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The role of the Registered Nurse or Newborn Care Provider is to feed, soothe, bathe, change & provide all other gentle care to baby through the night.

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Top 3 Infant Sleep Myths

We hear them at playgroups and baby showers, see them on message boards and read them on medicine bottles.  Parental Urban Legends add more confusion to new parents’ already overloaded brains and with no basis in fact, they persist like Mikey and Pop Rocks.  Here are our Top 3 Infant Sleep Myths and solutions that work better:

Top 3 Infant Sleep Myths from night nannies
Parental Urban Legends

Myth #1. Putting rice cereal in baby’s bottle will help baby sleep longer

There is absolutely no evidence that shows that thickening milk or formula with cereal will make baby sleep longer at night.  In fact, the most cited study on this topic, heartily disproves this parental urban legend.

In our desperation to “tank baby up” and buy an extra hour of rest, it’s often thought that a fuller stomach = more sleep.  This is true when we give baby milk before bed to ensure that s/he doesn’t wake unnecessarily from hunger, but the addition of rice cereal to thicken a feed does not help baby sleep longer.

There is also a very real, evidence based movement to completely remove rice cereal from babies’ diet but that is for another post.

Why it’s become a parental urban legend:  When parents introduce rice cereal in baby’s bottle, it is typically at the 8-12 week mark, when parents are at their wits end with getting up 3-4 times overnight.  The fact is, baby is naturally sleeping longer stretches at this time anyway.  Thickening formula receives the credit for what baby is doing naturally.

What to Do to Help Baby Sleep Longer: Time is the real answer to allowing babies to sleep longer stretches at night as the more baby grows, the more food their tummies can hold, keeping hunger from naturally waking them. But there are a few things that actually help newborns and infants sleep more soundly:

Myth #2. Mylicon will Eliminate Gas and Soothe your Baby

This myth is near and dear to my heart because like so many, I desperately believed it myself with my own 3 kids.  Study after study definitively demonstrate that Simethicone (the generic name for gas drops) is no more or less effective than a placebo.   What does this mean? Gas drops don’t work.  Period.

Why it’s become a parental urban legend: EVERYONE recommends Simethicone drops.  Everyone! They even have their own little section in the pharmacy department.  Once again well-meaning parents just want to help baby find some relief.  Please try to contain your shock when I tell you this, but marketing companies love to capitalize on “soothing baby” so they sell, sell, sell a harmless but useless product.

And once again it’s you and your baby who should receive the credit for getting that uncomfortable gas out of baby’s tummy.  Slow patient feeds, lots of burping and gently switching position or massaging baby to get gas out after feeding are tried and true ways to reduce gas.

What to Do to Help Eliminate Gas – While drops certainly can’t hurt there are several other options to help baby work out the gas that’s causing troubling:

  • Bicycle Kicks –like this!
  • Once again, slow feeds with lots of opportunity to burp during feeding. If bottle feeding, use the slowest nipple flow.
  • Probiotics – Probiotics to promote good gut health in baby may be recommended by your pediatrician.
  • When starting solids, give new foods for breakfast, this way baby’s system has all day to work out any issues that the new food might be causing…and by issues we mean gas! 🙂

Myth #3. Putting babies to sleep later at night means they’ll sleep later in the morning

We’ve all done this one.  According to pediatric sleep specialist, Dr. Lisa Meltzer, “the internal clock is a powerful force that typically wakes young children up around the same time every morning, no matter what time they go to sleep at night.”  This means that putting baby to sleep later robs them of sleep they should be getting.  Even worse, poor night sleep adds to the overtired cycle the next day, making it more difficult for baby to settle and rest again.

Why it’s become a parental urban legend: Because staying up late and then sleeping late seems so logical!  And we are desperate for sleep AND logic at this point! Sure there are times babies have a big day and sleep for long stretches out of sheer exhaustion, but this gives us a false positive.  Keeping baby awake longer than their bodies need may work for one night or one nap, but fighting against baby’s natural rhythms leads to true exhaustion and meltdown.

What You Can Do Instead– Unfortunately, we can’t fight a baby human’s natural body clock; this one goes in the “this too shall pass” category. Taking turns with your partner or a loving caregiver to handle early wake ups won’t cause baby to sleep later but it will help YOU to sleep later!

What Parental Urban legends can you add? Let us know on Insta!

Sample Sleep Schedule for a 6-7 Month Old

We’re often asked about “Getting Baby on a Schedule” here at LMS.  While baby’s routine is something that naturally emerges if we follow baby’s lead, it’s understandable that the rest of the family can benefit from predictable feeding and sleep times.    Below is a sample schedule for a typical 6/7 month old baby.  This is by no means the *only* schedule, and it’s certainly not the best schedule for everyone but if you are looking for a starting point, the Sample Sleep Schedule for a 6-7 Month Old template below is one we often use in Sleep Consultations.

helping your 6-7 month old infant sleep through the night
Sample Sleep Schedule

Sample Schedule for a 6 to 7 Month Old 

6:00am:  wake up, play and cuddle

6:30:       diaper change, get dressed, feed 6-8 ounces when baby is exhibiting signs of hunger; this can beright at wake up or after 1/2 hour or more.

