Dream-Angus

Ten things you can do to help your child to play.

2012-01-08T08:59:00.000-08:00

Without play children have difficulties forming healthy relationships, they won't learn to develop and function in the world without positive play experiences. Active children are happy children, they are better adjusted, more co-operative with their peers and more popular because of it.

Parents who actively encourage play and communicate with their children provide excellent opportunities for speech and language development, information sharing and use of imagination. Here are ten ways you can help your child to develop through play. This is not an exhaustive list, merely a starter for parents who are uncertain how to encourage their child to become involved in their environment.

1) Allow yourself time to play with your child. We all lead busy lives, so we need to recognise the importance of playing with our children.

2) Have a couple of "treasure boxes" for children to explore. Natural materials, pine cones, leaves,shells,a short chain, a wooden spoon, keys, simple household objects can allow exploration of colour and texture and the developing of hand eye co-ordination. A dressing up box for toddlers, with a variety of old clothes of different materials are good starting boxes.

3) Communicate effectively by using facial expressions, eye contact and a positive tone of voice.

4) Use music to encourage your child to dance and to move more in their play.

5) Encourage messy play using jelly, spaghetti, Playdoh and sand.

6) Provide opportunity for water play with different containers, hose pipes and moulds.

7) Even when the weather is inclement, pull on warm waterproof clothing and get out to the park or beach.

8) Read or look through books with your child and encourage them to tell a story or extend the story that they are familiar with.

9) Observe your child playing and comment appropriately, this will help them develop vocabulary.

10) Allow your inner child to have some fun too!

Monsters in the bedroom?

2012-01-03T11:45:00.000-08:00

It can be difficult for young children to differentiate between real life and imagination. Characters like Kermit and Big Bird are very real to pre school children. As a child's imagination develops, more imaginary characters can become real. When these characters are more threatening it can be worrying, and some children develop a real fear of being alone in their room. Parents need to recognise that although they know the environment is completely safe, in the mind of a child, monsters are very real indeed.

When young children "create" these characters they don't always understand how to banish them. Sometimes, they can become a little like imaginary friends and a relationship can develop which adults may find perplexing. If the child can talk about the character they "see" , and if the parent accepts this as the child's reality then a variety of techniques can be offered to calm, banish or kill the "monster".

Telling a child that there is nothing there and nothing to be afraid of, is logical to adults, but not always acceptable to the child. Some parents use "monster spray" a simple spray of water sprayed in the corners of the room, under the bed or wherever the child thinks the "monster" is lurking, can be effective. Sometimes it is better to create something the child can use by themselves. Praising their bravery in facing the scary helps the child to manage their own fear. There is usually something that your child can tell you that the monster will not like, it may be a torch, monster spray, a dream catcher, a ray gun or a simple "incantation" some noise or rhythm which "monster" doesn't like.

What scares you and how do you manage that fear?
If your child starts to talk about scary things and is reluctant to go to bed because of this it is time to review the media the child is exposed to and to ask more. Treating your child's fears as reasonable, will help your child to have more faith in you as being someone to confide in. Together you can find a way to conquer these simple fears and help your child to become more confident in his/her abilities as well as your own as a parent

Vitamin D Supplement or not?

2011-11-20T08:56:00.000-08:00

Vitamin D is available in very small amounts from dietary sources such as oily fish, fish oils, and egg yolk. Our bodies make this important "vitamin" in our skin, using sunlight.

The amount of UVB radiation required to meet the body's requirement depends on your skin colour. Fair skinned people need only one tenth of that required by people with darker skins.

For many years we have been told that if we take a good and varied diet, we should not need to take supplements. Now, new research shows how much we need this vital hormone.

Use of sunscreens, and traditional and religious traditions which encourage women to wear all-covering clothing reduces sun exposure and the body's ability to create this.

Regardless of skin colour and other factors it is impossible for anyone living within the UK to achieve sufficient sun exposure, in fact, from October to March, anyone living beyond 52 degrees north, must draw on reserves or take a supplement to avoid a deficiency.

The impact of this deficit is already being demonstrated in hospitals and Doctors surgeries, with the return of Rickets and other deficiency diseases which were considered the long-gone problems of the Victorian era.

Supplementation is now recommended by the Department of Health for all children aged 6 months to 5 years. Early studies show that with a Vitamin D supplement, the incidence of Rickets is reduced and so is the incidence of seasonal influenza.

Vitamin D influences almost every tissue in the body and does far more than simply maintain a healthy skeleton. There is increasing evidence that milder degrees of Vitamin D deficiency may predispose to a range of longer term problems such as diabetes, lung disease and, even some cancers.

There is still a lot of research ongoing. So far, the argument on favour of supplementing the diet, particularly of children, with Vitamin D is overwhelmingly in favour.

Most common food Allergies

2011-10-16T08:47:00.000-07:00

Allergies are different from intolerances. An allergic reaction triggers an immune response and this shows in the bloodstream. Intolerance may make life uncomfortable in the short term, but does not provoke an immune response and therefore cannot be identified from blood samples.

Parents often have concerns about their children being allergic to a foodstuff. The list below starts with the foodstuffs which are least likely to provoke an allergy. As you go down this list the risk of allergy grows with the most common allergic reactions being demonstrated in at the end of this list.

1) Baby rice
2) Puréed potatoes and mashed carrots
3) Swedes, turnip, green beans
4) Parsnips, cabbage, broccoli
5) Cauliflower
6)   Puréed apple, pear,banana
7) Oats, wheat, (rusks, biscuits, cereals)
8)   Chicken, Turkey,
9)   Beef,lamb,pork
10) Fish
11) Tomatoes and citrus fruits
12) Strawberries, raspberries
13) Marmite, honey
14) Cows milk, goats milk, cheese, yoghurt, eggs, shellfish, kiwi fruit, peanuts and tree nuts.

When introducing semi solid diet to an infant it makes sense to make these introductions slowly. Baby's taste buds are immature and only recognise sweet, sour and salt to begin with. Adding extra sugar or salt to any baby food is not recommended as too much sugar makes for an early sugar addiction, and salt is difficult for baby's kidneys to cope with, particularly in large amounts.

If you would like more information about starting your infant on semi solids ;- Contact Dream-Angus.com

Preventing Cot Death and using baby car seats safely.

2011-09-26T07:07:00.000-07:00

A neonatal nurse recently developed "Best practice" guidelines for the prevention of Cot Death while travelling and using car safety seats.Michelle Clark, neonatal unit sister at Doncaster Royal Infirmary, produced information to raise parents’ awareness of the risk of car seat cot death, due to a dearth of materials in this area. She spent two years researching the subject, studying findings from various sources, including New Zealand and the Foundation for Sudden Infant Death. Now Ms Clark has developed guidance for parents to help minimise the risk of car seat cot death and her work has been recognised by the national special care baby charity Bliss, which is publishing it on its website and in its information booklet for parents.

Key findings from Ms Clark’s work include:

Young babies may experience respiratory (breathing) problems if placed in a sitting position or car seat. A newborn baby’s reflex to keep its head held up is not fully developed, meaning the head flops down and restricts the airway. It is always best to keep a young baby on their back wherever possible.
Car seats should only be used to transport babies in cars, and other sitting baby equipment should only be used once the baby is strong enough to support their own head. (usually about 6/7 months)

Car seats are designed to keep babies safe while travelling, not as a main sleeping place. The research recommends that frequent breaks are taken on long journeys to get the baby out of the seat, even if this involves waking the baby up.
The same applies when bringing the baby into the home if they have fallen asleep in the car seat. The baby’s warm outdoor clothing should be taken off, even if this involves waking the baby.

If the baby is due a sleep, they should be taken out of the car seat and put into a cot or crib; the safest place for a baby to sleep is on a firm, flat mattress - a car seat does not meet this requirement. Worryingly, it has been found that some babies were spending hour after hour in car seats, ie during the journey, transferring the car seat in a travel system pram, and once home allowing the baby to continue sleeping in the car seat rather than waking the baby up and placing in them in a cot or crib.

All the advice suggests that babies should not spend longer than possible in a car seat, especially whilst sleeping.
1) So, stop your baby from scrunching up and over, keep an eye on their neckline.
2) Make sure the car seat you buy is age appropriate and correctly fitted.
3) Be sure grandparents and carers know how to fit the car seat and watch them practice.
4) When ever possible, babies travelling in a car seat should be observable by a responsible adult.
5) If you are a lone driver driving a significant distance use service stations to stop and check on your baby.
6) Babies find it difficult to regulate their temperature and quickly overheat. When in the car, remove any headgear the baby is wearing as they lose excess heat through their head.
7) Think about what baby is wearing, for example, thick snowsuits. It may be cold outside, but cars can heat up quickly. Natural materials will help the baby’s body with heat rather than nylon, polyester, and other man-made fabrics.

Infant Colic

2011-05-29T13:10:00.000-07:00

In medical terms "colic" is defined as "persistent inconsolable paroxysmal crying in otherwise healthy infants aged two to sixteen weeks old." It is presumed to be as a result of abdominal pain. There is an associated "rule of three" which gives the following criteria;-

Spasms of crying lasting up to three hours.
Occurring up to 3 days every week.
For Three weeks

Excessive crying is the main feature although some infants cry "excessively" in the evening hours as a non specific reaction to any number of stimuli. This does not necessarily signify colic. It may peak at 6 weeks of age and may simply be a normal phase for the infant to go through.

Infantile colic is considered to be a self limiting condition which resolves in 90% of children within the first four months. 95% of cases resolve by six months. There are many theories about the cause of colic. The most commonly held beliefs are that colic is caused by;-

Excessive wind or gas
Lactose intolerance
Reflux
That it is behavioural and a result of inadequate parent infant interaction which may be due to a difficult maternal experience or a temperamental infant.

When diagnosing Colic there are other things which should be excluded. Parents know their baby best and if they are concerned, then it is important that they are taken seriously. There are a variety of treatments for colic and these vary from changing the infants feeds, to drug treatments which must be prescribed by a doctor.

If you think your child has colic take breaks by using a baby sitter or extended family. Respond quickly to your child's cry as infants take in large amounts of air when left to cry. Sooth your infant, offer a comforter or dummy as a soothing mechanism. Skin to skin contact can also be soothing and reassuring. Some infants benefit from rocking. There are over the counter solutions which work well for some infants.

Allergy and Intolerance

2011-05-29T12:26:00.000-07:00

Food allergy is when the body reacts to certain foods by an abnormal immune system reaction. Some reactions such as "hives" or a red skin rash, swelling of the tongue or lips, happens very quickly.

Other reactions include eczema, vomiting or constipation may be delayed. Reactions can range from mild to severe and there may be overlap between fast and delayed reactions.

Food intolerance happens in a more delayed way, often occurring hours or even days after eating certain foods.The immune system is not involved in this reaction, therefore it is not life threatening and cannot cause anaphylactic shock. Typical symptoms include diarrhoea and vomiting.

Avoiding or reducing the intake of allergenic foods during pregnancy and breast feeding is not proven to prevent an infant from developing food allergies.

The ideal time for starting to introduce solid foods to an infant is after 17 weeks,(4 months) and before 26 weeks (6 months) based on the needs of the mother and child.

Less hypersensitivity has been demonstrated in infants who are weaned before 6 months but there is no ideal time on which all "experts" are agreed.

The Importance of play

2011-05-29T12:02:00.000-07:00

Play is the way children learn. In the past many generations lived together, either under one roof or close together in the community and there were many opportunities for play. Now parents want their children to play at home so playing opportunities with others are fewer.

Children with access to a wide variety of toys are more likely to be intellectually stimulated and challenged. They reach higher levels of intellectual development regardless of age, sex, racial or social class.

Toys that stimulate mental development are appropriate to the child's abilities, responsive to the child's movements and give feedback when manipulated.Whether playing alone or with others, quietly or with enthusiasm play is the way that children explore their world and use their imaginations.

A baby's first toys are important in teaching about size, shape, colour and texture. The availability of toys in infancy is strongly related to the child's IQ at 3 years of age. In the first year babies respond to bright colours and gentle sounds.

Musical toys and mobiles are ideal. At first babies cannot co-ordinate their hand and eye movements so all shape and feel is learned about through mouthing the object.

As they gain co-ordination an activity mat is good for exploring textures and shapes.

Half the waking hours of a toddler are devoted to play so toys that move, and stimulate the imagination, such as play sets, toy vehicles, soft toys and puppets are popular.

An active toddler needs toys for physical play, toys they can sit on, push or pull. Toys that are responsive to movements hold the child's attention. Increasing the attention span is important for reading.

Pretend play is important for 3-5 year olds. This is how new skills are developed, language being one of these. As children gain confidence and social skills they enjoy play with other children.

This is when role playing and fantasy games help because these are the things which help social and emotional development.

Realistic toys such as dolls, action figures, household items, things which resemble everyday people and objects help children to understand the world.

Active play on swings, slides and climbing frames encourages physical development, co-ordination and balance. As they develop logic and are able to concentrate for longer games with rules like "lotto" matching games and memory games become more interesting.

One of the joys of being a parent or grandparent is the opportunity to play with children. It is the ideal setting for getting to know each other while providing a foundation for the child's future, raising the child's self esteem and happiness. While playing adults are both teachers and learners. At all times they are role models. Shared playtime is an opportunity for mutual enjoyment and discovery.

Have you played with your child today?

Successful Napping

2011-04-10T02:21:00.000-07:00

All children, up to the age of 4 years, should have daytime sleep as well as night sleep.

Daytime sleep is as important to small children as night sleep.

Every child has a sleep requirement which we can calculate by looking at the age and stage of the child and the parents own sleep requirements. This is true because sleep is partly genetic and partly learned.

Newborn babies sleep an average of 18 to 20 hours a day. As they grow and develop they have periods when they can be happily awake, aware of their surroundings and interested in the stimulation this provides.

At 3-4 months babies can usually cope with 1-1.5 hours of alert wakefulness. As they get to the end of this concentrated stimulation they become restless and signal a need for sleep. To achieve a sucessful nap parents have a very small window of opportunity to get baby settled in a warm and comfortable place so that the baby will use the nap opportunity and sleep.

What are the basic requirements for successful naps?

1) Daytime sleep in normal ambient daylight; Obviously direct sunlight on baby's face may be too strong to allow the baby to go to sleep, other than shading baby's face no attempt need be made to completely darken the room.

2) Keep houshold noise at normal daytime levels; Baby has heard noise all the time inside mum. Silence is more concerning and makes sudden loud noises more startling.

3) Recognise your baby's sleepy signals and act quickly to give your baby the opportunity to relax and sleep.

4) Ensure that the room baby naps in is a comfortable temperature and that baby's temperature can be comfortable too. When we sleep our temperature naturally drops a degree or two. Sleep is more easily accomplished when we are comfortably warm and out body temperature can be maintained.

5) Offer regular opportunities for naps. Space them according to the age and stage of your child and make them part of the daily routine.

6) Do not try and eliminate naps in order to improve night sleep. This does not work and will leave you holding a very cranky baby.

Children who do not have enough sleep are irritable and confrontational. They can go into "overdrive" as they get beyond tired and struggle to remain awake. Although every child, just like the adults, have slightly different sleep requirements, the minimum length of time for a nap should be 45 minutes as this allows completion of 5 stages of sleep.

Naps shorter than 45 minutes are "catch up" sleep. A short "catch up" in the car or stroller should not interfere with the normal sleep routine.

If you miss the opportunity to get your child down for a nap, or if they resist your attempts, don't persist longer than 30 to 45 minutes. If you have been trying for 30 minutes or longer to settle your child for a nap, abandon that nap time and offer another opportunity later.

Most children will settle within 5-20 minutes. If this doesn't happen it is usually because there was too great a delay or the opportunity was offered too early.

If you struggle to get your child to nap contact us here at; Dream-Angus.com We will be happy to help support you in improving your child's sleep.

Constipation in children

2011-03-10T10:37:00.000-08:00

The biggest difficulty for some children, during toilet training, is learning to "poo in the potty". While many chldren achieve this without any great difficulty there are a few who, for a variety of reasons are reluctant to part with solid matter. This may be related to a fear of the toilet or to discomfort at something wieghted dropping away. Refusing to "poo", over a prolonged period, can cause constipation.

Children who have had difficulty in passing a bowel movement may have passed a hard stool which has resulted in a tiny tear in the anus. This can be painful and sting, consequently the child is reluctant to repeat the experience. Again, this leads to further difficulty and can compound the problem.

While it is important to have a good amount of fibre in the diet to help with the elimination of waste from the body, it is also important not to give children a diet too high in fibre as this may cause other problems. Children who are constipated may complain of abdominal pain, they may soil their nappy/underpants and may even have diarohoea as a symptom. This happens because the hard impacted stool blocks the bowel and some of the waste above this blockage is passed as fluid.

Encouraging the child to drink more water and eat more fresh fruit and vegetables, or drink more smoothies made with fresh ingredients, will certainly help aleviate this condition. Some children may require medication from the family doctor to soften the stool and allow this to be passed.

Prevention is definately better than cure. Ensure that your child is encouraged to drink plenty of water and to eat more fresh fruit and vegetables will help in making elimination a lot easier. Praise your child when he/she uses the toilet. Encourage good toilet behaviour. Avoid allowing children to postpone toilet visits. If the child needs to go, they need to go.

