Coffee Catchup 4th Nov - Hamilton - Dorothy Waide

Hi, can you please note down the creams etc you recommend for eczema. Thanks

Hi Dorothy,

Thank you for the advices yesterday!
My baby is 9 months old and it has been a battle to put her to bed, everytime is so much crying...
Last night she woke up 6 times and around 4am I decided to take her into our bed. She woke up twice more because she wanted the dummy and 6am to start the day.
Since 21 of October I am not breastfeeding her at night time, she has dinner at 5:30am and last feed around 7 or 7:30pm and most of the times she fall sleep during the feed.
She usually wakes up around 6am, has a feed then breakfast around 6:40am (fruit muesli or porridge) and then feed and sleep again after 2hours ou 2hours and 15 min. (After your talk yesterday I am going to try to keep her awake for about 3 hours in the morning) She sleeps for about 45min or 1 hour and half, if she wakes up after 45 min I try to resettle her, most of the times she cries and I pick her up until she is calm and try to put her back in the cot, sometimes does not work and she is up again, her luch is around 11:30am and then back to bed around 12noon.
She sleeps for about 1 hour to 2 hours and then up again, sometimes I try to put her down for the last nap around 4:30pm, some days she sleeps for 30min some days she doesn't, and she is quite upset around 7pm if she didn't have a nap and is up since around 3pm.
If she is awake and we leave her in the cot, as soon as we leave the bedroom she cries. If she does not stop in about 2 to 3 min and the crying is increasing I go to her bedroom, try to stay close shushing and patting her or I need to pick her up to calm her down.
Since we stopped with the night feeds, it feels that is getting worse, now when she wakes up we try to resettle her, but she wants someone in the bedroom for a long period of time, for 3 nights (before yesterday) she woke up at 1:30am and it took us almost 1 hour and half to resettle her. I don't know what we are doing wrong!
It is so exhausting and very frustrating specially because we don't know how to get her to sleep better and we don't have any family around to share the difficulties!
Hope you can help us! Thanks!
Roberta

Hi Dorothy

I am the mum of the active almost 7 month old wriggler that was sitting at the front.

Thanks for the advice you gave, I have been keeping him up longer between sleeps now (2.15 - 2.3 hours) and he hasn't seemed to get cranky towards the end of this time so is working good so far, but will have to see if this has any affect on how long his day sleeps are. I also tried today giving him cereal as soon as he woke up (which was 9.30 cause he slept 12 hours and went to bed at 9.30). I was a bit worried he would want his milk but he sat and waited in his chair for the food and although he didn't like the cereal by itself (he never was a fan and hasn't had it for a while) I added a little puréed pear that I had freshly made and he scoffed it up. I gave him some milk a while after that and before he had his next sleep.

Two things I wanted to ask were, just wanting to check if you mentioned how I would get him to re-settle if he woke up after 30 - 45 minutes during the day and was still wide awake after leaving him for 20 minutes. He almost never cries when he wakes, just normally talks and wriggles and gets a bit louder the longer he is left. He won't generally fall asleep in my arms (unless really tired) as wants to wriggle too much and doesn't like being held in the position you had the baby in the coffee catch up session. Also he currently sleeps in a SafeTsleep so is strapped in on his back.

I also wondered if there is a good way to transfer and settle him into his bed if he falls asleep in the car on the way home. Quite often he will fall asleep only a few minutes from home, but when I try to carefully transfer him and settle him in his cot he either wakes up fully alert as he believes this power nap was enough or cries and cries so I get him up.   Is it just better to let them have a bigger sleep in the car or is it worth getting them used to being transferred?

Thanks for your help.

Tina and Alex

Edited by M4DCAT - 06 November 2013 at 8:28am

Hi depending on how bad the eczema is depends on what I use.    

In the bath I tend to use olive oil, or alpha keri or pinetarsol.   SOme of the doctors are not using the pinetarsol as much anymore as it does dry the skin so if you do use then it is important to moisturiser the skin once he is dry.

