SOME IMPORTANT REASONS TO BREASTFEED

Babies who are not breastfed have a increased risk of:

• respiratory infections and ear infections
• gastrointestinal infections, diarrhea, or constipation
• allergies, including food allergies, eczema, and asthma
• iron-deficiency anemia
• problems with jaw and dental development that may require braces or other orthodontic work
• illnesses serious enough to require admission to hospital
• sids (sudden infant death syndrome)
• diabetes
• obesity
• some childhood cancers
• lower scores on intelligence and achievement tests

Sleep & Bedtime

Congratulations on the birth of your new baby. This is a glorious time in your life. Whether this is your first baby or your fifth, you will find this a time of recovery, adjustment, sometimes confusion and frustration, but " most wonderfully " of falling in love.

Babies younger than four months old have very different sleep needs than older babies. This article will help you understand your newborn baby's developing sleep patterns, and will help you develop reasonable expectations when it comes to your baby and sleep.

Read, Learn, and Beware of Bad Advice

Absolutely everyone has an opinion about how you should handle sleep issues with your new baby. The danger to a new parent is that these tidbits of misguided advice (no matter how well-intentioned) can truly have a negative effect on our parenting skills and, by extension, our babies, developmentSumif we are not aware of the facts. The more knowledge you have the less likely that other people will make you doubt your parenting decisions.

When you have your facts straight, and when you have a parenting plan, you will be able to respond with confidence to those who are well-meaning but offering contrary or incorrect advice. So, your first step is to get smart! Know what you are doing, and know why you are doing it.

The Biology of Newborn Sleep

During the early months of your baby's life, he sleeps when he is tired, it's really that simple. You can do very little to force a new baby to sleep when he doesn,t want to sleep, and conversely, you can do little to wake him up when he is sleeping soundly.

A very important point to understand about newborn babies is that they have very, very tiny tummies. New babies grow rapidly, their diet is liquid, and it digests quickly. Formula digests quickly and breast milk digests even more rapidly. Although it would be nice to lay your little bundle down at a predetermined bedtime and not hear a peep from him until morning, even the most naive among us know that this is not a realistic goal for a tiny baby. Newborns need to be fed every two to four hours ~ and sometimes more.

During those early months, your baby will have tremendous growth spurts that affect not only daytime, but also nighttime feeding as well, sometimes pushing that two- to four-hour schedule to a one- to two-hour schedule around the clock.

Sleeping "through the night"

You have probably heard that babies should start "sleeping through the night" at about two to four months of age. What you must understand is that, for a new baby, a five-hour stretch is a full night. Many (but nowhere near all) babies at this age can sleep uninterrupted from midnight to 5 a.m. (Not that they always do.) A far cry from what you may have thought "sleeping through the night" meant!

Here we pause while the shock sinks in for those of you who have a baby who sleeps through the night but didn,t know it.

What's more, while the scientific definition of ,sleeping through the night0/00 is five hours, most of us wouldn,t consider that anywhere near a full night,s sleep for ourselves. Also, some of these sleep-through-the-nighters will suddenly begin waking more frequently, and it,s often a full year or even two until your little one will settle into a mature, all-night, every night sleep pattern.

Falling Asleep at the Breast or Bottle

It is very natural for a newborn to fall asleep while sucking at the breast, a bottle, or a pacifier. When a baby always falls asleep this way, he learns to associate sucking with falling asleep; over time, he cannot fall asleep any other way. I have heard a number of sleep experts refer to this as a ,negative sleep association.0/00 I certainly disagree, and so would my baby. It is probably the most positive, natural, pleasant sleep association a baby can have. However, a large percentage of parents who are struggling with older babies who cannot fall asleep or stay asleep are fighting this natural and powerful sucking-to-sleep association.

Therefore, if you want your baby to be able to fall asleep without your help, it is essential that you sometimes let your newborn baby suck until he is sleepy, but not totally asleep. When you can, remove the breast, bottle, or pacifier from his mouth and let him finish falling asleep without something in his mouth. When you do this, your baby may resist, root, and fuss to regain the nipple. It,s perfectly okay to give him back the breast, bottle, or pacifier and start over a few minutes later. If you do this often enough, he will eventually learn how to fall asleep without sucking.

Waking for Night Feedings

Many pediatricians recommend that parents shouldn't let a newborn sleep longer than three or four hours without feeding, and the vast majority of babies wake far more frequently than that. (There are a few exceptional babies who can go longer.) No matter what, your baby will wake up during the night. The key is to learn when you should pick her up for a night feeding and when you can let her go back to sleep on her own.

