will harm their hearing.  Loud shush is used for a brief period when they need help to pull themselves together, and then the correct shush is the loudness of a bathroom shower.  Avoiding the loud shush is ignoring the needs of a newborn brain as it seeks organization and calm.
  8. Forgetting the Basics.  I was reminded of this when I taught my first class.  The host, a breastfeeding consultant, asked if I would mention checking whether a baby needed a feeding or a diaper change before starting the 5 S’s.  I will confess that it had never occurred to me that I would have to say that. It seemed so obvious.   I will say it here:  Before you use THBOTB to calm your crying newborn, check to see if he is hungry, soiled or wet.  First things first.  A baby that is healthy, full, and clean should be easily calmed with THBOTB.  A baby that needs those other things will not stay calm for long, regardless of your technique.
  9. Using Small Garments/Blankets for Swaddling.  The swaddle garment industry has exploded, and you can find all styles.  Blankets are often big enough for the first 2 months at least.  The biggest issue with garments, other than matching the fabric to the room temperature, is that once they are too small, they are a danger.  Outgrowing a swaddle garment means that the velcro isn’t correctly placed for a solid hold and can come undone, and the baby’s legs cannot move freely.  Legs that are stuck in an extended (straight) position are a risk factor for hip dysplasia, a condition in which the joint is not correctly formed.   If you are buying garments, better to have at least one in the next size up sitting and waiting for use.
  10. Waiting Too Late to Try HBOTB.  Some of the 5 S’s, such as white noise shushing and sucking, will help babies over 3 months calm down and sleep, but the real magic is in starting life with peace and good sleeping habits.  Parents who take a wait-and-see approach risk the development of poor sleep habits or feeding issues related to crying/poor sleeping.  Their own lack of sleep and sense of failure is a risk factor in postpartum depression.  Worst of all, they do not have the full joy of those precious first months because  they are exhausted and frustrated, struggling to calm their newborn or get just another hour of sleep each night.

Teaching Your Baby to Sleep Through the Night

No baby sleeps all night.  Not one.  Neither do adults.  Surprised? A normal sleep cycle bring us into a foggy awake stage and only then do we return to sleep.  This happens many times throughout the night, but good sleepers send themselves right back into a deeper sleep without being held, an extra feeding (excluding that magic dream feed), or a midnight sandwich run.  Developing the ability to send yourself back to sleep is learned, not acquired with time.   Babies that have learned this skill appear to stay asleep all night long.  They are actually settling themselves down repeatedly in the middle of the night, just like there rest of the family.  How babies learn to send themselves back to sleep depends on the mindset of the adults doing the teaching.

I believe that good sleep skills after those first few months of life depend on the parent’s perceived role as sleep coach.  Gradually sleeping through the night after the first 6 months is a skill, not an innate instinct.  Here is what you need to know to build those skills in the littlest learners. New parents aren’t often aware that children all the way to about age 4 have shorter sleep cycles than adults (60 minutes versus 90 for adults) and can begin to be able to shift to a day-and-night awareness late in the second month of life.  Yes, that early.  Good sleep for the smallest babies up to 12 weeks is largely a matter of respecting their need to have the womb experience replicated.  All of the 5 S’s in Happiest Baby on the Block do that really well, which is why I teach classes and provide personal consultations.  Providing the physical experiences that newborns need is essentially your job in those first couple of months.  Being able to fall asleep quickly and without hours of crying right from the start sets babies up to have good sleep habits.  It also gives parents a confidence boost and a sense that healthy sleep patterns are possible.  Teething, growth spurts, runny noses and all manner of things will happen in that first year to derail good sleep and shake that confidence.

After about 12 weeks babies’ brains are more mature, and need the social support of a routine and an adult that can “read” them well.  Sleep becomes more of a dance between habits, needs, and expectations.  You use the white noise, transition objects and shush-pat to help a baby quiet themselves down, put tired babies to sleep before they get too tired, and treat your sleep routine just like a dietary guideline for good health.  It is.  Communicating your confidence in their ability to calm and being aware of accidentally creating bad sleep habits is key.  “The Baby Whisperer” is my favorite reference for turning around bad sleep habits in a kind but firm way.  No one else does as good a job of advocating for children to be independent sleepers who do not feel abandoned.

In the terrific book “Bringing Up Bebe”, the characteristic French approach that is described is not cold and callous, but rather respectful, as parents wait to see if a whimpering baby can self-calm, and allow the baby to settle herself down much of the time.  Assistance is brief and while warm, it is understood that the baby is being taught to “do her nights”, as they say.  It certainly helps that maternity leave and good daycare in France is generous, so that parents are less stressed and fatigued.  But it is more than that.  Their culture also values developing independence in very young children throughout the day, not just around sleep training.  If your belief is that your job as a parent over time is to teach your child to NOT need you for sleeping, for feeding themselves, and for entertaining themselves, then this will seem like second nature. You will start with fostering them to settle themselves, and quickly move along with holding a spoon, playing alone, and even cooking dinner at 10.   If you believe that your job is to protect your child from every frustration that you can, then it will seem like cruelty not to go to her when she gently whimpers.  It all depends on how you see your role. For parents that decide to take this approach, they may have two hurdles here in America.  Friends and family that do not agree will erode your confidence, and our overall culture doesn’t support this attitude right now.  My family had this more traditional European approach to parenting, and many of our friends were also from this culture.  You may have to work to find a like-minded community if you want face-to-face support.  The internet can support parents who do not have direct encouragement.

