8 Reasons Not to Use The Swaddle or Sleeping Sack (And 2 Reasons For It).

 Baby Swaddling was an art that I practiced for hours upon hours years ago when I was an overnight baby nanny and when I became a Postpartum Doula- way before I was a Parent Coach and Educator.  This was when swaddling first came back into fashion. It was all the rage! It was helping babies sleep longer and then sleep sacks were released to the market as a way to have something to contain a now bigger baby when they were too wily to stay in a swaddle. But it turns out that both of these were causing some problems.

anti swaddle meme

Helping families with infant sleep specifically for over 10 years now, I have become less fond of swaddles and sacks. And everyone is asking me, “Should we, or shouldn’t we, swaddle or use a sleep sack?”  The answer isn’t super clear, even for me. Each family and baby is unique and truly some babies really love to be swaddled or in a sack. But do I recommended to every family? Recently, three different swaddle or sleep sack companies have asked me to endorse them.  That could be financially beneficial to me but I’ve said no thank you and here’s why:

1) Possible Hip Dysplasia.  In 2011, a study by the National Resource Center on Child and Health Safety (NRC) and the American Academy of Pediatrics (AAP) concluded that swaddling can increase the risks of “serious health outcomes” and they concluded that “swaddling is not necessary or recommended” in any childcare setting. Those serious health outcomes concluded that swaddling had long carried a known risk of hip dysplasia. Hip dysplasia used to be very common until swaddling went out of fashion in the 80’s.  These new recommendations by the AAP were meant mainly for daycare centers but were otherwise mostly ignored and we see at least 10 new swaddle products on the market each year.

2) Restriction of movements. A baby may be able to roll from back to tummy while swaddled but then they will not have the use of the limbs to roll into an airway-unrestricted position. This is a sleep death risk. Once a baby can roll over, he needs full use of his entire body, both in order to know how to use it to his advantage day and night, and this includes to help him turn his body away from something else which might be suffocating him.

3) Baby cannot find fist.  Unrestricted movement includes finding the fist (which is really the only way that new babies will ever “self-soothe”).

4) The chest wall can become compressed. Which can impede breathing. One example of one of these very tight swaddles is the Woombie. when you swaddle, make sure you can easily get two fingers between the chest fabric and the baby’s skin but that is isn’t much more loose than that.

5) Possible suffocation. With a blanket swaddle, babies DO get hands free. That hand could bring the swaddle blanket up over the face which is a suffocation risk.

A sleeping sack is generally used for older babies after a swaddle no longer works, and for older babies, this is a much safer option- the blanket cannot get pulled over the head, the arms are free etc. A sleeping sack not tight and  is not effective though for the hug swaddling that some babies love.

6) Though swaddling helps babies sleep more deeply, that deep, long sleep is associated with increased risk of sudden infant death. Swaddling is not needed or helpful if baby is kept close to mother and breast-feeds with skin-to-skin contact. Breastfeeding itself is proven to soothe babies and help them get to sleep much better than swaddling can.

7) Lack of weight gain in breastfed and swaddled newborns. One Russian study showed lack of weight recovery in newborns who were breastfed and swaddled compared to not swaddled. These infants were not nursing as well or as frequently and eventually needed formula supplementation. This likely has to do with a lack of rousing to eat frequently. http://www.ncbi.nlm.nih.gov/pubmed/16716541

We have a long fear that baby will self-harm if not restricted. We have a fear that baby will move about and not just sleep. We have a fear that baby will somehow escape. And we have a deep-seated belief that babies must be contained and as well as that, babies need STUFF to help them sleep.

While the reasons not to restrict baby in a swaddle or sleep sack above area actually dangerous, the next one is simply…frustrating.

8) It becomes a strong sleep association and dependency from which your child must be weaned– which can be difficult. One third of my sleep clients come to me with the goal to get out of the swaddler or sleep sack but are not sure how. I can help, but let’s not get there in the first place, shall we? Baby no longer has the strong startle reflex that these sleep aids were meant to help with, but baby now is not sure what to do with the limbs and is either frustrated by their movement or preoccupied in playing with the toes (hehehe).  And more often, baby is moving around in the crib and getting twisted and frustrated- does not have the ease of movement he has during the day. When I was first an infant overnight nanny and a postpartum doula- I witnessed this frustration often in more mobile babies.