Toilet Training (Getting ready)

2011-02-13T04:31:00.000-08:00

Here are some things you should consider when you are thinking about starting to potty train your child;-

• Get the right equipment. Getting the right equipment for potty training is always a good start. A child-sized potty or a special seat to attach to your regular toilet is a must. Whichever you choose, make sure your child can sit comfortably.

• Extra help. You may also want to buy a picture book or video all about potty training that you can look over with your child. That way, you’ll both be prepared for the training ahead.

• Time it right. Pick a period when you have plenty of time on your hands and be consistent – don’t chop and change from nappies to underpants during the day. If your child’s just about to start nursery, you’ve just moved house, you’re going on holiday, you’ve just had another baby or you’re going through any other upset it’s probably best to leave potty training until things are less hectic.

• Let your child one set the pace. If you know when your child is likely to want to use the potty, encourage them to sit down. But make sure he/she feels that they’ve made the choice – you’ll know by now that your child likes to feel in control.

• Create a routine. Try sitting your tot fully clothed on the potty seat once a day – after breakfast, before bath time, or whenever else suits you both. This will allow your tot to get used to the potty and accept it as part of the daily routine. If he or she doesn't want to sit on the potty, that's okay. Don’t force the matter. Put the potty away for now and try again in a month’s time.

• Be prepared… If you live in a two storey house, keep a potty upstairs and one downstairs. Be sure to have a potty with you when you’re out and about. It’s a good idea to keep one in the car too and to take a set of spare clothes out with you.

• Be prepared… for accidents! Lots of accidents are par for the course at first. If your tot has an accident, change him or her straight away and calmly encourage use of the potty or toilet next time. Your child may start having accidents again, after a period of thinking you had it sorted, if he or she is tired or busy. Just deal with it calmly as before.

• Encourage your little one with praise. As always, praise is your child’s best teacher so say something like ‘Well done’, ‘You were a big boy or girl to use the potty’ when your child uses the pot. But don’t make too big a thing of it. For example, don’t reward your tot with food or toys. Ignore the odd lapse and never tell your child off for failing to use the potty or having an accident.

• Don’t hang about. At first, when you child needs to go they need to go now, so don’t ignore it when the call comes. As your tot gets older, he or she will be able to wait longer.

• Make it easy on yourself. The summer months can be an easier time to try potty training, as your little one can run around without nappies. Make a note of when your child goes to the toilet so you can pick the best times of day to suggest using it.

• Get the clothes right. You don’t want to spend ages changing your toddler’s clothes, so make sure what he or she is wearing is easy to remove. You can try using training pants. Some toddlers like them, while others just think of them as a different type of nappy (which is confusing). Most toddlers are encouraged by having real underwear instead: it makes them feel grown up.

If you would like help or have questions please contact us at Dream-Angus.com

Toilet Training (Basic Principals)

2011-02-13T04:08:00.000-08:00

Toilet training can begin when your toddler demonstrates an interest in the process. This is usually somewhere between 24 and 27 months.

Simple signs to look for;-

1. Your child may tell you they’ve done a wee or a poo. At first this may be after, rather than before, the event! But never mind – it’s a sign they are becoming aware of their bowel and bladder movements.

2. The child's nappy needs less frequent changes as there are longer periods between wet nappies. They have a wet or dirty nappy after a meal or drink and then can be dry for a few hours.

3. They demonstrate awareness of bodily functions. They imitate you going to the toilet or show some other sign that they are aware of what’s going on inside their body, such as stopping what they are doing, grunting or holding their nappy.

4. You notice they’re becoming more independent in other areas of life. For example, they are feeding themselves and can follow simple instructions

You may be able to recognise your child's need to toilet and then encourage them to sit on the potty, or an adapted toilet seat. When they are successful, praise them, but don't make a big issue of mistakes. This is a learning process and it takes time. Some children manage this more quickly than others.

Note the times when your child is most likely to need to toilet and encourage the use of the potty at these times. Some children will happily potty before or after a meal. You should be able to read your child's signals and act upon them. If your child is not ready for this then don't push them to accept a toileting routine. This is more likely to exhaust and frustrate you and upset your child.

If your child follows you into the toilet do not become upset and push them away. Children can become confused about the use of the potty or toilet if we demonstrate upset about being seen, accompanied or surprised there.

There are a variety of training pants and diapers which can be useful in teaching your child how to use the potty. There are some books which you may find helpful to read to your toddler which explain what is involved. These too can boost the child's self awareness and be an aid to successful potty training.

If you would like some help with potty training, Contact Dream-Angus.com

Transitional Objects

2011-02-07T11:10:00.001-08:00

Transitional objects are usually soft toys. They are chosen to help a child cope with separation from the parents, situations which may be unfamiliar and to provide a level of reassurance. Some children become very attached to a soft toy that has been with them since they were babes in arms.

Sometimes these objects are chosen by the parents and sometimes they are chosen by the child. Some children never need a "transition object", they have enough confidence to master any social situation without recourse to a soft toy that reassures them with it's presence.

Transition objects should be small and washable, but do remember that it is not just the shape and form of the object, the texture and the smell of the object also matter.

For this reason some children may reject the object of their affection immediately after it has been washed. Parents are concerned that the toy is dirty, smelly and sticky, the child is unperturbed. Certainly for reasons of infection prevention, and basic hyigene it is important to be able to clean the toy.

These much loved toys travel with the child and can help in settling a child to sleep.

These toys are important for a particular stage in a child's life. They will grow out of their attachment, but, while it lasts, having a particular cuddly toy is very important and can be a positive support to a less confident child.

Positive Reinforcement/Praise

2011-02-07T10:46:00.000-08:00

How often do you praise your child/children?

Parents spend a lot of time and energy trying to get their children to behave well and appropriately in social and domestic situations. Children want to please their parents and look for a reaction to their actions. Too often they are met with critisism. "why did you do that?" "you shouldn't do that!" etc..

Yet, when they are playing quietly with friends or relatives parents seldom think to tell the children "I'm so proud of you, you are doing x so well!" A little positive reinforcement builds a child's confidence in themselves and pride in accomplishments.

All too often we see how noisy adults can be when they are angry. Yet, when they are happy and things are going well, people keep very quiet about it. One powerful antidote to our unfortunate orientation in this regard, is to give positive verbal reinforcement. Praise should be given early and often. It should be genuine, or it will fail to achieve the objective. Positive interactions with children should outnumber the negative by about three to one. Unexpected praise can be very powerful for a child. Praise in front of other people is also a really powerful way to demonstrate to your child that you appreciate their efforts.

Children up to the age of five or six respond very well to almost any kind of encouragement. As they get older, and they better understand how well or how poorly they are doing, they are much more aware of when praise is fake or genuine. Praise should be tailored to your child. Becoming more aware of your child's acheivements, and praising them as they do their best to impress you and to push their own limits, can improve the relationship you have.

The child who lives with critism learns to condem. The child who is praised, tries harder and has more self confidence.

While you think about this, also think about how often you praise your spouse. Think of all the little acts of kindness and support that you receive. How much more difficult life would be without these supports.

Praise more, thank more, smile more. It is surprising how much you receive in return.

Altering a sleep pattern

2011-01-31T12:28:00.000-08:00

While most children manage to soothe themselves to sleep, and to sleep through the night without the need for any intervention, there are a number of children who take a long time to learn to do this.

Some children have never learned to put themselves to sleep. They rely on a parent holding them, rocking them, feeding them or simply being with them until they fall asleep. These children come to believe that this is the only way to get to sleep and the parents are often very tired and frustrated. There is no time left to be an individual, to maintain a healthy relationship with a partner. Every evening is spent with the child, just as the day has been. There is no quiet time, no time to exchange comments about the day and often no private time between parents at night. Someone must remain with the child so that the child will sleep.

Altering a child's sleep pattern is possible. It requires an understanding of exactly what has happened to cause the difficulty. A sleep history helps clarify this.
What is the pre bed routine like, how do the parents react to the difficulty and what priorities do the parents have in mind when they want things to change? Sleep diaries illustrate exactly where the difficulties are, and completing these throughout the work to change things can also show what is working, and what is not.

Once the issues have been clearly identified, and the parents priorities decided, it is possible to work using graded techniques to improve the child's sleep. Cry it Out, a method that allows a child to cry with a parent checking at extending intervals, has long been discredited by sleep professionals.

This method does work but it teaches the child that being upset is not going to be met with comfort. The child learns to suppress such emotions and this is not healthy. Cortisol, the stress hormone, floods the body systems of parents and child so neither are happy with the situation. The parents may have been told that this is the way it has to be, but this is not so.

There are other ways to support a child who is afraid, who lacks confidence in their ability to fall asleep or remain asleep without mum or dad being nearby.

Altering a sleep pattern can be really hard work for both parent and child. It requires consistent repetition and demonstration of behaviour and consequenses so that things can and do improve. Most sleep difficulties can be resolved within a few weeks. Perseverance, persistance and calm confidence are atributes which are vital to success.

Once a child has learned to sleep and to remain asleep, their appetite and mood imnprove and parents find things so much easier.

If you would like help to improve your child's sleep, Contact Dream-Angus.com

Teaching our children

2011-01-24T13:51:00.000-08:00

I am often asked if resolving one sleep issue, means that there will be other issues to be worked on later.
Most pre school children who have a difficulty in getting to sleep, or staying asleep, and who then learn to sleep and to remain asleep have no further difficulties. Learning to sleep independently is a gift for life. Children who have difficulties and do not have them resolved often continue to have difficulties with sleeping.

Do children "grow out" of sleep difficulties?
Sometimes, but this depends on the reason for the difficulty. Children whose imagination is particularly active, and who cannot differentiate between dreams and reality may "grow out" of sleep difficulties if this is the cause. For many children the causes are multi factorial. Sometimes there is an obvious reason, and sometimes there is no obvious cause of the child's difficulty.

We teach our children many things, and teaching them to sleep is often done without being conscious of it. If we always allow a child to fall asleep on the couch in front of the television, then move them into a bed, that child comes to believe that this is what he or she needs in order to relax and fall asleep. Teaching this child that they can, and should fall asleep in their own room, in their own bed can take some time and perseverance. However, once the child has learned a new behaviour and repeated it on successive occasions it becomes the new norm. This is what altering sleep behaviour is about. It is about altering the perceived needs and demonstrating a better way to achieving a good nights sleep.

There are many ways to alter children's behaviour. Sometimes this is about giving the child confidence in ourselves as parents. Sometimes it is about giving confidence in the child's independence or in the child's ability to cope in new situations. Often the pace of change has to be slowed or hastened depending on how well the child copes with the changes.

Just as every adult is an individual, so is every child. What works well for one may not be as effective for another. Your child has to grow up within your home, living with your ideas and this has to be taken into account. No one knows your child as well as you do. Professionals can indicate good practice and direct your efforts.

The biggest single thing that parents need to identify is the difference between what your child needs and what your child wants. Children's needs should always be met unconditionally. This gives children a secure base, a belief in their parents ability to nurture and protect. We all want our children to have faith in our abilities to protect and care for them.

We all have "wants". Children who are secure can cope with wants not always being met as long as their needs are addressed. In the wider world we do not always get what we want, we hope we always get what we need. This is a difficult lesson for children and often it is difficult for parents to identify when something is needed, and when another thing is desired.

Speech and Language skills

2010-12-01T06:51:00.000-08:00

Overall about 5% of children entering school have significant speech and langauge difficulties without any additional sensory or cognitive impairments. When sensory and cognitive impairment is an additional feature this number rises to 25-35%.

For the majority of children speech and langauge develops without any problems and by the age of 6 years children are relatively sophisticated users of language. Speech and language skills incorporate a number of elements including;-

Structure of language
Use of language
Understanding of language
Vocabulary
Speech sounds

Some signs which may indicate that a child has a speech and language problem include;-

Inability to follow simple, everyday instructions at age 2years.
Restricted vocabulary development at 30 months. (70% of children have at least 500 words by this age)
Sentence structure of 2-3 words at the age of three years.
Family cannot understand the childs speech at 3 years of age.
Difficulties in attentionm understanding, development of play or with the social aspects of language.
Failure to use grammatical endings such as ing, ed, and plurals at 4 years of age.

It is important to ensure that the child has good hearing as missing a pitch or tone can result in poor speech. Language difficulties are pervasive and early intervention and support can make a considerable difference to the child's learning and speech and language development. Referral to a speech and language therapist for assessment and support can be invaluable.

Feet First

2010-12-01T06:13:00.000-08:00

The Human foot is a complex structure of 26 bones, which have usually hardened by about age 18. In a nweborn the foot is mainly made up of relatively soft cartilage which converts to bone as the child grows and matures. During this period of growth and development the foot is at risk of injury and deformity. For this reason children's footwear has special importance.

Babygrows and sleep suits should not cram little toes. Pram shoes are best avoided as it is very difficult to size appropriately, bootees which do not constrict the toes and ankles are much more suitable. Ideally a child does not require shoes until they are walking competently out of doors. In order for the foot to develop normally and naturally the child should be barefoot for as long as possible within the realms of safety.

On average a child's foot grows two sizes a year in the first four years of life, and one size a year after this, until growth is complete. Sometimes a childs foot seems not to grow for a considerable period then suddenly grows several sizes. It is a good idea to have a trained shoe fitter measure your childs feet every 8 weeks, more frequently if you are aware that the child is actively growing taller.

Children enjoy being barefoot, but if their feet are noticeably cold, or they complain of this, some form of protection may be neccessary. Socks alone may be dangerous if there is a danger of the child slipping. Slippers are only a short term solution as they are not held properly on the foot. Long term use may result in future deformities.

The age at which a child first walks unaided is variable. For girls the average age is 12 months and for boys 15 months, but some perfectly normal children do not walk unaided until 24 months. Nearly all babies appear to have flat feet when first they walk unaided. This is partly because of posture adn partly due to the deposits of fat which can make the foot look flat. The first time walking baby has to balance a relatively large head on a short body and in order to do so baby walks with knees bent, legs wide apart and feet turned outwards. The nervous gait control is still developing and so the child appears to be flat footed.

Baby walkers encourage loading of the joints before nature intended, often resulting in unusual walking patterns. Research has demonstrated that using baby walkers may cause baby to walk later than he or she normally would.

Keeping children warm

2010-12-01T05:56:00.000-08:00

It is generally accepted that an infants bedroom should be kept at between 18-20 degrees C. At this temperature the room is cool enough to allow baby to be warm and to sleep without being overheated. As winter cools the outside air there is a temptation to increase the temperature inside homes, as much for the comfort of the adults as the comfort of children. The ambient temperature of your living room is chosen for your comfort and that is a personal choice.

Children do not make these choices so what should we consider for them?

Toddlers should have one layer more clothing on, than their parents, to ensure that they remain warm and comfortable. Wearing a hat out of doors is helpful, as babies and small children lose a fair amount of body heat through their scalp. Where there isn't a great deal of hair, this loss is increased. Toddlers are notorious for wriggling out of hats shoes and gloves, which is why strollers have warmly lined "suits" or cosies to keep them warm.

Children's body thermostat is not as efficient as an adults, so it is important to ensure that they remain warm and dry despite the winter storms and snows. When ever possible parents should avoid taking very young children out after 3.30pm/4pm as this is when the temperature outside is most likely to start it's evening fall. Although the baby/child may have been warmly enough dressed earlier in the day this fall in temperature can make it more difficult to remain warm.

Is it healthy to encourage babies to sleep through in early life?

2010-11-10T12:51:00.000-08:00

Although we know that babies, from as early as two months, have a definate sleep pattern developing, how healthy is it to have an infant sleep through the night?
You may argue as a parent that you need your night sleep, and wake only to feed or comfort your child. That it is better for you, and makes it easier to cope, if your child sleeps through the night and lets you sleep too.

While this has become the accepted standard, and parents are particularly proud when they can tell others that their child sleeps through the night from as early as a few months old, we know that breast fed babies wake several times through the night and that this encourages milk production.
Breast fed babies usually feed quickly and with minimal disturbance to their own or their mothers sleep, depending on the sleeping place.

There is another school of thought that says babies who are encouraged too soon to sleep too deeply are more likely to overcome their bodies natural "protective" impulse to wake, may be more likely to succum to Sudden Infant Death.
This arousal mechanism is the primary means by which infants defend themselves against potentially fatal breathing or cardiac perturbations. Encouraging early sleep consolidation may be placing arousal-deficient infants at increased risk of sudden and unexpected death.

When the "experts" disagree it is confusing for parents who want to do the best they can for their baby. Perhaps parents whose children do not sleep through the night before 6-9months should take heart that, although they may have a sleep deficit as a consequense, they are not necessarily doing anything wrong.

The truth of the matter is, that what is a problem for one set of parents, is not necessarily viewed as a problem by other parents. We should be prepared to work with our children. Supporting them through life and encouraging the behaviours we find acceptable. At the same time accepting that we all develop at different paces and there is some joy in the differences too.

There is no "one rule suits all" nor should there be.

If you have concerns about your child's sleep, Contact Dream-Angus.com

When do babies start to sleep through the night?

2010-11-10T12:26:00.000-08:00

A new study suggests that babies should be able to sleep through the night from about three months old. From about five months, parents should be able to expect a longer period of sleep.