One of the first considerations when thinking about how you will address infant sleep issues is to determine how you see your role, and what you believe is possible for your child.  Then you can see your path to a good nights sleep more clearly.

Infant Separation Anxiety and Sleeping Through the Night

Between 6 and 12 months of age, babies learn a lot.  One important thing that they learn is that they are separate from their parents.  They can cling during the day when you put them down to go to the bathroom, but they can really scream at night when you start the bedtime rituals or when they wake up and you are not there.  Actually, you can celebrate this new mental milestone;  learning that they are separate from you is a good thing.  Dealing with their initial fears and all that crying can be tough. Here are some ways to support babies and save your sanity as well:

During the day:

  • Use peek-a-boo to practice imaginary separation.  Sounds silly, but at this age, they think you really are leaving when you go under a receiving blanket.  They don’t have a firm grasp of the concept of object permanence yet.
  • Use Patience Stretching from The Happiest Toddler on the Block.  Smile warmly, say “I will be right back” in a pleasant voice, and step out of the room for a few seconds.  Come back and engage with your baby again.  Next time, make it 10 seconds, and so on.  Build that ability to know that you do leave but you always return.
  • Be the kind of parent that always does what she says.  Plan to go to the park?  Deliver on that.  Promise a cookie?  Always get them that cookie, and be someone that can always be counted on.  Babies in this stage can remember the overarching sense of consistency you provide.
  • Respond to separation crying with warmth, but there can be no trace of anxiety or upset tones in your voice or your body language.  This is the time to deliver an Oscar-winning performance because young infants listen to your tone and all the non-verbal information even more than your words.  If you have a lot of anxiety about going back to work, or if you have issues with loss and separation that are coming up, speak to a trusted friend or a professional.  Parenting can often bring out your feelings that you thought were dealt with a long time ago.
  • Don’t Sneak Away.  Why?  You want to send the message that you can be counted on to return, and you need to do the firm, positive reassuring goodbye in order to send that message.  Without it, all you have is the emotional consolation when you return.  Think about the whole experience from your child’s perspective, and you will see why sneaking away only increases the anxiety and teaches the child to watch your departures like a hawk.

At bedtime:

  • Use all the techniques as needed from above, plus:
  • Use your bedtime routine and stick to it for reassurance.  This is not the time to change it up, even if your child pushes away the favorite book and the lovey.  Routines give children in a growth phase reassurance that some things in life will be familiar.  Crying when the bedtime ritual begins can be their way of saying that they anticipate the separation, and your routine will comfort them.  You may add to the routine as they grow, but the essential routine should stay the same for consistency at a time in the day when they are vulnerable.
  • Consider varying the person who does that routine, so that your baby feels safe and secure with more than one person.  That may mean expressing milk so that another person can do the bedtime feeding.  Think of the benefits for your baby in having many people to feel reassured by, not just one. So much more support  and a sense that the world is safe even if they are not with that one person.  Again, some parents really like being the only person a child can be comforted by.  It makes them feel special in a way they are not feeling in their adult life.  That may be something to think about, because parenting will bring up those kinds of issues.  It can put a spotlight on a marriage or on job satisfaction in a way that other events do not.
  • Look at other stressors contributing to crying.  New things like learning to digest solids (make lunch the heaviest meal of the day), teething, recent travel or new caregivers, and growth spurts disrupt sleep and make babies clingy and fussy.  Even learning how to stand in a crib can seem so exciting until you need someone to help you get down again!

Separation issues come up again later in infancy and toddlerhood, so this first period of anxiety, handled well, sets the tone for your parenting through the years.  Imagine that soon this baby will go off to school by herself!  Prepare her, and prepare yourself to give her roots and wings.

Prevent Pacifier Addiction With A Focus on Building Self-Calming Without Plastic

valeria-zoncoll-AVGc87j_vNA-unsplash

Parents of newborns are concerned that pacifier use will lead to pacifier “addiction” in later infancy and toddlerhood.  It doesn’t have to be that way.  Pacifier addicts are made, not born.  Parents should not feel guilty about the difficulty they encounter with pacifier weaning, since no one explains what pacifiers do for babies and how to prevent accidental addiction in an older infant.  It starts out as a natural way to soothe a newborn.  No one intends for things to get out of hand. Happiest Baby on the Block even includes sucking as one of the 5 techniques that make up the calming reflex response for newborns.  Pacifiers can be a way to incorporate the calming action of sucking, but then as a child gets older, he should be developing more mature coping methods as well.  Here is what you need to know:

Why pacifiers work so well for younger babies:

  • the need to suck is something your baby was born with.  Fetal ultrasounds show them sucking their thumbs.  Developmental reflexes support sucking at birth.  The shape of the newborn jaw and tongue make it easier for newborns to get a secure and strong seal.  A newborn has more ability to interpret sensory information from the mouth than the eyes or hands, but no ability to keep their fingers in their mouth to suck until 2-3 months of age.
  • this biological need to suck helps them learn to nurse right away, and can calm them quickly in the first 6 months of life.  The ability to self-calm is a learned skill, and develops over the first years.  Babies begin learning to calm themselves down in the first 12 months of life.  If we teach them.

