Wednesday 26 May 2010

Babies and sleep

I've been busy lately. Busier than the usual sort of busy even. Marie-Aibhlinn has got to the age when things get a bit livelier and she needs more than just to be cuddled and fed.
I find newborns a breeze mostly, and I don't really mind being disturbed in the night for feeds either, mostly because I have been fortunate enough to have babies that feed well and then fall back to sleep without too much fussing.
When Marie Aibhlinn is not in the bed with me, I keep her in an "Arms Reach" bedside cot that was loaned to me by my friend Elizabeth.
I have always slept with my babies. The crib was mostly a pretty adornment with it's frills and furbelows.  Practically speaking it did have some uses. It was a handy 'cotside', and was also used to store my night time reading material, muslins, hand cream, lip salve, bottled water and other sundry items, but hardly ever the baby it was designed for. A midwife friend and ex colleague used to laugh at this as she said it reminded her of the time she worked in Malawi and the W.H.O fund for something or other supplied cribs to all the new mothers in her district. When she visited them at home, not one of these mothers were actually using the cribs for the babies. Apparently they mostly used them to store the pots and pans.

When I had my first baby 20 years ago I had never heard of co-sleeping. At night I would put him down in the moses basket and spend the next hour or so getting up and down to peep my head over the frills and check that he was still ok. I hated that I couldn't see him unless I got up and looked over the top. Putting him out of sight, even though he was right beside me, just seemed to violate a powerful natural instinct and it made it hard for ME to settle. Eventually sheer tiredness would put a stop to my constant peeping and I'd fall asleep myself. At the next feed, in the small hours of the morning, I would happily lift him in to me and was too sleepy and cosily content with him curled up beside me to bother  to put him back. Before long I realised that I'd get a better sleep if I skipped the moses basket stage altogether.
Later I learned that this is referred to as co-sleeping and that some people get very agitated about this being either a very bad thing or a very good thing. Some people dismiss co sleeping as a faddish concept or an ideology. In my opinion it is just common sense and I have to believe that the practice of separating babies from their mothers when they are sleeping is, from an historical perspective, considerably more faddish and novel.
But whatever, I just love waking up next to her.

Dr Sears writes very well about co-sleeping here. For anyone interested in such matters it's a worthwhile read.
He identifies 7 benefits of co-sleeping medical and developmental. Here's a snip from that article:


1. Babies sleep better
Sleepsharing babies usually go to sleep and stay asleep better. Being parented to sleep at the breast of mother or in the arms of father creates a healthy go-to-sleep attitude. Baby learns that going to sleep is a pleasant state to enter (one of our goals of nighttime parenting). Babies stay asleep better. Put yourself in the sleep pattern of baby. As baby passes from deep sleep into light sleep, he enters a vulnerable period for nightwaking, a transition state that may occur as often as every hour and from which it is difficult for baby to resettle on his own into a deep sleep. You are a familiar attachment person whom baby can touch, smell, and hear. Your presence conveys an "It's OK to go back to sleep" message. Feeling no worry, baby peacefully drifts through this vulnerable period of nightwaking and reenters deep sleep. If baby does awaken, she is sometimes able to resettle herself because you are right there. A familiar touch, perhaps a few minutes' feed, and you comfort baby back into deep sleep without either member of the sleep-sharing pair fully awakening.
Many babies need help going back to sleep because of a developmental quirk called object or person permanence. When something or someone is out of sight, it is out of mind. Most babies less than a year old do not have the ability to think of mother as existing somewhere else. When babies awaken alone in a crib, they become frightened and often unable to resettle back into deep sleep. Because of this separation anxiety, they learn that sleep is a fearful state to remain in (not one of our goals of nighttime parenting).
2. Mothers sleep better
Many mothers and infants are able to achieve nighttime harmony: babies and mothers get their sleep cycles in sync with one another.
Martha notes: "I would automatically awaken seconds before my baby would. When the baby started to squirm, I would lay on a comforting hand and she would drift back to sleep. Sometimes I did this automatically and I didn't even wake up."
Contrast sleepsharing with the crib and nursery scene. The separate sleeper awakens – alone and behind bars. He is out of touch. He first squirms and whimpers. Still out of touch. Separation anxiety sets in, baby becomes scared, and the cry escalates into an all-out wail or plea for help. This piercing cry awakens even the most long distance mother, who jumps up (sometimes out of the state of deep sleep, which is what leads to most nighttime exhaustion), and staggers reluctantly down the hall. By the time mother reaches the baby, baby is wide awake and upset, mother is wide awake and upset, and the comforting that follows becomes a reluctant duty rather than an automatic nurturant response. It takes longer to resettle an upset solo sleeper than it does a half-asleep baby who is sleeping within arm's reach of mother. Once baby does fall asleep, mother is still wide-awake and too upset to resettle easily. If, however, the baby is sleeping next to mother and they have their sleep cycles in sync, most mothers and babies can quickly resettle without either member of the sleepsharing pair fully awakening. Being awakened suddenly and completely from a state of deep sleep to attend to a hungry or frightened baby is what leads to sleep-deprived parents and fearful babies.
3. Breastfeeding is easier
Most veteran breastfeeding mothers have, for survival, learned that sharing sleep makes breastfeeding easier. Breastfeeding mothers find it easier than bottlefeeding mothers to get their sleep cycles in sync with their babies. They often wake up just before the babies awaken for a feeding. By being there and anticipating the feeding, mother can breastfeed baby back to a deep sleep before baby (and often mother) fully awakens. A mother who had achieved nighttime-nursing harmony with her baby shared the following story with us:
"About thirty seconds before my baby wakes up for a feeding, my sleep seems to lighten and I almost wake up. By being able to anticipate his feeding, I usually can start breastfeeding him just as he begins to squirm and reach for the nipple. Getting him to suck immediately keeps him from fully waking up, and then we both drift back into a deep sleep right after feeding."
Mothers who experience daytime breastfeeding difficulties report that breastfeeding becomes easier when they sleep next to their babies at night and lie down with baby and nap nurse during the day. We believe baby senses that mother is more relaxed, and her milk-producing hormones work better when she is relaxed or sleeping.
4. It's contemporary parenting
Sleepsharing is even more relevant in today's busy lifestyles. As more and more mothers, out of necessity, are separated from their baby during the day, sleeping with their baby at night allows them to reconnect and make up for missed touch time during the day. As a nighttime perk, the relaxing hormones that are produced in response to baby nursing relax a mother and help her wind down from the tension of a busy day's work. (See
5. Babies thrive better
Over the past thirty years of observing sleepsharing families in our pediatric practice, we have noticed one medical benefit that stands out; these babies thrive . "Thriving" means not only getting bigger, but also growing to your full potential, emotionally, physically, and intellectually. Perhaps it's the extra touch that stimulates development, or perhaps the extra feedings (yes, sleepsharing infants breastfeed more often than solo sleepers).
6. Parents and infants become more connected
Remember that becoming connected is the basis of parenting, and one of your early goals of parenting. In our office, we keep a file entitled "Kids Who Turned Out Well, What Their Parents Did." We have noticed that infants who sleep with their parents (some or all of the time during those early formative years) not only thrive better, but infants and parents are more connected.
7. Reduces the risk of SIDS
New research is showing what parents the world over have long suspected: infants who sleep safely nestled next to parents are less likely to succumb to the tragedy of SIDS. Yet, because SIDS is so rare (.5 to 1 case per 1,000 infants), this worry should not be a reason to sleep with your baby. (For in depth information on the science of sleepsharing and the experiments showing how sleep benefits a baby's nighttime physiology.
Read more here.