8:00:       breakfast of solids: oatmeal + fruit. Give as much as s/he wants. ***Remember that any milk used to make oatmeal counts toward daily ounces. 

8:00 – 9:00:  Play

9:00 – 9:30: quieter play and wind down activities such a cuddling and books. Look for sleepy signs such as eye rubbing or disinterest in toys.   If you have trouble seeing those “sleep cues” a good rule of thumb is to place baby in the crib, after you see 1 yawn. 

9:45/10–11:00:  Nap        

11:00                   milk, 6-8 oz

12:00                   solids: grain + veg, ***top off with milk

12:00 – 1:00        activity (having a meal or snacks counts as an activity)

1:00pm – 1:30pm: wind down for nap

1:30 – 3:30:           nap

3:00:                     milk, 6-8 oz

3:00 – 5:00           activity

5:00                      dinner of solids

6:15 – 7:00           bath, milk 6-8 oz , quiet activities, low lights and in bed at 7ish

10:00p                    dreamfeed several ounces if needed to ensure she’s reached about 28 ounces. A dreamfeed is one last feed for baby.  This may not be needed at 6/7 months but we’re including it as another tool to help take away the question “What if s/he’s hungry?” when baby wakes overnight.  To do a dreamfeed, simply place breast/bottle to baby’s lips and s/he will instinctually take in what’s needed.  Do a quick diaper change at this time as well.

Things to remember:

– THIS IS JUST AN EXAMPLE.  It is FINE if your schedule differs and we should never force baby into a schedule that doesn’t work. The goal here is to give baby a start and end to the day with efficient feeds during daytime hours to set the stage for long sleep overnight.

– We are just using 6:00am as a starting point. If baby wakes earlier or later, simply adjust the schedule accordingly.

Sources:

Natasha Pressley, RN and the University of Maryland Pediatric Sleep Center

Secrets of The Baby Whisperer”,  Melinda Blau and Tracy Hogg

The hundreds of babies our nurses and NCP’s have cared for from 2010 to the present.

tummy time for infant

12 Holiday Activities to Do with Baby

You’ve been to Target to look at toys, decided if you’re going to be an “elf on the shelf” family and started cooking traditional holiday foods. Here are 12 Holiday Activities to Do with Baby to keep the holidays going that you may not have thought of!

1)   Make a Child-Sized Holiday Light Display! All you need is a large box and some LED lights that can’t get too hot! diyjoy.com calls this a Cave of Stars! We love this because it’s a great activity for siblings to do together and you probably have all the items on hand already!

happy infant playing in a cardboard box
Cave of Stars via diyjoy.com

2)   Read holiday themed board books: Whatever holiday you celebrate, there is a board book about it! And the holidays are the perfect time to learn about other cultural traditions too! Babies are never too young for books or learning about the world!

3)   Drive or stroll around to view decorations and lights:  Babies love to look at lights! Whether you go to an organized festival of lights or simply stroll or drive around your neighborhood, the light show will fascinate baby! Many towns have holiday light shows where you never leave the car too. Let baby experience the magic of lights BONUS: time your ride for an hour or so before bedtime for an easy wind-down!

4)   Sing holiday songs to your baby: Baby doesn’t care that you’re not a finalist on The Voice.  Belt out some traditional tunes. If baby is old enough, add some instruments and shakers and have baby play along.

5)   Buy special holiday or winter themed pajamas: Get cute and cozy with seasonal pj’s for your little one. Bonus points if the whole family has matching pajamas!

6)   Create a keepsake such as a plate or ornament: Commemorate this special milestone by capture his/her little handprint or footprint on a plate or ornament. Many paint-your-own pottery places offer these in studio or buy a take-home kit at a craft store, baby store, or online. 

7)   Use edible finger-paints to make a holiday craft: Crafts and holidays go hand in hand, but many of the materials on the market are not safe when digested.  We are huge fans of natural, edible fingerpaints which contain ingredients that are baby-safe, organic, vegan and have no wheat, sugar, or preservatives. Plus, they are made with real fruits and vegetables!

8)   Create a holiday themed sensory table/tub: Place wrapping paper, bows, a soft snowman in a big tub, and let baby touch, rub, shake, and play with the items to build tactile development and fine motor skills.

9)   Make a holiday felt board: Make or buy a felt Christmas Tree, Snowman, Menorah, or other holiday themed feltboard, and baby can safely “decorate the tree” or “light” some candles. There are a lot of fun options on Amazon! Bonus: Play, sing, and talk to baby using a holiday-themed puppet!

