Coffee Catchup 24th June with Dorothy Waide

Thanks OHBaby! for arranging this, and thanks Dorothy for your time today - was very interesting. One question I meant to ask... my (nearly) 6 month old is swaaddled in a merino wrap (arms down by side). It makes a big difference in her being able to settle well. She is just starting to be able to get her arm(s) out though and it wakes her up and prevents her from settling herself back to sleep (which she can do when still wrapped). What should we do? At the moment I go in, re-swaddle her, and put her back into bed for her to self settle back to sleep. Should I be weening her out of the swaddle since she's becoming too strong for it? If so, how please? Thanks heaps!Lauren

Hi Dorothy, I echo the others, thanks for your time today, and your time on this forum.

My almost five month old has trouble staying awake for more than 90 minutes in the day. He shows all the tired signs, yawning, rubbing eyes and cranky from about 60mins - 90mins. If he goes to bed within this time, he'll go down with very little fuss. If its longer then getting him down takes a lot longer as he's overtired.

This makes following any routine challenging, as most of them have awake times of at least two hours. Given he's also a cat napper (he wakes up happy after 45mins) it means he's up and down a lot in the day time - making it hard to get anything done, go anywhere, or feed on waking?!

You gave some suggestions for resettling a cat napper today, which I will try, but any suggestions for extending the up time? I've tried adding five minutes each up time before, but as mentioned, it just makes it really hard to get him to sleep...and seems odd to ignore his tired signs. Perhaps I just have a sleepy baby?

Any advice appreciated.
Thanks, Kerry

Hi Lauren
Ideally I replace the swaddle at 11 weeks with a sleeping bag, however every baby is different so I am also guided by the babies needs. When the swaddling is interfering with her sleep then I tend to replace the swaddle with the sleeping bag.

My suggestion would be to put her in an appropriate sleeping bag and then swaddle over the top of that perhaps with a muslin swaddle. I would also swaddle one arm down by her side and the other across her chest and swaddle this arm so that her hand is un- swaddled. Happy to show you how to do this on Skype if it is easier. Just let me know.

ONce she is comfortable sleeping like this then allow the arm that was across her chest to not be swaddled and then swaddle the other arm across the chest so you are slowly moving it from being down her side to across her chest and then finally free.

HOpe that helps and thanks for coming yesterday.
Dorothy

Hi Kerry
Yes, he is a sleepy baby as when he is napping he is only having a 45 minute nap which is is light sleep and we need to encourage him to have a second cycle which is a deeper sleep. You havent mentioned whether you breast or bottle feed him or whether he is on solids. So my suggestion here is that when he wakes you feed him breast, then play and then 15 to 20 minutes before his nap time re offer him his milk and then put him to bed for his nap. As long as you are putting him into a sleeping bag or swaddling after the top up then you do not have to worry about the feed/sleep association that others talk about.    This will also how extend his awake time out as you are actively engaging with him when he is starting to get tired. ANd you are right to extend his awake time do in either by 5 or 10 or 15 minutes at a time.   Do this for 10 days or when he is comfortable with it and then extend out again.

Here are some notes on how to resettle.
Resettling

This is how to get your baby to sleep and to enable her/him 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 baby 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/he grows you will need to step back and allow your baby the ability to try and resettle without any intervention.

The aim of resettling is to ensure your baby 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 her/his own.

RESETTLING SUGGESTED CYCLE

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

Respond immediately.

To coax your baby into her/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/him back to sleep. You can also turn your baby on her 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 baby does not change her/his sleep pattern then leave the room. If your baby wakes then you need to repeat the process and stay with her/him until she/he goes back into a deep sleep.

Second stage

Leave to cry up to 5 minutes

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

Third stage
Leave to cry up to 10 minutes

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

Fourth stage
Leave to cry up to 15minutes STOP THINK and ACT

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

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

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

Always try and settle in her/his cot. It’s harder to resettle if you take her/him 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 20 to 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.