It seems from all of this like nobody should swaddle- but wait, don’t throw the baby out with the bath water, so to speak. Just because it is possible to use a swaddle incorrectly- that does not mean you should not use it if you can do so correctly. And I’m not here to tell you that you should take a baby who sleeps well or is soothed by a swaddle right out of that thing! One size does not fit all families. I believe that parents get to make choices for their children and that children’s individual needs are unique (and sometimes those choices don’t always jive with what the AAP or professionals think). Like so many things in pediatrics- the second there is an issue from misuse of a product, everyone is told whey should not use the product. And like so many things in parenting, you balance your own understanding of risks and benefits So…  Here’s When I DO recommend a baby be swaddled:

A) For newborn babies who are crying a lot, having a hard time adjusting to the new world, and you have found that swaddling works wonders. In fact, that’s the only way baby will relax and the only way you all can sleep? Great. Do this only up until 2.5 months and gradually take the hands out, then legs. Only use a swaddle product like the Ollie Swaddle, not a blanket that could come loose and be pulled over the face. This swaddle is designed so the hips are not constricted and so that baby won’t overheat.

B) If your newborn baby is crib-sleeping on her back and has a strong startle reflex.  Make sure nothing but the swaddle is in the crib. And make sure baby isn’t wearing too many layers under the swaddle. A thin layer of cotton with socks is enough.

Why end swaddling at 2.5 months?  By 3 months, baby can roll over and has a greater chance of suffocating. Doctors weigh in: http://aapnews.aappublications.org/content/34/6/34.full

What should you do if you don’t want to use a swaddle or sleep sack and your baby has a hard time sleeping on her back or has a strong startle reflex?  

Though side-sleeping in a propped position is not considered as safe as back sleeping, many pediatricians recommend a propped side-sleeping position for newborns in cribs because it helps with the startle reflex (and can also help with gastrointestinal upset and GERD). So ask your pediatrician if they might recommend this for your family. Other family risk factors for infant sleep death should be considered because there is a small chance that an improperly bolstered side position would cause baby to roll onto his tummy. Side sleeping with a roles blanket or wedge like this should be done only when baby is rooming with you in a crib, aka co-sleeping, which is fortunately now recommended by the AAP- so you can keep an eye on the sleep position.

Dr. Bob Sears on Side Sleeping Safety:

“To lessen the chances of a side-sleeping baby rolling onto his tummy, stretch his underneath arm forward. This arm can act as a stabilizer to keep baby from rolling onto his tummy. If the baby’s arm stays closely tucked into his side, it will be easier for him to roll onto his tummy. Wedges to keep baby sleeping on his side are helpful, but never use just a back wedge. Rolling up a towel as a wedge between baby’s back and the bed may encourage baby to roll from side to stomach rather than from side to back. Be sure not to use props that totally restrain the infant’s movement. Freedom of breathing implies freedom to adjust body position as needed. I’m concerned that the multitude of commercial baby wedges may be more restrictive than necessary, and they have not been proven either safe or effective. For these reasons, SIDS organizations and researchers do not endorse these products. If you choose to use a wedge to keep baby on his side, it seems the most sensible to use a front wedge only, which allows baby to roll onto his back if desired.”

If your newborn is unsettled and crying a lot, you can also get help from an IBCLC lactation consultant, a cranio-sacral therapist for infants, see a naturopath to think about the dairy or gluten in your diet that your baby may be sensitive to.

The origins and history of swaddling is in ancient Greece first. Europe and the West is riddled with child neglect and misguided notions about the needs of babies and their development. You can read a slide show about it here: http://www.bflrc.com/ljs/documents/SwaddlingImpactUSLCAwebinarFeb2011SMITH.pdf

It’s important to know the modern history of infant sleep- that for many decades American Pediatricians recommended tummy sleeping above all else because it was the most natural sleep position for babies and because it helped babies sleep for longer periods of time, because the startle reflex was not present in this position. This means that when they came out of REM at the end of each sleep cycle, they would not startle awake and would more likely go right back into another sleep cycle without calling out, as long as they weren’t hungry. We now believe that there are major sufocation risks associated with tummy-to-sleep. Still, it’s important to realize that we have been dealing with thwarting the startle reflex and helping to make babies comfy and to sleep better – since at least ancient Greece.

Note: SWADDLES AND SLEEP SACKS should NEVER BE USED WHILE BED SHARING WITH BABY!  Many people do not know this. Swaddles and sleep sacks are only for cribs. (They are also not for sofas or sleeping on you or your bed, not for swings or carseats or strollers!) For many of the reasons listed above, especially inability to turn away from smothering them and overheating.

Each baby is soothed in a different way. Here’s hoping you find yours! My advice is just to wean from sleep aids early, as they become more of a strong sleep association over time.

Love, Moorea  www.SavvyParentingSupport.com 

Posted in Breastfeeding, Sleep | Leave a comment

Don’t Hide the Veggies: Radical Tips for Preventing and Ending Picky Eating

I call these tips radical because though I feel they are gentle, respectful, safe, proven, and effective, they are not the permissive, unhealthy, sneaky, and coercive methods that you  read just about everywhere else these days!  We will start with how to prevent picky eating and then we will go into how to reverse an unsavory picky eating situation.

