Now that we are fully into Autumn it is time to start thinking about the imminent clock change. Although this is the good clock change for us (we get an extra hour in bed- yay!) needless to say for the bubba it doesn’t work the same way. This can be a daunting prospect if you’ve worked super hard to get your little one into a routine or have in fact been following my Sleeping Bunnies Baby Coach routines. If you have been following my routines your 7am waking baby by the clock change will be a 6am waking baby, likewise a 6am waking baby will most likely be a 5am waking baby- oh the dread!
However, there are a few little tips and tricks to keep you on track in the lead up to make sure your little one adjusts accordingly. Babies are far more adaptable than we give them credit for and we also have the dark evenings on our side so this will be our greatest advantage into keeping the body’s melatonin nice high in preparation for bedtime.
•From the morning of Thursday 25th October push out all naps, feeds, meal times and bedtime by 15 minutes. Our aim here is that each day in the lead up to the clock change you move your routine out so that by Sunday 28th Oct baby will be fully adjusted -sounds simple right!?
•This means if you are on a 7am-7pm routine on Thursday 25th October bedtime would be 7.15pm, Friday 26th- 7.30pm, Saturday 27th- 7.45pm and Sunday 28th we’d be back on track for a 7pm bedtime which would have previously been 8pm -as the clocks go back at 2am on October 28th (basically, whilst we are sleeping on the Saturday night). So from Sunday baby will be fully adjusted and their usual 7pm bedtime and wake time will be in line with the new clocks.
•There are a few different methods for older babies and toddlers and my preference for 18 months and over is simply splitting the hour into three 20 minute segments so you complete the clock change adjustment three days prior rather than four. With an older toddler/ child, splitting one hour over two days is sufficient (30 minutes per day x 2 days). If it all goes wrong with baby or toddler, never fear- it’s only one hour and can be caught up pretty quickly on the subsequent days.
•As well as moving sleep times forward, we also have to adjust meal and feed times accordingly too- this will probably be trickier than moving sleep times out so be ready for a grouchy little human the first day! Feed and meal times also ‘set’ our body clock so making sure these are moved out too is important.
•Make sure you keep to your schedule of daily activities – classes, park trips, playdates. We want baby to feel that there is nothing really that different.
•Move bedtime routine up accordingly so that you have the same fluidity as you had previously with bedtime and wind down. So if bath was at 18.15 it will now be 18.30.
•If baby is looking drowsy later in the afternoon it is really best to keep them awake. If they are under 7mths and need a 10/15 minutes power nap (maximum) then that is fine. However, if they are allowed to sleep longer than 15 minutes or past 3pm we would have alleviated more melatonin than necessary, and bedtime will be tricky.
•There is nothing like a change of scenery for baby late afternoon when their patience starts to wear thin at home (us too!) So, if you observe that your little one is tired at 4.15/30pm a quick spin around the block in the late afternoon crispy air is advisable- making sure they don’t drop off to sleep if they do not routinely have a cat nap!
'Sleep Regression'... two words that are guaranteed to strike fear into the hearts of most parents! However, instead of seeing the word 'regression' make sure you see the word 'progression' as that is EXACTLY what this is. I'll start with the most infamous of all the progressions...
The Four-Month Regression
You may have previously had a baby sleeping through the night with one or two wakings and a dream to lay down for their daytime naps up until this point- this frustrating process is more commonly referred to as the 4-month sleep regression. Whereas before your baby had fallen quite easily into a deeper sleep state and stayed asleep in previous months the sleep regression refers to the sleep cycle becoming mature, more like that of an adult -or older child.
At 0-3mths your baby's sleep cycle would have been around 30 minutes in length, which would have looked like REM-DEEP SLEEP-REM. They would have dropped off to sleep nice and easily in your arms or in their moses basket and sleep was just sleep- simple! But not anymore...
This means your 4 month old baby will now have distinct stages of sleep with a sleep cycle of around 45 minutes opposed to 30 minutes and they will now have to go through light/active sleep to enter deep sleep. This sometimes causes tears and grizzling as it is harder for a baby to fall asleep but much easier with practise, positive sleep cues, a predictable routine, and simplifying the approach to nap put down.
The Eight-Month Regression
This is less of a sleep regression, more of a cognitive leap. Sleep becomes affected because in simple terms baby is becoming more active and using more of their brain space to practise crawling, babbling, sitting up and standing at all sorts of hours during the day and the night. Baby will seemingly be in the wide-awake club in the middle of the night with no signs whatsoever that they are going back to sleep! Given time they will drift back and intervention here is usually unnecessary.