The slide down the slippery slope to pacifier addiction can be prevented:

  • after 6 months, babies still using pacifiers have no biological need to suck, but have the ability to remember their routine.  It can now be a habitual need, not a physical one.
  • some babies aren’t so easy to calm after swaddling and swinging have ended.   Using white noise, a blanket swaddle with the arms out/swaddle garments that have the arms free, and plenty of opportunities for cuddling, rocking, nursing or bottle feeding help the transition for sleep.
  • building early communication skills and responding quickly and effectively to frustration and fatigue in older infants can minimize or prevent the use of pacifiers to calm them during the day.  Start Patience Stretching and the Fast Food Rule (from The Happiest Toddler on the Block) as soon as possible.  See my blog posts on these techniques How To Get Your Toddler To Wait For Anything (Hint: They hear “Wait” as “No”)Taming Toddler Tantrums Using Sympathetic Reframing.
  • families that haven’t established effective sleep routines can run for the pacifier to end bedtime fussiness, rather than taking a wide-angle look at the way they manage naps and bedtime.  Creating a firm but flexible sleep routine isn’t easy.  Step 1 is accepting that building calmness throughout the day (by crafting a daily eating and playing schedule that supports good sleep) is like investing money in the bank for retirement.  It seems a long, long way off until the time arrives when you need the cash.  This may mean that the working parent plays energetically with the baby in the morning or only plays quietly at night.
  • all caregivers, including daycare and nannies, have to be on-board with your exact routines.  No routine at all can be better for a baby than one routine with parents, one with the daycare, and one when grandma watches him on Saturdays.  Imagine if you went to sleep with music playing on Mondays, left Jimmy Fallon on for Thursdays, and had it quiet but the lights are on for Fridays.  Very disorganizing.  This is not easy to coordinate, and many families default to the pacifier to tie it all together.
  • changing the attachment from a pacifier to a “lovey”, which is a transition object that the child can hold and cuddle, is often very helpful.   Switching to thumb-sucking has been shown to be a potential issue for dental malformation. Holding a lovey has not.  This lovey could be a small toy, a tiny blanket, etc.
  • the American Academy of Pediatrics recommends pacifier use until 12 months to prevent SIDS.  If you follow that plan, you need a strong plan to get rid of the pacifier from an older, stronger willed and wiser baby.  It makes complete sense for safety, but parents need to know that it will take longer and be harder to eliminate the pacifier as the child gets older.
  • children who have spirited temperaments, and families that have difficulty creating and establishing routines, often struggle to successfully change any familiar pattern of behavior.  The pacifier can seem like the only sure fix for a child that gets upset easily or has to deal with a lot of unpredictability in their day.  Read  How To Respond to Your Toddler’s Aggressive or Defiant Acts  for some strategies to handle aggressive behavior before you decide that the paci is the answer.  The problem with running to the next idea too quickly is that some children are going to need a few days or even a week for any strategy to become familiar enough to tolerate.  Until then, you can’t clearly see what is going to work or not work.  My favorite book that gives practical advice on creating sleep routines for the strongest-willed babies  is “The Baby Whisperer Solves All Your Problems”.  If you have an older child with a pacifier addiction, check out  Weaning the Pacifier From An Older Child for ideas targeted to getting rid of a pacifier once an addiction has set in.

The most important life skill your baby will learn in the first few years may not be walking or talking.  It may be the ability to calm himself down in times of change and frustration.  Thoughtful planning and execution of a plan can avoid pacifier addiction but also build a skill he will use for the rest of his life.

How To Calm Crying If You Don’t Swaddle

Yesterday I taught a Happiest Baby on the Block class, and one mother was adamant that she would not swaddle her 3-week-old daughter.  She thought it would be too restrictive for her.  Although I taught the correct safety principles, how it mimics life in the womb, and the effective techniques for a good swaddle, this mom wasn’t convinced that it was for her.  My action of choice?  Emphasize the techniques she could embrace.  She learned the technique correctly, but she gets to choose what is right for her and her child.

I do not teach a “swaddle class”, I teach THB.  It is so much more than an opportunity to learn how to swaddle.  The class teaches the neurological and behavioral underpinnings for newborn sleep and calming, and that is powerful information for parents.  Understanding what is happening, why it is happening, and how THB capitalizes on the science of development is empowering on it’s own.

There are four other techniques with their own power to soothe and organize a tiny little being.  Using a safe and firm swaddle is considered the foundation of calming in THB, but the other techniques can be effective when used together, especially with a baby that isn’t exceptionally fussy and is easier to calm.  The correct shushing, swing/jiggle movements, sucking, and side/stomach calming positions can be enough for those babies, and she was lucky enough to have a pretty calm infant (for now – plenty of time for a colicky period to erupt).

Swaddling your baby is the bottom layer of calming, and should extend periods of sleep and create a “calming barrier” of deep sleep to prevent noises in the environment, first infant stuffy noses, and other distractions from waking her up.  If you have struggled with the swaddle technique, watch Dr. Karp’s DVD, use my phone consult sessions or trainings, or try a swaddle garment.  Used correctly, they are a quicker way to an easy “A” in swaddling.

We practiced the effective distance and volume for the shush, the different forms of the jiggle/swing in her arms, discussed sucking as a natural soothing approach, and why just turning a baby onto their side or stomach to calm (never for sleep) is like clicking a sleep switch with a newborn.  And her daughter slept through just about all of it.

