310 – Sleep

Season Intro and Sleep Overview 0:00

Hi, welcome to season three of the baby manual podcast, the holistic mama's handbook. This season will go through alternative and supportive care to help you take care of your little one when they're sick, but too young to take most medicines. I'm your host, a pediatrician and mom, and the author of The Baby Manual and The Holistic Mama's Handbook, Dr. Carol Keim. Hello, welcome to this week's episode of the Baby Manual Podcast. Today we're going to be talking all about sleep, and I know what you're thinking, yes, we've talked about asleep a lot, but this time we have a whole lot more information to talk about.

There's all these different types of providers that can help your baby to sleep better. And I can tell you just a little bit from a personal standpoint, my first baby was a pretty bad sleeper. And some babies are just like that. So I've learned over the years that part of the reason there are so many different sleep books out there and types of sleep advice is that what works for one baby doesn't necessarily work for another. There are lots of different things you can try. Hopefully, some of these things will help you and can help your family to get a little bit more sleep altogether.

Remember that all babies are different and that you can't really force a baby to sleep. You can always wake someone up, right? But it's really hard to make someone sleep, so some it is really just kind of going with their patterns and then just optimizing everything you could to sort of allow them to as much as possible. Sleep is a really frustrating thing as a new parent and so first let's just talk about real quick what is normal at different ages because there are some books out there that are pretty upsetting where they promise things like 12 hours of sleep by 12 weeks or baby wise is another one that sets really unrealistic and actually really unhealthy expectations about sleep.

Because if you let a little baby sleep too long, they end up missing feedings.

Newborn Sleep and Feeding Needs 1:58

They can get dehydrated. they can have electrolyte shifts.They can end hospitalized for failure to thrive or for low sodium or things like that, dehydration. So again, don't feel like you're ever failing at sleep, I know sleep is really hard and we can all just do our best with whatever information we have. And so trying a couple of different things might be helpful. Remember that whatever you do consistently is most likely to stick, and so you don't want to just try something for like one night and then be like, oh, it failed, And then try Something different the other night that gets really confusing for your baby.

So yeah, starting off with just what's normal at different ages. Newborns are meant to feed a lot. They're supposed to eat at least 8 to 12 times per 24 hours. And they have a tendency to cluster feed in the middle of the night. Now, mom's prolactin level is the highest naturally between about midnight and 6 a.m. and so babies will want to Eat pretty much back to back for that time. You might find that your baby eats for a half hour, falls asleep for 10 minutes, wakes up again and wants to eat again.

And they really do need that at the beginning. Newborns are supposed to be cluster feeding through the middle of the night. It's very inconvenient. But for the first month or two of life, if your baby is awake at night, you definitely need to feed them and you can't let them sleep more than four hours. So if you have a young newborn in the 1st 2 months that's sleeping more then 4 hours, You have to wake them up to eat because otherwise they're going to miss a feed and they could potentially lose weight, get failure to thrive.

It can be really serious. They can have developmental problems. We could even potentially be life-threatening if it happens multiple times like night after night. So wake them up if they're sleeping for four hours for the first two months of life. And then your doctor will be, you'll be going in for checkups regularly at the beginning. So your doctors can tell you when it's safe to let them sleep more than four hour. It's typically around two month of age when they've already passed birth weight and they are gaining consistently and their eating really well at each feeding.

So from around two to six months of life, it's okay to let them sleep longer, but you shouldn't expect it. So some babies will sleep really well starting at two months and some won't sleep well until they're a couple years old. And all of that is normal, unfortunately. what's normal for your baby, but most babies between the ages of two and six months will wake up between two to three times a night, sometimes a lot more than that, and they will want to eat. And so feed them. For the first six month of life, they're completely dependent on either formula or breast milk.

And so if they are awake, they need to eat that. Then you can help them sort of get back to sleep, you know, by rocking them, put them down in their crib. We always say put him down awake but drowsy. That's not always realistic. Of course they're going to want to stay in your arms. Remember that when babies are on the inside of you, like, when they very first come out, their not used to the outside world. And when their on inside, there constantly moving, theres constant white noise from your heartbeat and just sort of the sloshing of fluid around in there.