Babies can be up randomly at night for anything from 20 minutes to 1hr at a time often anywhere between the hours of 1-5am when REM sleep is prevalent. I often have worried calls from Mums at around 2/3am saying 'I was fast asleep and just glanced at the monitor and he/she is sitting there just staring into space rocking side to side, what shall I do?!' This is completely normal, albeit it looks a bit eerie on the monitor! The answer is unless they are distressed leave them to it. If they are crawling round their cot happily or just sitting they will eventually go back to sleep on their own. Our presence here can sometimes be counterproductive and we can rouse them from a sleep they may go back into on their own.
The 18- Month Regression & Toddler Sleep
The 18 month regression is yet another developmental change and leap forwards. You may find when you put your 18 month old down to sleep at 7pm that they do not go to sleep like they used to in months gone by. You will find them 'downloading' the words they have spoken during the day, singing songs and re-playing scenes from the day! There is not much you can do here other than make sure that they safety see themselves to sleep. Don't fall into the trap of putting them to bed later. If you are concerned that they are having too much daytime sleep then this can be cut down to around 60-90 minutes (60 minutes being the minimum in an case and never past 3pm).
Toddler sleep regressions are much more to do with any change in their little lives. This could be moving nursery classes, starting pre-school, having a new sibling, a change in family situation, moving house and so on. They can come on suddenly and out of nowhere. Very commonly this happens after a family holiday, for example....If your child spends a lot of their waking hours at nursery/with a nanny then their routine is really 'set', they know when they see you and compartmentalise their behaviour on Mummy & Daddy days and on Nursery/Nanny days. So, you all go on holiday you have that wonderful cherished time together but the flip side of this can be some separation anxiety when you are back at home. Toddlers can start to resist bedtime and start waking through the night having previously been great sleepers. If this happens on your arrival home it is really important to validate your child or toddlers feelings during the daytime and offer reassurance at night wakings but remembering to also leave at the end of this reassurance. Offering lots of love cuddles and praise during waking hours and keeping your bedtime routine really straight forward and calm is helpful. Leaving your toddler in their room to sleep post holiday on night one can often become upsetting for them, it is at this point we have to take care and nuture their emotional security. You may have to give them the benefit of the doubt and stay with them a little while longer (holding hands for example with no other interaction) whilst they drop off to sleep for a temporary period (I'm talking two or three nights) whilst they get back in the saddle. It is important this is short lived and brief so as not to create a long-term lingering bedtime!
Oxytocin is commonly referred to as 'the happy hormone’. It plays a BIG part in the let-down reflex and is released from the posterior pituitary gland. Let-down reflex refers to the burning, tingling or cramping feeling you may experience before milk is able to be ejected from the nipple. Oxytocin is also responsible for the uterine contractions you may feel when breastfeeding. If you have had a very stressful and painful labour or are in lots of pain post birth with stitches or after a c-section for days and weeks after, this can also inhibit your supply of oxytocin. This can jeopardise the milk supply as let down reflex may not be stimulated adequately. Oxytocin is responsible for the contraction of the alveoli cells within the breast therefore letting them be able to release milk. Similarly, if you have had a traumatic labour with blood loss, you may be put on a Synto drip (synthetic oxytocin) and this may also interferer with the natural production of oxytocin in the long term and disrupt the let-down reflex.
Prolactin is the hormone responsible for the primary production of milk. Prolactin is released from the anterior pituitary gland. During lactogenisis stage one milk production is hormonally driven, so that the first milk (colostrum) is ready for the baby on arrival. This prolactin hormone starts to be released halfway into pregnancy, which is when you start to feel slight changes in the breast. Prolactin stays high if you are breastfeeding and if you stop the levels drop. Although in some women, even if they continue to breastfeed their prolactin levels can sometimes drop to the normal level again. Three to five days after the baby is born the breasts enter lactogenisis stage two, where the breasts become fuller with milk. When the baby is born the gut is full of meconium which needs to pass, which is why in lactogenisis stage one only a small amount of milk is produced as the baby needs to pass these stools before they start feeding on a more plentiful supply by days three to five.
FIL- Feedback Inhibitor of Lactation
FIL tells the breasts to stop producing milk in the event the breasts are full. Normally within the first couple of weeks you want to keep FIL low so that the breasts produce enough milk and meet the needs of the baby, this is done by feeding at regular intervals. However, with breasts that are too full, feedback inhibitor of lactation hormone is released and this tells the breasts to stop producing milk which may jeopardise supply. If the Mother does not feed regularly the breasts remain semi full and FIL remains in contact with the alveoli cells within the breast and therefore tells the breasts to keep milk supply to a minimum. Therefore we want to encourage an emptier breast after a feed to keep FIL low and keep supply of milk in demand.