Safer With a Swaddle Blanket or Swaddle Garment? Research Says You are Asking the Wrong Question

As a certified Happiest Baby on the Block educator, I am often asked which choice new parents should make.  Swaddling with a blanket is cheaper (babies don’t grow too large for most blankets for months) and blankets can be repurposed after swaddling is finished.  Garments are easier to master; not everyone is willing to learn how to do a firm swaddle.  Parents with physical limitations, and parents of super-wriggly or very strong babies get a more secure swaddle with a garment.  But which is safer? There has been research on this topic.  A Journal of Pediatrics article in January 2014 found that ensuring a wide range of safe sleep practices was more important than method choice for safety.  The question parents should be asking is:  What should we do to make swaddling safe?  Safe swaddling has not been directly connected to very many documented injuries or deaths.  When unsafe sleeping practices are removed from the equation, using swaddling before a child can roll by themselves has a low level of risk.    Here are guidelines to help you make swaddling successful and safer:

  • Many preemies are allowed to sleep on their stomach while in the hospital.  Placing a baby on their stomach without the monitoring and supervision of  a NICU is dangerous.  Safe-to-Sleep recommends only back sleeping at home, swaddled or not.
  • Loose swaddling, soft bedding, rolling over on your child while co-sleeping, or engaging in the use of alcohol or drugs while co-sleeping are huge risks.  Using a co-sleeper next to your bed is much safer than having your baby in your bed.  Avoid having your baby sleep on you in a recliner chair or on the couch.
  • Swaddling your child too warmly is a risk, so learn to “summer swaddle” with muslin or a light cotton swaddle garment, or turn on the A/C.  Child still too warm?  Remove the swaddle until the room is cooler.
  • Not getting a larger swaddle garment once your child has grown is a risk for safety (velcro will not securely attach) and puts him at risk for hip injury if his legs aren’t able to move freely.
  • Once your baby can roll independently, swaddling is riskier. The American Academy of Pediatrics recommends that swaddling should stop when a child is beginning to roll independently.  If you are doing all the other Happiest Baby techniques for the older newborn, then you should have established great sleeping habits without swaddling by the time your baby starts to roll.

Why Stomach Sleeping For Newborns Isn’t the Answer to a Good Night’s Sleep

Why would parents place a newborn on her stomach to sleep, even though their pediatrician clearly advised against this position due to the increased risk of SIDS?  Simple: many babies fall asleep faster and stay deeply asleep this way.  Many, many babies struggle to fall asleep easily or stay asleep  when they sleep on their backs.  This leaves parents torn between safety and sanity. It does not have to be this way!

Parents have good reasons to be afraid of SIDS; the death of an infant is an almost unimaginable tragedy.  One of my best friends said that she could imagine surviving the death of her husband but she couldn’t imagine the pain of losing one of her children.  Back sleeping is one of the simple recommendations to lower the risk of SIDS that has a proven record of efficacy.  Simply put:  placing your baby on her back to sleep could save her life.

One reason that babies sleep so well on their stomachs is that it positions them so that the Moro reflex isn’t triggered when they move their head or limbs.  It also gives them a lot of nice soothing deep pressure as the weight of their body is pulled by gravity into the firm bassinet mattress.  This is also the reason it isn’t safe.  This position makes it harder for a tiny baby in that deeper newborn sleep to clear her airway to breathe, since she doesn’t have the strength to turn her head while barely awake that older babies have.

Getting a newborn to sleep isn’t easy, but it is made so much easier with The Happiest Baby on the Block techniques.  I am a certified HBOTB educator, and I find the greatest error parents have made when they call me for a consultation is that they haven’t layered all the techniques.  They bought a swaddle blanket or garment, they have a white noise playlist on their iPhone, and they got a swing as a baby shower gift.  They use a pacifier, and they know about calming in side lying.  Then they behave as if they are ordering appetizers at Cheesecake Factory: they pick the strategies that they think will be good tonight.

Very young or very fussy babies just don’t sleep as well if you don’t give them all of the 5 S’s.  The sequence is solidly based on the unique neurology and biology of newborns, and you ignore the details at your peril.  Each component gives some support for calming a baby, but most babies need more than one, and most of the consultations I have done are for very fussy babies that clearly needed all 5 right from the start.

Find a consultant if you just cannot get the swaddling or the jiggle down, and practice, practice, practice.  Buy a swaddle garment if you are all thumbs with the origami-like blanket swaddle.  But don’t think that since it works “a little” with just a garment and a pacifier, you are going to get the long, deep sleep that all 5 techniques together can allow.   Always use the side lying or stomach position to calm your baby, but not to sleep.  Don’t cave and put her on her stomach, thinking that most likely nothing will happen.  You do not have to make that kind of gamble with your baby’s life just to get a good night’s sleep!

Wean Pacifier Use by Teaching Toddlers How to Stay Cool and Collected

If I had a dollar for every toddler that greeted me at the door with a pacifier in his mouth……well, you know, I would be on an island in the sun today!  Some parents want to know how to end paci use, as they dread the crying on the day that they send their child to a no-pacifer zone, also known as preschool.  What is going on when a child can’t function for much of the day or night without a nipple in his mouth?

