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23.12.2014

Sleep issues 15 month old, tinnitus expert dr geoff barker - Review

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By the seventh month of pregnancy your baby will start to dream as their brain is now developed enough to partake in REM (rapid eye movement) sleep (Murkoff 2009). During REM sleep, muscular impulses in the foetus are not blocked as completely as they are in children and adults, so the foetus has some ability to practice actual body movements. At this point, the gestational age of your child would determine the sleep patterns or lack thereof. If your baby was born early he will probably sleep his way through the days until he comes to his due date, when he may suddenly wake up and you wonder what happened. Sleep is very erratic at this age and doesn't follow a pattern because basically the newborn's brain is still maturing.
If you watch your newborn while she is sleeping you will notice that there are times when, under her eyelids, her eyes flick frantically from side to side and she may frown, flutter suck, or wriggle her fingers and toes.
Your baby will spend half of their sleeping time in REM sleep, whereas you (as an adult) spend only a quarter of your sleeping time in REM (Friedman and Saunders 2007). Your newborn sleeps in cycles of around 50 or 60 minutes of REM (dream) and non-REM (deep) sleep. Towards the morning the proportions of non-REM and REM reverse, so that much of your baby’s early-morning sleep is REM (Sears 2009). A baby sleeping bag is a safer alternative to traditional sheets as your baby cannot wriggle under them; however, during these early newborn weeks it can be effective to use a sheet and blanket, as this helps your baby feel more secure when he is tucked in snugly.
During these early weeks your baby shouldn’t go for more than six hours between feeds at night and three hours between feeds during the day (La Leche League 2006), so wake her up if she has slept for this long. Your newborn sleeps an equal amount of time during the daytime (8 hours total) and nighttime (8 hours total). By now, feeding will have become established, and hunger is likely to drive your baby’s sleep-wake cycles.
After the growth spurt you are likely to find that your baby has a period where she sleeps longer (Lampl 2011). You may be tempted to introduce formula in the hope that it will help your baby to sleep through the night. At this stage, most mothers survive on an average of three and a half hours’ sleep a night (McLaughlin 2009). Your baby will now be more aware of her surroundings and won’t sleep quite as effortlessly as he did when he was newborn. The average number of hours of sleep your baby currently needs in the daytime is 7 and in the nighttime is 9 (Hames 1998). Nonetheless, your baby will sleep for longer periods than she did before, so that instead of one or two hours, she may be able to sleep for three or four.
Some believe that the earliest your baby will be physically capable of sleeping through the night without a feed is around now (Laurent 2009). After the growth spurt you are likely to find that your baby sleeps longer for a day or two (Lampl 2011). It’s a myth that you need to get your baby on a strict schedule from the get go, and doing so may be dangerous because his body is not developmentally ready to wait several hours between feeds or sleep periods. Towards the end of this month, at around twelve weeks, the morning nap should start to fall into place, lasting about one to one and a half hours and occurring around the same time each day (West 2010). For the majority of babies, one or more night wakings will still be a feature in this second month (Smith 2007). There are no bad habits at this age; your baby legitimately needs your help, so feel free to rock, feed, bounce, or walk her to sleep. The average time for a 2 month old to be put to bed for the night is 9:51pm (National Sleep Foundation 2004).
After the growth spurt you are likely to find that your baby has a period where he sleeps longer. Your baby will need about 14 to 15 hours of sleep per 24 hours but now much more of this is night sleeping (about 11 hours), with about three and a half hours of daytime naps.
Production of melatonin, a hormone that promotes sleep by relaxing our muscles and making us drowsy, begins around now (West 2010). Up until now your baby has experienced a phase of REM sleep at the beginning of each sleep cycle. Some researchers believe at this age your baby should be confident sleeping without your nighttime assistance for more than just an hour or two (Smith 2009).