To heal the skin I use different ones, sudocream, xmaease are good healing creams

To moisturise the skin is important and I will allow something at various times of the day - this can either be vaseline or one the creams you can get from the doctor.    I tend to put the vaseline on my hands and then apply to the skin. It is important though that the skin is dry and the layer is a light layer rather like putting on your face cream.

The second with eczema is to keep the skin moisturiser and also quick baths. It is the soaking in the water that damages the skin not having a daily bath.   

Hope that helps

Hi Roberta
Here is a suggested routine and notes for you and hopefully this will help. I do wonder whether some of her settling issues are because she needs more milk before going back to bed and also whether she is tired.   To ask her to resettle during the night, then it is important you teach her to resettle during the day. My suggestion is that you work with her on her naps and hopefully that will help with the waking and resettling over night.

6.00am Wakes
6.30am Breakfast Cereal and fruit mixed with milk, then offer breast once she leaves the highchair

9.00am Morning tea - offer full breast feed
9.15am Nap - minimum 1 1/2 hours resettle if she wakes before this

11.15am Lunch - Vegetables with a good protein. Offer finger food ideally the same as what is in the puree or mash - this teaches texture, taste and smell. Optional to offer water in Sippy cup with meal and optional to offer breast once she leaves her highchair.

1.45pm Afternoon tea - offer full breast feed
2.00pm Nap - minimum 1 1/2 hours resettle if she wakes before this

4.00pm Dinner Cereal mixed with vegetables (until you sort out the night waking) Again offer finger food ideally the vegetables that are in the mix.   Offer breast once she leaves the highchair

Evening routine - Bath, Breast

7.00pm Bed for the night

NIght waking - resettle, resettle - if feeding ensure that it is for hunger and not comfort

SETTLING AND RESETTLING NOTES
SELF-SETTLING TOOLS

•     Engulf Hold
•     Cupping and patting
•     Shushing

The ‘Engulf’ Hold
As the name suggests, this hold provides as much body contact as possible giving your baby the sense of being completely contained as if in the womb.

It positions your baby in such a way that you can initiate other settling techniques simultaneously. In addition, it also provides warmth, intimacy and the meditative beat of your heart.

Most mothers/fathers prefer using their dominant arm to support the baby’s body from underneath. Choose whichever side feels most natural to you.

Hold your daughter so that her head is resting on the upper region of your non-dominant arm. For mothers, this ensures that their baby is not too close to the breast where she could be easily distracted by being close to their milk supply.

Draw your daughter in close so that you are pressed tummy to tummy with your baby’s face nestled just below the top of your shoulder. Your palm will be on your baby’s bottom with her legs tucked up into your body and supported as such by your forearm.

With your non-dominant arm, reach around your daughter’s shoulder and take hold of her arm to steady it, in other words to control the startle movement.

For this technique to be effective, there should be no eye contact or communication between you and your baby. Allow your own body to do the nurturing.


Patting and Cupping
Patting or cupping your baby’s bottom or lower body mimics your baby’s heartbeat and reassures your baby of your presence.

Patting is a rhythmic, firm and repetitive action done with your palm flat.

Cupping is a stronger action and is done with a cupped palm, incorporating both cupping and a short but gentle thrust forward of Baby’s body.

Both patting and cupping can be done in your arms or adapted for the cot.

Shushing
Shushing is a long, low sound, resembling air being released from a tyre. It should be loud enough so that your daughter can hear it over her cry. It is thought that babies respond to shushing because it is similar to the sound that they experienced when in the womb.

Dummies (optional)
If you allow your daughter to wind down before offering a dummy, it becomes a settling tool rather than a prop.

Props
Babies do not need to be rocked or walked around the block to encourage them to sleep. While movement may seem an obvious method to help soothe a baby to sleep, it becomes the hardest habit to break and interferes with self-settling. It is an unnecessarily labour-intensive approach that often delivers little reward.