So when they come out into the real world and you set them in a bed, they hate it. It's flat, it's hard, and they only have pressure on one side of their body and not on all sides of So things like rocking them, shushing them and swaddling for the first month of life can help sort of mimic that womb environment. Keeping the room really dark can also help as well because it's very dark on the inside of your body. And they're just not used to the outside world. But you do need to keep putting them down into their crib or bassinet, face up with nothing else, just that a swaddle is okay,

Safe Sleep Setup and Soothing Newborns 5:52

and a pacifier is OK. Nothing else in there, so no stuffed animals, no bottles in the crib, nothing like that. No bumpers, no blankets, No pillows, none of that. And they do get used to it. It's just everyone for the first few weeks of life says, my baby only wants to sleep on me on my chest right after they finish eating. and that's normal, but they Do need to get use to their bed and it's much safer for them to Sleep in a bed. it is not safe for a baby to. Sleep on you or to, sleep in your bed with you.

Please do keep trying consistently to put them down once they're drowsy or if they've already fallen asleep, you can set them down to sleep and then just kind of put your hand on them, rock them a little bit to help them sort of get used to that bed surface. And they will get use to it. It just takes a lot of consistency at the beginning. So from six to nine months, babies are allowed to asleep as long as they want. At this age, they're already starting to eat foods and they well still typically wake up once or twice at night.

They'll wake more if their teething because They get like a little bit awake and then they're in pain and they wake all the way up and cry. But when they are not teething, if they do wake up, it's okay to offer them breast milk or formula and it is also okay for them to have water starting at 9 months of age because they don't necessarily need that extra breastmilk or breast formula during the night at that age. From that six to nine month range, if they are teething, from a Western standpoint, we would recommend something like acetaminophen or ibuprofen.

Ibupropen tends to last a little longer. It lasts for six hours. And so if their teeting and you want it to give ibipropen, that's something that can help them sleep in that age range when they're starting to teeth. Remember, they have to be at least six months old to get ibeproben though. So from 9 to 12 months, I would say start offering bottles of water at night. You don't need to give them breast milk or formula every single time. Rock them afterwards and help them a little bit to fall back asleep, but then try to put them back into that bed on their own.

If you're giving them higher fat and protein meals at dinner time, that can also help them to sleep a little bit better. And just a reminder, so starting at six months of age, we do start giving the solids or purees or baby lead type of foods These foods don't keep them full longer. That is a myth. And actually, breast milk and formula are a lot more calorie dense than almost any other food. So giving them rice cereal is not going to help them sleep better. I've had parents ask me, should I put rice syrup in the bottle?

And the answer is no, you should actually never do that unless your doctor's prescribed it for reflux. That's like the only rare exception and it's only the tiniest little bit that you add in. But no, you don't want to put rice cereal in the bottle. You don' want feed them rice cereals to fill them up. It actually has less calories per ounce than just straight breast milk or formula. And so it doesn't keep them full longer. Developmentally, around six months of age, babies tend to be able to sleep longer stretches, and that's also when they're starting to eat foods.

So parents sort of attribute those to each other, but it is not what's doing it. So between that like six and 12 month age group, as you're starting to feed them, if you want to feel them foods that are like maybe avocados in the afternoon or in evening, nut butters, things that kind of heavier, more fat and more protein, those take a little longer to digest at least,

Sleep Changes from 6 to 12 Months 9:26

and those might help them to sleep slightly better at night. Foods that high in carbs and sugars, the cereals are basically just simple complex carbohydrates. So rice cereal, oat cereal they actually will kind of backfire typically in terms of letting them sleep longer because they're so sugary they get digested faster, they hungry faster. After 12 months of life they definitely don't need any milk at night and so I would only recommend giving water after a year of age when they wake up and sometimes they are having bad dreams and they waking up scared so just reassure them for the night waking.

Remember that sleeping with your baby is not recommended for the first year of life and actually even the 1st 2 years is when it's the most dangerous and potentially they could suffocate. After 1 year they're allowed to have blankets but they are still not allowed pillows until they age 2 and if you are deciding to co-sleep with you baby around a year co-sleeping and your breastfeeding as well. I find that families who co sleep tend to get worse sleep for much longer, for years and years. Up to age three, four, five, six, the babies are waking up at night.