Don’t Hide the Vegetables.

kale irisThat is the most backward and ineffective way to help a child to enjoy them. If your child does not know the veggies are there, she cannot decide to appreciate them. You are also driving home your child’s suspicion that vegetables are scary and therefore worthy of hiding. Prepare vegetables with flavors your child likes (butter, salt?) but have them in plain, natural form, color and shapes.

You decide what is served. Your Child Decides How Much Is Eaten.  Yes, every person has unique tastes. But personal food preferences are not finished forming while your child is a toddler. If we decided that was true and to ‘respect our child’s preferences’, we would actually be dooming them to an unhealthy, stifling life of mac and cheese infinity. This is the time for exposure and learning. The division of responsibility of eating for young children according to Ellyn Satter is that the child is responsible for how much and whether. The parent is responsible for what, where and when.

Serve what YOU enjoy in front of your child and provide that meal for your child as well. Some books say that because modeling is so important (and it is!), you must eat healthy foods in front of your child even if you don’t like them. This is disrespectful to both of you. Definitely model trying new foods and trying new preps of foods you didn’t like- but be honest about the outcome.  Figure out what the healthiest foods you truly enjoy are and provide them regularly. If you want to eat junk and don’t want your child to eat it, do it when your child is not around. I have a super healthy paleo lifestyle “free” of so many things- but when I need to feel “bad” and eat some ramen- I do it late at night.

Don’t deny dessert as a punishment.  If your child doesn’t get dessert because she didn’t eat her meal, nobody in the house should be having dessert that night- but not as a family punishment, just because eating in front of the child is cruel. We don’t want to set up a child to force food she isn’t into down her throat because she is coveting sweets. We don’t want to turn the entire eating experience into reward and punishment when it is really about nourishment.

There is a way that you can make getting more frivolous calories into a positive logical consequence of consuming a meal of protein and green veggies. Logical Consequences can work for kids over 3yrs when you can explain the WHY of needing protein and veggies.  Dessert at my house is often fruit or sometimes something amazing. Can you see where the wording:

“If you don’t eat your food, you won’t get dessert”  can be changed to:

“After we put protein in our bodies, they will be ready for the dessert foods that are not as important.”  

This phrase gives context and information and sets a boundary instead of creating a punishment. And I’m queen of the “we” language of cooperation as it doesn’t single out and blame and instead invites modeling and cooperation.

But what If you already have a picky eater? 

We hear of toddlers who “eat like birds” or “subsist on air” and still thrive. We decide this is okay because the child is obviously making a choice even when favorite foods are put in front of him. Somehow when we are the parent of a picky eater, we feel that we are personally STARVING the child if we don’t give them what they want and they turn down other foods for the rest of the day. Your child has behaviors and makes choices and you do not control whether food goes in, therefore you are not to blame if your child chooses not to put food in when provided with a few lovely foods on a plate.

I’ve worked with at least 60 picky eaters in my 20 years loving children and none of them have starved. Some will go on strike for two days when you cease to be a short-order cook and then they slowly begin eating new foods. The strike will be longer if you do not prepare the child beforehand for the mealtime changes you are about to make- simply out of confusion.

I promise that your child will not starve if you make changes! Start doing everything above only after you have had a heart-to-heart with your child. Tell your child what things are going to look and taste like now. Let your child know what the change will be and give them at least 48 hours notice a la:  “On Friday we begin the new healthy whole family eating plan.” Young children need information about changes we make, heartfelt reasons and notice of transition.

If your child eats only macaroni and cheese and hot dogs, let your child know that those will become extra special treats for vacation only and that the reason is that you are concerned that those are not healthy to eat all the time. You have decided to provide healthier foods for your child.

You can find two foods that are healthy which your child does in fact like. Offer those in small portions at the beginning of the day and let your child know ahead of time that those foods will only be eaten once a day in small portion. This gives your child the option of getting some calories even when they may decide to go on strike.

Will there be low blood sugar meltdowns? Probably. Maybe two crappy days. For dinners I suggest leaving your child’s plate on the table and they can be encouraged to go back to it if they are hungry before bed. I always encourage before bed snacks for young children and tots, but if children will simply not eat dinner that isn’t their first choice when they know they will get an awesome snack in an hour. That would thwart your entire plan to diversify the palate and foster lifelong health.

Hints:

A) Giving a picky eater too many choices often makes them more picky. It’s great to keep a family meal to three items only.

B) If your child is a heavy carb eater, spend three weeks not serving bread or rice or pasta. If breads is one of the three items on the plate, many children will eat only that. Try quinoa, millet, bulgar, potato variations etc.

C) Ignore food complaints. Food whining can go on and on and create a terrible meal for everyone. However, it is respectful to acknowledge and address the first complaint. It sounds like this:

“Yes. I hear that you don’t like this dinner. I’m sorry you don’t like this dinner. One day you might like peas and tofu and quinoa . This is the dinner Chef Daddy chose to serve our family tonight and that is all that will go on our plates tonight.”