Happiest Baby on the Block (THB) and the Baby Whisperer both support pacifier use when needed in the first 3 months to help soothe fussy babies, and they are also totally supportive of nursing babies for the same purpose.  After that period is the best time to wean a pacifier, but that seems very rare indeed in my experience.  Something happens to a portion of babies and toddlers between the newborn biological need to suck and the near-addiction to pacifiers that some toddlers develop.  I have seen even 4 year-olds go absolutely bonkers if their paci is lost.  Parents who have decided to end paci use try the ‘paci fairy” story, the “a little baby needs yours so we sent it to them” story, and offers of just about any gift or reward.  I rarely hear of an older child that simply handed his mom the pacifier and said he didn’t need it any longer.  And this is fully years after the biological need to suck has faded away.

I did a little bit of on-line research to find out what leading pediatric websites and pediatricians are saying, and it seems that they are all at a loss to explain why it is that only some children hold onto those pacifiers so long and so fiercely.  Just about all of the medical websites warn of dental deformity and slow development of speech with prolonged use.  With my dual training as a THB educator and a pediatric OTR, I think I stumbled onto a pattern.  The kids that really need those “props” (as the Baby Whisperer categorizes them) seem to have either spirited or shy temperaments that continued to require extra help to calm during the day and sleep at night after the first 3-month period.  They also have very few self-calming tools when compared to the waves of uncertainty, moodiness, frustration, whining and aggression that comes with the toddler period.  These children experience major stressors in their days/nights and the only thing anyone has given them that works is the pacifier.

There are angel/textbook/easy kids, to use both the THB and Baby Whisperer temperament categories.  They handle changes and challenges with very little fuss.  They are in the minority by percentages.  Parents lucky enough to have one might not appreciate the day-to-day issues with spirited kids or grumpy temperaments.  There are kids with developmental delays that have more daily struggles than usual as toddlers.  But some parents are aware of potential problems and make very conscious efforts to build self-calming and self-control skills in their kids at an early age.  Like a toddler Venn diagram, I can see the perfect storm of kids with more struggles, parents with less awareness of pitfalls, fewer strategies to teach, and more stress at home and work (it is fast to pop in a paci if it works and you are exhausted) who will fall into that section of intractable pacifier use.

Developing self-control skills in toddlers is not a quick or easy business, but it can be done.  Parents are often unaware that they can teach any self-control strategies to children so young.  I won’t blame them for not having any tools to use.  The Happiest Toddler time-ins (which include kind ignoring and patience stretching) are the best strategies I have ever used to build self-control and mutual respect in my sessions.  I have seen children transform their behavior without anyone raising their voice.  These techniques respect the child’s feelings and accept that self-control is a learned skill, not something you wait to see blossom in the future.  I think that after giving a child some real strategies it is easier and kinder to take away that pacifier, and easier still to stop a pacifier dependency before it ever begins.

Move Your Baby Into a Shared Bedroom Using The Happiest Baby on the Block

One question I usually hear when teaching The Happiest Baby on the Block (THB) classes is “Can this help me when I want to move her into her sister’s room?”.  The answer is: absolutely!  Strategies that keep your newborn calm and sleeping more deeply will smooth the transition to shared bedrooms later on.

Most parents use either a co-sleeper or a bassinet for the first few months after birth. They can hear and see the baby more clearly, and the frequent feedings and diaper changes are less disruptive to everyone’s sleep.   Unless they use the “family bed” concept, they often plan to move their newborn to a separate room after 4 and 6 months.  I think every family should decide for themselves when and where they want their babies to sleep.  But if you want two children to share a room, you need to have a plan.  Twins can be a bit easier, but it is not a guarantee that they will have identical sleeping and feeding schedules.  When you have an older child already sleeping in a bedroom, moving your infant in with them is even more complicated.  Parents are generally worried about waking the infant when the toddler goes to bed later, or worried that the infant will wake for a feeding and then wake up the toddler.  They envision nights with one or the other crying, and nobody getting a decent night’s sleep.  It doesn’t have to be that way.  And it can be done without anyone crying.

My favorite saying about sleep issues in infants is that a good night’s sleep starts in the morning.  Using THB, you have strategies to calm your baby all day long, through naps and stressors like noise that other children make.  A baby that has spent the day being quickly calmed, had deep refreshing naps, and knows that their caregivers can calm them quickly is much easier to put to bed at night.  Parents who are no longer swaddling have asked me what they can use.  Well, swaddling isn’t the only THB technique.  In fact, it is only one of 5.  Parents can use sucking without risk of dental deformation or habitual dependence through month 6, and white noise is great for the whole first year.  Some children will use the adjustable swaddle garments to get the firm chest/abdomen swaddle input after they start rolling.

It helps if you use techniques like the dream feed to extend and deepen sleep at night (see my post on the magic of dream feeds).  THB techniques can be done by dads and nannies, so moms aren’t the only ones who have to get up at night.  Sometimes babies need to nurse, and sometimes they aren’t hungry but have a stuffy nose or need a diaper change.  Getting them back to sleep quickly is very important to preserve the concepts of day and night difference.  Recent research in the UK indicates that the circadian rhythm of naturally seeking sleep at night is developed in the second and third months of life, and is not entirely biological.  Their research suggests there is an interplay of brain development and the way babies are supported to sleep that promotes that circadian pattern.  It can be disrupted; ask any insomniac.  Give your baby the best chance at solid sleep patterns right from the start!

