Marc Weissbluth's Blog, page 9

Competent Parents, Competent Child

There are over 1,300 reviews of Healthy Sleep Habits, Happy Child on Amazon but not a single comment on Chapter 12, Competent Parents, Competent Child. The child psychiatrist describes how setting limits promotes growth and how saying no helps your child. Why are there no comments on this Chapter? Would some of you please be so kind and read this Chapter and give me your thoughts. Thank you.

Marc

Filed under: Barriers to Sleep Solutions, Healthy Sleep [image error]

Friday Parenting Myth #14

Hi everyone,

Nancy Nelson, our wonderful lactation consultant in our Practice, wrote in our next myth: "Breastfeeding Has No Nutritional Value after 1 Year of Age." Enjoy this post and check out or Free Parenting Myth App for iPhones-If you like our app, please leave it a positive review! Daniel Weissbluth

33 Popular Parenting Myths

You may have heard that after one year of age, breast milk has no nutritional value. This is not true. Breast milk, produced by the mother of a child over age 12 months, still has nutritional value for the child. It continues to have immune factors and antibodies that develop based on the mother's exposure to infections. By one year of age, the baby's immune system is more developed than it was at birth, but breast milk continues to supply immune benefits to the baby. By one year of age, the baby should be eating other foods such as fruits, vegetables, grain, dairy and meats, but breast milk is still an important part of their diet. In a study published in 2005, the average fat content of milk from mothers of babies 2 to 6 months of age was 7% while the fat content of the milk of mothers of babies 12 to 39 months was 11%. The American Academy of Pediatrics, in their statement on breastfeeding, has recommended that mothers breastfeed their babies for at least 12 months and thereafter as long as mutually desired.

References:

Fat and Energy Contents of Expressed Human Breast Milk in Prolonged Lactation.

Pediatrics, March 2005

Mandel, Dror et al.

American Academy of Pediatrics Committee Work Group on Breastfeeding,

Pediatrics, 1997, 100: 1035-1039

Breastfeeding and the Use of Human Milk.

Nutrition During Lactation-1991

Committee on Nutritional Status During Pregnancy and Lactation

Institute of Medicine

Filed under: Common Myths [image error] [image error]

Friday Pareenting Myth #14

Hi everyone,

Nancy Nelson, our wonderful lactation consultant in our Practice, wrote in our next myth: "Breastfeeding Has No Nutritional Value after 1 Year of Age." Enjoy this post and check out or Free Parenting Myth App for iPhones-If you like our app, please leave it a positive review! Daniel Weissbluth

33 Popular Parenting Myths

You may have heard that after one year of age, breast milk has no nutritional value. This is not true. Breast milk, produced by the mother of a child over age 12 months, still has nutritional value for the child. It continues to have immune factors and antibodies that develop based on the mother's exposure to infections. By one year of age, the baby's immune system is more developed than it was at birth, but breast milk continues to supply immune benefits to the baby. By one year of age, the baby should be eating other foods such as fruits, vegetables, grain, dairy and meats, but breast milk is still an important part of their diet. In a study published in 2005, the average fat content of milk from mothers of babies 2 to 6 months of age was 7% while the fat content of the milk of mothers of babies 12 to 39 months was 11%. The American Academy of Pediatrics, in their statement on breastfeeding, has recommended that mothers breastfeed their babies for at least 12 months and thereafter as long as mutually desired.

References:

Fat and Energy Contents of Expressed Human Breast Milk in Prolonged Lactation.

Pediatrics, March 2005

Mandel, Dror et al.

American Academy of Pediatrics Committee Work Group on Breastfeeding,

Pediatrics, 1997, 100: 1035-1039

Breastfeeding and the Use of Human Milk.

Nutrition During Lactation-1991

Committee on Nutritional Status During Pregnancy and Lactation

Institute of Medicine

Filed under: Common Myths [image error] [image error]

New Parent Support Group

We have a New Parent Support Group that meets every Friday at lunch time. About 5-10 mothers,2-4 fathers, and 1-2 grandparents come and we talk about sleep, breast-feeding with our lactation consultants, and any other items they wish to discuss. It's a small group and about half of the parents come a few times and some parents come almost all the time. The age range is one week to about 6 months. Parents with older infants support the newer parents. Last week, we discovered that many of the parents in our group had challenges such as short stays in the NICU or other challenges such as difficulty initiating breast-feeding. So it is fair to say that this not a random group of parents but it is a self-selected group of parents who were challenged in the neonatal period and now put forth the effort to come to the office. Maybe they can be described as extra motivated to learn and succeed in helping their babies sleep well and breast-feed.