The WORST that can happen is your child will go to bed hungry of his own volition.

D) Take Your Child to Restaurants! Often, if you can afford it. Read this article I wrote on children in restaurants. 

F) Go out and eat ethnic food and model trying new foods often. Let your child see you sometimes love and sometimes dislike new foods. even if your child won’t try it at first. Normalize the eating of a wide variety of foods.

So many families have picky eaters. So many parents are picky eaters. Your food challenges are common and though they are not “your fault”, you may have fallen into a rut that you didn’t see coming simply because it felt good and right to feed your child what made him happy and now feel trapped in that rut. Though you are not “to blame”, you are the one who decides what comes in the house and what goes on the plate.

RELAX! As with my sleep clients, my gentle discipline clients and my potty learning clients- the best recipe for living with picky eaters is simply to create a plan and then relax. I really hate to say this but it’s important-  anxious, worried and worked up parents are making the challenge worse as your child is picking up your feelings.  I’ve set up food for my daughter using everything above from the very beginning, so I do not have a picky eater. But even when she just isn’t eating as much protein as I’d like in a sitting I have to tell myself to lean back in my chair, take a deep breath and enjoy my own damned food! I kid you not, it is an extremely helpful parenting trick to simply say “F*ck It” in your mind and move on with your day.

What to feed them? Here is a great article from Dr. William Sears with some healthy food ideas to try- though I obviously don’t agree with the suggestion of making sandwiches with cookie cutters- at least not regularly. If you are really concerned about weight gain, write to me for my toddler weight gain smoothie recipes. moorea @ savvyparentingsupport.com

What does science say about picky eating? It seems we can be genetically predisposed to picky eating because of differences in sensitivities of the tongue to various tastes. And yet we train our tastebuds into our cultures beginning first in the womb, then through breast milk, then by first foods (Did your baby eat sweet potatoes and bananas first- that may create a hankering for sweet things versus green veggies and savory dishes.)  And so on with the foods we put on the table…

So…Are you ready to stop hiding the vegetables? 

Love, Moorea at www.SavvyParentingSupport.com

Posted in Health, Parent Coaching, Recipies/Allergies, Uncategorized | 2 Comments

8 Brilliant Non-Toy Gifts for Baby

Just what do you buy for a baby outside of a board book or the same ole’ little toy? Here’s a list of thoughtful presents. Your family asking for hints? Send this article to them before the holidays!

Enrichment Classes: Ask baby’s parent what classes they would like to take? ASL? Gym? Music Together? I teach a combo of world languages, ASL, music and sensory play.Indirayellow But academics are not what we’re really aiming for with babies even in my own classes- fun and friends are key. Social learning and parent connection are the greatest joy money can buy. If baby is not born yet or just born, the family may enjoy breastfeeding drop-in groups, newborn groups etc.

Snacks: Make baby a delectable treat. Babies can eat real food with real spices and it doesn’t have to start with purees.  Homemade sweet potato crackers. Apple butter without sugar. Carrot muffins. Dried Apple Teething Rings. 

Books: The classic gift that endures the test of time. Board books are wonderful but don’t be afraid to buy “older kid” books so that they can be enriched with real literacy. Used books? Hand me down books? All good!

A Potty: Did you know that babies can crawl onto a potty and use words and signs to communicate potty needs by 10 months? Besides peeing in them, potties are fun to climb and read a book on. As a potty coach for 10mo and up, here’s my favorite inexpensive one: The Potty Pod Basix.

First Art Supplies: First art experiences can happen much earlier than preschool! Artsensorykitchenmemesupplies can be enjoyed with the hands, feet and all the senses. Glob paint is safe, gluten-free, sugar-free and just sticky enough to be really interesting. It’s more of a water-color consistency once mixed. Get a big, long roll of paper for baby to just go crazy on!

DIY Sensory Tubs: Make your own sensory kit to gift to baby. A big, shallow tupperware, some organic lentils, quinoa, cups for water play, possibly some silica-free, sensorykitchenmemepreservative-free sand.  Some bulk items in bags, some bowls and supervision will also do just fine!

Parenting Classes:  The Parent of the baby you love might want some help in the arena of gentle and effective discipline, communication, how to cloth diaper, how to use various baby carriers or infant CPR, baby massage. Ask the parent what they are interested and beloved baby will reap the benefits! You can even find some of these classes online, like my gentle discipline, potty savvy and sleep savvy online programs.

Membership: To the local children’s museum or play center? To the aquarium? To the pool! Botanical Gardens? Ahh..the gift of getting out of the house!

Love,

Moorea     www.SavvyParentingSupport.com 

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Carnival of Natural Parenting -- Hobo Mama and Code Name: MamaVisit Hobo Mama and Code Name: Mama to find out how you can participate in the next Carnival of Natural Parenting!