Previous studies show that a sleep pattern develops before a real feeding pattern and this is usually at about 60 days (two months) of life.

Jacqueline M. T. Henderson, PhDa, Karyn G. France, PhDb, Joseph L. Owens, PhDa, and Neville M. Blampied, MSc of the Department of Psychology and Health Sciences Centre, University of Canterbury, Canterbury, New Zealand set the objective of investigating the consolidation of infants' self-regulated night sleep over the first year.
The idea was to determine when infants first sleep through the night from 24:00 to 05:00 hours, or for 8 hours, or between 22:00 and 06:00 hours. These times were chosen as the times that most parents would love to have babies sleep through without waking.

Parents of 75 typically developing infants completed sleep diaries for 6 days each month for 12 months. The accuracy of the parent reports were assessed by using videosomnography. (time lapse video of the sleeping child)

The researchers found that the most rapid increase in uninterrupted sleep occurred between one and four months, during which the babies gradually stretched their sustained snooze time by nearly three hours.

At five months of age, 50% of infants were sleeping from 10 p.m. until 6 a.m. Babies reached the easier milestones earlier. Half of the babies slept from midnight to 5 a.m. by three months of age and 8 hours a night by four months, according to the October 25th online report in Pediatrics.

By 12 months, 85% of the babies met these two criteria -- but one of every four still wasn't sleeping from 10 p.m. to 6 a.m.

This study found that the most rapid consolidation in infant sleep regulation occurs in the first 4 months. Most infants are sleeping through the night at 2 and 3 months, regardless of the criterion used.
The most developmentally and socially valid criterion for sleeping through is from 22:00 to 0:600 hours.
At 5 months, more than half of the infants were sleeping concurrently with their parents.

Many infants have difficulties in consolidating their sleep and frequently wake during the night, which is a source of distress for the family. Understanding normal maturation may help in developing interventions and early prevention tools.

Sleep-promoting routines should include creating a sleep environment that is quiet, dark and at an appropriate temperature; maintaining consistent routines and sleep schedules; encouraging a baby to fall asleep and resume sleep in their cribs with little help; and gradually increasing intervals between night feedings.

If you would like help to improve your child's sleep Contact Dream-Angus.com

Toddler Tantrums

2010-10-24T07:11:00.000-07:00

Toddler Tantrums occur at least once a week in 50-80% of pre school children.
The most common cause of toddler tantrums is conflict with parents ;-

1) Over food and eating (16.7 per cent),

2) Being put in a pushchair, high chair or car seat (11.6 per cent

3) By getting changed or dressed (10.8 per cent).

There are peak times for tantrums – more tantrums occur in the late morning and early evening, when the child is probably hungry or tired.At this stage in a child’s life, what may seem weird, irrational or just plain naughty is perfectly normal. It does not help – you or the child – to get stressed about it.

Of all the challenging types of toddler behaviour –for example, getting into everything, asking endless questions or refusing point blank to get into the buggy/car seat – it’s the tantrum that gives toddlers a bad name and provides parents with the most headaches.

Coping strategies.
There are times when nothing less than a miracle will stop your child kicking off – like the moment you realise you’ve left their favourite teddy at the supermarket and it shut two hours ago. You can employ some tactics to ward off trouble.

At home
‘Toddler-proof’ your home so you don’t have to keep taking things away from your child. Look around your home and put away breakables or things children can hurt themselves on. Your house may not look as pretty, but it’s better than shouting at them all day.

Out shopping
When you have time get your toddler to help by picking out objects you want to buy. Choosing which colour of toilet roll, bubble bath or soap to buy.

Visiting
Visiting friends or family, take a goodie bag with you with toys, books, colouring pencils and chewy foods to keep your child amused, particularly when visiting elderly relatives or friends who have no children.

If you would like more information about coping strategies or parenting;-

Contact Dream-Angus.com

Cradle Cap/Seborrhoeic Eczema in Infants

2010-10-18T12:05:00.000-07:00

Cradle Cap is generally the name given to the thick yellow scurf on the scalp of children under a year old. This occurs soon after birth and generally is completely gone by the time a child is a year old. Some babies have this from a one or two weeks of life, and others from a few months, while others never seem to have this problem at all.

Cradle cap starts quite suddenly with the scalp becoming thickly coated with greasy yellowish scales, which stick to the scalp and may extend to the eyebrows, behind the ears, and neck folds. The skin may be slightly red beneath the scales but it is not sore or hot to touch. This condition does not cause any discomfort and does not mean that baby is unwell, and it does not itch. Often it will simply go away and not come back.

When this happens in the first few weeks of life it is often due to persistent secretion of vernix, the greasy coating that baby is born with. As this dries up the scales fall off and the scalp becomes clear.

Cradle cap which occurs later is often due to infantile seborrhoeic eczema and may also affect the groin, and the skin under the arms. In most cases this will clear by itself but, if you are concerned you can try the following;-

1) You can use a gentle shampoo and tepid water to wash the affected skin daily. Don't use harsh shampoo which is recommended for adult dandruff.

2) Massage warmed olive or grape seed oil into the scalp to losen the scales. Leave this on for an hour before shampooing with a mild shampoo.

3) Massage aqueous cream or emulsifying ointment into the scalp if it remains scaly. Leave this on for several hours before washing off with warm water. You do not need shampoo as the aqueous cream or emulsifying ointment will be enough. If the emulsifying ointment is very thick stand it in a dish of warm water to soften it before using.

If Cradle cap is on other parts of the body then see your family doctor so that an appropriate treatment may be prescribed.

Dream-Angus.com

Teaching children to make choices.

2010-10-12T11:02:00.000-07:00

How many choices do you offer your child or children on a regular basis?

If we teach our children to make good choices while they are young, there is a better chance of them continuing to make good choices as they grow and the choices become more important.

Start when your child is about a year old. Only offer a choice of two things as more is confusing. You don't want to wait for a long time while the child makes this decision so keeping it simple is easier for both of you. "Do you want to put your socks or your vest on first?" Only offer choices that you are happy to live with. Then, if the child wants to do something that you would not like them to do, it is not an option.

Too many parents offer a choice which includes something they hope the child will not choose. Children can read their parents, and will opt for the choice that you find least acceptable, so don't make it part of the process. If your child has made lots of choices in the day and you want something done, you can point out the number of choices they have made, and tell the child that it is now your turn to choose and you want them to ......

This seems much fairer to the child than making all the decisions for them and makes your child feel that they have had some control over their day.

Help your child to have a level of control over their own life so that they can develop a sense of responsibility. If a bad decision is made, then living with the consequenses is part of understanding how things work in the real world, while being in a safe environment.

Parenting can be fun. If you would like to join a parenting class and learn more about helping your child to make choices and take responsibility,
contact Dream-Angus.com

Six problems using a dummy/comforter can cause.

2010-10-12T10:41:00.000-07:00

On average, half of the toddlers who are using a dummy, are 3 times more likely to have ear infections and will require speech and language therapy.
Children who have had a dummy/comforter for too long are at greater risk of;-

1) Upper and lower front and back teeth not meeting properly, or they become overcrowded at the front of the mouth.
2) Tooth decay in the front teeth in particular.
3) Incorrect tounge position which affects swallowing and may be linked to developmental and speech problems.
4) Breathing through the mouth rather than the nose.
5) Speech sound problems which the child may not "grow out of" but may require speech and language therapy to correct. ("T" becomes "K")
6) Glue ear causing hearing problems so again language development is more difficult.

The dummy/ comforter may be useful in the early months. Use it appropriately by using it selectively, after a feed.
Wean your child off using this by no later than 10-12 months.
Never put sugar or other sweet tasting substances on a dummy/comforter.

If you need advice and support in getting rid of the dummy,
Contact Dream-Angus.com

Protecting your child's teeth

2010-10-08T13:54:00.001-07:00

Sugary drinks in bottles, especially at bed time can lead to tooth decay. The most dammaging drinks are those high in sugar and acid like fruit juices and squashes and fizzy drinks.

Protect your child's smile.

1) Dilute unsweetened fruit juice and squashes.

2) Limit these to meal times only.

3) Offer water/milk in between meals and at bed time.

4) Try drinks in a feeder or cup from six months onwards.

5) Brush your child's teeth twice a day, particularly at bed time, with a flouride toothpaste.

6) Register your child with a dentist, and take them there regularly from two years of age.

How old is too old for a dummy/comforter?

2010-10-08T13:39:00.001-07:00

Babies have a natural sucking reflex in the first few months which makes sucking a bottle, or dummy, comforting for them. From about six months you should introduce the use of beakers or cups.

By a year you should have separated your baby from the bottle or dummy. At about this time continuing with dummies can stop your child from talking properly, and increases salivation and drooling, which in turn can cause skin problems.

Here are six simple things you can do to encourage your child to do without their dummy/comforter.

1) Reduce the use of the dummy to only making it available at bed time and remove it once your child is asleep.

2) Encourage your child to talk by listening carefully and giving your full attention.

3) Encourage choices by naming the foods at meal times.

4) Encourage your child to use words instead of simply pointing at things.

5) Take the dummy out of your child's mouth when they are speaking.

6) Talk to your child. Use picture books and everyday situations like shopping, to encourage your child to talk. The more you talk to your child the more your child will learn and respond.

If you want help to get rid of the dummy
Contact Dream-Angus .com

Dreaming and night waking

2010-09-15T13:02:00.000-07:00

At 2 -3 years of age dreaming becomes vivid. By three years of age your child may not require a nap, but until that time an average of an hours nap in the day is usually helpful to avoid sleep deficit.
This is the stage when children’s sleep may be disturbed by Nocturnal confusion Night terrors or Nightmares and there is a difference.

Nocturnal Confusion occurs mainly in very young children who are distressed and agitated but do not respond to parents attempts to reassure them.

Night terrors occur early in the night, usually in the first third of sleep (deep Non REM sleep) the child is distressed and agitated, and although your child’s eyes may be open the child is not completely awake and no reassurance from you will comfort your child. Sleep returns fairly quickly and there is no memory of events in the morning.

Nightmares usually occur in the second part of the night (middle to late REM sleep)
Your child has had a frightening dream and will accept comforting and reassurance. It can take longer to re settle the child to sleep afterwards and it is important that the parents reassure and encourage the child to remain in his/her own bed and return to sleep. While the child was asleep, during this episode they are fully awake and remember this afterwards. Nightmares can be precipitated by illness or stress, in which case there may also be night terrors.

Nightmares usually peak at about 3 -6years of age. They are universal and a normal part of cognitive development.

There are things you can do to reduce the frequency of nightmares and night terrors for your child and Dream-Angus can help you with this.

If these are a problem for your child let us give you some simple strategies to try first.

In most cases simple measures are very effective; however, if the night terrors or nightmares remain persistent and severe and fail to respond to behavioural strategies, then a psychological assessment may help.

Contact Dream-Angus.com

Dreaming and night waking

2010-09-15T13:00:00.000-07:00

At 2-3 years of age dreaming becomes vivid. By three years of age your child may not require a nap, but until that time an average of an hours nap in the day is usually helpful to avoid sleep deficit.
This is the stage when children’s sleep may be disturbed by Nocturnal confusion Night terrors or Nightmares and there is a difference.

Nocturnal Confusion occurs mainly in very young children who are distressed and agitated but do not respond to parents attempts to reassure them.

Night terrors occur early in the night, usually in the first third of sleep (deep Non REM sleep) the child is distressed and agitated, and although your child’s eyes may be open the child is not completely awake and no reassurance from you will comfort your child. Sleep returns fairly quickly and there is no memory of events in the morning.

Nightmares usually occur in the second part of the night (middle to late REM sleep)
Your child has had a frightening dream and will accept comforting and reassurance. It can take longer to re settle the child to sleep afterwards and it is important that the parents reassure and encourage the child to remain in his/her own bed and return to sleep. While the child was asleep, during this episode they are fully awake and remember this afterwards. Nightmares can be precipitated by illness or stress, in which case there may also be night terrors.

Nightmares usually peak at about 3 -6years of age. They are universal and a normal part of cognitive development.

There are things you can do to reduce the frequency of nightmares and night terrors for your child and Dream-Angus can help you with this.

If these are a problem for your child let us give you some simple strategies to try first.

Contact ;- info@Dream-Angus.com

Gastric Reflux

2010-09-15T12:54:00.000-07:00

Gastric Reflux is a common problem particularly in pre term babies. It can be defined as a transient, inappropriate relaxation of the lower oesophageal sphincter allowing stomach contents to flow back into the oesophagus. This can result in regurgitation or vomiting, which may upset the child by causing pain and discomfort or, in milder cases there may be no apparent distress related to these events.

Recently there was an article in the BMJ which looked at this topic and the rich variety of treatments on offer. This article found that, although there are treatments offered there are no drugs licensed for use in infants and the trials that have been completed have been too small with inadequate controls to be accepted.

Using formulas which thicken on contact with stomach acids , such as Efamil AR and SMA Staydown ( both available on NHS prescription) are only moderately effective in treating reflux in otherwise healthy children.

A study looking at positioning the infant with the head of the crib raised, found that this is not always justifiable, but placing infants on their left side, can reduce reflux. Lying on one side is not a stable position for infants and using pillows to maintain this position is not recommended.

Gaviscon Infant powder was effective in reducing vomiting and regurgitation in episodes at 14 days, but did not reduce the level of vomiting, and another double blind trial found no difference when Gaviscon was used.

In using drug treatments to reduce the level of acid in the stomach may increase the rate of gastroenteritis in children younger than 4 months, and would not be acceptable in pre term infants or low birth weight babies.

Reflux, like colic, is self limiting. It can be difficult for parents to watch an infant in distress and pain without seeking assistance to make the child more comfortable. Unfortunately this article has no positive statement to make on an effective treatment or intervention, for this condition.

Starting your child on Solids.

2010-09-15T12:49:00.000-07:00

There are a rich variety of sources of information on feeding children. Every source has a different idea about what method and substance. Here are a few points to consider when you want to start your baby on solids.

1) Children can remain on breast or formula until they are 2 years old.
2) The World Health Organisation recommends starting solids at about 6 months.
3) Big Babies do not need to start earlier on solid diet.

Your child is ready for solids when;-
1) He or she can sit up unsupported.
2) He/She can reach out and grab things accurately.
3) He/She takes things into his /her mouth and chews them rather than automatically pushing them out.

Babies are more likely to develop allergies and intolerances when there is a history of hay fever, eczema or asthma in the family.
In the drive for a healthy diet organic foods are an attractive option for feeding children, however beware;-

Organic foods still need to be processed to make them suitable for baby. In the course of this processing many important nutrients are lost. As these are to be sold as “organic” the missing nutrients destroyed in the processing cannot be re introduced because the foodstuff would no longer be eligible for labelling as “organic”.

If you want to feed your child “organic” foods then prepare them yourself. Cook them without adding salt or sugar and push them through a sieve, mash with a fork or offer as “finger foods”. Your child will benefit from the experience and you will not be denying your baby important vitamins and minerals which they need for healthy growth.

Organic foods and babies.

Do you know how much sugar has been added to your child’s convenience food?

Check the food labels carefully.

5grams = an ordinary heaped teaspoon of sugar.

A “food” containing 35 gms sugar contains 7 heaped teaspoons of sugar.
Not something you should be feeding your child!

7 Things to Improve Teenagers Sleep

2010-08-07T03:46:00.000-07:00

The recommendation of Sleep Specialists, is that teenagers should have at least 9/10hours sleep per night. In fact, it is generally recognised that most teenagers fall short if this and only have about 7.5 hours per night.

Although when they were 8 to 10 years old, these same teenagers will have been sleepy and in bed by 8pm, now, in the teen years, they are not sleepy until about 10-11pm. This shift in their circadian rhythm is in part due to the hormones released during adolescence. Not being able to get to sleep before 10/11pm means that they have a shorter sleep cycle. Most teenagers must be awake and alert by about 8am, particularly during the school term. Consequently teenagers, if given the opportunity will lie in until lunchtime as they try to catch up on their sleep.

Regularly not getting enough sleep (chronic sleep deprivation) can affect a teenager's academic and sporting performance and may increase their risk of emotional problems such as depression. Even 30 minutes of extra sleep each night makes a difference. One recent US study found that lack of sleep was a common factor in teenagers who receive poor to average school marks.

A hectic after school schedule,with social commitments, homework and part time employment can cut into sleep time. In western cultures these activities are valued above sleep and this can become a vicious circle. Light cues from television, computers, and mobile phones can prevent the release of melatonin which would help make the teenager sleepy.

The typical teenage brain wants to go to bed late and sleep late the following morning, which is usually hard to manage. You may be able to adjust your body clock but it takes time.

Seven things you can do;-

1)Choose a relaxing bedtime routine; for example, have a bath and a hot milky drink before bed.

2)Avoid loud music, homework, computer games or any other activity that gets your mind racing for about an hour before bedtime.

3)Keep your room dark at night. The brain’s sleep–wake cycle is largely set by light received through the eyes. Try to avoid watching television right before bed. In the morning, expose your eyes to lots of light to help wake up your brain.

4)Do the same bedtime routine every night for at least four weeks to make your brain associate this routine with going to sleep.

5)Start your bedtime routine a little earlier than usual (for example, 10 minutes) after four weeks. Do this for one week.