Instead, imagine that your body takes the place of the cot in which your daughter will eventually sleep independently; it makes sense that you remain stationary when settling her.

All props, including music, white noise, movement that cannot be done in a cot, dummies (when given straight away to a baby) create bad habits and interfere with a baby’s ability to learn self-settling.

Giving a dummy as a comfort tool is different from plugging a baby when they first go to bed (prop).

SLEEP, SETTLING AND RESETTLING
Much of your daughter’s first 3 months was spent establishing feeding and sleeping rhythms. Her digestive system is still maturing and her sleep patterns are still evolving.

In the first 12 weeks your aim is to teach your daughter, in a nurturing way, to settle and find sleep unaided and how to stay asleep.

How your daughter’s sleep patterns evolve in the first 12 weeks will have depended on you and your household. Keep in mind that daytime rhythms will affect the night rhythms.

This routine is repeated throughout the day and night. With time, the amount of assistance with settling should decrease and eventually your daughter will learn how to self-settle.

Once your daughter learns how to settle and resettle, she will eventually be able to sleep anywhere.

You can’t spoil a baby at this age; they need lots of nurturing and reassurance.
Teaching good sleep habits requires TIME, ACCEPTANCE, CONSISTENCY and TRANQUILITY (TACT)

SLEEP CYCLES AND PATTERNS
It takes a minimum of 10 days to see changes (i.e. you are just looking for a dim light at the end of the tunnel at this stage) and the circadian sleep cycle takes at least 3 weeks of consistency. The changes do not happen over night but will happen over time.

Remember sleeping is a learned behavior.

Self-Settling
I believe one of the most important skills that parents can teach babies is that of self-settling. It teaches babies how to gain control over their emotional state and this in turn leads to them developing their emotional backbone as they grow. It does not happen overnight and needs to be taught in a nurturing way.

When you go to bed you read a book, meditate, watch TV, or chat with your partner – a baby can only do one thing and that is cry. There is nothing unhealthy about a baby crying before going to sleep. As a parent, it can be difficult to listen to but as long your baby is happy and contented generally, crying is just part of life. Remember you are not leaving her there to cry it out; you are leaving her there to give her the ability to find his own sleep. You will not get anywhere by leaving your baby to cry for hours. You will succeed quicker by giving her space and then helping her find his sleep.

Self-settling is the key to establishing healthy sleep patterns. It gently teaches babies how to find sleep naturally, without the use of sleep aids, props or interference. It is about allowing your daughter the ability to find her own sleep unaided. By stepping back and doing this you are giving her the ability and her right to find her own sleep.


It is that small window that occurs when your daughter starts crying until the moment you intervene to help her find his sleep. This window initially may be for only a minute or two but as baby grows it increases until eventually she will be able to find sleep independently. It is a crucial step in Baby’s sleep development.

Self-settling does NOT involve leaving your baby to cry it out alone to finally fall asleep due to stress and exhaustion.

Settling Cycle
Little steps will get you there quicker than taking big steps then finding you are not able to stick with it. I work on the principle that it takes most babies/toddlers 20 minutes to wind down before going to sleep and adjust this for each individual.

When putting your daughter to bed you should do what I call ‘dump and run” i.e. put your daughter in his cot and walk away and “do not hover like a helicopter”. Walk out of the room and shut the door. Remember a dark room creates calmness and also signals time to go to sleep. Light is for playtime and dark is for sleeping.

Any insecurity that you may feel in practicing this ‘dump and run’ technique can be alleviated by the use of baby monitors. A monitor with movement, sound and/or camera will provide you with confidence whilst allowing your baby to have a calm environment to have their naps and nighttime sleep.

