We Could All Use More Sleep! Advice from Dr. JJ Levenstein

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For the next three Wednesdays, Dr. JJ Levenstein will be taking over my blog, offering tips about that thing we all need more of. That thing our little ones don't really give a shit about, but we desperately need them to. That thing that makes every mom happier. And when mom is happy, everyone is happy. I'm talking about sleep! Trust me, you will want to read below and check back the next two Wednesdays for some incredible information I wish I had when my toddler was going through these various sleep transitions! You can also subscribe below and get each new post sent directly to your inbox. Then you don't have to worry about mom brain and missing out! Top 10 sleep tips to help babies and parents sleep through the night:

  1. Very early on, establish a minimal number of sleeping environments for your child. Whether it is just a bassinet, or a crib or co-sleeper, try to consistently put baby there for naps and sleep.  If a baby sleeps in innumerable locations, she will become confused as to what she is supposed to do.  From the first breath, babies develop associations quickly – if the expectation is sleep, the locale is consistent, and the baby is tired, a baby will know what to do.
  1. Learn to recognize signs of sleepiness in your baby. Typically, young infants will become fussy and difficult to console if they have been up for 2-3 hours (and if their bellies are full and bottoms are dry, this is generally a sure sign they need to sleep). Older infants will also be fussy, and may combine that behavior with yawning, eye rubbing, banging their faces on your shoulder, or just dozing off. Learning to recognize these signs and seizing the moment (carpe diem) will allow a parent to get a baby down before she gains a second wind and is so tired she becomes wired.  A crawling/cruising/walking baby typically becomes cranky, less active, and seeks the solace of bed often by pointing, or calming once she is near her sleeping place.

  1. Embrace the concept that naps, however long or short, are essential for good nighttime sleep. Newborns nap many times during the day--infants 3-4 times daily, and older babies generally 2-3 times daily. If a baby has a chance to rest her brain during the day by napping, ironically she will sleep better at night (as she can go deeper into sleep and stay there, being well rested). Make it a priority, early on, that napping is part of your routine.
  1. A baby will learn to sleep if we ENABLE her to be successful. If we DISABLE a baby by using too many external assists, a baby will be unable to self soothe. Developmentally a young infant can’t self soothe effectively, so swaddling her after she feeds may be necessary until she can suck her fingers at 4 months – gradually lowering her swaddle will enable her to find a comfortable position on her own. Abandon the concept that swings and strollers, or rocking, shushing and walking the halls, or worse yet, driving around, are helpful to induce sleep – once a baby becomes dependent on these external devices and behaviors to sleep, it is VERY hard to break those habits. I still feel the best advice for starting early in enabling a baby to sleep is to carve out a few moments between feeding and landing on her mattress so that she learns not to expect a nipple in order to go to sleep. Eating, then having a brief diaper change or change into pjs, followed by the remainder of her soothing routine will eventually pay off with a baby who doesn’t expect to eat in order to fall back to sleep.
  1. Establish a bedtime and a bedtime routine despite the expected awakenings that will happen for the first few months. 7-8pm should be the latest bedtime for baby, no matter what her age. That being said, then a bedtime routine of breast/bottle, bath, putting on pajamas, perhaps a little more feeding, a book and bed should start 30-40 minutes in advance of that time. Believe it or not, babies respond to fairly regular/rigid routines, and if done in the same order, she will know what comes next……….that she is expected to sleep.
  1. Once babies sleep mostly through the night, putting them to bed later will NOT result in a later morning awakening. So dialing BACK the bedtime to earlier in the evening will result in MORE sleep, not less. Unfortunately, most babies love to rise at 5:30 or 6, so often a quick feed is necessary at that time to get baby back to bed for a few precious hours.
  1. For baby’s safety, always use an approved crib or bassinet (babies are too big and active in bassinets after 3-4 months), or a co-sleeper if you want baby “in” your bed. Placing a baby between parents or on the edge of a bed adjacent to a wall asks for a rollover suffocation risk, or equally dangerous, a baby who ends up wedged between bed and wall. Always place baby on her back and never have pillows, fluffy quilts, blankets with long fringe (due to strangulation risk), stuffed animals or other non-breathable objects near her. Keep her sleeping space zen-like – a firm mattress, sheet and baby are all that is necessary for safe sleep (and pajamas of course for warm nights, a light blanket/swaddler/sleep sac and more clothing layers for cold nights).
  1. Keep the temperature of baby’s room a little on the cooler side. Remember crib mattresses don’t breathe due to their plastic cover, so your baby’s bed is warmer than you think.  Cooler temperatures stimulate respiratory drive, especially in young infants. It’s OK to have the AC on when it is hot, and if you are concerned about it blowing on baby, change the location of her crib.  When it is cold, several thin layers (a onesie, thermal pajamas, and a sleep sac) are usually sufficient to keep most babies comfortably warm. Her room at night can be in the high 60’s as long as her body is appropriately dressed.
  1. Babies are active and often loud during sleep. I like to envision them as having super-hero baby dreams as their development progresses.  For this reason, they will often cry out, make peeping noises, or become physically active at night……and yet be asleep. Desperate for our own survival, we often snatch up a baby at the first peep and actually WAKE THEM, when they weren’t ready. Forcing yourself to count to 30 will give your baby a chance to move through the scene of her dream (if she is asleep) or to more fully convince you she is awake.
  1. Once your baby is sleeping 4-5 hours at a stretch, put her in her own room (if she has one). If her room is close to yours, keep both sets of doors open and put away the nursery monitor.  If she needs you her cry will wake you. Being in her room at this point will allow HER to not be awakened by YOUR noises, and her little utterances and peeps will not wake YOU.

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BIO: Dr. JJ Levenstein has spent the last 30 years caring for children. She received her undergraduate degree from UC Berkeley, graduated summa cum laude with a second undergraduate degree from Duke University, and completed training as a Physician Assistant with a specialty in Pediatrics at Norwalk Hospital/Yale University. After serving as a Pediatric PA for 5 years, she was accepted at the Keck School of Medicine at USC and completed her internship and residency at Children's Hospital of Los Angeles. There she was acknowledged as the outstanding pediatric intern, and was also recognized as one of the top three graduating residents in her class. While in private practice, she was voted one of the Best Doctors in America® 2004 through her retirement in 2012 and recognized as one of the top pediatricians in her community. Dr. JJ continues as a fellow of the American Academy of Pediatrics and continues to be committed to promoting infant and child health by serving as an educational and media speaker and is also a regular contributor to several parenting websites. Since 2013 she has appeared as a regular medical expert on Hallmark Channel’s Home & Family television show, and leads the Food Allergy Awareness Committee for the National Peanut Board.