Breath holding in young children.

Young children who have limited language and cannot easily express their frustration in other ways, sometimes do so by breath holding. This is very alarming for the parents. The child may be crying and then stop suddenly, turn an unusual blue-grey colour, and flop back. This lasts only a few seconds but results in parental panic.

Children do and will grow out of this and as it becomes less effective it is used less. Limits must still be set and maintained but, recognising a child's frustration, and distracting them before they have the opportunity to hold their breath and scare the adult can be very effective.

This behaviour occurs in about 5% of infants and toddlers up to about age 5 -- children aged 1-3 are particularly at risk . This behaviour is usually associated with a need for attention, to express emotion or, in rare cases, to indicate an underlying medical condition. Breath holding is recognised as attention seeking behaviour which occurs when a child is extremely upset and has not learned other, more socially appropriate ways to express themselves.

Shock or surprise can also induce breath holding in very young children, exacerbated by, or as a result of accompanying crying or hyperventilating. However, most breath holding spells do not last longer than a few seconds. As soon as the child passes out, the respiratory centre in the brain kicks in and breathing returns to normal.

Breath holding can be associated with medical conditions such as seizure disorders, anemia or, rarely, cardiac disorders, and parents may want to rule out these conditions after their child's first breath holding event. At this stage children are rapidly evolving beings and medical problems can be expressed at this time.

Without a solid underlying problem resulting in breath holding, there is little treatment available. Children grow out of behavioural problems such as breath holding as they learn to express themselves in more sophisticated ways. If the breath holding is purely behavioural and parents fail to respond to these events with attention, the behaviour ceases.

When you give children lots of positive attention in other ways, it decreases the amount of time the child can use to obtain attention in a negative way. If the child is in a safe place and not going to fall off a table or chair, then you really just have to ignore it.

Daytime napping

When a child is born most of the day is spent in sleep. During sleep the brain is growing and although asleep the child is seldom completely quiet. During the first three months it is not usually difficult to settle an infant. As long as the infant is fed and comfortable sleep will usually follow.

Children who do not settle quickly and easily at this stage often have reflux to some extent, or are victims of "colic". Reflux should be treated, as the issues this causes are often prolonged and difficult to resolve otherwise. Colic usually peaks at 3/4 months and is seldom an issue after that time, with the notable exception of children who have allergies to lactose.

Children need to have regular daytime naps. At first three scheduled naps during daytime until they are about 6/7 months when two naps making a total daytime sleep of 4 hours is the goal. When night sleep is disturbed some parents think that removing a nap time will increase night sleep. Unfortunately this is far from the case. If daytime naps are reduced the child is too tired to settle properly at night so night waking may become more frequent.

By the 6/7 month stage baby should be sleeping through the night for 10 hours and having two naps, the second of which should be completed by 3/3.30pm if the child is on a "wake at 7am bed at 7pm" schedule.

Working on improving daytime naps is easier on parents who are more awake and more patient during the day, and has a knock on effect of improving the child's night sleep, which is easier for parents too.

By 3 years of age one single 1 hour nap is enough and by 4 years most children no longer require naps. As daytime naps reduce night sleep should be slightly longer and eventually even out at 10-11.5 hours.

If you need help to resolve your child's sleep issues, Contact Dream-Angus.com

Pacifiers/Dummies

Sucking is a soothing thing for most babies so many mums use pacifiers from birth. This is soothing and comforting for baby and can work really well in calming a fussy baby/child. While there is definately a place for these, too many babies, once started on using pacifiers become difficult to settle without.

There is no point in introducing a pacifier as an aid to sleep, if the baby is going to wake when it falls out, and demand that a parent return this to their mouth. By all means use a pacifier to calm baby but, baby should learn to fall asleep without this in place. When a child has developed the manipulation and co-ordination to find and replace the pacifier by himself/herself and has no problems doing so it becomes less of an issue.

Pacifiers should be regularly sterilised, and sucking a pacifier which has fallen on the pavement, before returning it to your child's mouth, is not a clean, hygienic or healthy thing to do. Nor should pacifiers be dipped in foodstufs such as honey, soup, chocolate or in fact any foods to provide "tasters". There are teaspoons for this! Introducing sugary foods to baby starts an early interest in sweet and not savoury foods and can dammage developing teeth.

If you feel you need to use a pacifier use it with some thought. It will reduce crying and help calm a fussy child but, allowing dependancy to develop encourages poor sleep associations and will not improve sleep habits.

If you need help to improve your child's sleep habits:- contact Dream-Angus.com

Sleep disordered breathing/apnoea in children.

Sleep Apnoea is a disordered breathing pattern which occurs during sleep.

Our brains have a respiratory centre within them which regularly check the level of oxygen circulating in our bloodstreams and control our rate and depth of breathing to ensure that good blood levels of oxygen are maintained. This is not something we think about, it is a naturally occuring phenomenon.

During sleep our breathing is slowed and can be shallower than during periods of wakefulness. We require less oxygen as we are not generally active at this time. For some children, because of upper airway infection, obesity, bone structure or differences in the internal structure of the nose, mouth and throat breathing may be slightly obstructed during sleep.

The respiratory center notes a drop in oxygen levels and "nudges" the response to breathe deeper until the levels return to acceptable limits.

Some children who experience morning tiredness, snoring, regular headaches, and a variety of other symptoms are actually suffering from sleep disordered breathing. Technically, where breath is held for 10 seconds, this is sleep apnoea. In daytime these children often breathe through their mouths and do not feel rested after sleep. Review by a Consultant Ear, Nose and Throat specialist should be carried out, as removal of enlarged tonsils and adenoids can resolve the breathing issues quite quickly.

If your child has an unusual sleeping position, with their head tilted well back to allow a clearer breathing pathway, has excessive night sweats, sudden awakings related to breathing or does not seem rested after sleep this is a condition that should be considered. If your child has this problem and is treated you may find that their learning also improves along with their sleep.

If you have concerns about your child's sleep pattern, Contact Dream-Angus.com we can help you to help your child to a better sleep.

Importance of sleep for memory consolidation.

For generations mums have been told that sleep is important for babies because it involves actively consolidating memories. Now a team at the Department of Neurology in Massachusetts have undertaken a study to look at learning and sleep.

We all know that memories evolve. After learning something new, the brain initiates a complex set of post-learning processing that facilitates recall (i.e., consolidation). Evidence points to sleep as one of the determinants of that change.

Previously whenever a behavioral study of episodic memory shows a benefit of sleep, critics asserted that sleep only leads to a temporary shelter from the damaging effects of interference that would otherwise accrue during wakefulness.

To evaluate the potentially active role of sleep for verbal memory, this study, by Ellenbogen, Hulbert, Jiang, and Stickgold, compared memory recall after sleep, with and without interference before testing.

They have demonstrated that recall performance for verbal memory was greater after sleep than wakefulness. When when using interference testing, that difference was even more pronounced.

By introducing interference after sleep, this study confirms the active role of sleep in consolidating memory.

This is yet another reason why we should encourage good sleep habits in our children. They are learning on a daily basis and a good sleep/wake pattern can only enhance that learning experience and help them to be "all that they can be".

If you need help to improve your child's sleep pattern, contact Dream-Angus.com