First Stage
Leave to cry up to 5 minutes STOP THINK and ACT – the ACT may be to leave your daughter for another 5 minutes OR

•     Provide comfort with cupping/shushing. Optional to offer dummy. Remember this is to reassure and should be shorter than the crying time.
Then leave to cry up to 5 minutes, you may choose to do just 2 or 3 minutes here to begin with - STOP THINK and ACT

•     Provide comfort with cupping/shushing then patting and shushing. Optional to offer dummy. Stay in the room until your daughter goes to sleep. At this stage if your daughter does not go to sleep then you do have the option of picking her up and putting her to sleep in your arms (see engulfing notes).

Second Stage
Leave to cry for 10 minutes then STOP THINK and ACT- the ACT may be to leave her for another 5 minutes OR

➢     You may choose to do just 2 or 3 minutes here to begin with - STOP THINK and ACT . Optional to offer dummy.
Provide comfort with cupping/shushing then patting and shushing. Stay in the room until your daughter goes to sleep.

➢     Provide comfort with cupping/shushing. Remember this is to reassure and should be shorter than the crying time.
Leave to cry up to 5 minutes, - STOP THINK and ACT Optional to offer dummy.
Provide comfort with cupping/shushing then patting and shushing. Stay in the room until your daughter goes to sleep.


Third Stage
Leave to cry up to 15 minutes then STOP THINK and ACT – the ACT may be to leave her for another 5 minutes OR

•     Optional to offer dummy. Provide comfort with cupping/shushing then patting and shushing. Stay in the room until your daughter goes to sleep.   

•     Leave to cry up to 10 minutes, - STOP THINK and ACT Optional to offer dummy.
Provide comfort with cupping/shushing then patting and shushing. Stay in the room until your daughter goes to sleep.   

Fourth Stage
Leave to cry up to 20 minutes STOP THINK and ACT Optional to offer dummy.
•     Provide comfort with cupping/shushing. Remember this is to reassure and should be shorter than the crying time.

Leave to cry up to 10 minutes, - STOP, THINK and ACT. Optional to offer dummy.
Provide comfort with cupping/shushing then patting and shushing. Stay in the room until your daughter goes to sleep.   

REMINDERS ON SETTLING
You need to take small steps so depending on how you feel you can do the full cycle above or start with doing two lots of crying and at the end of the second cycle cup/pat/shush off to sleep.

Always try and settle in your daughter in her cot. It’s harder to resettle her if you take her out of the cot, but trust me there will be times that you will do this.

Try not to use movement as a calming tool or to put your daughter to sleep – this is the hardest habit to break.

When comforting don’t talk or give your daughter eye contact – both of these stimulate. Instead, you can use the shush noise and let your body talk to her. Also try and stand to the middle or bottom end of her body when comforting. Remember we all do end up giving eye contact it is human nature; however, try to avoid doing it as much as possible.

You need to work within both your and your daughter’s comfort zone. It is not about leaving her alone to cry until she is exhausted and goes to sleep, but it is about giving her space to find her sleep.

The crying isn’t to be crying at the top of his lungs for this length of time. your daughter may start out loud and slowly reduce and also stop and start.

If the crying is constant at one level and goes for a long time then you need to reassure and see what is happening.

The crying time does depend on the cry but try not to go in under the time frame that you are working with - nothing is set in stone but you do have to push the boundaries to get results.

Do this settling up to 10 days – if it is not working then you need to reassess what you are doing. You may need to step back and allow her more time to find his sleep.

Resettling

This is how to get your daughter to sleep and to enable her to stay asleep.

Resettling teaches babies how to progress from light to heavy sleep. This is essential to avoid the pitfalls of frequent waking and catnapping. In a sense, resettling is the second stage of teaching baby how to find sleep and does demand more time and patience than settling (TACT).

Most babies stir or wake when progressing from light to heavy sleep and this occurs anywhere between 20-45 minutes. In the beginning the idea is not to let your daughter wake fully during this transition; a sleepy baby is easier to resettle than a wide-awake, crying baby.

