Wednesday, September 21, 2016

The article dr. chang sent about sleep

http://www.parents.com/baby/sleep/issues/teach-baby-to-sleep-in-7-days/

Baby Sleep: Get the Facts

    During the early days of life with a newborn, you're focused on what's best for the baby, so sleepless nights seem like a small price to pay. Until about week six, that is, when waking up every few hours starts to get old. By month three, you're pretending to be asleep, hoping that your partner will get up first and fetch a bottle. You can't remember what it feels like not to be tired.
    The good news is that most babies do begin to sleep through the night between 3 and 4 months of age if you let them, says Charles Schaefer, Ph.D., author of Winning Bedtime Battles: Getting Your Child to Sleep (Barnes & Noble Books, 1998). But many parents unwittingly encourage bad sleep habits that can continue for years. If your baby is 6 months or older and is still a night owl, it's time you get with the program. And even if you have a young infant, it's never too early to teach smart sleep skills. Our expert seven-day plan will guarantee a good night's sleep for you and your baby, with a minimum of crying along the way.

    Day 1: Start a Regular Routine


    mother putting baby to sleepPhotodisc/ Veer

    Many babies get their days and nights mixed up, napping for long periods in the afternoon and waking up to play at bedtime. But today you're going to fix that. "The latest research shows that infants can be taught the difference between night and day from the get-go," says John Herman, Ph.D., clinical director of the Sleep Disorders Center at the Children's Medical Center of Dallas. You simply need to provide the cues that will allow this to happen.
    Wake your baby up early tomorrow, and get into the routine of always rising at the same time every day. Position her crib near a window and keep the blinds up. "The natural light helps babies organize their circadian rhythms," says Dr. Herman. Letting her nap with the blinds up also promotes this process. "If they wake from a nap in the daylight, they understand it's time to get up. If they wake at night in the dark, they'll learn to go back to sleep," he explains.
    At nighttime, begin some quiet rituals. "Decide on a specific bedtime routine," says Claire Lerner, M.S.W., a child-development specialist at Zero To Three: The National Center for Infants, Toddlers and Families, in Washington, D.C. Dress your child in her pajamas and put her down in her crib for the night with the lights out. Just prior to tucking her in, you may want to read a story or sing a song, which helps your baby's motor and sensory system slow down.

      Day 2: Practice Makes Perfect

      Today you're going to build on the consistent routine you began yesterday. If your child still requires nighttime feedings, that can be a good time to accentuate the difference between day and night, says Robert Ballard, M.D., director of the Sleep Health Center at National Jewish Medical Center, in Denver. "Keep night feedings very relaxing, with the lights low. Do everything you can to avoid stimulating your baby," he says. "And during the day, make feedings a time of high activity, when you tickle her feet or sing songs, so she begins to perceive the difference."
      Continue to pay careful attention to what soothes your baby in the evening too. "A bath may be calming for one child and invigorating for another," Lerner says. You might also want to try adding white noise, says Carl Johnson, Ph.D., a psychologist and pediatric sleep researcher at Central Michigan University, in Mount Pleasant. "The hum of a fan or air conditioner or a radio set on static works well for many infants. The good thing about white noise is that you can fade it out over time, once your baby begins to sleep more predictably."

        Day 3: The Crying Begins

        Steel yourself: Tonight you start putting your child down in his crib while he's still awake. "It's the single most important thing you can do," says Dr. Schaefer. "If he falls asleep at your breast during his bedtime feeding, for example, arouse him enough that his eyes are open when you place him in the crib." Of course, a little -- or a lot of -- crying may ensue. But rest assured, it will be tougher on you than on your baby. Parents naturally find crying agonizing to listen to, but just keep reminding yourself that the end result -- sleep! -- will be good for the whole family. "Get over the worry that ignoring your baby while he cries will do psychological harm," emphasizes Dr. Schaefer. If you've been meeting his every need in other ways, this situation certainly won't lessen his sense of security.
        Nor should you worry about letting a very young baby cry. In fact, the younger the infant, the easier the process will be. "Babies older than 5 or 6 months are naturally going to be more upset because you've changed the rules on them," Dr. Schaefer says. A 3-month-old, on the other hand, knows only the routine that you create. "With younger babies, parents always think the crying is going to go on longer than it usually does," agrees Pamela High, M.D., medical director of the infant development unit at Women & Infants' Hospital, in Providence. "Infants under 5 months often last only for 15 or 20 minutes."
        If a battle royal does ensue, go in periodically to check on your baby and reassure him that you're there -- aim for every five minutes the first night. But keep your visits brief: Don't turn on the light, remove him from the crib, or offer him a pacifier or a bottle. "If he falls asleep with one of these crutches, he'll cry for it again if he wakes up or at bedtime tomorrow night," Lerner says.

          Day 4: Tough It Out

          So last night was a long one. Expect an improvement tonight. Your baby will remember a little sooner that crying doesn't produce results. When she protests, lengthen your response time to every ten minutes. And whatever happens, don't give in. "If you're inconsistent, the baby learns to hold out -- she'll just up the ante and cry twice as long tomorrow night," says Deborah Givan, M.D., director of the Children's Sleep Disorders Center at Riley Hospital for Children, in Indianapolis.

            Day 5: Baby Settles In

            Most babies get with the program in three to five days, so tonight could be your lucky night. If your child is still holding her own, lengthen your response time to 15 minutes. "Some babies need the frequent reassurance that you're checking on them, but others find it a tease," Lerner says.
            "Checking on the baby is really for the parents' benefit," says Dr. High. "If you notice that you're fueling your child's reaction every time you go in and you can tolerate staying away, it's fine to do so. Just peek at him through a crack in the door instead so he doesn't actually see you."
            The other frequent problem at this point is night feedings. At about 12 pounds or 3 to 4 months, most infants are ready to give them up. Obviously, you can't just decide to cut them out with a younger infant. But you can keep them as brief and quiet as possible: Cuddle your baby but don't sing to her, keep the lights out even during diaper changes, and settle her in the crib as soon as she's done. Don't fall for the myth that bigger babies wake up because they're hungry. Heavier babies actually have less need for night feedings if they weigh more than about 12 pounds, so they're likely to be waking up out of habit. Bigger babies are sometimes night owls precisely because they're being overfed, Dr. Givan points out. "Overfeeding means they'll have wet diapers, which makes them wake up again."

              Day 6: Baby Sleeps Through

              Sounds like bliss, doesn't it? But chances are you'll be wandering the halls a little anyway. You may find yourself getting up to check on the baby. Relax. Dress him in warm PJs so you don't need to worry about kicked-off covers, and turn the monitor down so that you hear him only if he's really in distress. Now that you've made so much progress, don't wreck it by rushing in too quickly. Let your child soothe himself. You also need to relax so that you can fall asleep.

                Day 7: You Sleep Soundly Too

                Give yourself a big pat on the back. You've not only regained your sleep but given your baby an important gift: Good sleep habits are as critical as good hygiene to a child's well-being. Of course, there will be setbacks, such as an illness, a new sibling, or an unfamiliar hotel room. "Even children who are good sleepers will have problems now and then," says Dr. Givan. But fall back on our foolproof plan whenever you need to. Your child will respond with even less difficulty the second time around because she already knows the drill.