I raised the subject whether mothers vary in their ability to soothe their babies when fussy or soothe their babies to a drowsy state before sleep. The group seemed to agree that slow rhythmic stroking and rocking was usually more effective than rapid bouncing or patting. But one mother described how the intensity and rapidity of her movements coincided with her baby becoming more fussy and we discussed whether this wa being "attuned" to her baby or whether the she was reacting to the increased fussiness by becoming more stressed herself. Another mother described that she felt her style of soothing was organically part of who she was and although she had tried different methods suggested by books and friends, she ultimately did what she felt comfortable with. I would appreciate comments and observations from our readers on whether you think one style of soothing is better than another. Or is their no "best" way but every mother-baby discovers what works for them?

The group also agreed that Dads sometimes seemed more effective in soothing because they had a more matter-of-fact approach and talked to the babies as if they were adults. "Here's the deal, I'm going to rock you for a while and then you're going to be put down to sleep because it's time to sleep. Got it? So don't give me any problems." Have any of you made similar observations?

Some mothers in the group started when their babies were only a week old and heard from the other moms how they wished they had done "drowsy but awake", "get dads on board", and "brief intervals of wakefulness" earlier. One mother described how she implemented these items early, felt comfortable with some successes, and decided that she would let her baby cry at night to learn some self-soothing for night sleep. Her baby cried for 20 minutes and then slept well at night and has slept well since. She did this at age 4 weeks and her baby is now 5-6 months. There was no gasping or astonished looks but simply smiles and nods. I think that more mothers and fathers should experiment with a few minutes of crying to allow self soothing at night in the newborn period if they feel comfortabledoing this.I pointed to a couple present with 38 week new-born twins and described how when attending to one twin, the other might cry and stop crying and fall asleep before you could get to the crying twin. My impression is that 10-20 minutes of low-level or quiet crying cannot be harmful. But here is a curious observation. After soothing a two-week old following an exam, I put the baby down on the examination table and the baby was whimpering and quietly crying. I said to the mother, let's watch the minute hand and leave your baby for 1-2 minutes as long as the crying does not become loud or strong, to see if your baby might fall asleep. Her immediate response was,"Isn't she crying hard?" I pointed out that hard crying occurs after an immunizations shot and this was quiet crying. So, is it possible that some mothers in the beginning are less able to make the distinction between very quiet crying or whimpering and hard, loud crying and are therefore loath to allow any crying to occur in the context of allowing a child to learn self-soothing?

Please remember that these were not a randomly selected group of parents so what you suggest or observe might not apply to all parents.

Marc

Filed under: Uncategorized [image error]

Repost: CUMULATIVE SLEEPINESS

CUMULATIVE SLEEPINESS occurs when your child is a little short on sleep day in and day out. Small amounts of sleep loss add up and the effects of sleep deficiency or sleep deprivation increase. In the beginning, if the daily sleep debt is small, the adverse effects might be minimal at first but they grow and grow as the debt increases. Sometimes, an event such as an illness or three day week-end of messed up sleep throws the child over the edge and "all of a sudden" sleep issues surface. Bedtime battles, night awakenings, early morning wake ups, or deterioration of naps develop. Often, these sleep issues start out as mild problems but they predictably grow into major sleep issues due to the accumulation of an ever increasing sleep debt. This is the explanation why parents are puzzled by their previously good sleepers suddenly going south.

There are some predictable patterns to recognize:

1. The bedtime is a little too late around 6-9 months of age when the third nap disappears, 12-21 months when the morning nap disappears, between 3-4 years when the single nap disappears.

2. The bedtime is a little too late during the summer time when the days are longer and you want to be outdoors in the evening.

3. Family vacations when naps are skipped or the bedtime is too late.

Have any of you noticed cumulative sleepiness in your children?

Marc

Filed under: Cumulative Sleepiness

Data on Sleep Duration for Different Ages

In HSH,HC, I published data from my own research regarding the sleep times, the awake times, and duration of naps. My research showed that the average sleep durations for specific ages had not changed much since the early 1900s. Therefore, I concluded that sleep durations had a strong biological basis but at any give age, there was a range of sleep durations. This type of data is descriptive and not prescriptive. For any child at any age, the amount of sleep needed should be based on how the child looks near the end of the day; does my child appear to be well rested?

I have noted in other publications charts showing how much sleep children "need" but there is never a scientific citation of source material. In the absence of evidence, these reports should be viewed as simply opinions.

Additionally, there are recently published reports showing that young children now sleep less than in my original study population. I think this is correct in settings where factors such as dual career families, day care, digital distraction, or more scheduled afternoon activities play a role in causing children to stay up later than in previous decades.