6)Add an extra 10 minutes every week until you have reached your desired bedtime.

7)Avoid staying up late on the weekends. Late nights will undo your hard work.

Remember that even 30 minutes of extra sleep each night on a regular basis makes a big difference. However, it may take about six weeks of getting extra sleep before you feel the benefits. If you would like some help in adjusting your sleep pattern, contact Dream-Angus

Children and sleep disturbances.

2010-08-04T07:56:00.000-07:00

Children's sleep is slowly becoming a more recognised issue both in the media and in the field of research. Channel 4 (UK television) recently presented a programme where two different Sleep specialists "competed" to see whose methods were more successful. The families who took part had different sleep issues and both had difficulties in being consistent. This is often the case. When you have a big sleep deficit it is very difficult to manage situations, to make clear decisions, and to follow through.

Both families did experience resolution of their sleep disturbances and now the children are reported to be sleeping well. The parents will have their own sleep deficit to address and gradually they too will experience the full benefits of an improved sleep.

There are as many ways to address the various sleep disturbances of childhood, as there are families who need this help. The real expertise is in choosing the most appropriate intervention for a particular family and their child. Then the majority of the work, which the parents have to do, is about being consistent. When a plan works, it works because the parents have accepted the method and have been consistent in following it. How quickly resolution occurs is entirely down to the appropriate method and the parents ability to be consistent.

Children learn by demonstration and frequent repetition. The boundaries have to be set and maintained. This helps the child to become secure in understanding what is expected of them, and to settle to a desired pattern of behaviour. Our children want to please us. When we have a sleep deficit, and when we fail to be consistent, they become confused and this leads to insecurity.

In the interests of the programme, making interesting television, there was more emphasis on the competition between the two experts than on the resolution of the sleep issues. There is no reason why, in this day and age, any parent should have to struggle to get their child or children to settle well at bed time and sleep through the night. There are services out there to help.

Children with special needs have particular issues, but, even with the complications of their specific requirements, they can be taught to sleep and to sleep properly. The main difference is that children who have other health issues are likely to require a more prolonged programme.

If you would like help to resolve your child, or children's sleep issues,
Contact Dream-Angus. A fifteen minute telephone conversation is free.

Prevent simple infections

2010-07-31T05:31:00.000-07:00

Even young children can learn to protect themselves from aquired infections. Most will enjoy this method of information delivery.

Confusional Arousals

2010-07-21T23:10:00.000-07:00

This is quite common in infants and toddlers. Episodes may begin with movement and moaning, and may progress to quite agitated and confused behaviour. The infant may cry intensely, toddlers may cry out and thrash about. Although the little one appears to be alert, they do not respond when spoken to.

This is quite an alarming situation for parents who may try to rouse the little one in an attempt to console them. It will take quite a bit to waken the child and trying to do so is only likely to prolong the arousal. If the child is woken there is also the possiblity that they are likely to be confused and upset.

These arousals can last five to fifteen minutes, only occasionally a little longer. The little one will calm by themselves and return to sleep once it is over. These events more commonly take place in the earlier part of night sleep, before midnight, but can occasionally happen later.

Preventing such occurances requires that the child has a good sleep/wake routine. Children who are overtired or have not had a good and regular sleep pattern are more prone to these events than those whose usual sleep pattern is good.

If you struggle with a child who frequently exhibits this behaviour, Contact Dream-Angus, we can help you to help your child to sleep better.

Night Terrors (Pavor Nocturnus)

2010-07-21T22:49:00.000-07:00

Night terrors should be more accurately referred to as Sleep Terrors. They are a form of arousal which occurs in about 3% of children, usually in later childhood.

Typically parents are woken by a loud scream or sudden loud alarming noise from the child who is at the start of a sleep terror. The child appears to be awake, eyes wide open and staring, sweating profusely, with a rapid pulse and crying out as if terrified. The child may jump out of bed and rush about frantically as if fleeing some danger. Injury caused by bumping into things is a serious risk.

Usually the episode ends as abruptly as it began. The child goes back to sleep and has little or no memory of the event in the morning. If the child wakes at the end of the terror, then a feeling of definate threat may be expressed, but not a nightmare.

Such dramatic events do not mean that the child is ill. Trying to calm a child during such an event is pointless. The child is not aware of anything outwith this feeling of primitive threat. The best thing parents can do is to ensure that the environement is as safe as possible, wait until the event is over, and then resettle the child in bed.

Trying to discuss this in the morning will only make the child more anxious about themselves. Ensuring that the child has a good sleep pattern with regular and adequate sleep will reduce the frequency of these events. If, despite good quality regular sleep these events persist there are recognised effective behavioural methods for dealing with them. Medication is a last resort.

Most children will grow out of these events by adolescence. If your child experiences sleep terrors and you have concerns that they remain frequent despite following good sleep hyigene guidelines, contact Dream-Angus. We can help you to overcome this.

Things we thought we knew.....

2010-07-08T00:49:00.000-07:00

It is interesting to see that some of the things we always thought we knew, are now being confirmed in scientific research.Check out this interesting link;-
http://bit.ly/cQU0BQ

If you would like help and support to improve your child's sleep,
Contact Dream-Angus.com

Seasonal sensitivities and disordered breathing.

2010-07-05T06:31:00.000-07:00

The American Academy of Sleep Medicine reports that approximately two percent of otherwise healthy young children have obstructive sleep apnea, a common form of SDB that occurs when soft tissue in the back of the throat collapses and blocks the airway during sleep.

Most children with OSA have a history of snoring that tends to be loud, and may include obvious pauses in breathing, and gasps for breath. Parents often notice that the child seems to be working hard to breathe during sleep. The study involved a random sample of 687 children in grades K-5. Their parents completed a brief questionnaire, and each child was evaluated between June and November during an overnight sleep study in the sleep laboratory. Mild sleep-disordered breathing was defined as having an apnea-hypopnea index (AHI) of one to five breathing pauses per hour of sleep.

The most surprising thing about this study was the difference in the children's breathing during sleep, over the summer and autumn. Disordered breathing was increased over June to September and decreased from September through November. This highlights the importance of the need to be aware of the childs seasonal ensitivities and allergic reactions.

In the June 2009 issue of the journal SLEEP, Bixler and his research team reported that nasal problems such as chronic sinusitis and rhinitis are significant risk factors for mild sleep-disordered breathing in children. However, the extent to which allergies may promote a seasonal variation in sleep-disordered breathing still needs to be determined.

These findings impact on the medical and drug treatments which are used to treat children who experience disordered breathing during sleep.

Scots ditty /nursery rhythms

2010-07-05T06:17:00.000-07:00

Not really a surprise.

2010-06-18T01:12:00.000-07:00

A recent study of 8,000 children, published in a suppliment of the Journal of sleep and presented last week at a Professional Sleep Societies Conference, found that children with a regular bedtime perform better in a range of developmental measures.

Researchers found getting adequate sleep – at least 11 hours a night – was an important factor in four-year-olds’ development in the use of language, literacy and early maths ability, and a consistent bedtime resulted in the highest outcomes.

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

Preventing Sleep Problems

2010-06-14T12:07:00.000-07:00

In infants as young as two months, a definate sleep wake cycle has been demonstrated. Traditionally it is expected that from about three months of life, infants have a recognisable sleep wake pattern. How can parents help infants to develop an understanding of a good sleep pattern?

Babies learn to tell night from day when they are offered naps in normal ambient daylight with normal household noise. Your infant has listened to your breathing, heartbeat and digestion during their time in the womb. To suddenly have a silent world is strange and worrying. Background noise helps make sudden loud noise less upsetting. Don't close the curtains and darken the room at nap times.

Decide when you want your child to go to bed and when is a good time to wake up. Most families work on a 7am-7pm sleep wake cycle but there is nothing wrong with an 8am to 8pm pattern. Your child will live in your home in your lifestyle. Choose the times that best suit that lifestyle and develop recognisable routines so that your child can learn to anticipate what happens next. This makes the child secure and confident.

Young children have a very small window when they will settle to sleep quickly. Miss this opportunity and settling is a prolonged and difficult process. Learn to recognise your child's sleepy signals and to settle your child quickly.

Your routine before bed should consist of three things which you could do anywhere on the planet. These should be completed in the same order at the same time every night. Children learn by demonstration and repetition. This routine should not be longer than 30 minutes. Your child will quickly learn the order of this routine and know what is expected of them once it is completed.

Put your child down to sleep when they are calm and drowsy. If your child learns to settle by themselves you won't need to spend a lot of time with them to get them to go to sleep.

If you need help and support to teach your child to settle or stay asleep,
Contact Dream-Angus.com

Believing you can sleep

2010-06-14T11:49:00.000-07:00

Many children believe that they cannot sleep unless their parents do specific things to help them relax and settle to sleep. These things which may include being rocked to sleep, being held with ot without added movement, being fed have become part of the child's touchstones, because they have never learned to fall asleep without them.

Every child can learn to go to sleep by themselves. As parents this is one of the most valuable lessons we can teach them.

Children's sleep is not a quiet still loss of awareness of the world. Children can be very noisy in sleep, babbling to themselves, moving round in their bed or crib. They also experience lighter and deeper sleep. As adults when our sleep is lighter, we may alter our position in the bed, become aware that we could wake up, but realise that it is too early, and return to sleep. For children who have developed the need to have mum or dad hold them, or be present, this lighter sleep can result in waking and not returning to sleep, because the association that they have developed, requires the presence of a parent to ensure a return to sleep.

Children who have developed associations and cannot sleep without them need to unlearn these bad habits so that they can settle by themselves. It is very important however, that one association is not replaced by another as this is not a solution.

Any alteration in behaviour needs to be consistent and repeated many times before it becomes accepted as a normal part of life. Following a sleep plan requires repetition for at least ten days before it can be reviewed and evaluated. Most behaviours, in healthy children can be resolved within four to six weeks. Children with specific health needs may require a prolonged repetition of a few months before any progress is made.

If you need help to alter your child's sleep associations contact Dream-Angus.com

Did you know?

2010-05-30T06:55:00.000-07:00

Here are a few things you may not have known about sleep.

1) Your body's internal alarm enables you to wake up spontaneously at the time that you feel is right for you, is triggered by the stress hormone adrenocorticotropin. The levels of this hormone may occasionally rise an hour or two before an expected wake up call to prepare your body for waking up. Sometimes this works "too efficiently" and you wake half and hour or an hour before the time you had in mind.

2) In a study, completed over six years, and looking at a million adults, it was demonstrated that people who get only six to seven hours of sleep a night have a lower death rate than those who get eight hours.

3) The Spanish, possibly because of their "Siesta" in the afternoon,sleep an average of 40 minutes less per night than other Europeans. This is balanced by the fact that Spain also has the highest rate of workplace accidents in the EU, and the third lowest productivity rate. In a gesture to integrate Spain into the EU a campaing was launched to eliminate these afternoon naps/siestas.

4) Oxford University researchers, in 2002,unsurprisingly concluded, that the traditional practice of counting sheep is an ineffective cure for insomnia. This mental activity is so boring that other problems and concerns inevitably surface.

5) During REM sleep, every 90 minutes or so, there are bursts of electrical activity through the brain stem. These are related to dreaming. During an average lifetime, the ordinary person spends more than six years dreaming, clocking more than 136,000 dreams in all. The reasons why we dream have been speculated on for many years, but no one has yet identified the reasons for dreaming.

Separation Anxiety in Childhood

2010-05-27T07:45:00.000-07:00

Many mothers believe that their child has anxiety about being separated from their parent or parents. It is normal for children of 8-10 months to be visibly concerned about leaving parents or carers. Current research tells us that 90% of 10-month-old infants will become upset if a stranger approaches them in an unfamiliar room. Only 50% will become upset if the child is given time (10 minutes) to become familiar with the room. This suggests that, in new situations, infants cope better if they come across new things gradually.

Small children cope better when adults take time to allow the child to get to know them first. Seating a child of a few months on mum or dad's knee, facing a new adult and allowing the child to observe the interaction between the adults first, can help the child become more confident in the new adult and then interaction between the other adult and child is more acceptable. The infant will still look for mum or dad's reaction to their interaction with the visitor and will probably only accept a short interval of direct contact without seeking a return to mum or dad. This is entirely normal.

Separation Anxiety peaks at between 14-18 months and decreases through childhood. Children need to socialise and they need the security of knowing that their parents are there for them. Offering a series of short separations over time will help a child cope with being away from mum and dad.

Allergic or Intolerant?

2010-05-13T10:22:00.001-07:00

Many people mistakenly think that they, or their children, are allergic to a particular food substance. A recent report commissioned in the USA, found the field of diagnosis of food allergies is rife with poorly done studies, misdiagnoses and tests whose results are misleading.

So how do you know you have an allergy? True allergies can be demonstrated in a rise of Immunoglobin E antibodies. That said, there are many people with Immunoglobulin E antibodies who do not react to the foods that this suggests. Allergies affect the immune system. Even people who have had genuine food allergies as children, may not have them as adults. Sometimes people develop allergies for unknown reasons. One of the most effective ways of deciding whether there is a food allergy or not, is by using a "food challenge". This involves giving some one a suspect food disguised so that they do not recognise it, or a placebo food. In practice most doctors believe this to be time consuming, and in the case of peanuts for example, there is the possiblity of a frightening response.

For this report Dr. Reidl and his colleagues reviewed all the papers they could find on food allergies published between January 1988 and September 2009, more than 12,000 articles. In the end only 72 articles met their criteria which included having sufficient data for analysis and using rigorous tests for allergic responses.

Intolerances such as Lactose Intolerance, is due to the lack of sufficient enzymes in the body, to digest the sugar in milk. Sulfites in wine, can cause headaches for some, and this is again an Intolerance not an allergy.

During development, the immune system tends to react to certain food proteins, and can produce IgE antibodies, but these antibodies can be transient or inconsequential. By themselves pinprick tests and antibody tests are not sufficient to demonstrate food allergy. The people involved in this study hope that their report will lead to further research and clarify both the definition of, and testing for, food allergies.

Sleep and the Autistic child

2010-05-09T11:19:00.000-07:00

The rate of sleep disturbance and sleep disorders is notably higher in children who have other health or developmental disorders. Children with Pervasive Developmental Disorders and Autism have particular difficulties in sensory processing. These can be general or specific to that child. There are ways to assist children affected by these difficulties to improve their sleep pattern and thus improve the whole families sleep.

Patterns and routines are even more important as they cue the child to expect the next consequence or next event. Having a good, simple, regular routine is comforting to a child. Other sensory assistance in getting the child to be calm and ready to sleep can be successfully used in different formats, different intensities and variations to meet the child's sensory needs.

Using "heavy work" concentrates the child's energy and calms. Pushing a weighted basket round an obstacle course can be fun. The basket should be heavy and require effort but not so heavy as to strain the child pushing it. Playing wheelbarrow games where the child is the wheelbarrow may also be helpful. Again, this requires concentration of effort.

Some children benefit from the use of a weighted blanket. There are a variety of manufacturers who produce these. The blanket may be weighted with a variety of fillings. Ideally the weight of the blanket should be about 2.2Kgs heavier than the child. Tucking a child in a weighted blanket offers firm pressure over the body and for some children this is very comforting. It can feel a little like being swaddled, held comfortably without the need for someone to do the holding.

Using white noise in the bedroom can help some children because it blocks other noise and reduces distraction. For some children the same techniques which help children settle to sleep and remain asleep are every bit as effective for children affected by Autism and Autistic spectrum disorders. It simply requires more repetition before the child can relax and settle into the routine.

Every child is different. What works for one child may be less effective for another and it can take a while trying and repeating things to identify the most effective routine and resource for your child.

If you would like help with your child's sleep, Contact Dream-Angus.com

Children and choices.

2010-05-01T02:15:00.000-07:00

Children have very little control of their lives. Parents will make all the decisions for them. To give them some control, it is good to offer them simple choices. As they learn to make these choices, they learn the consequenses of them and to take responsibility at their own level, for the decisions they make. Choices should be simple, between A or B.

The more choice a child has the more confused they become and the more difficult the choice. From a very early age children should be given choices to make which give them a feeling of control without becoming battle ground between child and parent.

A child who learns early in life to make choices for themselves is more secure in that they realise and appreciate that every decision comes with a consequence. Choosing not to wear wellingtons and stomping in puddles results in wet feet! Choosing to wear a summer dress on a winter day makes life cold and uncomfortable.

If your child is used to making simple decisions for themselves then they are more co-operative when you decide that it is now your turn to make the decision for them. The child becomes more self aware and more responsible, within the limits of their age and stage of development.

Learn to trust your child and let them make some simple decisons for themselves.

How long does it take to alter sleep behaviour?

2010-05-01T01:54:00.000-07:00

If your child has a sleep difficulty it is important that that difficulty is first clearly identified. There are a range of sleep disorders which children and adults can experience.
Once that difficulty is identified, through a detailed history, and the duration of the problem is known, it can take as little as four to six weeks to resolve.

When a child has another underlying health issue, or has a handicapping condition, it may take three to four months to properly resolve the sleep difficulty.

The main requirement in following any behaviour altering programme, is that the routines set are consisitent and this can require a great deal of effort from parents and carers. Being consistent with a child when you yourself have a sleep deficit is not always easy. There are always times when it is much simpler to give in, to accept a level of unwanted and/or antisocial behaviour, than to be firm and insist that a set behaviour has a consistent consequence.