This is a time when you need to focus your instincts and intuition. This is when you should try very hard to learn how to read your baby's signals. Here,s a tip that is critically important for you to know. Babies make many sleeping sounds, from grunts to whimpers to outright cries, and these noises don,t always signal awakening. These are what I call sleeping noises, and your baby is nearly or even totally asleep during these episodes. I remember when my first baby, Angela, was a newborn. Her cry awakened me many times, yet she was asleep in my arms before I even made it from cradle to rocking chair. She was making sleeping noises. In my desire to respond to my baby's every cry, I actually taught her to wake up more often!

You need to listen and watch your baby carefully. Learn to differentiate between these sleeping sounds and awake and hungry sounds. If she is awake and hungry, you,ll want to feed her as quickly as possible. If you respond immediately when she is hungry, she will most likely go back to sleep quickly. But, if you let her cry escalate, she will wake herself up totally, and it will be harder and take longer for her to go back to sleep. Not to mention that you will then be wide awake, too!

Help Your Baby Distinguish Day from Night

A newborn baby sleeps about sixteen to eighteen hours per day, and this sleep is distributed evenly over six to seven brief sleep periods. You can help your baby distinguish between nighttime sleep and daytime sleep, and thus help him sleep longer periods at night.

Begin by having your baby take his daytime naps in a lit room where he can hear the noises of the day, perhaps a bassinet or cradle located in the main area of your home. Make nighttime sleep dark and quiet. You can also help your baby differentiate day naps from night sleep by using a nightly bath and a change into sleeping pajamas to signal the difference between the two.

Watch for Signs of Tiredness

One way to encourage good sleep is to get familiar with your baby's sleepy signals and put her down to sleep as soon as she seems tired. A baby cannot put herself to sleep, nor can she understand her own sleepy signs. Yet a baby who is encouraged to stay awake when her body is craving sleep is typically an unhappy baby. Over time, this pattern develops into sleep deprivation, which further complicates your baby's developing sleep maturity. Learn to read your baby's sleepy signs and put her to bed when that window of opportunity presents itself.

Make Yourself Comfortable

I've yet to hear a parent tell me that she or he loves getting up throughout the night to tend to a baby's needs. As much as we adore our little bundles, it,s tough when you,re woken up over and over again, night after night. Since it,s a fact that your baby will be waking you up, you may as well make yourself as comfortable as possible. The first step is to learn to relax about night wakings right now. Being stressed or frustrated about having to get up won,t change a thing. The situation will improve day by day; and before you know it, your little newborn won,t be so little anymore ~ she,ll be walking and talking and getting into everything in sightSumduring the day, and sleeping peacefully all night long.

Your baby's development Week By Week

First Trimester:

Weeks 0-4:

Seven days after the egg is fertilised the blastocyst in your uterus starts to produce human chorionic gonadotrophin (hCG) hormone.

Week 5:

The embryo is now around 5mm long. Little buds form, which will become the lungs.

Week 6:

He's now 10mm long. The first signs of his kidney appear and his hands begin to form at the ends of the arm buds.

Weeks 7-8:

Separate fingers can be identified. The foot plate and external part of the ears also begin to develop.

Weeks 9-12:

During this phase his eyes form, his head and brain grow and his face takes shape. He's around 6cm long. Ovaries or testicles have formed. His jaw and mouth have also formed and tiny milk teeth buds are in place.

Week 13:

The placenta maintains the pregnancy and substitutes for lungs, liver and kidneys.

Second Trimester

Week 14:

Your baby is floating in the amniotic sac. He can hiccup and flex his legs.

Week 15:

Blood vessels are visible under your baby's skin. He grasps the umbilical cord and sucks his fingers.

Week 16:

Your baby's legs are longer than his arms. His skin is covered with downy hair (lanugo).

Week 17:

Your baby is now about the size of a large banana. He measures about 14cm and weighs about 200g.

Week 18:

He makes breathing movements and takes amniotic in and out of his lungs.

Week 19:

Your baby swallows amniotic fluid which passes into his bowels. This meconium will constitute your baby's first bowel movement after the birth.

Week 20:

Your baby is around 15cm long (about the size of a large bunch of grapes) and weighs 400g. Eyebrows and lashes start to grow.

Week 21:

His head and body are now more in proportion. Fat is being distributed under his skin.

Week 22:

His eyelids and ears are well formed. A cycle of waking and sleeping may be established.