Marc

Filed under: Bedtime, Individual Differences

Friday Parenting Myth #13 Spacing Out Vaccines

I asked one of our colleagues, Dr. Scott Goldstein to guest write in this myth.

33 Popular PArenting Myths

Enjoy!- Daniel Weissbluth

Myth – It is better to space out vaccines

At a typical 2, 4 or 6 month check-up, babies are vaccinated against 7 or 8 different infectious diseases. They don't get 7 or 8 shots though – some vaccines protect against several different diseases in one injection. So most babies won't get more than 2 or 3 needles at any one check-up.

Some parents mistakenly believe that it is somehow safer to give "one shot" at a time, and want to "space out" their child's vaccines. The idea of modifying the schedule has also been given support by a popular but medically unsound parenting book about vaccines. In addition to not being necessary, is not so simple to "space out" vaccines.

Most vaccines are given in multiple doses, and each dose has to be given a certain time period apart. Some vaccines cannot be administered after a certain age. And some vaccines cannot be given within certain time period of other vaccines. Sound confusing? It is. The current vaccine schedule has been studied in detail and has been shown to be the safest, most effective way of protecting the largest amount of children in the time period that they are most vulnerable to disease.

"Spreading out" vaccines can lead to many problems including extra doctor visits, missed or extra doses of shots, and a delay in being protected from life-threatening illnesses. While there is no evidence that giving vaccines on a different schedule is less effective than the current schedule, there are a huge number of variations on the vaccine schedule that a person could come up with – none of which would be expected to be any more effective than the current schedule. Vaccinating on time is the best way to make sure that your child is protected at the earliest possible age.

Sources: History of the Vaccine Schedule http://www.chop.edu/service/vaccine-e...

http://www.aap.org/immunization/famil...

Filed under: Common Myths

Strategies to Improve Self-Regulation in Preschool and School-Aged Children Parts 5

Robert Daniels, PH.D., has helped many families in Chicago and is our guest blogger for this week. Enjoy!

-Dan and Marc

5 Strategies to Improve Self-Regulation in Preschool and School-Aged Children

Robert E. Daniels, Ph.D.

Licensed Clinical Psychologist

Executive Director,

Chicago Children's Clinic

Regulating mood, behavior, and performance requires healthy sleep habits; however, sleep alone is not sufficient to teach your children how to regulate themselves. Below I will summarize some of the basic needs your young children require. After you review these basic needs, ask yourself which of these needs are you providing, or failing to provide for your children:

5.Time: Children need time to play, to make mistakes, to explore, and to simply be surrounded by the comforts of home. There is a mistaken belief that because children are endowed with the ability to learn quickly, we should actively take them to lessons to learn everything possible, at as an early of an age as possible. Children learn through play. They learn to experiment. They learn to cooperate, collaborate, negotiate, and tolerate frustration. Children require time to play in order to recover from the stress of separation from parents, from their room, from their toys, their siblings, and their stuffed animals. The magic of childhood is stolen when children are placed under the same time pressures as adults. When you are lying on your back staring at the sky, stories are imagined with clouds as the characters. Without the opportunity to spend 20 minutes staring at the clouds, we are depriving our children of their most magical gift—their imagination. Without imagination, society would not have invented anything. Our next generation of scientists, artists, doctors, and entrepeneurs need to be well rested, so they require time to sleep. They also require time to dream.

Filed under: Behavior

"Healthy Sleep Habits, Happy Twins" has been translated into Czech

Dobry Den! Marc Weissbluth's book, "Healthy Sleep Habits, Happy Twins," has been translated into Czech

PS: We are going to make an App that collects the "sleep consult" blog posts (past and future) for our readers. Keep an eye out for that!

-Daniel Weissbluth

Filed under: Announcement

Literal Interpretation

Here is a sentence that might appear in the Blog or my book. "Children begin to develop nap circadian rhythms about 3-4 months of age. The morning nap develops first and occurs around 9am."

Sometimes, sleep deprivation in parents naturally causes some mental fog and impatience so they might remember this sentence as "4-month old babies take a nap at 9am."

Obviously, to well-rested parents, this is a too literal interpretation leading to frustration. Clearly, the morning nap might occur earlier than 9am, especially in the younger babies and clearly the morning nap might not be regular until after 4 months of age perhaps in the post-colic baby. Babies develop sleep patterns at different rates because of differences in nature and nurture. Please be patient, don't compare babies, and develop coping strategies to deal with your own sleep deprivation such as taking breaks, getting help, and indulging in some self-maintenance as a reward for all your hard work.

Marc

Filed under: Barriers to Sleep Solutions