Circadian Rhythm disorders require the greatest comittment as the behaviour alteration has not only to alter the body clock, but to maintain that alteration for at least two or three months longer than the original duration of the difficulty. Even at that, altering routines by as much or as little as one hour can upset the system and require a "re start". This can try the motivation of the young person as well as the patience of the parents.

That said, the resolution of these difficulties brings enormous rewards in the entire body system, mental health and attitude to life.

If you would like help in resolving your child's sleep difficulty..
Contact;- www. Dream-Angus.com

Children with ADHD and sleep.

2010-04-19T10:51:00.000-07:00

Attention Defficit Hyperactivity Disorder is a common condition that begins in childhood and may persist into adulthood. Children with ADHD typically have trouble sitting still, staying focused, and/or controlling their behavior and emotions, which can lead to poor social skills, isolation, dependence, and poor performance in school.

ADHD is linked with a variety of sleep problems. For example, one recent study found that children with ADHD had higher rates of daytime sleepiness than children without ADHD. Another study found that 50% of children with ADHD had signs of sleep disordered breathing, compared to only 22% of children without ADHD. Research also suggests that restless legs syndrome and periodic leg movement syndrome are also common in children with ADHD.

In general, sleep deprivation is a problem among children. A 2004 "Sleep in America" poll, more than two-thirds of children experience one or more sleep problems at least a few nights a week. For children with ADHD, poor sleep (too little sleep or symptoms of sleep disorders) may profoundly impact ADHD symptoms. In fact, one study found that treating sleep problems may be enough to eliminate attention and hyperactivity issues for some children.

Children who experience sleep deficit may be moody, emotionally explosive, and/or aggressive as a result.In one study involving 2,463 children aged 6-15, children with sleep problems were more likely to be inattentive, hyperactive, impulsive, and display oppositional behaviours.

Treating sleep problems in children and adults with ADHD may improve symptoms and quality of life.

If you would like help to improve your child's sleep, Contact Dream-Angus.com

Difficulty in settling young children to sleep

2010-03-26T10:57:00.000-07:00

Difficulties in settling to sleep are often under diagnosed in infants and toddlers. Parental behaviours which reduce the child’s independence about sleep, for example requiring a parental presence, or being put to bed once asleep, are the primary grounds for the development of settling difficulties. Potentially, a small but chronic loss of sleep in childhood could directly affect the child’s behaviour and social competence, cognitive performance and physical condition.

Children who have short duration night sleep before 3.5 years of age show increased risk of hyperactivity, impulsiveness, and poorer learning skills at 6 years of age compared with children who sleep for 11 hours a night.

Children who experience persistent short sleep duration in early infancy, are also at increased risk of obesity at 6 years. The importance of sleeping for at least 10 hours a night in early childhood is stressed, as the National Sleep Foundation poll suggests, for optimal child development.

If your child has difficulties in settling to sleep, Contact Dream-Angus and let us help you to help your child.

Attachment and separation issues

2010-03-25T11:56:00.000-07:00

A study, partly funded by the National Science Foundation, and conducted by researchers at the University of Reading (in the United Kingdom), the University of Leiden (in the Netherlands), the Barnet, Enfield & Haringey Mental Health National Health Service Trust (also in the U.K.), and the University of Illinois at Urbana-Champaign investigated Attachment Parenting theory.

This study, published in the March/April 2010 issue of the journal Child Development, suggests that children who cannot maintain a coherent strategy for coping with separation, are at greatest risk of later developing behavioural problems and becoming aggressive.

This study is a meta-analysis of 69 studies involving almost 6,000 children ages 12 and younger.

According to attachment theory, children with secure attachments have repeated experiences with caregivers who are responsive to their needs, and thus expect their caregivers to be available, and comforting when called upon. In contrast, children with insecure attachments, have an experience in which requests are discouraged, rejected, or responded to inconsistently, which is thought to make them vulnerable to developing behavioural problems.

The researchers sought to clarify the extent to which bonds between children and their mothers early in life, affect children's behavioural problems later, such as aggression or hostility. Behaviour problems were measured up to age 12. The studies included in their review used a range of methods for assessing children's behaviour problems, including parent and teacher questionnaires and direct observations.

If you consider all the small separations which allow your child to practice separation from mum and dad, like sleeping in their own bed, staying with another carer, attending nursery or creche it becomes even more obvious that these small events allow your child to develop coping skills. Children who never experience such small scale "practice" have much more difficulty in coping, not just with the separations life brings, but with many other events, for which they are totally unprepared.

If you would like help and support to move your child to their own bed;- Contact Dream-Angus

Bouncing to the beat.

2010-03-20T08:37:00.000-07:00

How many mums-to-be have noted the increased movement of their unborn child in apparent response to music? Well, now psychologist Marcel Zentner, from the Univeristy of York, and his colleague Tuomas Eerola, from the Finnish Centre of Excellence in Interdisciplinary Music Research at the University of Jyvaskyla, in Finland, have detailed their findings of infants responses to music, in the March 15 issue of the journal Proceedings of the National Academy of Sciences.

This research showed babies respond to the rhythm and tempo of music, and find it more engaging than speech. The findings, based on a study of 120 infants between 5 months and 2 years old, suggest that humans may be born with a predisposition to move rhythmically in response to music.

"Our research suggests that it is the beat rather than other features of the music, such as the melody, that produces the response in infants," said researcher Marcel Zentner, a psychologist at the University of York in England. "We also found that the better the children were able to synchronize their movements with the music, the more they smiled."

During the experiments the babies were sat on a parents lap. The adults wore headphones so that they could not hear the music, and were asked to sit still so that they could not affect the babies responses.

To test the babies', the researchers played recordings of classical music, rhythmic beats and speech to infants, and videotaped the results. They also recruited professional ballet dancers to analyze how well the babies matched their movements to the music.

The researchers found the babies moved their arms, hands, legs, feet, torsos and heads in response to the music, much more than to speech. Though the ability appears to be innate in humans, the researchers aren't sure why it evolved.

Parenting and infant sleep

2010-03-19T09:33:00.000-07:00

It is becoming more fashionable these days to co-sleep. Co sleeping is accepted as a "norm" in Asian countries, and becoming part of "attachment parenting" in the West. Co sleeping has it's attractions and, as with every parenting style, those who believe it is the best possible thing to do, and those who warn of the dangers. There should be in all things a balance. Co sleeping while breast feeding an infant has benefits for mother and child. There should be a recognised time when co-sleeping is no longer an option.

A recent study reported in the Sleep Science Review journal looked at the effects of adult behaviour on infant sleep. Parental behaviours, particularly related to bedtime routines and interactions are recognised as having an effect on infant sleep patterns. It appears that parental personality, and related views on parenting, and emotions. contribute to parental sleep-related behaviours. This ultimately influences infant sleep. These links are effective in both directions, and they are dynamic. This means that poor infant sleep may influence parental behaviours, and poor infant sleep is recognised as being a family stressor and a risk factor for maternal depression.

In another study by Professor Mindell, it is reported that both mum and child.miss out on one stage of sleep when they co-sleep. There is certainly room for more work, looking at the effects of missing this stage of sleep, and at the effects of co sleeping which is prolonged beyond 6-9 months.

While co sleeping is a parental choice, setting a time after which the child will be in their own room in their own bed, is something which should be agreed and adhered to by both parents, in the interests of the child and of their own relationship.

When should sleep training start?

2010-03-07T08:51:00.000-08:00

Training your child to sleep should begin as soon as possible. We teach our children to become reliant on us by always holding, rocking, allowing baby to suck and fall asleep when we are present. This builds the idea in the child's mind that falling asleep is difficult without the associated presence and action.

From only 8 weeks babies have a rudimentary rhythm to their sleep/wake cycle. They may not have such a good routine around food but it is developing. The earlier we encourage babies to fall asleep without us the easier it is for baby and parent to become confident about this. Of course if baby is unwell the demand for comfort and cuddles increases. Learning to anticipate baby's needs and recognise wants is an important part of parenting.

Children's needs should always be met, unconditionally. In the real world our desires/wants are not always me and it is easier to teach children this life lesson early. It is also kinder not to allow them to expect that they are always going to be given the things they desire as well as the things they need.

Baby should be put down in a safe sleeping place when he or she is drowsy but aware that this is what is happening. This will build security and independance into sleep time. If you are confident that things are fine baby will be confident too.

If you struggle to establish a routine for your little one, contact Dream-Angus, we can help you to teach your child this valuable lesson.

Sleep patterns in infants.

2010-03-03T10:38:00.000-08:00

We expect babies to wake frequently through the night for feeds and for comfort. Most healthy term babies no longer require feeds at night when they are about 6 months old. Some stop looking for a mid night feed before that. Others are used to this feed and are reluctant to go without but usually they can be gently disuaded from maintaining this habit.

What may surprise mums, is that babies who are exposed only to daylight in the first few weeks of life demonstrate the begining of a sleep wake pattern at as early as 60 days/8 weeks. Starting to "sleep train" infants from this early stage could be highly effective.

When we start to discern a pattern to an infants sleep/wake periods the patterns could be reinforced by ensuring that naps are taken in daylight with normal ambient household noise, and night sleep started when the daylight fades. This follows our primeval sleep/wake pattern which we have adapted by using electric light and altering our lifestyles.

Learn to recognise your infants "sleepy signals". If your child is demonstrating these signs then take advantage of this and put your child to bed. There is only a short window when you can successfully persuade an infant to nap. Miss that slot and baby has gone beyond napping, got a second wind and become fussy and reluctant to settle.

If you would like help to improve your child's sleep Contact Dream-Angus.com

Children's sleep difficulties.

2010-02-28T02:38:00.000-08:00

Children's sleep difficulties vary with the age and developmental stage of the child. They can be simple with a single cause and a quick solution, or they can be complex with more than one difficulty. It is always important to differentiate between a genuine sleep difficulty and a physical or psychological problem. The most common sleep difficulties are related to going to bed, getting to sleep, and staying asleep all night without interruption.

Some children are resistant to bed time. They always want another story, another drink or snack, and generally put off the time when they must go to bed. For some children this is because they are fearful of being alone, of the dark or because they have had bad dreams, or fear bad things lurking in their room. Developing a good short recognisable pre bed routine which allows the child to quiet their thoughts and calm before bed is helpful and there are simple reassuring measures that parents can take to make the experience less worrying.

Learning to go to sleep without requiring any other stimulation is entirely possible. Always being be held, fed, rocked or to have a parent present, leads the child to believe that without these contacts and reassurances they cannot get to sleep by themselves. In fact every child can get to sleep without these associations but some take longer to learn this. Parents who have had difficulties in getting their child to sleep may inadvertantly create a situation where the child will not sleep without their presence and this has to be unlearned.

Although sleep is considered to be a quiet activity this is not always the case. Most children have between five and eight periods of lighter sleep when they may waken. If they required a parental presence to get them to sleep at bed time, they will require this again when their lighter sleep results in a night waking. Adults also have these periods of lighter sleep but they are usually aware that this is light sleep and may change their position and return to sleep without a full awareness of having been lightly asleep. Children have to learn to do this too.

If you need help to teach your child to sleep Contact us at Dream-Angus.com

The Fourth Shift

2010-02-10T12:16:00.000-08:00

While a great deal of research has looked at sleep and children's sleep patterns the sociological effects of childrens sleep on that of their parents, has been largely ignored. Last year a sociological study examined how couples with children have their sleep influenced by caring for their child or children.

The key concerns were not only related to caring for young children and their physical needs at night, but also how the nature of caring for older children impacts on parents sleep. A number of couples aged 20-59 with both younger and older children took part in the study which involved completing auditory sleep dairies, individual in depth interviews, and follow up interviews.

It is not really a surprise to find that the physical and emotional care of young children at night was largely provided by women, with a lack of explicit negotiation between partners about who should provide this care, even when the woman returns to work. Overall considerably more women than men continued their daytime and evening employment, as well as undertaking a third shift, or sentient activity, for their family into the night. This resulted in a fourth shift where physical caring and sentient activities continued.

As a consequense mothers were more likely to subjugate their sleep needs to those of the family. Fathers, in general, did not undertake this fourth night time shift. Those fathers who did, were more likely to be fathers of older children who were staying out late at night, with their focus of concern being the safety of the children.

If you find your children are demanding during the night and you would like to alter this behaviour, Contact Dream-Angus.com

Migraines and Sleep Related Breathing Disorders.

2010-02-06T07:20:00.000-08:00

Children who experience migrane headaches are more likely than the rest of the population to have sleep disorders, which are related to how they breathe while asleep. Obstructive Sleep Apnoea, where breathing is discontinued for 15 seconds or more while the child is asleep, is a recognised sleep disorder. Often this can be simply resolved by removal of large tonsils and/or adenoids. Other children experience this problem because they are overweight, or for other physical reasons.

Children with sleep related breathing disorders may wake suddenly in the night, when the brain announces a lack of oxgyen, and demands a breath be taken. This can result in a sudden, and to the child, inexplicable and terrifying waking, and may be accompanied by an associated gasp as the required breath is taken.

A study by Dr. S. Kothare looked at children who reported having regular headaches. The study found that children with migrane were twice as likely to also have obstructive sleep apnoea. This same study found that children with tension headache also grind their teeth at night.

Migraine in children, is a big and separate subject. It is not always reported as headache, and can, depending on the age of the child, be reported as abdominal pain. The relationship between sleep disordered breathing and headache, migraine and tension headache should be brought to the attention of parents so that appropriate investigations, advice and treatment can be obtained. Migraine is associated with a shorter total sleep time, a longer total time to fall asleep and a shorter period of Rapid Eye Movement sleep.

Obstructive Sleep Apnoea occurs in 2% of children. It can develop at any age, but is most common in pre school children (3-6 years). At this stage of life the tonsils and adenoids are large compared to the throat. The rate of occurance is the same regardless of gender. It is more common where another family member has the same disorder, and it is common in obese children.

If your child regularly wakes suddenly, with a sharp cry in the night, you should consider your family's sleep patterns and possibly seek advice regarding Obstructive Sleep Apnoea.

If you would like more information Contact Dream-Angus.com

Calming babies and children under 1 year.

2010-01-19T03:53:00.000-08:00

The most difficult thing in getting a young child to sleep when they are resisting, is getting the child to be calm enough to relax and become drowsy. There are a number of simple techniques which can help with this.
If the child is still a baby and not yet mobile, there are the much lauded "4 S's"

Swaddling a baby is conforting, gives a feeling of being held without the need for a parent or carer to hold the child. It provides "deep pressure", avoids waking from the startle (moro) reflex when hand coordination is not fully developed, and for a majority of babies helps to calm.

Shuushing, providing background noise which reduces the effects of sudden loud noise and replicates the noises heard by baby while in the womb.

Sucking is calming for most babies unless they have reflux and associate this with pain. Using a comforter/pacifier/dummy to calm a baby is good but they should not be left in the mouth until the child is asleep or they may become dependant on this aid.

Shoogling, the short gentle movements which replicate the gentle movements felt as mum went about her day before delivering baby. Some parents use a swing, stroller, or rock baby in their arms.

All of the above in a variety of intensity and combinations will soothe a distressed baby. Unless a child is calm getting them to sleep is virtually impossible. Having a recognisable routine which is always done in the same order at the same time is reassuring for every child and the older the child the more important that routine is. This makes some certainties in the child's life. If a certain set of circumstances occur, then the anticipated response is also familiar and it is easy for the child to give the appropriate response. Our children want to please us and having at least one thing which they recognise and know how to respond to, helps build confidence in an otherwise uncertain world.

Some parents, who struggle with settling and sleep issues resort to the use of medications, or homeopathic, or herbal remedies. These may help but do not address the root cause of the undesirable behaviour. Adults come to rely on the administration of these products to acheive a calm and sleepy child. The child also learns that sleep can only be accomplished by the use of such substances. This is not a healthy route to sleep. It does not allow the development of independant abilities to self soothe to sleep. This can become a long term issue which, when behavioural interventions are used would be short lived.

There are very few occasions when it is appropriate to medicate to sleep. While there are treatments which will achieve this they are not without side effects and they do not address the problem, they only treat the symptoms.

If you have difficulties settling your child, Contact Dream-Angus.com

Depression in teenagers

2010-01-03T02:03:00.000-08:00

Professor Gangwisch, of Columbia University College in New York, is the lead author of a recent study published in the journal Sleep which looked at the theory that inadequate sleep is a risk factor for depression.

Those of us working with children and families have always been aware that many young people spend their formative years chronically sleep deprived. As a result they are tired and inattentive and more prone to obesity,hypertension and depression.

Researchers now believe that sleep deprivation is directly linked to depression and suicidal thoughts, making it much more difficult for these young people to cope with daily stresses and making it more difficult for them to engage with their peers and with adults.

Teens allowed to stay up to midnight are 24% more likely to suffer depression and 20% are more likely to consider self harm than those who have set bed times of 10pm. Adolescents who sleep for five or fewer hours per night are 71% more likley to suffer from depression and 48% are more likely to consider suicide than those who reported getting eight or more hours of sleep per night.