They're needing that parent to help them regulate, to fall back to sleep. and they're looking for that breast smoke and then the mom's not getting any sleep as well. So if you are co-sleeping after age one and your baby is breastfeeding, you can try sleeping with a tight shirt on and that can sometimes help to curb that nighttime breast feeding so that they get a little bit more sleep. And then just remember no thick blankets and talk to your doctor about how to do it safely after a year of life.

All right, from a Western standpoint, in terms of teaching babies to sleep, We don't recommend crying it out anymore. That used to be something that we would suggest of just letting them cry until they fall asleep. but we don't recommend that anymore because it does cause emotional trauma in babies. So what we recommend now is this graduated or progressive extinction method, and that's where basically you set the baby down and at first, if they start to cry, you can pick them up right away or you could put a hand on them and then pick up, then you progressively lengthen that interval of time before you help them out.

And then also you sort of creep closer to the door as they're falling asleep. So maybe at first, like the first couple of nights, you're right there next to them, and then if they cry you put a hand on them and if that doesn't work you pick them up. And then, a few nights later, put them in their crib and you take a step or two back and maybe wait a couple seconds before putting your hand back on. Then you wait longer amounts of minutes. As you're doing this, they're starting to learn how to regulate themselves and it takes a long time.

It's not going to happen overnight. days to weeks, possibly even months. But it takes a while for them to learn how to fall asleep on their own because they are so used to being on the inside when they're little like that, you know, when their first newborns. So take your time with this and help them learn to how fall sleep and everyone will get better sleep overall. Remember not to use your phone when baby's trying to sleep because the blue light from the screen actually tricks everyone's brain into thinking it's daytime.

even just like the light bouncing off the walls in the room from using your phone in there. can keep your baby awake longer and can trick their brain into thinking that they need to be awake. And so it makes it harder for them to fall asleep. It takes longer for him to follow sleep. So keep you phone off and all the screens off. No TVs in the bedroom, nothing like that. Anything with blue light also. Blue light is like the wavelength that makes your body think that it's daytime. You want to avoid any blue lights in their rooms.

If you want, you can do things like blackout curtains. You can try things, like white noise machines. I find that those types of things can be helpful, but also babies can become pretty dependent on them. And if you're the type of family that wants to travel or if have family members that want to watch baby, it can really be hard to replicate that environment outside of their own bedroom. If your just the kind of type family thats home all the time and they're only going to be staying in this one room for a very long time,

Sleep Training, Routines, and Screen Avoidance 13:40

great. That is a great way to make the environment really optimized for that. And it's okay also to try once in a while to have the black outlines and the white noise machine. But having it just dark enough and maybe an amber colored nightlight or amber light in the hallway even is okay to allow babies to sleep. We don't recommend using melatonin. Melatonine is a hormone that your body naturally produces when it's bedtime and it signals your that it is time to sleep. And you can get melotonin as gummies, as medicine.

It is widely available and I definitely don�t recommend it in babies and children because it�s addictive, it is habit forming. So what that means is you'll need higher and higher doses to get the same effect and then it just stops working completely and also your body stops producing as much melatonin when you take it and so then you get this rebound effect where if you don't give it one night the baby can't sleep. like you become really dependent on it. If you are considering melatonin, I'd say the only time that I would recommend it is if you're traveling and say you've got jet lag, that's a good time to use it because then your body's naturally gonna be producing it at the wrong time of day.

And so you sort of override that by giving the melotonin. But don't give it more than two or three days in a row. You should be used to jetlag by then, and also your bodies starting to kick in and regulate at that time. Yeah, just in very rare instances, if you can think of any other instances where you would just need it for a day or two, but really traveling is the big one where he might want to use melatonin. Outside of that, I'd say don't use it on a regular basis. Any other sleep medicines too, they're all the same.

Benadryl is not recommended because it also decreases the respiratory drive. And so it can make babies stop breathing and it's addictive for older kids and adults and they become dependent on it. All of the sleep medicines that adults have are not recommended for children, again, because of their respiratory suppression and because the addictive effects of it, so yes, if you can avoid all of that entirely, that is the best. And then having a consistent bedtime routine can really help. So what I would suggest for bigger kids, let them run around or play after dinner time.