Colic is defined as intense, frequent and inconsolable periods of crying. It is important to note that crying is a natural instinct to a baby and the following Dr Sears guidelines will help us establish whether your baby is a colicky baby or not, Dr Sears rule of 3’ are
1. Crying starts within the first few weeks of life?
2. Lasts at least three hours per day?
3. Happens at least three times per week?
4. Carries on for at least three weeks?
Although there is no medical evidence for over the counter medications I believe ‘Colief’ works well. Theoretically it should work as it contains the enzyme lactase which is the enzyme that breaks down lactose which it thought to cause the pain of colic. Always seek advice from your GP before administering any product to your baby. Lactose is a disaccharide which means it’s a combo of two sugars joined together. Disaccharides are too large for our bodies to absorb so firstly they need to be broken down into glucose and galactose which are monosaccharides (single chain sugars). This is done by lactase (our digestive enzyme), so with a lactose intolerance life can become very tricky for a baby, especially a baby where it goes undiagnosed. Lactose that cannot be broken down and digested draws unnecessary fluid to the bowel by osmosis which results in many watery stooled nappies with a green hue. Additionally, bacteria in the bowel ferment the undigested lactose and produce gas excessively. All of this extra work the body of an infant is doing to simply digest milk deprives them of energy and metal wellbeing for other pursuits and they can become tired, withdrawn and lose weight as the body uses its own fat as fuel as they cannot absorb adequate calories from feeds and have disproportionate calories leaving the body in the way of soiled nappies. Infacol is another over the counter remedy that works quite well with colicky babies, essentially gathering up all the tiny little wind bubbles and creating one big bubble so baby can burp easily. It is also worth researching whether your baby may have something other than colic. Advice from your GP is always advised before administering any product to your baby, even if it is an over the counter med. There could be a number of issues that cause colic these include:
1. Secondary Lactose Intolerance. This is a damaged gut lining, it is temporary and can heal. Probiotics can be useful as this usually follows a bout of gastrointestinal upset such as gastroenteritis/ tummy upset. Once the inflammation of the small intestine has gone the calls that produce lactase return to normal and thus baby is able to digest lactose again.
2. Lactose Overload or Functional Lactase Insufficiency. Usually an unsettled baby with large amounts of weight gain. Frequent wet nappies and explosive green soiled nappies. Usually characteristic of Mothers with an oversupply or hungry bottle fed babies. Mothers feed frequently as they have an upset baby and don’t realise that the lactose overload is the cause so feeding frequently makes the situation worse (as breastmilk contains lactose). Babies have a natural instinct to suck until around 3-4 months and cannot self-regulate so the standard advice to feed on demand can sometimes be detrimental in these cases. Feeding management should be looked at and can usually be resolved in 24hrs following the help of a lactation consultant.
3. Sensory Overload- Exactly what it says on the tin. An environment so stimulating baby can’t settle. Look at bringing audio and visual stimulation down and bring things back to basics
4. Anterior/ Posterior Tongue-Tie- Affects the suck/ swallow breathing flow mechanism of feeding babies and they end up taking in too much air causing wind. Tongue tie can usually be dealt with by your Midwife or Doctor with a simple snip. Babies who have tongue tie experience latching difficulties and are frequently upset whilst feeding so as well as having colic pain due to the excess wind the source needs to be found – e.g.- The tongue tie
5. Reflux – Possibly a cow’s milk protein allergy. Mother can eliminate dairy from her diet or if formula feeding introduce a hydrolysed protein formula such as Neocate or Nutramigen. Very useful to keep a food diary and note down when baby is upset in relation to what Mother has previously eaten and drank.
Why is it important for babies to have so much sleep and why is it beneficial?
Babies use sleep to organise their brains. When babies sleep well they have a better and more responsive immune system, mental wellbeing and energy levels are increased, growth hormones are released, cortisol/ stress levels are reduced, memory is reinforced, appetite regulates itself (hormones such as leptin work in harmony), new skills are processed and energy levels are revived during deeper phases of sleep.
Babies are born with millions of neurons that are not yet connected. When a baby attains restorative sleep and only when they fall into this state of deep and dream sleep do these neurons fire up and make the relevant connections to link the left brain and the right brain via the cerebral cortex. If babies do not sleep enough and turn into toddlers who don’t sleep enough they are more at risk of developing behavioural type disorders such as ADHD. Sleep and diet account for a massive array of behavioural issues in young children sadly.
Babies are born with 25% of a developed ‘adult’ brain and as they get older the connections mentioned above are made. By two years of age they have 75% of their adult brain. This ONLY happens when they sleep hence why getting baby into a routine is so important.
Young babies enter sleep differently- REM- Deep Sleep- REM. Rapid eye movement sleep counts for 50% of total sleep vs 20-25% of adults. They spend so much time developing from 0-3 months that it is no wonder they spend so much of their time in developmental REM sleep! Once babies get to 3-4 months old the sleep cycle starts to evolve (commonly referred to as the 4-month sleep regression) to become more similar to that of an adult. They now have to move through light/ active sleep in order to get into deeper sleep. This often comes as a shock to parents who previously had a baby who could fall asleep relatively easily! Working through this with routine implementation is the way forward.