The more sleep adolescents and teenagers get the lower the rate of depression, and the better this is for both their mental and physical health. Nine hours of sleep per night is the recommended level for adolescents. Of the 15,000 students, aged between 12 and 17, who took part in this study, the average sleep duration was only 7hours and 53 minutes. Those with a bedtime of 10pm or earlier slept on average 33minutes longer than those who went to bed at 11pm and 40minutes longer than those who went to bed at midnight.

This highlights once again the important part a good nights sleep plays in mental and physical health and wellbeing. Teaching your children good sleep habits is vitally important. Recognising when things are going wrong and working to resolve sleep issues at an early stage is worthwhile from a health perspective. Ensuring that young people get regular exercise, fresh air and have a regular sleep pattern gives them the optimum start in life.

If your child has difficulties developing a good sleep pattern contact Dream-Angus, we can help you to help your child to a better sleep.

Seasonal issues

2009-12-15T06:51:00.000-08:00

At this time of year it is particularly important to ensure that our children get enough sleep. Excited children, fighting sleep in the hope of catching Santa leaving presents, seeing the reindeer, or just taking part in the more sociable aspects of Christmas and New Year make life more difficult as their accompanying sleep deficit makes them more active and often more confrontational. It is so important to have a quiet period before bed. To allow and encourage children to wind down and sleep.

At the same time many manufacturers are promising all sorts of "aids to restful sleep" and in the Christmas spirit we may be tempted to spend money on gadgets which offer this golden promise. Unfortunately there is no golden gadget which can fulfill the promise of a good night's sleep. Medication can acheive this, but who wants to become dependant on medication for a good nights sleep? Light therapy can help individuals with circadian rhythm disorders, but have little benefit for the rest of the population.

In order to acheive a good nights sleep routines of wake and sleep times are vital. Ensuring that one wakes at the same time and settles to sleep at the same time every night are the practical habits which reinforce our body clocks. Having some out door exercise in the fresh, albeit cold/wet air every day will also help. Sleep is something we learn to do. We learn by repetition and by habit, so it is important that our habits are good.

Having a quiet hour, making the last hour of wakefulness less stimulating, even boring, prepares our minds for sleep. Breathing excercises, yoga, or meditation may help adults to remove themselves from the stresses and cares of the day and quiet the mind. Children who are read to or who read or work on quiet activities are much more likely to go to bed happily than those who have had a busy time or participated in stimulating exciting activities before bedtime.

There are recognised "Good Hygiene Guidelines" which we should review and adhere to if we want our children to go to sleep and wake rested and bright in the morning.

If you would like a free copy of these contact Dream-Angus.com

Bed Wetting ( Nocturnal enuresis)

2009-12-09T01:59:00.000-08:00

Bed wetting does not result from bad parenting or naughty children. Bed wetting is often seen as a private problem which occurs in the home at night and is seldom discussed outwith the family. This problem affects one in ten children at seven years of age. Some children may experience urgency, frequency or wetting during the day. Others who have managed to toilet well in day time, and progress from nappies to underwear, may still have difficulty in remaining dry overnight. This is something which can be overcome by bladder training.

If bed wetting occurs after 5 years of age, and there has been a period of 6 months of more being dry at night, then there may be a specific trigger factor which must be investigated. Children with ADHD are 2.7 times more likely than the rest of the children in the population to have problems staying dry at night. If one or both parents have been bed wetters then the risk of their children also having this problem is increased. Children with normal bladder function at 7 years of age should pass urine 5-7 times a day when their fluid intake, spread over 24 hours, is about 1.2 liters.

Some children sleep very deeply and are not aware of a feeling of bladder fullness. Others may not reduce urinary production at night. This is something our brain has overall control of. It is difficult to teach bladder control in sleep. Although the World Health Organisation defines nocturnal enuresis as bed wetting at 5 years of age or older, there is new evidence that this problem should be tackled before the age of 4 years. Statistically the odds against becoming dry at night after the age of 4 decreases slowly as the child gets older.

Children who bed wet are much more likely to experience urinary tract infections and this should be one of the first things that requires to be checked out. Untreated and unrecognised urine infections can result in kidney dammage and high blood pressure. Restricting fluids before bed time has no effect on reducing or eliminating bed wetting. Toileting the child before bed, and again before parents retire can be helpful. If the child has a bladder disfunction then the irritablity of the bladder can make it difficult to cope with a "normal" volume of urine.

Children who bed wet should be seen by their doctor and have a urine specimen checked for infection before any treatment plan is instigated. There are a variety of medications which can be used to help resolve nocturnal enureisis but these should be used along with behaviour modification or enuretic alarms. Enuretic alarms may be bed or body worn and have a lasting success rate of about 40%. They must be used every night for 6-8 weeks and at first may wake the whole family. The use of an alarm together with medication or behavioural management is more effective than the alarm on it's own.

Winter colds

2009-12-09T01:28:00.000-08:00

It is inevitable that children get coughs and colds in winter time. When they start school for the first time, on their first time in creche or playgroup, they meet all kinds of infections which they may not have met before. These are usually mild illnesses which are of short duration. Many of them are viral and therfore do not respond to antibiotics. For most children keeping them well hydrated, giving plenty of fluids and keeping them warm and comfortable is enough to see them through the worst of this.

It is important that, should they develop a high temperature, this is treated. In small children prolonged febrile illness which is untreated can result in convulsions and this is something to be avoided. Tepid sponging has little benefit, it may give parents something to do, but it is seldom effective in reducing a child's temperature. The careful use of medication will reduce temperatures by 2-3 degrees. If the child is at home reduce the layers of clothing/bedding so that the child remains warm but does not become chilled. If you are concerned you should seek your Doctors advice. Better to be over cautious than lax about this.

Babies often become snuffly and it can be helpful to take smaller children into the bathroom while mum/dad has a shower. The steam will loosen secretions and then by simply tickling baby's nose with a little paper hanky or cotton wool cause baby to sneeze so that the secretions can be wiped away. Cotton buds and other external tools should not be inserted into a child's nostrils. Nostrils and ears are self cleaning. Poking things into noses can make the child move suddenly to remove themselves from the object, and result in the accidental dammage to the nasal septum. (Cartilage which separates the nostrils)

There are a variety of menthol rubs available for use in treating children. These assist in clearing the nasal passages and make breathing easier. Babies naturally breathe through their noses and have to learn to use their mouths to breathe when their nasal passages are blocked. This makes feeding more difficult and the careful use of menthol preparations before a feed may assist in making it easier for baby to take a feed.

Fresh air is important, both for general health and a good nights sleep, but in winter the temperature drops quite dramatically after 3pm. so small children benefit from being at home before then. When taking your child out, you should expect to clothe them in one layer more than you require yourself.

If you are trying to alter your child's sleep pattern and the child is unwell it is better to abandon the plan until they have fully recovered. Ill children require more attention and are more demanding. Once they have recovered they learn more easily and are less likely to react badly to alterations in the behaviour of their parents.

Loss of a pet or a relative

2009-11-23T03:48:00.001-08:00

Grief and loss in childhood is a very specialist subject. Some families have pets to teach their children a sense of responsibility and caring. The loss of a pet is a lesson in life. It teaches the child that life is precious and not permanet. Learning to accept that loss is helpful in later life but explaining that loss to your child can be difficult.

There are a number of books written for children of different ages which can be useful in helping them to cope with the grief and loss of a relative or friend. These are books which should be read together, child and parent, and offer opportunites for discussion afterwards.

The level of understanding about grief and loss is also a part of the general development of a child. Even a baby will pick up on parental distress without any understanding of the cause. We often try to hide out fears from our children so that they do not experience the same fears, fear of spiders for example. We should be able to find a balance in sharing grief without overloading children. Loss is part of life, and if we want our children to be well balanced and confident, then we also want them to have an understanding of the many changes in a lifetime. This involves learning coping skills to help them deal with the many experiences they will have.

If you would like some titles of books to help you broach this subject with your child contact Dream-Angus.com

Anxiety in childhood

2009-11-23T03:07:00.000-08:00

Anxiety in childhood is not unusual and in most cases with reassurance and time spent building the child's self esteem and self confidence this is short lived. Children can be anxious for a variety of reasons. It is normal for young children to be concerned about being separated from a parent or to be afraid of the dark, storms, animals, insects or strangers. With reassurance this can be overcome.

Some children are so anxious and uptight that this anxiety impinges on activities and they require a great deal of reassurance. Anxious children are quiet, compliant and eager to please and their anxiety may be overlooked.

Anxiety increases the heart rate and rate of breathing. This is part of our fight or flight mechanism and encourages good oxygenation of the arms and legs in case we have to run away or fight. This causes a feeling of pounding heart and breathlessness. The child may have diarrohea or be constipated. The divertion of blood from the internal organs causes a feeling of stomach churning or "butterflies". The mouth becomes dry, muscles tense, sweating increases and the child is very alert. This can lead to a feeling of lightheadedness and even fainting.

While a certain amount of anxiety is useful and even healthy when a child is exessively anxious they lead to panic. Panic attacks sometimes happen when there is no immediate threat to life. These panic attacks are one of the most common psychological problems in the Western World affecting 2-3% of the population. Young people experiencing these distressing feelings and events are often not fully aware of why they feel so frightened and they cannot always express this feeling or communicate it to their parents. This adds to their distress.

Parents often feel frustrated as they do not understand why their child is behaving in this way or what has caused this. It is important that they control and hide this frustration from the child. What then can parents do?

Be calm, relaxed and confident. Reassure the child but do not raise your voice you will only increase the child's discomfort and distress. Using positive language " I will keep you safe" "you will be all right" , distracting them by offering a focus that the child can use to think about instead of the frightening situation that they are in. Talk about normal happy things, remove the child to a quiet relaxing place and offer them a drink which does not contain caffine. Stay with the young person, ask them to concentrate on their breathing and to breathe deeply until they are calm and relaxed. People in a panic do not make good decisions as they cannot properly assess risk.

If these panic events occur more than once and are affecting school work or other activities then consult a Child Psychologist. There are effective treatments available and it is important that these events are not ignored.

Parenting skills

2009-11-18T07:14:00.000-08:00

There are many decisions which have to be made when one becomes a parent. Some are comparatively easy and straightforward but the sense of responsibility that goes with parenting makes many very aware of the "guilt" experienced or immagined when things are less straightforward.

Parents are responsible for the safety of their children, for their first impressions of the world and their fellow humans. We all want our children to be able to be independant people and to have the necessary skills to cope in the complex world of relationships, with peers and authorities,and to be able to feel secure and confident in that world. There are as many different parenting styles as there are children and parents. No one style works for everyone. There are a rich variety of books on the subject, but even these often contradict each other. At the end of the day there is no perfect parent just as there is no perfect person we all seek to do the best we can with the knowledge available to us.

While many parents want to be their child's friend, they do their children a great disservice in following this path. Children require guidance and firm rules, which they will challenge as they grow. The very rules set by parents are important as a form of security. The certain knowledge that a particular behaviour or behaviours are unacceptable, and will be met with equally unacceptable outcomes, are part of the fabric of learning to live in society. While conflict is not always pleasant or positive, there are times when it is inevitable and should be met with understanding and with firmness which demonstrates that the caring person guiding the child is capable of fully accepting that responsibility.

Children who learn to live by the rules of their parents and to accept that there are consequenses when they behave badly are generally much happier. Setting limits for your child does not mean that you need to be particularly strict or harsh. It is always more comfortable to live within the bounds of known and accepted rules than to be in conflict where there appears to be little reason or no known guidelines to follow.

Quiet play.

2009-11-18T06:42:00.000-08:00

How does one define "quiet play"? Well, for most mums' it is any activity which keeps a child or children working quietly on a project which is interesting, but not exciting or very stimulating. Many sleep experts define quiet play as reading or being read to, listening to music, drawing or colouring in. Quiet play is a good wind down activity which leads to bed time and doesn't over stimulate or over excite the child. That's fine as far as it goes.

If you are working, even with a child as young as three to six months, then reading a book to them is a pleasant activity which does not require any active response from the child. Starting this kind of activity at an early age is good because it encourages use of language and recognition of simple objects. Even reading nursery rhythms is useful as the learning of cadence, rhythm and phrasing helps with language development. Listening to music which is quiet and soothing without any sudden loud phrases or jarring noise, (this is surely a matter of personal taste) can be soothing to the child. In one so small being held comfortably and patted slowly or stroked gently can also be soothing.

Quiet play does not include computer games or games which require interaction at a high level. These undoubtedly have their place but it is not as a pre cursor to bedtime. It is important to stimulate immagination but bed time is not a good time for this particularly if your child has nightmares or fears of the dark or being alone.

Quiet time is a useful time in bonding with a parent who is always busy, or not available during the day. The last hour of wake time is a good time to spend listening to your child telling you about his/her day, enjoying close physical contact, and learning to relax and wind down together is good for both parent and child. The last hour before bed time is quality time for parents and children and we do all a disservice if we just switch on the television and expect that to be enough.

Swaddling.

2009-11-10T10:06:00.001-08:00

Swaddling is the art of wrapping a baby or infant so that they are held firmly in cloth binding. This is a practice that has been carried out through the ages since biblical times. Originally swaddling was a method of restricting the movement of the child, and was thought to encourage strong, straight growth of the child's limbs. The degree of swaddling, which used to involve several different bindings altered in about the 17th century when it was decided that this was too restrictive a practice. Since then swaddling has been refined to the wrapping of the infant in a single piece of cloth or a shawl.

Many cultures still swaddle children until they are independantly mobile. In the west we swaddle newborn babies but some people think that swaddling should be discontinued at 8 or 12 weeks. There is no evidence to suggest that this is good practice, in fact the research completed in 2002 and 2005, and quoted in Pediatric journals, suggests that swaddling has a rich variety of benefits for the child and for the parents.

Swaddling a newborn makes the baby feel secure. While in mothers womb only limited movement was possible, baby was confined by mothers womb and abdominal muscles. Swaddling gives the baby the sensation of being held. Surrounded by the deep pressure of a breathable wrap, only baby's head is left free. This "holding", without physical contact, allows baby to relax and sleep on his/her back. The startle reflex, which causes baby to abruptly open arms and swing unco-ordinated hands and arms, can result in an unswaddled baby hitting themselves and can waken an otherwise settled baby.

Swaddling calms a fussy baby because it makes baby feel secure. One well recognised Pediatrican points out that this is one of the "four S's which calm and settle babies!" Today many mums are discouraged from maintianing swaddling after 12 weeks on the grounds that after this time swaddling impacts on a childs growth and motor development. Again, there is no evidence to back up this eroneous claim.

Swaddling has the following positive benefits;-

1) Swaddled babies sleep longer and better. Startles are reduced, there are fewer awakenings during deep sleep, and there are shorter arousals during REM sleep.

2) Swaddled babies are kept at a warm temperature without the risk of loose bedding covering their face and head.

3) Swaddling reduces fussiness and may even help eliminate colic.

4) Swaddling keeps baby sleeping on his/her back which is recommended for the prevention of Sudden Infant Death.

5) Swaddling is associated with increased awareness of environmental auditory stress, so although baby sleeps longer and deeper baby is also more alert to danger.

6) Swaddling makes it impossible for baby to scratch themselves or jerk their limbs and wake themselves by the unco-ordinated limb movement.

As babies grow stronger and more mobile they will wriggle free of the swaddle but there is no evidence that swaddling will inhibit a childs development in any way. Of course, as the child grows swaddling should only be done for naps and night sleep. The rest of the time baby should be able to use their limbs freely and experience the world.

As recently as July of this year researchers were being quoted as having further evidence of the benefits of swaddling even in older children. It is never too late to swaddle although some children do take a little time to get used to this if it has been discontinued earlier.

Bruxism, Teeth grinding in sleep

2009-11-05T04:13:00.001-08:00

Bruxism (forceful teeth grinding during sleep) is thought to be the third most common parasomnia (partial arousal) experienced in the population. Parents notice this in their children and it can be a disturbing sound. Although parasomnia's tend to decrease in childhood, bruxism tends to remain for some children even at 13 years.

Approximately 20% of children are reported to grind their teeth during sleep and wake complaining of facial pains or headache. Stress has been considered to be a contributing factor but some studies have found no related day time stress reported in patients who grind their teeth.

Bruxism tends to be part of a chewing and swallowing process and a study in 2003 postulated that children with reflux may experience bruxism as a secondary effect along with increased saliva production. Sleep position also has an effect on the level and frequency of bruxism.

In 2008 further work on sleep disordered breathing showed a positive reduction in bruxism following tonsil and adenoid removal. Randomised Controlled Trials of occlusive dental splints have not conclusively demonstrated this device is sufficently effective in resolving sleep issues, although they may reduce wear and tear on teeth.

Perhaps the assessment of children with bruxism by Ear Nose and Throat Specialists would be worthwhile, particularly for those for whom sleep disordered breathing is an issue? There seems to be no current consensus on how best to resolve this parasomnia. Some authorities believe children may outgrow this but there remains an adult population who also experience bruxism.

Further research should lead to a better overview of both causes and the identification of effective treatment.

Childcare outwith the home.

2009-11-04T07:48:00.000-08:00

Many mums have to work these days and this means that they must seek child care. Finding a suitable place which has a space to take your child involves considerable research. What are you looking for in a creche or day care centre? What recommendations have you had and what or where is the most convenient place for you?