Resettling is not about calming them down or staying until they just start to drift off, it is about staying with your baby until they go into a deep sleep.

However, as she grows you will need to step back and allow your daughter the ability to try and resettle without any intervention.

The aim of resettling is to ensure your daughter sleeps for not less than 1½ hours per sleep rhythm. Your baby can also sleep longer than 1-½ hours – ideally 2 to 2 ½ hour naps are what you are working towards.

Generally a baby who does not learn how to resettle will have short sleep cycles and wake during the night without the ability to fall back asleep on his own.

RESETTLING SUGGESTED CYCLE

First stage – you may choose to miss this stage and go onto the next stage.

Respond immediately. Optional to offer dummy.

To coax your daughter into his deep sleep, place one hand over her chest (this is what I call ‘engulfing’ in the cot) and with the other hand begin the cupping action and then progress to gently patting and shushing her back to sleep. You can also turn your daughter on his side facing away from you and then do the cupping action.

Remove hand from chest and then pat lighter, ending up patting the air. If your daughter does not change her sleep pattern then leave the room. If your daughter wakes then you need to repeat the process and stay with her untils he goes back into a deep sleep.

Second stage

Leave to cry up to 5 minutes. Optional to offer dummy.

Provide comfort by cupping/shushing then patting and shushing. Stay in the room until your daughter goes to sleep. At this stage if she does not go to sleep then you do have the option of picking her up and putting her to sleep in your arms.

Third stage
Leave to cry up to 10 minutes . Optional to offer dummy.

Provide comfort with cupping/shushing then patting and shushing. At this stage stay in the room until your daughter goes to sleep.

Fourth stage
Leave to cry up to 15minutes STOP THINK and ACT. Optional to offer dummy.

Provide comfort with cupping/shushing then patting and shushing. At this stage stay in the room until your daughter goes to sleep.

Comfort - two ways of doing this, you stay in the room until your daughter goes into a deep sleep and then you leave OR you can attempt to calm her down then leave and give your daughter an appropriate time to see if he will resettle.

If your daughter does not go back to sleep then you will need to stay with her until she goes into a deep sleep.

Always try and settle in her cot. It’s harder to resettle if you take her out of the cot, but trust me there will be times that you do this.

You can’t spoil a baby at this age; they need lots of nurturing and reassurance.

Do this settling up to 10 days – if it’s not working then you need to reassess what you are doing.

An example of resettling could be that your baby sleeps for 45 minutes wakes and it takes you another 45 minutes to coax them back into sleep and then they will sleep for another 45 minutes or less or sometimes more. Eventually over time your baby will not wake but continue to sleep through this wakeful period.

Waking Up
When your daughter eventually wakes from sleeping, enter the room but avoid immediately picking her up. Instead reassure your daughter with your voice, talking whilst opening the curtains. He will feel reassured with your presence.

This process is a subtle way of teaching your baby that his crying doesn’t automatically lead to her being immediately picked up and therefore not to stress about it.

It is a balance of letting your daughter know you are there for her yet by not going straight to her, you are giving her a crucial opportunity to experience his own space and his own emotions, all the time knowing that you are coming

Tina and ALex
I have just posted the settling and resettling notes earlier so you will be able to follow those.

With regard to resettling I wouldn't intervene until he needs you to help - this could be that he wriggles and makes a noise for approx 20 minutes and when he gets louder go in and do the resettling. The idea is not to go in to early allow him the time to do it himself.

Once you teach him to self settle and resettle in the cot, then you will be able to manage to do the transfer from the car to the cot. This will be the same as what you would do when resettling.   

As he doesn't like to be held to settle or resettle then you would need to just do the cupping in his cot. As he is in a safeTsleep you are still able to turn him on his side, as the idea of the safeTsleep is that they can move from their back to their side and tummys

Hi Lucy
Oops forgot to do the attachment - here is a menu planner for you.
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