6 comments:

  1. The part about storing everything but the baby in the crib made me smile - good memories! I don't think I ever had pots and pans in ours, but diapers, bum cream, extra baby clothes, and the like found a very good home there. I basically used it as a very roomy changing table!

    When I was pregnant with my first I was determined to do things the "American way". I soon caved and gave over to the "Japanese way", otherwise known as co-sleeping (not that I had ever heard of that term back then). Though I think the arguments on both sides get a bit over zealous sometimes, I've never regretted giving up on that custom!

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  2. I remember when I tried to keep my first baby in bed with me at the hospt that I got really mixed responses from the staff. One nursing assistant told me off quite crossly and demanded I replace him in the fish tank thing between feeds. One of the midwives said it was bad and another said it was good.
    That was just over 21 yrs ago.
    There was still a pretty mixed response by the time I had No 4 just over 7 years ago but things had settled to a kind of mums can if they must by the time Avila was born and then I remember when Heleyna was born (3 yrs ago) there were posters up around the ward encouraging co-sleeping.
    Co sleeping with Avila probably saved her life. She was a very sick child and didn't breathe through the night until she was 2. I would wake up and get her breathing again sometimes as often as 3 or 4 times in a night. We didn't have an alarm-and never needed one. She was with me and I knew each time she stopped breathing.
    One of the Paediatricians was shocked I had managed like that- but although I looked into buying a machine I thought it was more dodgy to rely on something I wasn't sure would work and she would have had to sleep separately from me.

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  3. Lovely post. I always love to read about the benefits of co-sleeping. I'm absolutely fascinated and impressed with mum6kids' comment! wow! It reminds me of the whole kangaroo-care in Russia(?) where they could not afford high tech equipment for preterm babies, and yet had great success with strapping the teeny babbas to their mothers' chests. Aaahhhh
    Paolax

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  4. Interesting comments, thank you!
    Sue, that's really interesting to know that co sleeping is the norm in Japan. I wonder (cynically) how long it will take, for Japanese mothers to start adopting the 'American way'. For good and ill it's a powerful culture.

    Mum6kids, that's very interesting. Your story makes alot of sense to me. Midwives are a funny bunch. The ones I trained with are really incredible, very very respectful of mothers and hugely supportive of their mothering instinct. Hearing about bossy midwives makes me wince though, I've certainly worked with a few of those too. They make maddening colleagues!

    Paola! Thanks for dropping by! I didn't know that kangaroo care started in Russia. And out of a lack of resources? Wow, what a rebuke to our devotion to technology.

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  5. I should have checked it out before my comment, it's actually Bogota, Cambodia where kangaroo care originated.

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  6. LOL Paola, I'm sure you meant to type Colombia!
    Thanks for the correction though.
    I Googled and found this site which explains more:
    http://www.kangaroomothercare.com/whatis02.htm

    This quote is on the photo's page:
    "The instinct of a mother to hold and care for her baby is primordial and primitive, and an overwhelmingly powerful feeling."
    - Jane Davis, Bogota, Dec 1998 who kangarooed her prem baby.


    I think that is so true. Instinct is powerful and important for survival. Somehow we have learned that science trumps instinct. Because there is no scientific model for 'instinct' it has become relegated in modern minds to the equivalent of old wives tales.
    It makes me sad when mothers subordinate their natural mothering response to a prevailing idea, book or trend.
    One particularly egregious example of this is the Ezzo's "Babywise" programme.
    See here:
    http://www.ezzo.info/index.htm

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