Babies that have grown accustomed to always nursing or bottle-feeding to get back to sleep, or expect to play a bit before going back to sleep are going to be the most difficult to blend into room sharing.   A baby that is quickly calmed by THB techniques at the earliest age is practically asleep by the time you put them down.  They can save the fun for the times when the sun is shining.  They are so sleepy when you use THB that they will not develop habits that work against getting their precious nighttime sleep, even in a shared room.

Swaddle With a Blanket or a Swaddle Garment? How to Decide What is Right for Your Family

You have decided to swaddle your baby, and you read the book/watched the DVD/had a private consultation with me.  You know why swaddling helps your infant calm down, fall asleep, and stay asleep.  But what do you actually use for swaddling?  Two choices appear: the blanket or the manufactured garment.  Swaddle blankets can be muslin, microfleece, synthetic, natural or organic, and come in a fairly standard size.  Manufactured swaddle garments can be made from the same materials, usually have velcro closures, and are sized newborn-large.  Some are convertible from arms-in to arms-out.  So how do you choose?

  • Preemies may or may not fit the small sizes, and some babies are large for their age.  Swaddling success depends on a firm wrap that doesn’t leave any fabric covering your baby’s mouth or nose, and is large enough to prevent accidental unraveling.  For a firm custom fit with the tiniest or the largest babies, you can’t do better than a blanket.
  • A few generously-sized blankets may be all you need for the entire period you use swaddling.  Once your garment needs to be washed, and overflow diapers and spit-ups do occur, you will need at least 2 of each size.
  •  Effective swaddling is a skill that you learn, and not everyone is good at the origami-like wrapping right away.  Are you good at wrapping a package, or does the mere thought of tape and ribbon send you over to the gift bag section? This a moving package and it could be fussy!   I think anyone can learn to swaddle, but not everyone wants to.  If you want something that is easy to get right, then you might want the garments.  You should know that it is possible to use them incorrectly.  If you ignore the signs that a child has grown out of their first one or you bought a larger garment than you needed, you will find that they either fuss more or they get their arms out and wake up.   And just like blankets, there should be plenty of room for both legs to move. Swaddling never involves limiting leg movement.   If your baby cannot stretch those legs out straight and out to the sides, you need a bigger garment right away.
  • Some daycare centers will not use a blanket but will allow you to provide a garment.  Why?  I am not sure, but I suspect it is because unless all the employees really know how to swaddle correctly, they are aware that loose fabric over a child’s airway (that no one notices) is a danger.  Even if your swaddle garment is wrapped too loosely to be effective, the velcro usually holds and doesn’t come fully undone and cover the airway. You probably won’t be able to challenge rules like that, so if you need daycare while you are using a swaddle strategy, you should check their policy closely.
  • As your baby transitions out of swaddling, many parents go to the one-arm swaddle.  Either the blanket or the garment will allow you to swaddle with one arm out, but again, the garments make it very easy to get that right.  Just check that it is still a firm swaddle, and that you are using all the other great steps to keep your baby calm and sleeping (white noise and sucking can still be very effective as they transition out of swaddling).

If you need more assistance with your decision, or want more support as you use swaddling or any of the other 5 S’s from The Happiest Baby with your little one,  visit my website: tranquilbabies.com, and purchase a phone/video support session.  You can get answers to all your questions and feel more confident in minutes!

Baby Wearing for Premature Babies

As a nationally certified Happiest Baby on the Block educator, I think that baby wearing is a great way to nurture your preemie, and I approach this topic as I do all the Happiest Baby training: parents need to know why wearing their baby is helpful and why correct technique matters so much.  The government’s Consumer Product Safety Commission has a short list of safety recommendations for baby wearing, but they do not explain why they should be followed nor do they explain the benefits of using wraps or slings for any baby.  There are many websites that either explain all the benefits, sell you products, or help you find a trained educator in your area.  But none seem to take a look at the special needs population.  My guess is that in this litigious age they don’t want to take responsibility for accidental misuse with the most vulnerable population.  Neither do I, but as a professional, it seemed an important topic to cover.  So let me say up front that I am not instructing you on how to wrap your baby or which carrier to use, but I will highlight specific considerations for the parent of a special needs child that wants to use baby wearing safely after they have been cleared by their pediatrician to do so.

The reasons to consider baby wearing are numerous.  The deep emotional connection between adult and baby (dads and caregivers can and probably should try wearing babies), the movement stimulation for balance and self-soothing, and the support for nursing are fairly obvious benefits.  Baby wearing can even help your little one sleep better Baby Wearing For Better Infant SleepThere is substantial research that babies need the stimulation received when moving inside a progressively tighter womb, and even passing through the birth canal.  These experiences are huge sources of tactile, vestibular, and propriocpetive input (touch, movement and pressure) to the sensory system.  Premature birth with a C-section delivery deprives a growing brain of that information.  Preemies have no alternative but to gain more learning outside the womb after birth.  I think baby wearing a preemie correctly and frequently is possibly the most powerful thing that you could do to give them this missing sensory input.