For little babies, maybe do some tummy time or a little enrichment just playing with them with toys and stuff. And then brush their teeth once they have them. If they're under a year, you can just brush with plain water. Over a years, use a tiny little rice-sized amount of toothpaste. Maybe have a bath after that. Do a little massage with some nice lotion or not. Just dry them off after the bath. Read or sing to them. Keep the lighting low. Use amber lighting if you are gonna have any. And then avoid screens for two hours before bedtime.

Then place them into their bed and you can read to while they're in the bed still or talk to or even just hang out and then progressively get further away and closer to the door. And so over time you're teaching them how to fall asleep on their own. Okay, so that's all the Western stuff. Sorry, that was a lot. From a traditional Chinese medicine standpoint. So I found that with my own child, we did all of these things and it still wasn't really helping. I went to a pediatric acupuncturist. Pediatric acupuncture is called shonishin.

It's where they just tap or press or stimulate points that are along meridians of chi and I can't explain it, but it helped. And I know that Chinese medicine is very old, thousands of years old. It's based on thousands years of observational studies. So it really does help, and it helps a lot with sleep. That was the one thing that got my child to sleep, before we went to the acupuncture, she would consistently sleep from about 10.30 PM. We'd spend like three hours on the bedtime routine. Finally, at like 1030, she would fall asleep and then she'd wake up at five in the morning.

It was horrible and she didn't do naps. When we started doing the pediatric acupuncture, we went in, they just tapped these little points. They put a laser pointer on some of her points, like a red light and a blue light, and I saw her just relax visibly in front of my eyes. I'm like, this is weird. She fell asleep in a car on the way home, then started sleeping consistently from about eight or nine at night, she would fall asleep and then she was sleep all the way until like six thirty or seven in the morning.

So it made a huge difference in my life to take her to that. Also, Chinese herbs can help with sleep.

Traditional Chinese Medicine and Chiropractic 18:18

And so if you go to a pediatric acupuncturist, they can recommend which herbs you can do herbal tinctures. They can even speak to you about like potentially topical herbs, you know, that you could put into like a massage oil to put on their body that will help them sleep so. I'm a huge fan of Chinese medicine for sleep. I found that it helps a real lot. And then I also, I mean, go to an acupuncturist myself. It helps me also to relax and to sleep and when I am waking up in the middle of the night, and I know that I do for an Acupuncture treatment and then that stops happening.

Definitely try to find a pediatric acupunturists that is certified in Xiongni Xin and one that's a DACM, which is a doctor of Acupuncture in Chinese Medicine. All right, from a chiropractic standpoint, that was the other thing that helped us the most. And so a pediatric chiopractor, remember they are very gentle. They will be trained in Webster technique. Some of them can also do craniosacral therapy, which is even more gentle, And the pediatric chiropractic should not involve any twisting or popping.

It really just involves very gentle adjustments where they might use their pinkies or they may use just soft tissue manipulation, which is sort of looks like massage or even just looks running their hands sort next to your baby's spine. And that was the other thing that really helped my child and me to sleep through the night. Chiropractic is built all around relaxing and resetting the nervous system. So going regularly for adjustments can actually really help with sleep. And especially if you have like the sort of racing thoughts or you find that your baby is like talking to themselves before sleep or just making a lot of noise or being really distracted at bedtime, I find the chiropractic can help them to kind of calm down and calm that nervous down so that they can sleep a little bit better at night.

from a nutrition and supplement standpoint. So as I mentioned, eating a dinner high in fat and protein and low in sugar at least two hours before bedtime so that you have time to digest it a little bit, that can help. Magnesium is a supplement that can help with sleep. You want to speak to your doctor about dosing of magnesium, because magnesium's a finicky one. And too much of it, and you just get diarrhea from it. Too little of, it doesn't work. So you need the right amount for your baby's weight.

Talk to you doctor, about docing magnesium. But that's one that really can really help. There's also different types of Magneium too. Again, speak with your Doctor about that. For babies that are over a year old, you can do chamomile tea at bedtime. For baby's who are less than a, if they're breastfeeding, mom can drink chamonile, that will make you both sleepy, just a heads up. So, make sure you are having it at least like two hours before bedtime so that it gets into the breast milk and then baby will drink some of that chamoile or you make some dilute tea, like half strength, no honey in it for babies under a and you give them a spoonful of chamomoile under age one.