Week 23:

Growth now begins to slow as your baby matures in other ways.

Week 24:

He has a strong sense of touch and can feel his surroundings. His hearing is developed and he can respond to music and loud noises. He may recognise your voice and may move when you speak.

Week 25:

His nostrils have opened and he is now practising breathing.

Week 26:

His eyelids may open for the first time.

Third Trimester

Week 27:

The amniotic sac contains about 770ml of fluid and your baby can move about quite freely.

Week 28:

Your baby is about 26cm long and weighs about 900g. His heartbeat is around 120 to 140 beats per minute, about double an adults heart rate.

Week 29:

If your baby is in the breech position, don't worry, he should turn between 32 and 34 weeks.

Weeks 30-31:

Your baby can hear both your own and your partner's voice, despite his watery surroundings. Your baby's tastebuds are now developed and he can distinguish between sweet and sour and bitter tastes.

Week 32:

His eyes are open for some of the time. His skin is covered with a layer of vernix which prevents it from drying out.

Week 33:

His lungs secrete a soapy fluid which keeps them open, ready for breathing.

Week 34:

He's now 32cm long and weighs 2kg. His head should be down, ready for birth, although around four per cent of babies are born bottom first - this is the breech position.

Week 35:

The different parts of the baby can be felt through your tummy.

Week 36:

Your baby is around 34cm long and weighs about 2.8kg.

Week 37:

His head mat have engaged (moved through the opening of the pelvis), especially if this is your first baby.

Week 38-39:

Your baby is now quite plump. There is no longer move for him to stretch out and make big movements, but he can still lift and turn his head.

Week 40:

Your baby is around 35-37cm long, weighs around 3.5kg and is ready to be born.

Newborn - Sleep Patterns

What are the sleep patterns of a newborn?

The average newborn sleeps much of the day and night, waking only for feedings every few hours. It is often hard for new parents to know how long and how often a newborn should sleep. Unfortunately, there is no set schedule at first and many newborns have their days and nights confused - they think they are supposed to be awake at night and sleep in the daytime.

Generally, newborns sleep about eight to nine hours in the daytime and about eight hours at night. Most babies do not begin sleeping through the night (six to eight hours) without waking until about three months of age, or until they weigh 12 to 13 pounds. Newborns and young infants have a small stomach and must wake every few hours to eat. In most cases, your baby will awaken and be ready to eat about every three to four hours. It is not necessary to wake a baby for feedings unless you have been advised to do so by your baby's physician. However, do not let a newborn sleep longer than five hours at a time in the first five to six weeks. Some premature babies need more frequent feedings and must be awakened to eat.

Watch for changes in your baby's sleep pattern. If your baby has been sleeping consistently, and suddenly is waking, there may be a problem such as an ear infection. Some sleep disturbances are simply due to changes in development or because of overstimulation.

Never put a baby to bed with a bottle propped for feeding. This is a dangerous practice that can lead to ear infections and choking.

What are the sleep states of a newborn?

Babies, like adults, have various stages and depths of sleep. Depending on the stage, the baby may actively move or lie very still. Infant sleep patterns begin forming during the last months of pregnancy - active sleep first, then quiet sleep by about the eighth month. There are two types of sleep:

• REM (rapid eye movement sleep)

This is a light sleep when dreams occur and the eyes move rapidly back and forth. Although babies spend about 16 hours each day sleeping, about half of this is in REM sleep. Older children and adults sleep fewer hours and spend much less time in REM sleep.

• Non-REM sleep:

Non-REM has 4 stages:

1. Stage 1 - drowsiness - eyes droop, may open and close, dozing
2. Stage 2 - light sleep - the baby moves and may startle or jump with sounds
3. Stage 3 - deep sleep - the baby is quiet and does not move
4. Stage 4 - very deep sleep - the baby is quiet and does not move

A baby enters stage 1 at the beginning of the sleep cycle, then moves into stage 2, then 3, then 4, then back to 3, then 2, then to REM. These cycles may occur several times during sleep. Babies may awaken as they pass from deep sleep to light sleep and may have difficulty going back to sleep in the first few months.

What are the different alert phases of a newborn?

Babies also have differences in how alert they are during the time they are awake. When a newborn awakens at the end of the sleep cycles, there is typically a quiet alert phase. This is a time when the baby is very still, but awake and taking in the environment. During the quiet alert time, babies may look or stare at objects, and respond to sounds and motion. This phase usually progresses to the active alert phase in which the baby is attentive to sounds and sights, but moves actively. After this phase is a crying phase. The baby's body moves erratically, and he/she may cry loudly. Babies can easily be overstimulated during the crying phase. It is usually best to find a way of calming the baby and the environment. Holding a baby close or swaddling (wrapping snugly in a blanket) may help calm a crying baby.

