21/10/2020

 Checklist – Before putting your baby down to sleep

HUNGER – So first of all you have to rule out hunger. How long did you feed for or how much milk did you feed from a bottle? Small/newborn babies will happily settle in your arms with a half empty or even empty tummy but the minute you put them down that comfort and warmth has gone and they switch back to hunger mode wanting to be fed again. A baby with a full tummy who is warm (not too warm obv!) and comfortable will sleep. The way to test if they have had enough to eat – and also if the have wind – is to put them down right away when they have fallen asleep on the breast or bottle and look like they are finished. This faux fullness can be caused by just being tired out from feeding and needing a little rest or being full of wind. Either way 5 – 10 mins after you put them down they will wake again if they haven’t had enough to eat or have wind that hasn’t come up. Don’t let them sleep on you, afraid to move, no matter how long they lie on you when you put them down they will wake if they haven’t had enough to eat. Some health professionals will tell you breastfeeders feed more frequently I have never found this to be the case unless there is a supply issue (breastmilk is just as calorific as formula). I would happily go toe to toe with anyone on that particular myth. The vast majority of my mums breastfeed and their babies are happy in exactly the same routine as the bottle feeders. And those breastfeeding babies sleep 11 hours through the night by 12 weeks of age exactly the same way the bottle feeders do. No depriving no ‘stretching out’ a hungry baby. Just simply meeting all their needs makes them so happy to sleep, which very importantly they need much much more than their poor tired parents.

DISCOMFORT/PAIN – Did you wind your baby well enough? I haven’t rubbed a babies back to burp them for many years. A much more effective way is to put baby on your chest/shoulder area and gently apply pressure to their back. This slight pressure helps move the wind enough so your baby can bring up the burp. Patience is a virtue here set your timer for 5 mins (most burps come up in that time). If this doesn’t move it simply lie your baby on their back and when they start to wriggle and squirm pick them up put them over your shoulder and the burp should come right up. Incidentally dads are usually better at winding than mums as they have squarer broader shoulders and chests and also big hands which tend to be firmer with when applying the pressure needed. Sometimes just that movement from one person to another is enough to dislodge a big burp too!!

COLD – Not really an issue in warm weather but if your house is cooler (under 21 degrees) a newborn/small baby will feel a significant drop in temperature when you move them away from your warm body and place them in their cold cot. I can’t say this enough – babies LOVE to be cosy and swaddled! For about the first 8 or so weeks your baby will be happiest when attached to you this is perfectly normal and ok. They need this contact for number of reasons. You will not (cannot) ‘spoil’ a baby by holding them a lot in the first few weeks. However you are not a robot and will actually need to put your baby down to sleep safely on your own so you can rest. A swaddle is essential kit. I cannot overstate what a game changer using a swaddle was for me as a maternity nurse, from no sleep to 2-3 hours between feeds in some instances! I will add a link to my favourite swaddles. Read the reviews they have changed the lives of a lot of sleep deprived parents! I only use the zip up/button up swaddles as the wraps or muslins just don’t cut it. They either wriggle out, or can’t move at all. With a zip up they can wriggle out the burps and farts without getting ‘arms free’ which is a big no no for new babies. They don’t know their hands belong to them and they will scratch and hurt themselves, constantly wakening themselves up with the mora reflex. I advise leaving arms in for at least 10 weeks. You can then start to practice day naps with arms out before moving on to arms out at night by 12 weeks or so.

COMFORT – This one rarely gets a mention anywhere when it comes to settling your baby to sleep and it always surprises me that it’s not considered. If your baby is happy to fall asleep on your comfy big but immediately wakes up when put down in their cot common sense would dictate that the cot mattress is a bit too hard/thin/uncomfortable for your baby. A Moses basket is fine for the first few weeks but after that your baby will need something a bit more substantial to lie on as they grow. If you think about lying on a hard thin mattress on a floor you’re probably coming close to how your baby feels in Moses basket or some of the ‘next to me’ style cribs. It’s the reason why the Sleepyhead is so popular, babies are simply comfortable sleeping in it. It’s warm, cosy and comfy. Babies also love a boundary. We have been making them for years in NICU with a (rather crusty) rolled up hospital towel and ‘softie’ (sort of double sided muslin) We would never leave a small baby to roll around a cot after being snugly enveloped in the womb for 9 months they would never have settled without a boundary. I am sure the idea for the sleepyhead came from watching nurse do this in baby ICU. Additionally I always tilt the cot until around 9 – 10 weeks of age. All babies reflux a little bit so it’s really helpful to let gravity work for you to keep that milk in the tummy where it belongs. I never recommend using a wedge as this can be very dangerous, affecting the baby’s position by tilting the chin onto chest, effectively obstructing their airway! The simplest, safest (and cheapest) way to tilt is to place 2-3 books (3-4 inches) under the top legs of the Moses basket or cot. You can buy products designed specifically for this job but personally I find the books perfectly fit for the purpose.

I have been applying these rules for more than a decade as a maternity nurse to guide babies into sleeping 11 hours by 12 weeks. The last 2 weeks before the 3 month mark are the most crucial and I have a guide for this in our courses section if your baby still isn’t sleeping well at night by 3 months. I have to stress this is not a sleep training course as it is normal for some babies under 6 months to waken in the night for feeding. However the establishment of a good day time routine and some simple adjustments at night can help set your baby on the path to great sleep forever. I do not make that bold claim lightly! I’ve been doing it so long I know the formula works and I see how happy the babies and their parents are I want every baby and parent to have that same experience should they want it. 

 

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