This is something we also did with my first one where we would have like tea parties at nighttime and that was really fun for us to kind of, you know, have a little activity together. We'd have our chamomile tea together and then we just like start with the rest of the bedtime routine, like the bath and the brush teeth and all that. And so it's like a nice way to kinda wind down, connect, if that sounds fun. A homeopathy standpoint, so there are a lot of different ones that are thought to be helpful, but remember not fully supported by Western science.

Nutrition, Supplements, Homeopathy, and Aromatherapy 21:38

And you want to careful with the preparations just to make sure that there's nothing poisonous in them. But from a homeopathic standpoint the ones recommended are aconitum nepellus, arsenicum album, belladonna, china aficionalis, chamomile, and calceria carbonica and pulsatilla. Now, Belladonna is the one that I want you to be especially careful with, because a few years ago, there were these teething tablets that contained detectable amounts of Belladauna in them, and Belladanna is poisonous. And there was actually a handful of children that died because of these teething tablets.

If there is any of that active ingredient in there, that can be very, very dangerous. So speak to a certified classical homeopath, Sleep, like many other things, can also depend on a person's constitution and they might need different remedies. Some remedies might actually make them sleep worse rather than sleeping better. So a CCH should be able to help you to choose the right remedy for your child and then also to make sure that it's a safe remedy. From an aromatherapy standpoint, there's actually really good research on this and you can either diffuse oils in a diffuser in the room or you can dilute them in a carrier oil and rub them onto your baby's back or onto their feet.

And remember for younger babies, less than six months, you want to make it really, really dilutes. So like one ounce or 30 mls of oil to a drop or two of the essential oil. And then, you know, it's less and less dilute as they get bigger. And I have instructions for this in Holistic Mama's handbook. But the essential oils can help, either diffused or put onto your baby. The one that we always think about is lavender, right? You know that there's lavender in like all these relaxing things. But for some people, lavender is stimulating.

And that was the case in our family. So I found that the lavender lotions and putting lavender in the diffuser made my kid go wild. That is not always helpful. When that's happening, if your baby doesn't calm down from lavender stuff, You can actually try German chamomile or Roman chamamile. Those are available as oils and they can be diffused or rubbed on and that's what we ended up doing and it helped a lot as well in terms of like just helping wind down at the end of the night. Other oils that could potentially help, neroli, tangerine, and pettigrain, lavender, of course, works for some.

You can try some of these oils, whatever you have on hand, but I'd say lavender and chamomile are the two big ones, usually one of those will work for your baby. or your child. And I like them in a diffuser because then it's just in the room. It's a lot safer versus rubbing it onto their body. You can also potentially put a drop of this oil onto the bedsheets where they're sleeping or onto pajamas and then they'll be smelling it through the night. All right, so, oh my gosh, this is the end of this season and I hope you've enjoyed all of these holistic and alternative care.

I really hope this helps your baby and your child if they are not feeling well and then also yourself. A lot of things can be applied to adults as well. You can check out the Holistic Momma's Handbook on Amazon.

Season Wrap-Up and Show Notes 25:18

I've got all of this and more in that. And definitely stay tuned. We're going to have some future seasons coming up with a lot more exciting stuff, more of the Western things, and stuff for things like your support person, birth partners, I want to speak to some specialists. So we got lots of exciting things planned. Hit that subscribe button. You could go back and listen to seasons 1 and 2 if you have a young baby or a newborn. Season one covers the first year of life, and season two covers ages one through three of live from a Western standpoint.

And also, please leave me a review. I would love it. And follow me on social media if you don't already. We've got some links in the show notes that will go to all of my different social-media sites, the books. There's a link to get some vitamins or supplements. That's my affiliate link, to Get Vitamins and Supplements at 10% off. Everything else can be found in that same place. So go ahead and look at the Show Notes. Have a wonderful day. Thank you so much for listening. Take care. Thank you for listening to the Baby Manual Podcast.

Please hit that subscribe button below so you don't miss the new episodes as they come out. I would also love it if you could leave me a review. You can also follow me on YouTube, TikTok, Instagram, or Facebook for quick tips and tricks that will make you feel like an expert.