Archives for May 2014

• The Good
Are all sleep props bad? Absolutely not. Take the pacifier for example: if it is soothing to your child and you are not required to replace it all night, then I say go for it. But the minute you become a human ping pong ball racing back and forth from your bed to your child’s crib to replace a fallen binky – game over. Same goes for the swaddle. In the early months, the swaddle is a lifesaver for many newborns, allowing them to contently sleep for longer stretches before they have the ability to self soothe. However, like the pacifier, its useful days are numbered once your child learns to rollover or starts breaking free. Many sleep props are not a problem unless they become one. The lovey is one sleep prop that I never see as an issue. As long as your child is of the age that it can be safely included in their crib, a lovey is a soothing and comforting transitional item.

• The Bad
Ok so these aren’t truly bad products, they are just products that have potential issues, especially if they are used for too long. Rather than waste your time and money on a temporary fix, you should invest your energy in teaching your child healthy sleep habits that will stay with them for a lifetime. There are so many products that are marketed to parents as the champion of their child’s sleep. Many even deliver on these promises, but often there are consequences. This is a long list, but here are a few: Take Merlin’s Magic Suit for example, I know a good many parents who love this item, LOVE. Here are my issues with it – 1) It is equivalent to wearing a snowsuit to bed, which makes me worry that about overheating. 2) Once your child starts actively rolling and they have the stamina to roll this snowsuit over – what if it doesn’t allow them to roll back or position themselves properly on their tummy due to their restricted range of motion? 3) Part of it’s design is to limit your child’s range of motion and soften their startle reflex, but again that makes it almost impossible for them to move and if you can’t move, how can you learn to self soothe? So once they are out of the suit and have zero self-soothing skills, what then? You are back to ground zero. Or what about a good old-fashioned baby swing? It is a great product for your baby in those early colicky days, but it should never become your child’s primary sleep location. This is for a few reasons: 1) Safety (click here for the AAP swing safety recommendations). 2) The sleep that your child gets in a swing is not as restorative as sleep that happens in a stationary crib. This is because motion during sleep appears to force the brain to a lighter sleep state and reduce the restorative power of the nap. 3) If your child is spending all of his time sleeping in a swing, he is not learning self-soothing skills. Lastly, every heard of the Fisher Price Rock-n-Play? This item has a cult following and it should. Young babies sleep fabulously in it and it reportedly helps with reflux issues. So what’s the problem? Unfortunately there are many. Rather than recreate the wheel, I will let you read the details in full in this thoughtful and thorough blog post by Dr. Natasha Burgert. In short, she states 3 main concerns: According to AAP recommendations on sleep, the Rock and Play is not safe for overnight sleep as it’s bottom is not firm and many models come with pillows. Also, it has been highly documented that the Rock-n-Play is responsible for causing deformities as it does not allow a baby to naturally move about and changes positions in their sleep, instead keeping them secured in just one position. Lastly, it does not allow an infant to learn self-soothing skills. In my opinion, these products are just not worth their risks.

• The Ugly
Ugly? Ok that sounds pretty harsh, but I feel very strongly about this one. There is a current trend to give children melatonin to aid them with sleep. There are even some pediatricians that prescribe it for short-term use to aid children with sleep issues ranging from trouble falling asleep to night wakings. Melatonin is a hormone produced by your brain’s pineal gland and is linked to the body’s sleep/wake cycle, or circadian rhythm. The release of melatonin is stimulated by darkness and suppressed by light. The levels of melatonin in your blood are highest just before you go to sleep. While melatonin naturally occurs in the body, synthetic melatonin is sold as a dietary supplement and FDA approval/regulation of manufacturers is not required. For this reason, there is very little research available on how it may impact children. Melatonin is the only hormone available that does not require a doctor’s prescription. So what’s the problem? In this Wall Street Journal article Stuart Ditchek, clinical assistant professor of pediatrics at New York University School of Medicine explains “I’ve never seen such widespread abuse of any drug or therapy in all my years of practice”. One mother told him that “she lines up her six healthy children nightly to give them their melatonin pill.” Dr. Ditchek believes the supplement should only be used for the most serious sleep and neurological disorders. Why? Because although there have been very few studies on melatonin and children, one thing we do know is that melatonin appears to impact sexual maturation. On the National Institute of Health’s website they warn: “Melatonin should not be used in most children. It is POSSIBLY UNSAFE. Because of its effects on other hormones, melatonin might interfere with development during adolescence.” I know that it may seem like a quick and easy fix to just give your child a pill and “poof” their sleep issues magically disappear, but with so much still unknown about its impact on children I implore you to steer clear. Instead, figure out the underlying cause of your child’s sleep issues and make a solid effort at improving what ever the cause may be. As West Hartford Pediatrician Dr. Tom Fromson says in this nbcconnecticut.com article, “As a routine medication to help a child sleep, I think I should first have a better understanding of why [the] child is having trouble sleeping.” He strongly recommends “examining bed time routines, exposure to bright screens, exercise and diet before taking melatonin”. And if this isn’t enough reason for you to not give this supplement to your child in lieu of implementing healthy sleep hygiene, I think Dr. Ditchek from the above WSJ article says it best – “For thousands of years our children have been falling asleep without the need for pills. Giving your healthy child a pill to fall sleep is sending him the wrong message—that he needs a pill to do what should come naturally”.

The Tip Take-Away: As parents, we are bombarded with products aimed at helping our children sleep better. The key is committing the time and energy to provide your child with a strong foundation for healthy sleep. If along the way, you use an occasional sleep prop – so be it. As long as your child learns to become an independent sleeper, you have done your job.