10) Have an indoor snowball fight! That’s right…a bucket of plush white “snowballs” can’t hurt anyone or anything in the house. At less than $20 this fun toy is a great investment in laughs and memories for years to come.

11)  Start the tradition of giving: Even though baby is too young for an American Express card, give special gifts in baby’s honor to friends and family members.  Teach your infant the joy of giving.

12)   Facetime/Zoom relatives and friends that are far away. Looking at pictures on Facebook is nice, but those who are far away really want to see baby in action.  Set up a computer date and share some special conversation!

12 Holiday Activities to Do with Baby

The Four Month Sleep Regression Explained

Registered Nurse Pam Jones has been helping new babies and parents since 2009. We collaborated with Pam on The Four Month Sleep Regression Explained, to help parents and nannies understand how to help baby sleep peacefully during and after this milestone.

In order to understand what’s happening to your baby during this stage, we first need talk about sleep in general:

The 4 Stages of the Sleep Cycle

Many of us just think of sleep as an on-or-off situation. You’re either asleep or you’re not. But sleep actually has a number of different stages, and they make up the “sleep cycle,” which we go through several times a night.

  • Stage 1 is that initial stage we’re all familiar with where you can just feel yourself drifting off, but don’t really feel like you’ve fallen asleep. Anyone who has ever seen their partner nod off in front of the TV, told them to go to bed, and gotten the response of, “I wasn’t sleeping!” knows exactly what this looks like.
  • Stage 2, considered the first “true sleep” stage. This is where people tend to realize, once woken up, that they actually were sleeping.
  • Stage 3 is deep and regenerative. Also known as “slow wave” sleep, this is where the body starts repairing and rejuvenating the immune system, muscles tissue, energy stores, and sparks growth and development.
  • Stage 4 is REM (rapid eye movement) sleep. This is where the brain starts to kick in and consolidates information and memories from the day before. It’s also the stage where we do most of our dreaming.

Once we’ve gone through all of the stages, we either wake up or come close to waking up, and then start over again until morning.

The Four Month Sleep Regression Explained for newborns and infants
The Four Month Sleep Regression Explained

The Four Month Sleep Regression Explained

Newborn babies only have 2 stages of sleep; stage 3 and REM, and they spend about half their sleep in each stage. At around the third or fourth month, there’s a reorganization of sleep, as they embrace the 4-stage method of sleep described above. Here is the Four Month Sleep Regression Explained.

  • REM and Waking Up – When the change to the 4 stage method of sleep takes place, baby moves from 50% REM sleep to 25% in order to make room for those first two stages. Although REM sleep is light, it’s not as light as the 2 new stages of sleep they’re getting used to. With more time spent in lighter sleep, there’s more of a chance that baby will wake up.

Waking up is absolutely natural, and we continue to wake up three, four, five times a night into adulthood. As adults however, we’re able to recognize that we’re in bed and safe and we go back to sleep. This usually happens so quickly that we don’t even remember these brief encounters with consciousness.

A four month old baby, of course, lacks these critical thinking skills, and to a baby who’s fallen asleep at the breast for example, waking up alone in a different location can be jarring! Baby most likely will not go back to sleep without a significant amount of reassurance that everything is OK.

What About Pacifiers?

  • Pacifiers and Soothing – The other major contributor to this 4 month regression, is that up until this point, baby is used to going to to sleep with a pacifier, or by being rocked or breastfed. These are all perfectly appropriate for newborns. At 4 months however, baby may need new ways to get back to sleep after the initial nodding off because more time is spent in light sleep with higher probability of waking up. Pacifiers and the like are appropriate in the newborn stage and in helping baby initially nod-off, but the lack of a pacifier or being rocked when they wake up means that baby’s not able to get back to sleep again without this “outside help”. Cue the fight-or-flight, the crying, and the adrenaline…

The good news for anyone experiencing Four Month Sleep Regression is that it’s not, in fact, a regression at all. Regression is defined as “reversion to an earlier mental or behavioral level,” and that’s actually the opposite of what your baby is experiencing! This would be much more aptly titled the “Four Month Sleep Progression

Pam Jones, RN

What you can do to help your little one through the Four Month Regression

  • Baby’s room should be dark… – Newborns and infants are not afraid of the dark. They are, however, responsive to light. Light tells their brains that it’s time for activity and alertness, and the brain secretes hormones accordingly, so we want to keep that nursery absolutely pitch black during naps and bedtime.
  • And quiet – The other nemesis of sleep is noise. With more time spent in lighter sleep, noises can startle baby awake so white noise is a great addition to your nursery.
  • Instill a Bedtime Routine – Bedtime routines should be about 20 – 30 minutes long, and baby should go into their crib while they’re still awake. Feeding should happen first with songs, story (or whatever calm activity baby likes!) and getting into PJs at the end. Feeding shouldn’t happen at the end of the bedtime routine because baby might nod off at the breast or bottle. This creates an association with feeding in order to sleep that parents can’t continue to do every time baby wakes up.