It is usually best to feed babies before they reach the crying phase. During the crying phase, they can be so upset that they may refuse the breast or bottle. In newborns, crying is a late sign of hunger.

Helping your baby sleep:

Babies may not be able to establish their own sleeping and waking patterns, especially in going to sleep. You can help your baby sleep by recognizing signs of sleep readiness, teaching him/her to fall asleep on his/her own, and providing the right environment for comfortable and safe sleep.

What are the signs of sleep readiness?

Your baby may show signs of being ready for sleep when you see the following signs:

• rubbing eyes
• yawning
• looking away
• fussing

How can you help your baby fall asleep?

Although it is surprising, not all babies know how to put themselves to sleep. When it is time for bed, many parents want to rock or breastfeed a baby to help him/her fall asleep. Establishing a routine like this at bedtime is a good idea. However, be sure that the baby does not fall asleep in your arms. This may become a pattern and the baby may begin to expect to be in your arms in order to fall asleep. When the baby briefly awakens during a sleep cycle, he/she may not be able to go back to sleep on his own.

Most experts recommend allowing a baby to become sleepy in your arms, then placing him/her in the bed while still awake. This way the baby learns how to go to sleep on his own. Playing soft music while your baby is getting sleepy is also a good way to help establish a bedtime routine.

What sleeping positions are best for a newborn?

For many years in the United States, babies have been put to bed on their stomachs. In most other countries, babies sleep on their backs. Research has found a link between sudden infant death syndrome (SIDS) and babies who sleep on their stomachs (in the prone position).

Experts now agree that putting a baby to sleep on his/her back is the safest position. Side-sleeping may also be used, but this also has a higher risk than back sleeping. Other reports have found soft surfaces, loose bedding, and overheating with too many blankets also increase the risk for SIDS. When infants are put to sleep on their stomachs and they also sleep on soft bedding, the risk for SIDS is even higher. Smoking by the mother is also a major risk for SIDS, as are poor prenatal care and prematurity. Since the American Academy of Pediatrics (AAP) made the "back-to-sleep" recommendation in 1992, the SIDS rate has dropped more than 40 percent.

Back sleeping also appears to be safer for other reasons. There is no evidence that babies are more likely to vomit or spit up while sleeping on their back. In fact, choking may be more likely in the prone position.

A task force of The US Consumer Product Safety Commission (CPSC), the American Academy of Pediatrics (AAP), and the National Institute of Child Health and Human Development (NICHD), offer the following recommendations for infant bedding:

• Place your baby on his/her back on a firm, tight-fitting mattress in a crib that meets current safety standards.
• Remove pillows, quilts, comforters, sheepskins, stuffed toys, and other soft products from the crib.
• Consider using a sleeper as an alternative to blankets with no other covering.
• If using a blanket, put your baby with his/her feet at the foot of the crib. Tuck a thin blanket around the crib mattress, only as far as the baby's chest.
• Make sure your baby's head remains uncovered during sleep.
• Do not place your baby on a waterbed, sofa, soft mattress, pillow, or other soft surface to sleep.
• According to the task force report, bed sharing or co-sleeping may be hazardous for babies in certain conditions. The report advises the following:
• Parents should consider placing the infant's crib near their bed for more convenient breastfeeding and parent contact.
• If a mother chooses to have her infant sleep in her bed to breastfeed, care should be taken that the baby sleeps in a non-prone position, soft surfaces or loose covers are avoided, and the bed is moved away from the wall and other furniture to avoid the baby becoming entrapped between them.
• Adults other than the parents, children, or other siblings should not share a bed with an infant.
• Parents who choose to bed share with their infant should not smoke or use substances such as drugs or alcohol that may impair their ability to awaken.

To prevent overheating, the report recommends that the infant should be lightly clothed for sleep and the room temperature kept comfortable for a lightly clothed adult. Avoid over bundling and check the baby's skin to make sure it is not hot to the touch.

Additional research has found that infants should not be put to sleep on a sofa, alone or with another person, as this practice increases the risk for SIDS.

While babies should sleep on their backs, other positions can be used during the time babies are awake. Babies can be placed on their stomachs while awake to help develop muscles and eyes and to help prevent flattened areas on the back of the head.