Please take time to read the submissions by the other carnival participants:

(This list will be updated by afternoon December 9 with all the carnival links.)

  • I Want to Buy All of the ThingsThe Economama discusses whether there’s a way to buy all of the baby stuff she desperately wants for her daughter without spoiling her.
  • The “Collectors” and the “Concentrators”: How Children React to Lots of Presents — Laurie Hollman, Ph.D., at Parental Intelligence discusses two types of children who receive gifts: the “Collectors” who rip open the wrappings on their their presents and love to count them and the “Concentrators” who spend endless time on each gift ignoring the array of presents around them.
  • The Joy of Giving and Receiving — Ellen at Life With Lucien shares her three-year-old son’s new favorite toy for imaginative play.
  • Books: Best Present Ever! — Holly at Leaves of Lavender discusses some of the many reasons why books are the ideal gifts for little ones.
  • 10 DIY Gifts You Still Have Time To Make — A roundup of 10 DIY gifts that don’t take much time to make from Doña at Nurtured Mama.
  • Pumpkin Gingerbread Loaves – A Delicious Holiday Gift — Jennifer at Hybrid Rasta Mama shares one of her favorite recipes to make and give during the holidays. This Pumpkin Gingerbread Loaf is much anticipated by her friends and loved ones. Learn how to create this delicious gift from the heart!
  • Christmas gifts for dreamers — Tat at Mum in search shares her favourite books and resources that have helped her get inspired and move forward towards her dreams this year.
  • Natural parent’s baby shower registry — Since she had everything already for baby #3, Lauren at Hobo Mama is amusing herself by building a list of essentials and a few fun fripperies for a natural-parenting nursery.
  • Gifts of love — Charlie at PeelingClementines recalls her favourite Christmas gift of all time and thinks about how to add this magic to her little one’s first Christmas.
  • The Gift of Letting Go — Dionna at Code Name: Mama has discovered that when you’re a perfectionist, sometimes the best gift is simply releasing yourself from self-imposed expectations.
  • Montessori Inspired Gifts for Babies and Toddlers — Rachel at Bread and Roses shares gift ideas that were a hit with her son last year and what’s on her wishlist for this year.
  • Giftmas Ideas for KidsMomma Jorje offers an original gift idea that hasn’t been overdone and is good for the kids!
  • Favorite CDs for Babies and Toddlers {Gift Guide} — Deb Chitwood at Living Montessori Now shares her family’s favorite CDs for babies and toddlers, some of which were favorites of her children and are now favorites of her granddaughter.
  • The Birthday Turned Christmas Wish ListThat Mama Gretchen forgot to share her birthday wish list this fall, but she’s still wishin’ and hopin’ a present or two will arrive for Christmas!
  • 8 Thoughtful Non-Toy Gifts for Baby — Is your family asking for hints for presents to give baby? Moorea, guest posting at Natural Parents Network, offers this list of ideas that won’t overwhelm your little one with toys.

 

 

 

 

Posted in Music, Play, Potty Learning, School/Teaching, Uncategorized | Leave a comment

She’s Up All Night To Get Some…Breast Milk!

This following message was sent by a very sleepy reader. It reminded me of that famous song,  “Get Lucky” by Daft Punk. “She’s up all night till the sun, she’s up all night to have fun, she’s up all night to get lucky….”  I imagine that song is talking about adult activity, but some of us parents now know  “Up all night” in a very different way!

“Hi Moorea- My baby is 11 months and co-sleeps in my bed. She nurses to go to sleep and wakes up maybe 5-7 times through the night and always has- and needs my breast to get down. I feel like she’s up all night but doesn’t show any ill effect and I’m losing my mind! What do you do to fix this? Not up for the CIO [cry it out] sleep training method and she does not use a pacifier…other than me! ” Natalie (shared with permission).

Dear Natalie, violin memeBaby’s getting her heart’s desire and you’re going crazy. Well, I was once there and I was near postpartum psychosis waking up every hour as a tiny one. I’m here to tell you from both personal and professional experience (150+ sleep clients so far!) that you can gently gradually teach her new boundaries with your body, not nurse every time she wakes, help her learn to go to sleep after the breast and not on the breast.

Falling asleep with the breast in the mouth, is totally normal and natural and awesome* for many families-  but it sets up a sleep association. That means that she needs to wake all the way up and nurse (and wake you up) whenever she comes out of a normal short baby sleep cycle, rather than just rolling over. So not falling asleep on the breast at the beginning of the night is the place to start.  It is possible to make some changes without weaning or ending co-sleeping!

bedsharing nursingFor many families this is the first time they have ever set a boundary with their baby! Think of it as communication and consent regarding your body and not as sleep training. There is never a need to think of our parenting as “training.”