HI Petra
I have just posted some charts on the forum which hopefully will answer some of your questions and I have also posted resettling notes as well.

With regard to when you go in to resettle I would suggest that in the beginning you go in straight away as it is easier to resettle a sleepy baby than a baby that is wide awake. Eventually over time you would need to step back a few minutes at a time so that eventually he will just resettle him self.

The sooner you can stretch him out for his awake time even if its 5 or 10 or 15 minute intervals over time and you can resettle then you will loss that bit at the end of the day where you cant actually decide what to do. My advice there is to do a cat nap (I call it a band aid) and you only need it until you can do the stretching for both awake and nap times. Trying to put an overtired baby to bed at the end of the day will just result in a baby who will probably wake at various times during the night but also it just doesnt make for a happy end to the day.
Dorothy

Hi Dorothy

Thanks so much for your time on Monday, alot of great information and advice.

I have a question about swaddling. My daughter is 15weeks and currently sleeps in a love to dream sleeping sack/swaddle overnight. This allows her to sleep with her arms up which she seems to like but stops the intensity of her startle. You say to stop swaddling when it interferes with their sleep but I'm just wondering what you mean by that/what I should be looking for to know when to give it up? Even though the sleeping sack limits that startle there are still quite a few times where she does startle and its enough movement to wake her up from her sleep. Shell start crying like she's annoyed she's been woken up and I'll have to resettle her again. Should I be looking to stop swaddling her or not yet? The sleeping sack we have is a 50/50 so you can zip off one arm at a time like you suggested, I'm just not sure when to start doing that?

Thanks!
Kelly =D

Hi Kate,
Can I also suggest www.babybutton.co.nz for NZ-made good quality well priced merino & cotton sleeping bags. I purchased one and am very happy with it.
Cheers,
Sarah

Hi Kate
Thanks will check out that site.

Thanks so much Dorothy, that makes total sense!
I tried to do the swaddling as you suggested but failed miserably . Every time I put her arm across her chest, she'd manage to get it fully out. Last night she was awake for 1.5 hours whacking herself in the face! Needless to say it kept her awake, so I resorted to swaddling her fully again - and then she fell back to sleep fine.
I would really appreciate the Skype offer - so I can see what I'm doing wrong please! How should I arrange a time with you please? My Skype name is lozcressy if that helps.
Thanks again so much - your advice on Monday is already helping with getting Emily sleeping better at night!
Lauren     

Hi Judi
With regard to her passing gas - I would ensure that I was burping her well.   You need to be careful here though as burping shouldn't take over the feed - the actually feeding is more important. I tend to say that if you cant get there wind up within 5 minutes then move on. I would also suggest tummy time on the floor after her feed to help with her gas.

IN regard to the length of time she takes to feed, some babies empty the breasts very quickly and I am wondering whether your daughter is doing this.   During the night you may also be more relaxed and I find a lot of babies with tummy issues tend to feed better at night due to less stress in the home.    Stress is about how busy your home is and how busy you are as well as other factors.

My suggestion is to just spend some time and encourage her to have regular awake times and offer her the breast when she wakes and again 15 minutes before going back to bed for her nap.   Remember its not about the length of time a baby is put to the breast but it is about how well they suck and your daughter sounds liek she has this figured out.

Her routine would look something like this

6.00am Wakes, full feed,
7.15am Top up
7.30am Nap - minimum 1 1/2 hours

Then just repeat these times throughout the day. Ideally she will be feeding 3 hrly during the day with top ups before each nap.

At the last feed of the day (bath time), I would fully breast feed her, bath her and then offer the top up that you give to her later at night. When she wakes for the 10.30/11pm feed try resettling before feeding her - this ensures you are feeding for hunger and not comfort.

I have also attached my burping notes for you to look at, but I actually think your daytime routine is not too bad.



burpingohbaby.docx