No matter how caring the staff they are not going to do things as you would yourself. That's not possible when they have numbers of children to care for. If you have a good routine for your child there is every possiblity that this will be maintained, if you tell the staff about it. If you are still struggling to get your child to nap in the daytime, or if you really want your child up and awake by 3.30pm to avoid the knock on effect on night sleep, then you have to consider the routine within the care facility.

If you have the opportunity to develop a good routine for your child before you need child care then use that opportunity wisely. It can take 3-4 weeks to establish a sound daytime nap routine, once you have confidence in this it can be easier to allow your child to be cared for outwith the home. This is a big adjustment period for both parents and child. As long as the experiences the child has at home are loving and supportive, children will adapt reasonably easily to a child care facility. For most children day care can be a positive experience offering them the opportunity to play and interact with other children. Learning that there are some experiences which don't include mum and dad but are still enjoyable can help with a degree if independance before separation to start school.

When you have to find care for infants it is not so easy to explain to them that they cannot be with you all the time. The best you can do for your infant is to make the time you have together happy for both of you. Starting to make routines early in life can prove a touchstone for a little one. If the care facility can continue to maintain these routines then it is so much easier all round. If you are confident in the care provision you have set up for your child and confident that your child has the routines in place to calmly accept this new adaptation the whole experience can be so much simpler.

Breath holding in young children.

2009-10-24T07:12:00.000-07:00

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

2009-10-07T08:14:00.000-07:00

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

2009-10-04T10:36:00.000-07:00

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.

2009-10-03T10:16:00.000-07:00

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.

2009-10-03T09:44:00.001-07:00

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

Sleep and adolescence

2009-09-19T11:55:00.000-07:00

Sleep deficit in adolescence has been recognised and commented on for some time. It is well recognised that sleep duration affects the health of children and adolescents. Shorter sleep durations have been associated with poorer academic performance, unintentional injuries, and obesity in adolescents.

Earlier this year, a study looked at this school population and their experience of sleep and sleep quality.

General education classes were randomly selected from a convenience sample of three high schools in the American Midwest. Three hundred eighty-four ninth- to twelfth-grade students (57%) completed a self-administered valid and reliable questionnaire on sleep behaviours and perceptions of sleep.

The findings showed that most respondents, (91.9%) obtained inadequate sleep. In many ways this is unsurprising as most adolescents seem to live in a "twilight" zone.

How much is due to poor sleep hyigene and bad habits around sleep is not explored. Nor is there any investigation of what type of sleep disturbance is most common in this group. Other studies suggest that school activities, jobs after school and other hobbies and responsibilities may impact on the sleep schedules of adolescents. One can only hope that in highlighting the difficulties some measures were put in place to address the sleep deficit that these individuals experience.

Australian study of sleep in primary school children.

2009-09-19T11:42:00.000-07:00

It has long been recognised that adequate sleep optimizes children's learning and behavior. However, the natural history and impact of sleep problems during school transition is unknown.

This study was set up to determine
(1) the natural history of sleep problems over the 2-year period spanning school entry and
(2) associations of children's health-related quality of life, language, behavior, learning, and cognition at ages 6.5 to 7.5 years with (a) timing and (b) severity of sleep problems.

To acheive this data was drawn from the Longitudinal Study of Australian Children. Children were aged 4 to 5 years at wave 1 and 6 to 7 years at wave 2.
Parent-reported predictors included (1) timing (none, persistent, resolved, incident) of moderate/severe sleep problems over the 2 waves and
(2) severity (none, mild, moderate/severe) of sleep problems at wave 2.

Outcomes included parent-reported health-related quality of life and language, parent- and teacher-reported behavior, teacher-reported learning, and directly assessed nonverbal (matrix reasoning) and verbal (receptive vocabulary) cognition. Linear regression, adjusted for child age, gender, and social demographic variables, was used to quantify associations of outcomes with sleep-problem timing and severity.

Sleep data was available at both waves for 4460 (89.5%) children, of whom 22.6% (17.0% mild, 5.7% moderate/severe) had sleep problems at wave 2. From wave 1, 2.9% persisted and 2.8% developed a moderate/severe problem, whereas 10.1% resolved.

Compared with no sleep problems, persistent and incidental sleep problems predicted poorest health-related quality of life, behavior, language, and learning scores, whereas resolving problems showed intermediate outcomes. These outcomes also showed a dose-response relationship with severity at wave 2, with effect sizes for moderate/severe sleep problems ranging from -0.25 to -1.04 SDs. Cognitive outcomes were unaffected.

The final conclusion was that sleep problems during school transition are common and associated with poorer child outcomes.

(QUACH J, HISCOCK H, CANTERFORD L, WAKE M.
Pediatrics 2009;123(5):1287-1292.)

Sleep and behaviour in 2-3 year olds

2009-09-19T11:19:00.000-07:00

This year in the Reid Hong and Wade, of the Department of Psychology in the University of Western Ontario, completed a study reviewing the relationship between common sleep problems and emotional and behavioural problems among 2- and 3-year-olds.

The contribution of sleep problems to emotional and behavioural problems among young children within the context of known risk factors for psychopathology was examined. Data on 2- and 3-year-olds, representative of Canadian children without a chronic illness, from three cross-sectional cohorts of the Canadian National Longitudinal Study of Child and Youth were analysed (n = 2996, 2822, and 3050).

The person most knowledgeable, usually the mother, provided information about her child, herself, and her family. Predictors included: child health status and temperament; parenting and any symptoms od maternal depression; family demographics (e.g., marital status, income) and functioning. Child sleep problems included night waking and bedtime resistance. Both internalizing/emotional (i.e., anxiety) and externalizing/behavioral problems (i.e., hyperactivity, aggression) were examined.

Adjusting for other known risk factors, child sleep problems accounted for a small, but significant, independent proportion of the variance in internalizing and externalizing problems. Structural equation models examining the pathways linking risk factors to sleep problems and emotional and behavioral problems were a good fit of the data. Results were replicated on two additional cross-sectional samples.

The relationship between sleep problems and emotional and behavioural problems is independent of other commonly identified risk factors. Among young children, sleep problems are as strong a correlate of child emotional and behavioural problems as symptoms of depression in mothers, a well-established risk factor for child psychopathology. Adverse parenting and depression in mums, along with difficult temperament all contribute to both sleep problems and emotional and behavioural problems.

Children's sleep problems appear to exacerbate emotional and behavioural problems.

If you struggle to help your child to sleep contact Dream-Angus.com

Sleep in children starting school

2009-09-19T11:01:00.000-07:00

Sleep disorders in children starting school are associated with impaired performance and behavioural difficulties. This is not at all unusual and a recent study by Lehmkul G Fricke-Okermann L, Wiater A and Mitchke decided to look at the causes and effects of sleep disorders in this group. It is already recognised that these disorders manifest themselves highly variably among children of any given age, and even in an individual affected child, they need an appropriate diagnostic evaluation so that the many environmental and background factors that may be relevant to the further course of the problem can be assessed.

In order to look more closely at this extensive data was obtained on approximately 1400 children who were tested before beginning school in 2005. This was accomplished using a special sleep questionnaire and another screening instrument that is used to assess behavioral strengths and difficulties (the SDQ, Strengths and Difficulties Questionnaire).

Five percent of the children were found to have difficulty falling asleep, difficulty staying asleep, or nocturnal awakening. Less frequent problems included parasomnias such as pavor nocturnus (0.5%), sleepwalking (0.1%), and frequent nightmares (1.7%).

This study showed that sleep disorders increase the risk of daytime fatigue and of psychological problems in general, including both hyperactivity and excessive emotional stress.

These results imply that sleep problems and emotional disturbances are intimately connected and underscore the importance of diagnosing sleep problems in young children.

If you are aware that your child is having sleep difficulties contact Dream-Angus.com for support and advice.

Parasomnias

2009-09-01T11:21:00.001-07:00

Parasomnias are unusual behaviours or strange experiences, which occur mainly or only when going to sleep, during sleep or when waking up. Parents are often very concerned about these events, however they do not mean that the child is psychologically disturbed or medically ill in any way. Very often these events will stop after some time and without any intervention but sometimes safety measures must be taken to protect the child. For example in sleep walking it is useful to ensure that the child does not injure themselves.

There are currently over 30 types of recognised Parasomnias in two main groups.

Primary Parasomnias can be grouped according to the time of night when they occur.

Secondary Parasomnias are the expression of underlying medical, behavioural or psychiatric conditions. Nocturnal epilepsy, nocturnal panic attacks

Parasomnias occur at all ages but are more common in children than in adults. Children may have more than one type of parasomnia as they may also have more than one type of sleep disorder. Sleep apnoea can be associated with sleep walking for example.

It is very important that the parasomnias are correctly identified as the treatment and interventions required are dependant on this. Accurate identification depends on a detailed account of the experiences both from a subjective and objective sequence of events, the timing of the event and the cicumstances in which the event occured. Audio visual recording, in the form of home video can be very helpful in this.

Specific medication is usually only required in a minority of primary parasomnias but may be required to treat the underlying problem in secondary parasomnias.
Research information on Parasomnias is quite limited at the moment.

If you need help with your child's sleep disturbance Contact Dream-Angus.com

Clock changes and sleep patterns.

2009-08-14T00:44:00.000-07:00

Most of us experience no problems when the clock goes back an hour or forward an hour. Unfortunately there is a group of individuals who find this a very difficult experience and find that their sleep pattern is disturbed by this event for a good few weeks. This leaves these individuals struggling with all the associated symptoms of sleep deficit and makes life for the other family members much more difficult. However, with a little planning these difficulties can be avoided.

If you know how long it takes to "recover" from the clock change then you can anticipate and plan a strategy that will avoid the process of sleep deficit and sleep disturbances. The clock goes forward or back at a set calander date. If you know, for example, that it will take three weeks to catch up with this change then you can avoid the problems altogether by simply dividing the 60 minute change into 3 segments of 20 minutes.

Three weeks before the clock changes start to adjust pre bedtime routine by a few minutes so that by the end of the first week a 20 minute delay in bedtime routine (or an earlier start to this routine) is accepted. Continue this over the following three weeks and by the time the clock has moved the brain and body will be in sync with this altered sleep/wake time.

This can be further enhanced by altering the supper snack before bed to ensure that it is rich in the chemicals which encourage the release of sleep hormones.

If you would like further advice about sleep disorders Contact us at Dream-Angus.com

The Golden Rules

2009-08-13T09:59:00.000-07:00

These are the "golden rules" which, if observed, will help ensure a good night's sleep.

Make sure your child's room is quiet and dark.
Keep environmental noise to a minimum, no loud TVs.
If your child still needs a nap, schedule that nap for early afternoon, before 3pm.
Wake your child at a regular time every morning. This will strengthen the circadian rhythm.
Avoid drinks of tea, cola and drinks containing caffeine before bedtime.
Quiet play in the hour before bed is better than stimulating, exciting play.
Keep the room at a comfortable temperature. If the room is too warm sleep may be disturbed.
Use a short pre bed routine that your child will recognise and stick to it.
Make sure that your child does not go to bed hungry, but do not give children over 6 months feeds or drinks through the night.
Help your child to fall asleep without your presence. Use a favourite toy or blanket and put your child to bed while he/she is drowsy but still awake.

You may find you are already doing some of these things, or all of them. If your child is still having difficulty getting to sleep or staying asleep contact Dream-Angus.com we can help you to help your child.

Reflux/spitting up in infants

2009-08-08T10:17:00.000-07:00

It is not uncommon to wind/burp a baby and have some altered milk returned with the process. Some babies are known as "happy spitters" and from the begining these babies return mouthfulls of altered feed when they are encouraged to release any wind they may have swallowed. If this is an occasional rather than an regular occurance then there is no need to take any action. Other children suffer from gastro oesophageal reflux (GERD) to a degree that makes them very uncomfortable. Imagine having persistent heartburn which worsens with feeding. This makes feeding a much less comforting and enjoyable experience.

What causes this problem?

In newborn babies, and especially in babies born before their due date, the gastric tract can be immature and the muscles at the top of the stomach are less efficient than they should be. These muscles are there to allow air out but keep feeds, which are mixed with the acids in the stomach, in their place. When they are less efficient semi digested food is returned with the acids of the stomach, to the oesophagus and to the outside world. Over time, if this is untreated, asthma can result. For many years thickeners were added to feeds in an attempt to reduce reflux but research shows that this is totally ineffective and only results in increasing the time that food remains in the stomach.

What are the symptoms?

The most common include :-

Frequent spitting up or vomiting
Irritability when feeding
Refusing food or eating only small amounts
Sudden or constant crying
Arching the back while feeding
"Wet" burps
Frequent hiccups
Frequent coughing
Poor sleep habits with frequent waking

Bad breath

What can I do about this?

Give baby smaller feeds more regularly.

Wind/burp baby regularly during a feed.

Keep baby upright for 30-45 minutes after a feed and gravity will help keep feeds down.

Put baby down to sleep on his/her back but raise the mattress by putting a pillow or folded towel underneath the mattress so that there is a slope keeping baby's head slightly higher than baby's feet.

Do not thicken baby's feeds. This does not work and can result in other problems. Starting semi solid feeds early does not help and can increase the risk of allergy or other gastric problems. If baby is consistently upset by reflux do see your Doctor because there are suitable medications which will help. By the age of one year many babies will no longer have symptoms.

Preparing your child for a new baby.

2009-08-03T02:42:00.000-07:00

New arrivals mean major changes for the entire family. Children can be excited about the arrival of a new baby. They may be very gentle and caring and yet at other times they can be jealous and agressive towards a sibling. Preparing your child for a new brother or sister can help get this new relationship of to a good start.

Tell your child about the new baby about 3 months before the baby is due. Do not tell your child you are having a baby to give them a new friend. Children may be dissapointed when the new baby sleeps most of the time and does not play with them.

Explain a little about babies to your child. There are a variety of good books written for children about the arrival of a new baby. These can help you help your child to know what to expect. If you chose this time to move your child from a cot to a bed do not use the baby as a reason. It is far better to explain that "you are a big girl now so it's time for you to have a big girl's bed."
Avoid making any changes to your child's routine in the month before the arrival of the new baby.

Tell your child ahead of time where you will be going when baby is born and who will look after them until your return. When you do return after the birth be available to give your first child your full attention. Be consistent use the same approach as you used before baby arrived with the same rules and consequenses for unwanted behaviour. Try to mainitian the routines your child is used to. It is important that your older child is given some uninterrupted time and space for play away from baby each day.

If you need help in moving your child from cot to bed ;-
Contact Dream-Angus.com we can help.

Separation issues.

2009-08-03T02:16:00.000-07:00

All children have to learn to cope with temporary separations from their parents. Learning to be apart can be difficult for both parent and child however parents need time to themselves occasionally and children benefit from spending time with other people and other children.

Shyness around new people and anxiety about separation from parents is common in children of pre school age.

Before starting your child at a child care centre talk about this with your child. Visit the place together so that your child feels comfortable there. Stay close and allow your child to watch the other children. Don't force your child to join the activities and if possible make several visits gradually extending the time you spend together there. Invite other children from the group to your home so that your child can get to know them a little and look for them in the group.

On the day explain to your child where they are going where you are going and when you will return. Do this in terms that the child can understand. Make sure that the care giver has all they may need to take care of your child. Suggest that your child bring something to the group, a special toy or other comforting item from home. You could perhaps leave something of your own to reassure your child that you will return. For the first few times you may want to reward your child by spending time in the park on the way home, or playing a special game with mum or dad.

Develop a routine for the times when you leave your child with some one else. After a while your child will be able to say what the steps are, e.g.

Say hello to the care giver and other children.

Find something to do.

Kiss or say good bye to mum/dad.

Explain to your child that you will leave, even if they do not want you to, once you have said "goodbye".

When you return greet your child and spend some individual time with them. Ask about what they did while you were gone. If your care giver tells you about something interesting your child has done show an interest and praise your child. Be prepared for your child to be a little clingy this is normal after separations.

Remember;-

Prepare your child ahead of time.

Tell your child where you are going and when you will return.

Develop a routine and explain the steps to your child.

Talk about rewards.

Prepare the care giver.

Introduce others to your child.

Help your child find something to do.

Praise your child for mixing or playing with others.

Say goodbye and leave ignore protests and do not go back.

When you return, greet your child and spend time with them ask about their activities.

Review the steps with your child in a way that they can understand

Hormones and sleep.

2009-08-01T08:18:00.000-07:00

Deep sleep triggers more release of growth hormone, which fuels growth in children and boosts muscle mass and the repair of cells and tissues in children and adults.
Sleep’s effect on the release of sex hormones also encourages puberty and fertility. Consequently, women who work at night and tend to lack sleep are, therefore, more likely to have trouble conceiving or to miscarry.

During sleep, your body creates more cytokines cellular hormones that help the immune system fight various infections. Lack of sleep can reduce the ability to fight off common infections.
Research also reveals that a lack of sleep can reduce the body’s response to the flu vaccine. For example, sleep-deprived volunteers given the flu vaccine produced less than half as many flu antibodies as those who were well rested and given the same vaccine.