Each week I teach families how to do this in my classes and coaching practice. You don’t have to “do nothing” and you don’t have to stop nursing or cosleeping. That’s the good news! The bad news is that there is sometimes fussing or even crying when we set a boundary. Most babies (and adults!) hate change they must now adapt to!  But if you make changes, you will see changes. It requires a few days of strength, but you can do it! You will kiss yourself…and your baby!

Many families can create and stick to a plan on their own or with the help of my online sleep program- or I’m available to help you over the phone! FYI, a pacifier is not any better than your current situation. They fall out multiple times a night and even a toddler often can’t find it in the dark and will need you to wake up to help. Plus you’d eventually need to wean off of it for dental reasons so it isn’t a good habit to start now.

*Note, I mostly work with family sleep changes when children are 9mo or older because infants need to eat at night, breastfeeding should be on demand if possible for a tiny one, and littler babies are all need and very little “behavior” that we would want to change.

Love, Moorea www.SavvyParentingSupport.com  

Posted in Breastfeeding, Gentle Discipline, Sleep | Leave a comment

Original SIDS Researcher Says Baby Bed-sharing is Not Dangerous

The same doctor who made SIDS known to the American public believes that bedsharing with your baby is not dangerous. You heard that right. Dr. Abraham B. Bergman was the first president of the National SIDS Foundation. He got SIDS research into federal programs in the 70’s. He helped pass the national Sudden Infant Death Syndrome Act in 1974. His latest paper was released in 2013 and didn’t go mainstream then, which is a tragedy for American families.

This latest article in JAMA Pediatrics, “Bed Sharing per se Is Not Dangerous” calls out the American Academy of Pediatrics in making unfounded claims against bed-sharing with babies. Baby sleeping close to her mother, holding her finger Bergman lists the many reasons why SIDS diagnosis and recording has been flawed, non-uniform, and subject to human opinion and prejudice; so that there is no specific evidence that bed-sharing is a risk factor for sudden infant death.

“The National Center for Health Statistics receives its in- formation about causes of death from a potpourri of US coroners and medical examiners in 2185 different death investigation jurisdictions. This lack of uniformity means that the personal beliefs of coroners and medical examiners determine the diagnoses written on death certificates.”

Referencing another article in the very same issue, Bergman states:

“Colson and colleagues report that from 1993 through 2010, the overall trend for US caregivers to share a bed (also known as cosleeping) with their infants has significantly increased, especially among black families. Because of their belief that bed sharing increases infant mortality, the authors call for increased efforts by pediatricians to discourage the practice. I find the report disquieting because evidence linking bed sharing per se to the increased risk for infant death is lacking.”

Bergman has worked with families for over 50 years in Seattle as a pediatrician at the University of Washington Medical Center, and Harborview Medical Center. He has worked with families for over 50 years in Seattle as a pediatrician at the Seattle Children’s Hospital and Harborview Medical Center. My favorite thing about Bergman? He spearheaded a national movement to support families who had lost a child to SIDS- rather than sending them to jail. Bergman has also made huge changes in the areas of food stamps and school lunches, bike helmet laws, safe and educational playgrounds, and Indian health improvement. He has always fought for lower income families and families of color and that’s why his work with SIDS is even more important. He believes that something prejudiced may be afoot here with SIDS diagnoses.

Milwaukee’s famous scare-tactic using anti co-sleeping campaigns aimed at families of color has been a total flop. It isn’t saving babies. I could have told you that. Families co-sleep because they are exhausted in the middle of the night and because babies love and need closeness. Those two things have greater importance to families in the moment than how one’s city advises them to parent. Bergman notes:

“…I detect a note of irony in the AAP’s position. Are we advising our patients against a practice that many of us follow? Colson et al1 show that bed sharing is reported among 12.2% of caretakers with some college education and 9.2% of caretakers who have graduated from collage and/or had post- baccalaureate education. Many pediatricians’ families seem to be among those who ignore the AAP recommendation, with or without guilt.”

The American Academy of Pediatrics has a policy against bedsharing but researchers, medical professionals, and worldwide organizations question the AAP’s position. The truth remains that there are no studies that show bed-sharing as a risk factor with a  control for major concurrent risk factors like formula feeding, excessive bedding, and nicotine use in the home.  Personal and cultural biases play a role in death reports which have no standardization methods. A major concern is that countless officials use their own judgment to decide cause of death rather than using a standardized reporting system that looks at all SIDS risk factors.

If an infant dies in an adult bed it would be common for the bed-sharing itself  to be cited as the cause of death when there may be other important factors to consider.  What many people don’t know is that SIDS has remained very mysterious for so long because determining exactly what caused breathing to cease in an infant is extremely difficult. We have begun moving toward calling it Sudden Unexplained Infant Death (SUID) for this reason- it doesn’t have the characteristics of a syndrome at all. When possible suffocation deaths began being called SIDS, SIDS stopped meaning anything. The death of a baby while sleeping with an adult on a couch or lounge chair (both dangerous sleep situations with a high risk of entrapment and suffocation) is classified as a death due to bedsharing as well even though suffocation itself is not SIDS.

