Good Night, Sleep Tight Workbook (16 page)

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Authors: Kim West

Tags: #Family & Relationships, #Life Stages, #Infants & Toddlers, #Parenting, #General

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My child can’t seem to settle down at all when I sit by his crib. What do I do?

If you’re absolutely convinced after a few days of sitting in your child’s room that your presence is overstimulating to him,
or
you find it so hard to do it yourself that you can’t be consistent, then I suggest you either have the other parent try, or you leave the room and do timed checks on your child. There is no magic rule about how often you check or how many times you check, and you may have to experiment a bit. If you check on him too soon, he may treat it like a game and get even more stimulated. If you are away too long, he may get himself quite worked up and upset. I suggest that you start with every seven minutes and gradually increase it, but trust your own instincts and make necessary adjustments; this isn’t a one-size-fits-all approach. When you check on him, go right into the room to his crib. Give him a quick reassuring pat, but don’t linger. You will defeat the whole purpose if you stand there for a half hour patting him to sleep.

Here’s another variant: Sometimes the Shuffle works at night but not for naps. The child is more awake, and more likely to keep trying to engage. So feel free to stick to the Shuffle at night, and use the timed checks I just described for the naps if that’s what feels right to you.

Safe-Sleeping Recommendations for Babies

Here are some tips for baby sleep safety. Most of this information is from the American Academy of Pediatrics and First Candle. I’d like to emphasize that this advice is primarily for healthy infants. Always talk to your doctor, particularly if your child was premature or has any health problems or unique circumstances. Recommendations have changed over the years as we have learned more about child safety and development, and they may well change again, so revisit safety issues with your doctor frequently. You may see all kinds of contradictory information on parenting and health websites. A good place to sort it all out is the American Academy of Pediatrics parenting corner:
http://www.aap.org/parents.html
.

1. Back to sleep. Always place your baby on his back to sleep—both at naps and at night. Side and tummy positions are not safe. This is absolutely essential to reduce the risk of sudden infant death syndrome (SIDS). Once your baby rolls over consistently backward and forward you won’t be able to keep him on his back all the time, unless that’s his preferred sleeping position, so make sure he has enough room to move around and there are no unsafe items in his crib. Unsafe items include quilts, loose blankets, soft bedding, pillows, soft or pillowlike bumpers, and stuffed animals or toys with pieces that can come off.

2. Babies should sleep on a firm surface, such as a safety-approved crib mattress, covered by a tight-fitting crib sheet. Never place your baby to sleep on pillows, quilts, sheepskins, or other soft surfaces. Infants should never sleep or nap on adult beds, waterbeds, sofas, or soft mattresses.

3. Be careful about buying or using secondhand cribs, bassinets, or co-sleepers, even if they’ve been in the family for years. Safety standards have changed and some products have been recalled or taken off the market. Contact the Consumer Product Safety Commission at 1-800-638-2772 or at
http://www.cpsc.gov
http://www.cpsc.gov
.
Consumer Reports
has also reminded parents that co-sleepers have not been tested as of this writing.

4. You’ll see numerous devices and gadgets on the market that claim to help a baby maintain a safe sleep position, but they have not all been tested for safety and efficacy, and are not recommended. Generally, avoid them. If you have some specific concern about your child’s sleep position or movement, talk to your doctor.

5. Cribs should be placed in a warm, dark part of the room, away from windows. Blankets should not dangle from the side of the crib, and wall hangings need to be well out of a baby’s reach so she can’t pull them down on herself. Keep soft objects, toys, and loose bedding out of your baby’s sleep area. Don’t use pillows, blankets, quilts, sheepskins, or pillowlike crib bumpers (other than the small blanket you swaddle a newborn in, and that should be away from the face). They all pose a risk of suffocation.

6. At 6 months, remove all crib mobiles or toys attached to crib sides because once the baby can pull and grab, they become a hazard. In fact, I like keeping mobiles away from the crib all the time; use them someplace where she’s awake. Make the crib or sleep area “boring” as well as safe.

7. Do not let your baby overheat during sleep. Keep room temperatures at what would be comfortable for a lightly clothed adult. Once you stop swaddling your baby, use a microfleece sleep sack or blanket sleeper. If the bedroom is cooler, use two sleep sacks or place one over the pajamas or onesies.

8. Remember that the American Academy of Pediatrics, strongly recommends that you do not smoke around your baby and should not allow anyone else to smoke around your baby. Smoking exposure may increase the risk of SIDS and other respiratory illnesses.

9. The American Academy of Pediatrics recommends that babies
not
sleep in a bed or on a couch or armchair with adults or other children. But it’s fine to have an infant close by in your room, particularly in the early months. (See my advice on room sharing in
Good Night, Sleep Tight
for more information.) If you bring your baby into bed with you to breastfeed, put him back in a separate sleep area, such as a bassinet, crib, cradle, or a bedside co-sleeper (infant bed that attaches to an adult bed) when finished. When he starts to roll and move in his sleep, graduate to a standard crib for better—and safer—sleeping.

Remember that beds that are perfectly safe and comfortable for adults or older children can be very hazardous for babies. Soft bedding and other items in the adult bed increase the risk of SIDS and suffocation, especially for young babies. A baby or small child can also fall from the bed or get trapped between the mattress and the structure of the bed (the headboard, footboard, side rails, and frame), between the bed and the wall or nearby furniture, or even between railings in the headboard or footboard. Fatalities have been documented.

If you do choose to have your baby in the family bed, understand all the bed-sharing safety rules and
always follow them
. Parents who do have a baby in bed with them for even part of the night must never smoke or use substances, such as alcohol or drugs (including prescription drugs that make you sleep heavily), that may impair arousal, making them less aware of their baby’s needs or position in the bed.

10.
Pacifiers can significantly reduce the risk of SIDS (see
www.firstcandle.org
). They also soothe infants. Talk to your pediatrician about when to start—and stop—the pacifier. Many doctors advise using a clean pacifier when putting the infant down to sleep, although you shouldn’t force the baby to take it. If you’re breastfeeding, wait four to six weeks before introducing a pacifier. Many parents stop the pacifier after 6 months, so the baby doesn’t get so accustomed to falling asleep with something in his mouth. (Medical advice has changed frequently over the years, so make sure you raise this topic with your doctor and check back as the child gets older.)