Four month old infants typically go about two hours between snoozes, with bedtime between 7 and 8 at night. Once babies graduate from the four month sleep progression, they follow the sleep patterns they’ll have for the rest of their lives…four glorious stages repeated multiple times a night!

Of course, some kids are going to take to this process like a fish to water, and some are going to be a little more resistant. If yours falls into the former category, count yourself lucky! For those of you in the latter camp, Pam Jones, RN is here to help. You can contact Pam at www.sweetdreamslittleones.com or 708-822-0059 for a personalized program for your little one.

6 Easy Tips to Help Your Reflux Baby

updated, November 12, 2023 – To help newborns and infants with reflux, we need to first understand what reflux is and then find comfort techniques.  Reflux is a backward flow of the contents of the stomach into the esophagus that causes heartburn. Our team of night nannies presents advice to help here, with 6 Easy Tips to Help Your Reflux Baby.

  1. Keep baby elevated
  2. Burp frequently
  3. Small feeds
  4. Try paced feeding
  5. Coleif drops
  6. Wear your Baby

Reflux is one of the most common conditions newborns face and is often caused by the esophageal sphincter valve not being fully developed. This causes milk to come back up the esophagus through the throat and causes baby to spit up and vomit. Reflux can be upsetting, alarming, and painful to our babies! When the contents of the stomach come back up, it is usually mixed with some stomach acid, which creates a burning sensation.

While the only true remedy for reflux is time, there are some techniques to help keep your baby comfortable during and after feeding.

6 Easy Tips to Help Your Reflux Baby

6 Easy Tips to Help Your Reflux Baby:

1. Keep your baby elevated while feeding. Whether breastfeeding or bottle feeding, use a position that keeps baby’s head higher than their stomach. Gravity helps hold contents in the belly, and reduces the amount of spit up. Also, be sure not to place your baby in a spot where they can easily slide down because this could put pressure on the belly and force contents back up.

2. Burp frequently during feeding.  As you might have guessed, burping helps keep air out of the belly so try to minimize those air bubbles. Air or gas can force milk back up the esophagus, causing pain and discomfort.

3. Have smaller and more frequent feedings.  When baby is too full, the full tummy can put pressure on the sphincter valve forcing baby to spit up. This can lead to pain and possibly choking, so slow, smaller feeding sessions are recommended.

If you’re breastfeeding, La Leche League recommends trying to have baby nurse at one breast only at each feeding. This avoids two strong milk ejections, therefore reducing overfeeding and excess swallowing of air. Also, leading sources in breastfeeding including LLL and KellyMom agree that in general spicy foods do not contribute to infant reflux.

4. Pace Feed.  For bottle fed babies, conventional thinking tells parents to keep the bottle nipple full of milk or formula. This way air doesn’t get into the nipple and then into your newborn or infants tummy. However, the technique of paced feeding has shown to be more effective in minimizing reflux and pain. As Jordan Stubblefield, CLC and owner of Let Mommy Sleep Central New Jersey says, It’s not so much air intake as it is pacing the baby! Pace feeding helps to not overfeed by allowing baby to take breaks when they want, and following babies cues.

Here’s how to pace-feed:

  • Keep baby in a slightly reclined position so that the bottle isn’t pouring down and your baby can control the flow of milk/formula.
  • Let baby pull the nipple into his mouth. Once latched, keep the bottle just above horizontal.
  • Continue feeding this way. This allows baby to control the flow of milk better without taking in air. This also helps your baby to feed at their own pace, which keeps them more comfortable.

5.  Try Coleif drops. Some babies have reflux not only due to immature sphincter valves, but because they have trouble digesting lactose in milk. This can lead to bloating, gas, discomfort, and a lot of crying.  Coleif is a natural lactase enzyme that helps to break down lactose in an infant’s breast milk or milk-based formula. (not sponsored, just like the product!)

6. Wear Your Baby! Carrying baby in an upright carrier helps gravity do its job by minimizing the amount of liquid flowing upwards. Less liquid = less pain. Baby wearing also reduces muscle tension in baby as they can completely relax when being snugly carried by you.

this is an artist’s rendering, it doesn’t show safe sleep

Is Reflux More Common in Preemies and Twins?

The only cure for reflux is time, as newborns and infant systems may need a few months to fully develop. Because twins are often born prematurely they have a higher risk of experiencing GERD or reflux. Additonally, preemies who have spent time in the NICU may have other issues compounding digestive challenges.

For more tips on keeping baby comfortable check out 10 Ways to Calm a Fussy Baby. You can also ask our team of night nurses and postpartum doulas any questions on Instagram!