Your baby’s naps are becoming a little bit longer and there are blocks of time around the clock where sleep happens regularly. Between now and 6 months, most babies will begin to sleep through the night (defined as five consecutive hours) (Friedman and Saunders 2007; Pantley 2009). Despite what you may hear from well-meaning friends that you should get your child into a sleep schedule, follow your child’s lead, and allow him to sleep when he wants to sleep and feed when he wants to feed. At three months of age, 46% of babies are still waking their parents regularly through the night (Scher 1991). By now, most babies will sleep 12-14 hours out of 24 and for twice as long at night (8-10 hours) as during the day, although this will not be unbroken if your baby is still waking for feeds (Laurent 2009; Welford 1990). Your baby will have a relatively peaceful block at the beginning of the night, but from the early hours onwards, sleep becomes much lighter and more fragile overall (Grace 2010). Some studies suggest that the longest stretch of unbroken sleep your baby is capable of at this age is 6.8 hours (Huang et al 2009). By 4 months, your baby has entered a significant cognitive milestone; her brain is going through an enormous growth spurt, which accounts for all of the increased alertness and distractibility.
When your baby was a newborn, deciding when to put her down for the night was as easy as watching for the signs of sleepiness she gave such as crying, yawning or rubbing her eyes. Your baby needs to sleep 3-4 hours during the day usually in three naps: a morning nap, an early afternoon nap, and a short nap before dinner (Friedman and Saunders 2007).
Some sources suggest that for a five-month-old baby, staying awake for 3-4 hours before going to sleep through the night is ideal (Skula 2012). At this age your baby will begin having shorter REM periods of sleep and longer non-REM (Sears 2009).
According to some sources, your baby is now physically capable of sleeping for up to 12 hours at night uninterrupted and without milk (Cave and Fertleman 2012).
The average 6 month old still wakes two times a night (Cooke 2009) for an average of 23 minutes each time (Teng et al 2012).
Your baby will usually nap two to three times a day and then sleep for 10 to 12 hours at night, though not always continuously. The risk of SIDS is reduced significantly by 6 months, likely related in part to a baby’s ability to roll herself over and lift her head effectively and also to the fact that she is more neurologically mature. The Foundation for the Study of Infant Deaths recommends that your baby shares your bedroom for the first six months, so she can now be moved to her own bedroom if you wish.
Some connection between sleeping and eating remains, but the link is not as strong as it was. Don’t be alarmed if you see your baby start to adopt strange sleeping positions, even curled up on his stomach with butt in the air and head to one side. It’s dark, warm, quiet, and when you walk or move about, your baby is rocked to sleep. The kicking and poking sensations that you can feel are often movements made during sleep (Pantley 2009). In REM sleep, the higher centres of the brain receive stimulation from deeper, more primitive areas.
Then from 6-8 weeks you can change to using a sleeping bag as your baby develops more mobility.
However, some babies, especially those who had a difficult or traumatic birth, or preterm babies, may continue to be sleepy most of the time for longer than the first two or three days (Fredregill 2004). He will sleep for 2 to 4 hours, wake with a cry, feed, then be awake for 1 to 2 hours, and settle back to sleep (Friedman and Saunders 2007). That means she goes into a state that looks like sleep but is actually just a way of shutting everything out.
His sleep patterns will settle in time, but they will take longer than other babies (Johnson 2005; Pantley 2009).
About 20% of babies get colic, which can last for three months or longer (McLaughlin 2009). Each day may be completely different from the previous one, and imposing a rigid sleeping pattern on your new baby will not work.
Also bear in mind that the ability of your baby to produce cortisol in response to stress is greatest during these first few months of life, thus sleep traing would keep them awake even longer (Larson 1998).
If you’re BFing, take comfort in the knowledge that nursing triggers hormones that will help you and your baby resume sleep after each feed.


The usual scenario is that they drop a feed between 12am and dawn so they sleep through from an hour or so before midnight to six or so in the morning. Consequently, she may start waking at night or taking short naps – even if she was previously a great sleeper. However some sources suggest that your baby is unlikely to need more than one night feed at 4 months (although she may want them), unless she was born prematurely and your doctor advises it (Laurent 2009). Although it can be a wonderful tool for helping babies to sleep up until this age, it ceases to work well as babies become increasingly mobile. If you’ve kept your baby in your room with you for the recommended six months and have decided to move her into her own room, allow her whatever time she needs to get used to this arrangement before starting any kind of sleep training. If your baby has started eating solid food, she should have this meal at least an hour or two before going to sleep at night. At seven months, your little one still needs 12 to 14 hours of sleep per 24 hours to aid the maturing of his growing brain and body, so a couple of daytime sleeps are still necessary to make up the full quota. This awakening is likely to be a sleep arousal, an event that occurs every 60 minutes or so during sleep. He may suddenly become difficult to settle and get upset when you leave him to go to sleep. Anything from 18 months onwards is about the right age to consider the transition.RoSPA also warns that bunk beds can pose a hazard to children under six years of age where entrapment (becoming wedged or trapped in the bed) can lead to strangulation, suffocation and injury to the neck or spine.
As a consequence of these factors, your baby seldom has difficulty falling to sleep (Holland 2004). Wakefulness in the first few hours after birth, followed by a long stretch, often up to 24 hours, of intermittent sleep, is the normal newborn pattern. So for example, if your baby was born 3 weeks early then at 1 month your baby would be 1 week old.
Unlike adults and older babies, newborns fall directly into REM sleep, a pattern that continues until they are around three months old. Sleeping patterns vary from baby to baby, and the evidence on sleeping through the night shows no difference between breastfed and formula-fed babies (Rosen 2008; Quillin and Glenn 2006).
Over the fourth and fifth months, melatonin secretion rises and non-REM sleep increases, meaning your baby sleeps more deeply than she did as a newborn.
In addition, babies 4 months and older tend to burst out of the swaddle in the middle of the night, which means it also becomes a safety hazard.
This is because her sleep-wake cycles are becoming less dependent on hunger: as her stomach capacity grows, she can go longer without needing to feed. However whilst teething can interfere with sleep, it does so far less than many parents anticipate or believe. Bear in mind that most sleep therapists recommend that you wait until your baby is 12 months old before you attempt any sleep training which involves leaving your baby to cry (Hames 1999). Allow your baby the opportunity to put himself back to sleep before going in to check on him. At night, she may be sleeping for longer stretches, typically up to four hours at a time, sometimes longer towards the end of the second month (Grace 2010; West 2010).
The first sleep through is often a big surprise to parents, especially the breastfeeding mother who will have exploding melons. She will probably respond well to routine at this stage, and enjoy the rituals of preparing for her night-time sleep.
To ascertain how much sleep disruption stems from your baby’s teeth, compare day with night behaviour. You could try moving his lunch forward a little so that he has his afternoon sleep a bit earlier.
This timeline, collated through years of research, will outline these typical sleep patterns.
It will explain what sleep behaviour you can reasonably expect of your little one at each stage of their development.




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