An important but less obvious benefit is that the baby who is worn correctly is one more baby that isn’t resting his head flat on a mat or strapped into a carrier for more than 30 minutes.   As an occupational therapist, I have treated too many toddlers whose infant siblings have been wedged in carriers for my whole session.  Every session.  And they are probably in there much longer and more frequently than those 45 minutes.  When I am the occupational therapist treating a child, the physical therapist and I often struggle to figure out how to get special needs children into safe and dynamic  positions that do not put them at risk for positional plagiocephaly (flat head caused by positioning).  You just cannot do tummy time all day.

The family of a special needs infant can still use baby wearing and foster all those wonderful experiences.  But please consider the following issues and get professional advice if possible:

  • Position your baby tightly, so that she doesn’t slide around as you move.  Recheck and re-position after nursing.  Many wrapping fabrics stretch, so that must be considered.  But tight doesn’t mean compressed.  If your child has a history of respiratory problems, difficulty expanding their ribcage or filling their lungs when lying flat, you really need to clear any tight wrapping with your pediatrician first.
  • Make sure you can see your baby’s face and your baby can see you.  You would never cover her face with a cloth in any other position, and so make sure that the wrap/carrier never covers her face.
  • Preemies and low-birthweight newborns may be too small for the structured front-facing carriers, or take a while to develop the necessary head control.  Use a wrap for a more custom fit, and one that fits both of you well.  Never use a back carrier for a medically fragile infant.
  • Only use the upright or vertical position with their chin up; the cradled or horizontal hold puts a medically fragile or very young child at greater risk for struggling to clear their airway.  A word about seeing your child struggle to breathe: they can be getting less air but not gasping at all!  Compression of their ribcage or airway can be just enough that they slowly become unresponsive.  This means that you watch their face, their color, their respiratory rate, and their activity level.  If you are really tuning into them, you know what “bad” color looks like, and what is normal for them.
  • Baby wrap advocates often recommend the warmth of wrapping, but just like swaddling, you want to match the fabric, your activity level and the length of time you wrap with the environment.  Medically fragile babies lose heat rapidly but they also cannot get rid of excess heat, and sleeping too warm is a risk for SIDS (sudden infant death syndrome). Choose your wrapping based on logic.
  • Think before you move.  Even with a well-wrapped infant, bend from your knees and be very aware of your movements and anything else you carry.  But that is not where movement concerns end with NICU graduates.  Special needs infants can sometimes become overwhelmed with the normal movement of a busy parent, or the common noises of daily life.  Sensory sensitivity doest just disappear once they are out of the NICU.  Some babies just can’t handle being that close to the blender to make your smoothie or listen to lost of talking.  A child who can’t handle the typical stimulation from an all-day wear deserves respect.  Watch for signs that he is shutting out stimulation or becoming fussy after lots of movement or location changes.  Your baby will still get the benefits of baby wearing for shorter or quieter periods, and his tolerance should increase over time.  And don’t fear swaddling, even though some baby wearing sites will show an awful swaddle with the legs jammed together.  A correct swaddle doesn’t restrict any leg movement and is approved by the American Pediatric Association.  Again, if you understand the swaddle and use it correctly, it is as safe as well-planned baby wearing.
  • If you are exceptionally concerned about using baby wearing techniques, ask either your pediatrician or an occupational or physical therapist that works with your child for some advice that pertains to your baby before beginning to use a wrap.

Try a Dream Feed to Lengthen Your Newborn’s Sleep at Night

Imagine that you know an easy way to send your baby into a longer and more restful sleep.  But guess what?  You have to wake him up to do it.  Welcome to the world of the dream feed. The dream feed concept is not my own, but it is one of the most useful strategies a parent of a 2-10 month old can have.  Both Dr. Harvey Karp ( of Happiest Baby on the Block fame) and the Baby Whisperer write about using the dream feed.  This can be used for both nursing and bottle-fed infants.  The theory is sound, but the understanding is that the parent is intervening to build deeper and more satisfying sleep, not just hoping it will happen.

The dream feed challenges parents to do the one thing they might not ever want to do: wake a sleeping baby.  But if you think about the pattern of infant sleep and what makes babies sleep longer and deeper, you will completely lose your fear of waking your baby. The key is to time your dream feed somewhere from 10PM-midnight to avoid the creation of a habit of crying triggering more night feeding, and subsequently reversing night and day.   For mothers who are nursing, that first let-down milk is rich and full of nutrition.  You may switch your baby to the other breast before he is completely full in order to get a double dose of that early and belly-filling milk.  What a lovely idea; an almost-midnight snack filled with nutrition to send your baby to sleep !

To review:  dream feeds give your baby….

  • extra calories to sleep deeper and not wake from hunger
  • parents who are well-rested and alert during the day
  • a sense of night and day, with longer periods of sleep at night
  • hunger in the morning, setting her up to associate daytime with mealtime.

a last bit of advice: this is not playtime, so be loving but not very talkative or playful.  You are sending the message that this is mealtime, not a social hour.  If your baby is fully awake and wants to play, use white noise and low light to send her attention back down to a drowsy feeding.

Need more information?  Take a look at Teaching Your Baby to Sleep Through the Night and Baby Waking Up Early? Reset that Habitual Pattern Tonight.

Want more support for your newborn?  Visit my website tranquilbabies.com. and purchase a phone/video session.  Ask specific questions, receive recommendations on books and newborn equipment like swaddle garments/swaddle blankets, and more!  

Why Would Your Daycare Refuse To Use Happiest Baby on the Block?