With co-sleeping, we are really talking about suffocation deaths and not SIDS. Automatically labeling a family with a suffocation death simply because they had been co-sleeping (which may not be the actual cause of death) is problematic and has been biased against lower income and African American families.

Bergman quotes the Centers for Disease Control:

“Since 1998, it appears that medical examiners and coroners are moving away from classifying deaths as SIDS and calling more deaths accidental suffocation or unknown cause, suggesting that diagnostic and reporting practices have changed. Inconsistent practices in investigation and cause-of-death determination hamper the ability to monitor national trends, as certain risk factors, and design and evaluate programs to prevent these deaths.”

Another sleeping and SIDS researcher, Dr. James McKenna has published his belief that co-sleeping is safer than crib sleeping namely because of his research showing steadier breathing and heart rate while bed-sharing and that co-sleeping babies are likely to sleep on their backs. McKenna’s Research is compiled here. An international survey by the SIDS Global Task Force showed that countries practicing the most c0-sleeping and bed-sharing had the lowest rates of SIDS. They also happen to be countries with high breastfeeding rates. And what’s more? JAMA published a review of data from the National Infant Sleep Position Survey that recorded numbers actually rising of self-reported bed-sharing during the same time period that SIDS deaths lessened. That’s what we call very interesting indeed. 

Here we have a trusted pediatrician in Dr. Abraham Bergman who worked for many years to save babies from unexplained death- and he’s saying that the science just isn’t there to  name bed-sharing itself as a risk factor for sudden infant death. So this is my continuing call for more research about infant sleep deaths and the actual risk factors for SIDS, as well as how protective breastfeeding and co-sleeping actually may be. Let’s not throw baby (and baby’s natural needs for closeness) out with the bath water. We aren’t helping anyone with the scare tactics.

People are co-sleeping anyway. Let’s figure out how to get info about safe co-sleeping out to parents. *Note that though we don’t yet know the exact risk factors for infant sleep death, what knowledge we do have suggests it is a good practice to not co-sleep if your child is exclusively formula fed, if you have a sleep disorder, if you are morbidly obese or use nicotine or if there is any alcohol abuse in the home- in those cases, baby should sleep solo on their back on a firm mattress in clothing and without pillows or blankets.

Moorea Malatt-  Supporting breastfeeding, co-sleeping families with my gentle Sleep Savvy Method.  http://www.SavvyParentingSupport.com Moorea

Posted in Breastfeeding, Health, Sleep | 9 Comments

How to Gently Stop Nail-Biting with Children

I’ve helped a few families stop the nail biting, without chemicals or punishment. Here are is a step-by-step plan and the ideas that have worked best.

1) Pay Attention. Nail biting is a nervous/anxious behavior and should be looked at as a sign that there is an underlying issue. Not one which every child must go to a therapist for (in actuality, many, many children and adults bite nails), but one which shouldn’t go ignored. Ask yournail biting child what they are feeling once you notice the biting and pay attention to what was just happening and what is upcoming for your child. These are self-soothing behaviors and only a budding rational mind will be able to compete with the impetus and change a behavior, therefore we must not get angry. If we ourselves bite our nails, discuss with your child why you do it, when it started and work on ending it as partners. Help your child address the cause of the stress.

2) Prepare for Change. Let your child know that you’re hoping to work together to stop the nail-biting and that you will try some things together. If there is any pain, uncomfortable fingers or shame from the behavior, ask your child how it feels and let them know you are there to help them learn how to stop. When nails are too short it can be slightly painful, ripping them off can be painful and often there is cuticle biting involved which can open up into open sores. Let your child know that it’s your job to help them learn how to stop having uncomfortable fingers.

3)Re-Direct: Decide together to keep fun band-aids around the finger-tips as reminders not to bite for about a week, not during sleep.  It won’t feel the same as before and even though they may bite the band-aid or take it off, a child over 2 years may be able to have enough time between the impetus to bite and the act of biting to stop and re-direct themselves to something new. Help your child learn how to re-direct to feeling some jewels in the pocket, find a real or stuffed animal to hug, ask an adult for a hug, learn to take deep breaths, or do 5 jumping jacks. All are proven to reduce anxiety without creating new compulsive behaviors. Something on the fingers like band-aids or essential oils may be needed at first, to help stop the behavior when it usually hasn’t been conscious.

4) Essential Oils: This is probably the last resort, but there are healthier ways than yucky chemical nail polishes meant to derail nail-biting. There are bitter essential oils that you can rub under the nails and on the cuticles. Bitter orange oil is a good one. Melaleuca/Tea Tree oil you may already have in your home. Those two are not meant for ingestion. Oregano oil is an anti-fungal and really spicy, safer for ingestion as is clove, but either way you are just rubbing a tiny bit into the cuticles and under the nails. I would start with a drop of the oil mixed in a few drops of coconut oil, fractionated is best. You can find the safest quality fractionated coconut oil and these essential oils here. 