Recently I taught a mom to use the Happiest Baby on the Block techniques to calm her 11 week-old son.  He was soon a very easy baby to settle, and was sleeping very well.  When she tried to explain these new strategies to her high-quality daycare providers, she was brushed off.  They have “their ways of doing things”.  Why would any caregiver NOT want to hear what a parent has to offer?

Sadly, the oldest reason in the book.  It is new to them, and most people, even the most well-intentioned staff, resist anything new.  They can rationalize any other reason, but most of the time it boils down to the simple fact that changing how you understand newborn crying, and changing your response when a baby cries or fusses is hard.  Even when the parent is telling you what works.

Happiest Baby on the Block: Misconceptions and Misunderstandings

AS a certified HBOTB educator, I have received comments and questions that help me clarify my message and improve my instruction. I imagine that many parents are thinking about these questions but may never ask me in person or on the phone. Time for some refinement.

Q: How can I use side or stomach-lying? The pediatrician said never to put my baby to sleep that way?
A: You are right; babies under 12 months should never sleep on their stomachs, in order to reduce the risk of SIDS. The HBOTB 5 S’s are used to CALM your baby, and then they sleep swaddled on their backs.

Q: Doesn’t pacifier use ruin their teeth?
A:  HBOTH is used with babies 0-12 weeks old.  Babies under 6 months of age generally do not have teeth. Sucking is a natural way babies soothe themselves at this stage of development.   Pacifier use after 6 months is more likely to affect dental development AND become an emotional attachment, not a biological need.

Q: I have heard that pacifier use will disrupt breastfeeding!!
A: If you are breastfeeding, HBOTB recommends that you wait until your baby has mastered nursing before you introduce a pacifier. That could take a few weeks. But most babies get very good at nursing very fast. Watch your baby’s swallowing; if she is at the breast but not swallowing, she is just soothing herself by sucking, which is normal and perfectly acceptable.

Q: My baby sleeps so well swaddled, won’t he sleep through a feeding?
A: If your baby is hungry, he will awaken unless he is experiencing other issues that create lethargy. True hunger cannot be eradicated by the 5 S’s: your baby will momentarily calm, then realize he is still really hungry!

Swaddle Products That Confuse Parents

Parents should not be faulted for being totally confused!

Parents should not be faulted for being totally confused!


I found this product at a local big-box store, and my first thought was ” Created by a dad; how terrific!” Then I thought a bit more. How would a parent know when to go sleeveless? Warm weather? Babies who still cry when fully swaddled? Most babies are still crying after you finish swaddling them, even though they calm down after some shushing and swinging. Without the use of the other infant calming techniques (the 5 S’s from The Happiest Baby on the Block) you have served an incomplete meal of comforting. But a new parent would be truly forgiven for thinking that their newborn didn’t like being swaddled with their arms in when they continue to cry.

Newborns are not seeking freedom; after 9 months in a studio apartment, they are most comforted in a smaller space. That is why being cuddled is so wonderful for them. Swaddling firmly prevents those arms from flailing when they are crying. With their arms free, parents will see more of the Moro (startle) reflex and will have to hold them more firmly to replicate that cozy touch that swaddling provides. When put down in a loose or partial swaddle, babies can start crying again. This appears to be a plea to be picked up again, but it is more likely that your baby wants to be firmly held, all the way up through their arms and shoulders.

When is the arms-out swaddle just right? After 3-4 months, babies often have more arm control and less frequent Moro reflex responses. They can sleep well without a full swaddle, and this product makes it easy to wean your baby from swaddling. But nothing in the exterior packaging explained that.

I am thrilled that there are good products out there for parents to choose from. But the most valuable ingredients, knowledge and experience, still seem to be the hardest items to find.

Can You Sleep Train a Newborn?

image courtesy of papaija2008/FreeDigitalPhotos.net

image courtesy of papaija2008/FreeDigitalPhotos.net

Sleep training is a hot topic with parents of older babies and toddlers. So many are struggling and bewildered. New parents either pray they will escape this fate or confidently assume they are the exception. It isn’t really the roulette wheel that it seems. Parents are often told that they cannot do much to develop good sleep habits until a child is 3-4 months old. Well, waiting until then may have already set your child up for trouble.

Both the Baby Whisperer series and Dr. Harvey Karp’s Happiest Baby on the Block books describe routines that are loving and sensitive to a baby’s needs. They don’t take sides on the co-sleeping controversy. Both teach families how to read a baby’s cues and create early healthy habits that can survive teething, illness, and growth spurts.

A very young baby can anticipate and can benefit from a routine (not a rigid schedule) that starts in the morning and brings them to nighttime ready to rest and renew. My favorite newborn strategy is the “dream feed”. Waking your baby (yes, waking them up!) to have a filling feed not too long after that initial bedtime nursing or bottle tops them off for a longer period of sleep. A brain that is used to a cycle of naps during the day and a longer sleep at night is ready for the greater demands of the day (and night) at 3-4 months. The child who has no sense of day and night and wakes habitually at all hours is never refreshed. Never mind the state of his parents.

The other strategy that makes a huge difference to families is to understand that bedtime really starts in the morning. If your child’s schedule has been disrupted intentionally or unintentionally, it will make it very difficult to fall asleep. Not responding to those subtle sleep signs will sabotage a very good bedtime plan. If you want to develop good sleep routines,then time, tide and sleep wait for no baby.