What not to do:

  • Don’t compare the child to other kids who don’t have the habit.
  • Don’t make it all about how somebody else wants the child to stop. Focusing on negative attention may cause stress which might cause more of the behavior you are trying to change together.
  • Don’t begin when the child is starting a new school or moving.
  • Don’t put something toxic on the digits.
  • Don’t point out the habit if the child does it as comfort when they get hurt.
  • Don’t make it about germs. It is just as true that germs on our hands make us healthy as make us sick.  Children are susceptible to fear of germs, phobias and obsessive compulsion around germs. Don’t let that be what replaces the unwanted habit.
  • Don’t neglect to address a problem with a professional. I highly recommend play therapy or art therapy with a professional for children who have severe nail biting that you an relate to other issues with stress, adjustment, or sensitive personality.

Love,    Moorea

http://www.SavvyParentingSupport.com

Posted in Gentle Discipline, Health, Parent Coaching | Leave a comment

7 Ways Parenthood Made Me A Better Person

lovemyself meme

How did becoming a parent change you? I’m inspired by this HuffPost article When Will I Feel Like Myself Again After Baby? The answer is NEVER. And I’m so glad because now i’m:

1) Patient. In ever area of my life now. Even though I was always patient with kids as a preschool teacher, postpartum doula, etc. You have never known patience like letting a small person put her shoes on by herself while you are late to a doctor’s appointment or waiting for a breastfed baby to poop after 5 days of no poop. Yes first there is anxiety- but then you realize it will kill you if you don’t let it go. And then you’ve learned patience. I realize it might have taken 2 years to get there.

2) Smarter. After the initial brain drain of pregnancy and postpartum and then the sleep deprivation, I got smarter. Smarter about priorities, common sense, time management, creatively making anything work out. I’m more emotionally intelligent because I have observed closely as the emotional intelligence of a young being grow steadily each day and I’ve figured out how to nurture that.  I’m talking about smarts that actually count for living. Still I won’t pretend I’m not sad that I have lost species names memorization for marine invertebrates and the ability to solve for x.

3) More Spiritual. Even though I used to have time to meditate a lot. Now I congregate more with a spiritual community that my child is a part of- we know our higher power through our connection to other people because I desperately have needed the community. And that is a more real spirituality and when I tried to attain nirvana on my bed or in self help books. I have seen a person come to creation out of thin air. I have found love in my heart of a calibur I could not have fathomed. Spirit is about giving and receiving love and kindness but I couldn’t have told you that before becoming a parent.

4) More Ethical. Your ethics change when you no longer live for yourself. I have an example to set. What is my child hearing me say? What is she watching me do? What sort of planet am I leaving for her? How do we treat people? Living ethically used to seem confusing and challenging. Now it is has become second nature. What would you want your child to do?

5) More Self-Loving.  Our children become us (even if they aren’t of our flesh).  And one’s child is as worthy as worthy gets. Though self-care has gotten harder for me because of time constraints of parenthood, my drive for it is stronger than ever. I’m trying model self-esteem so my child can see how it is done. I stopped complaining about my big saggy boobs. They really make fabulous cuddle pillows.

6) More Present.  I was always trying to escape that fancy and free young adult life I had. Drinking, weed, sex, (Okay I’m keeping the Rock and Roll!) and fiction and someone else’s drama- were all fun escapes.  And yet now that life is more challenging than ever, my desire is to be more present to it and not less. Maybe because children grow up so fast and I know it. Maybe because the joy of watching a tiny person you love grow is higher than any high I had before. Okay maybe I still have some work to do putting down the iPhone more often. Nobody’s Perfect!

7) More Powerful. I am not so humble anymore. Many of us had bumpy roads to motherhood that showed us what we were really made of. Vunerabilities that brought in our true strengths. Multiple times in my very difficult pregnancy I though I would die. Maybe you had a traumatic birth? Maybe you had a terrible time conceiving but stuck with it or decided to adopt and now you are so trusting in that intuition that told you you must become a parent! And the baby is surviving while so dependent on you? Amazing. I brought a frikkin’ baby into the world. I had to get up the nerve to fire two disprespectful nurses in order to birth that kid while battling painful gallbladder attacks while in labor. I can do anything I set my mind to. I am beyond powerful and I walk around like that now. I own my strengths and I make the most of them and because I do that I can also share my weaknesses and I ask for help.

How did Parenthood Change You for the BETTER?

Love,

Moorea  www.SavvyParentingSupport.com

Posted in Health, Parent Coaching, Spirituality | Leave a comment