When we sleep less, our stomach secretes more of an appetite stimulating hormone, and we produce less of the hormone which reduces our desire for food consequently we gain weight. A recent French study of 1,138 children found that 26% of children in the sample who had a sleep deficit were overweight, and 7.4% were obese. Day time naps do not compensate for proper night sleep which is generally deeper and longer. This same study showed that 22% of children who slept less than 10 hours a night when they were only 2.5 years old were hyperactive at 6 years of age. This is twice the rate of those who slept 10-11 hours a night at 2.5 years of age.

Sleep is undeniably an important part of our daily lives. Sleep deficit has profound effects not just on our mental health but also on our physical health.

If you need help to resolve your families sleep issues Contact Dream-Angus.com

Extinction (Crying It Out)

2009-08-01T02:30:00.000-07:00

Crying it out involves putting a child to bed at a set bed time and then ignoring the child's cries until a set time the next morning. While this method has been documented as successful in resolving settling issues it is seldom an acceptable choice for parents who must listen to their distressed child crying.

One study showed that although the child cries for a prolonged period there is no memory of this and perhaps the child cries for so long that they forget why they were crying. Other children may cry until they vomit, which is even more distressing for the parent. Parents are naturally concerned about the effects of this "treatment" on the child's emotional and psychological development. Feeling that this is unnatural and goes against the parents natural desire to comfort the child, makes this harsh type of "treatment" difficult to administer and difficult to be consistent with.

There are many other ways to resolve this issue. Allowing a child to become and remain distressed for a period of time does not teach the child to learn to soothe themselves to sleep and this is one of the most valuable lessons we can offer our children.

If you have tried, or are considering using this method to get your child to sleep, be assured there are other techniques which are very effective and much kinder to parent and child.

If you struggle to get your child to self soothe to sleep Contact Dream-Angus.com we can help you to help your child improve their sleep pattern.

Sleep and the newborn baby.

2009-08-01T01:22:00.000-07:00

Most newborn babies will sleep 16-20 hours out of 24. They wake when hungry or uncomfortable and are fairly easy to soothe once the reason for crying has been established. For the first few weeks it would appear that there is no routine. Baby can demand a feed at intervals of bewteen 2-4 hours. Some times this interval varies throughout the day. During growth spurts more feeds are required. In these early weeks it is not possible to alter baby's sleep wake cycle and there should be no need to. A baby will wake and sleep as the infant's body requires.

Recognising when an infant is tired takes time. Some babies will rub their faces on the person holding them, yawning, closing their eyes and sometimes even stretching before a nap. In the early stages the infant lacks the co-ordination to pull at an ear or rub tired eyes. An upset baby can be soothed by low frequency noise. A washing maching, vacum cleaner, a radio not quite tuned in to the station, music which before was heard through the thick abdominal wall, now played softly may halp.

If you are holding an upset baby try patting slowly at slightly less than heart rate, about 60 pats a minute, this reflects a resting heartbeat and is reminiscent of the rhythm heard in utero.
Soothing a baby to sleep requires a general slowing down of everything. Voice interaction should be quiet and of a low pitch. Put your infant down in the crib before they are completely asleep will help them to accept that going to sleep does not require any adult intervention. This will prevent problems later.

Once the child is about 3-4 months a more definate pattern starts to emerge.

For help, advice and support with your child's sleep
Contact Dream-Angus.com

Night Waking

2009-07-27T02:12:00.000-07:00

Waking in the night is one of the most common difficulties that beset children. Recent studies looking at the age and stage of children who have difficulty in sustaining sleep show that 25-50% of 6-12month olds, 30% of 1year old children and 15-20% of toddlers 1-3 years old continue to have night wakings.

These night wakings occur for a variety of different reasons but persistent problematic night wakings are often due to inappropriate sleep onset associations. For some these wakings occur as regularly as every 45-90 minutes. This is of great concern to parents who are also deprived of sleep in order to settle the child.

There is often considerable variation in the night to night and week to week patterns and neither infants, nor parents, are consistent in the way they behave and interact at these wake times. Of course what one parent sees as a difficulty another parent or family accept as "normal" so night wakings are seldom addressed in the same fashion across the population.

Children or adolescents who experience persistant night wakings that are extermely disruptive to the family as well as the complainant should be seen by a sleep specialist. There are very effective ways to alter this night waking behaviour and to improve the night sleep.

If you are experiencing this difficulty within your family Contact Dream-Angus.com we can help you to resolve this issue and improve your night sleep.

Nightmares

2009-07-25T11:39:00.000-07:00

Nightmares are frightening dreams that occur during Rapid Eye Movement (REM) sleep, which usually result in waking from sleep and seeking reassurance. The content of nightmares varies with the age and developmental stage of the child. They may coincide with a frightening event, trauma or stress. They are more prevelant when there is sleep deficit. On average 75% of children experience at least one nightmare and 10-50% of young children require parental intervention to reassure them in the night. Chronic nightmares are nightmares which occur regularly over 3 months or longer. One study shows that 24% of children aged 2-5 years and 41% of children aged 6-10 years experience chronic nightmares.

If a child has experienced frequent nightmares then this can make the child afraid to go to bed (bed time resistance) because they anticipate frightening dreams.

Children remember the scary content of the dream and they awake with feelings of impending harm and anxiety. Return to sleep following this experience is delayed. The child has this experience in the later part of the night whereas Night terrors usually occur within the first few hours of settling to sleep, do not result in a full awakening and return to sleep is much more rapid.

There are a variety of strategies which can be successfully used to reduce and eliminate nightmares. Where behavioural strategies fail or the nightmares are extremely disruptive and persistant referral to a mental health specialist for evaluation and treatment are worthwhile.

If you would like help to reduce your child's nightmares contact Dream-Angus.com.

Bed Wetting/Nocturnal Enuresis

2009-07-07T02:14:00.001-07:00

Bed wetting or nocturnal enuresis, remains a common issue for parents and children.

Nocturnal Enuresis is defined as spontaneous emptying of the bladder during sleep occuring in children 5 years of age or older. In the USA this affects 5-7million children.

Restricting the amount of fluids given before bed,and/or toileting the child before the parents retire has little or no effect on this.

Medications are rarely appropriate before the age of 7 years and generally if the child is not distressed it is wise to wait and see if this does resolve over time. For many children resolution is a matter of maturity and by the time they have reached 7 years there is no problem.

If the child is 5 years old and distressed by wetting the bed then it is possible to look at methods of training the bladder. Studies show that the use of Enuretic alarms combined with behavioural therapies are effective when the child is motivated. Children should not be made to feel guilty about this problem and they should be reassured that it can be resolved.

There are a variety of theories about the cause of bedwetting and these are probably the most familiar;-

1) That there is a difference between the bladder's capacity and the production of urine overnight.

2)That the child sleeps so deeply that the normal "alert" of a full bladder is not disturbing.

3) That the child's bladder is smaller and with maturity this will change.

Various factors can potentially influence the balance between nocturnal urine production and functional bladder capacity. Different types of bladder dysfunction, resulting in a small nocturnal bladder capacity, probably contribute significantly. As different clinical subgroups may have different responses to treatment, it is necessary to distinguish these subgroups before a decision on the specific treatment protocol can be made. New insights have an important bearing in our future management strategy for bedwetting

If you would like help and advice in dealing with this problem,

Contact Dream-Angus.com

Babies and circadian rythm.

2009-07-07T01:44:00.001-07:00

The hormone Melatonin produced in the pineal gland regulates sleep. It does so using the initial building block of tryptophan which is an omega 3 fatty acid. This initial and important building block is present in breast milk. Mum's circadian rythm is usually well established and it is interesting that a study looking at the levels of this important omega 3 in breast milk has found that mum's circadian rythm has an effect on the amount of "sleep related hormone" secreted in breast milk.
Sleep efficiency in babies of 12 weeks, both only breast fed and those who were formula fed was measured over a week and it was found that assumed sleep, actual sleep and sleep efficiency was significantly better in exclusively breast fed babies.
It follows that breast fed babies are already learning to develop a circadian rythm which is parallel to that of mum. The levels of tryptophan which fluctuate to follow mum's rythm are starting to "train" baby.

Another study investigated the relationship between exposure to light and 24-h patterns of sleep and crying in young, healthy, full-term babies living at home and following a normal domestic routine. Babies were monitored across three consecutive days at 6, 9 and 12 weeks of age. There was an early evening peak in crying which was associated with reduced sleep at 6 weeks. Across the trials there was a gradual shift towards a greater proportion of sleep occurring at night. Sleeping well at 6 weeks was a good indication of more night-time sleep at 9 and 12 weeks. Babies who slept well at night were exposed to significantly more light in the early afternoon period. These data suggest that light in the normal domestic setting influences the development of the circadian system.

Both of these studies demonstrate the ability of babies to "learn" a circadian rythm and confirm that encouraging naps in normal daylight will improve infants night sleep patterns.

If you would like information and advice on training your baby to sleep
Contact Dream-Angus.com

Research and Narcolepsy

2009-07-07T01:44:00.000-07:00

In May of this year groundbreaking research about the key role the immune system plays in Narcolepsy was published. A team of international researchers led by Emmanuel Mignot, MD, PhD, and Director of Stanford’s Center for Narcolepsy found a tight association between narcolepsy and a genetic mutation in T cells, the immune system’s vehicle for identifying and attacking foreign bodies.

Although further research is needed to determine exactly how this mutation leads to narcolepsy, the research behind this highly technical article, titled, “Narcolepsy is strongly associated with the T-cell receptor alpha locus” is based on a study of the analysis of DNA samples from over 800 patients with narcolepsy and cataplexy. Dr Mignot stated that this is opening the door for preventive therapies. The implications of this research go well beyond the narcolepsy field. As the first of its kind to link a disorder associated with the immune system to the T cell alpha locus, it provides a model for the study of over 100 other similarly associated disorders including juvenile diabetes and multiple sclerosis.

Generally children with narcolepsy have a completely normal development although secondary narcolepsy is associated with underlying neurological disorders such as Nieman-Pick disease where there is developmental delay. In first degree relatives 10% may also have narcolepsy and up to 40% of narcoleptic patients may have a family member who has excessive daytime sleepiness.

Narcolepsy is fortunately one of the less common sleep disorders but has long been recognised as having a definate genetic link. Most sufferers are diagnosed in late teens although some younger children have also been identified as narcoleptic.

Narcolepsy is a lifelong chronic disorder that will always require management. The aims of "treatment" are adaptation to living with this disorder and improving quality of life.

Sensory integration and sleep.

2009-06-29T04:03:00.000-07:00

What does it take to make your child comfortable? For some children light touch is irritating. They prefer firm contact. These children often have difficulty settling to sleep when the bed covers are light but offer a weighted blanket and they settle much more easily.
Our perception of touch, sound, colour and texture is part of what makes us who and what we are. Children who have difficulties with their sensory information often also have difficulties in other areas of their lives. When we recognise this we can address it and provide the comfort that the child needs to feel secure in their environment.

Some children who require "deep stimulation" like to be held firmly and this will also assist in settling them to sleep. Using a sleeping bag or a weighted blanket is comforting because there seems to be a defined place in the bed for them, they feel as if they are being held, without any danger of "falling out" or being left loose.

Small babies enjoy being swaddled because it replicates the space they came out of and being swaddled is like being held without mum or dad having to hold them. Most children grow out of the need for this but some do not.

Settling to sleep is a behaviour that we want our children to acomplish by themselves, without the need for our intervention. Looking at each child as an individual and identifying the measures that make that child feel secure can help in assisting that child to relax and go to sleep.

Sleep disturbances are much more common in children with sensory difficulties than in the rest of the population. This is well recognised, but it is also possible to alter their sleep behaviour. It may present more difficulties and may take longer but it is certainly possible.

If you would like help and support in altering your child's sleep behaviour,
Contact Dream-Angus.com

Relaxation before sleep (1)

2009-06-29T03:42:00.000-07:00

Some older children have problems getting to sleep. They may already have a short pre bed routine, getting washed and toileted, brushing their teeth, getting dressed for bed and lying down ready for sleep, but it seems difficult for them to get over to sleep.

This can be for a whole variety of reasons. Their minds may still be busy, perhaps there is something special happening or the day has been exciting and they are still reveiwing the events. For others there may be concerns about tomorrow, a school exam, a big event or it may just be perceived as "normal" for that particular child to have this difficulty.

Ensuring that the hour before bed time is unstimulating, that the bedroom is seen as a safe place and that the pre bed routine is maintianed will all help but some children need a little more.

There are two basic relaxation techniques that are helpful, not just for children but also for adults.

The first is a visualisation technique which requires that the child close their eyes and breathe deeply. Keeping one hand on the diaphragm, to feel the movement of the chest during breathing, close the eyes and picture a wall of velvet. The velvet is black or navy blue and the true colour is only seen in the deep folds as it flows down from the ceiling.

In a corner above the velvet is a bright white light. As breathing in occurs the light gets brighter, on breathing out this light gets dimmer. After watching the light for five breaths, watch the velvet and the effect of the light on the surface.
Observe the deep colour and the softness of the fabric.

This exercise calms the mind and offers a different focus for intrusive thoughts. For some this offers a speedy relapse into the gentle arms of sleep. This is so simple that it can be used at any time and requires no other intervention. Learning to use this method offers a solution to some of the distractions which make sleep so difficult to obtain. It can be used to start a nap or a deep overnight sleep.

If your child has difficulty settling to sleep or staying asleep they are not alone. It is estimated that 37% of children aged 4-11 have difficulties with this. When these difficulties are not addressed they can become chronic.
For help and support, contact Dream-Angus.com

Teething and Sleep

2009-06-21T06:26:00.000-07:00

Two recent studies have indicated that, contrary to many beliefs held by parents and professionals, the links between the emergence of teeth and significant physical symptoms are very weak.
The researchers compared signs of fever, sleep disruptions, irritability and other symptoms on days close to teeth eruption (before and after) and on days remote from teeth eruption.

The findings indicate that for most infants there are no links between the emergence of teeth and other behavioral or physical symptoms. In the minority of the infants tooth emergence was associated with some symptoms but these associations existed only for a brief period (4 days before teeth eruption, the day of eruption and 3 days after). In both studies, sleep disruptions were not associated with tooth emergence.

The authors suggest that parents' tendencies to blame teething for physical and behavioral symptoms is often unwarranted. Physical symptoms and distress are likely the result of other factors.

Sources:1) Wake, M., Hesketh, K., & Lucas, J. (2000). Teething and tooth eruption in infants: A cohort study. Pediatrics, 106, 1374-1379. 2) Macknin, M. L., Piedmonte, M., Jacobs, J., & Skibinski, C. (2000). Symptoms associated with infant teething: a prospective study. Pediatrics, 105, 747-752.

Sleep and the sensory strategies.

2009-06-20T05:57:00.000-07:00

Every child can learn to sleep regardless of physical handicap or mental disability. Children with sensory impairment may require a more detailed plan and children with developmental delay or disability often experience more profound difficulties in settling and maintaining sleep.

Routine is a very important part of forming regular patterns in children's behaviour. Routines are reassuring touchstones in every child's day. Children who have a different understanding of the world value routines even more than average. In an uncertain world where every day brings new challenges, routine reminds the child of the time of day, and leads to the expectancy of fixed events. Bed and wake time should be the most fixed of all the events in the child's day. Routines built to ensure a calm and responsive reaction to bedtime and wake time help the child to cope and understand the actions that are expected and follow on from them.

For sensory impaired children a bedtime routine that starts at the same time EVERY night is vital. Ensuring that the hour before bedtime is spent in calming activities without recourse to playstations or television, enjoying quiet calming activities help cue sleep.

Using a weighted blanket, flannel sheets, giving deep pressure contact or making a snug place in the bed using pillows or, a sleeping bag makes a child feel "held" and comforted which is relaxing and prepares the body and mind for sleep. If a light is required it should not be bright but a soft dim light is more calming.

Limiting the time for each pre bed activity helps acceptance of that activity. White noise and story tapes have their place in this and are very soothing for some children. The child who learns to achieve simple tasks with encouragement and by themselves gains in confidence.
The rituals which form part of the cues for sleeping and waking also help instil a sense of confidence and self awareness in the child.

There is no reason to endure sleep deficit when it is entirely possible to alter a sleep behaviour with a good plan and committment to following through. Sleep deficit doesn't just affect the child but the whole family.

Contact Dream-Angus.com for information and support to improve your child's sleep

Routine, Routine Routine

2009-05-22T10:51:00.000-07:00

A number of recent studies have looked at sleep behaviours and routines in both adults and children and throughout the investigations one thing has been highlighted as singularly important, and that is, routine.

Adults have a short pre bed routine which they complete regardless of where they are, at home, away on holiday or on a business trip. We all have a short pre bed routine which cue's our individual body clocks. This is our reminder to ourselves that it is time to sleep, time to rest and renew so that we can face the coming day. Adults can rationalise their behaviour, children are at the mercy of their parents.

We are our children's teachers and teaching children the cues to help them sleep and rest at appropriate times is one of life's important lessons. Children learn very early in life to expect certain things to follow from parents actions. Routine is part of a child's security in the environment and helps the processes of learning about the world and one's place in it. Children associate certain actions with outcomes and as they grow and gain awareness they find reassurance in the stability of home through the routines learned there. This makes the pre bed routine particularly important because if it is a good routine it encourages sound sleep. All is well with the world.

Children who have no regular pre bed routine are slower to relax into sleep and often wake regularly in the night. Sleep deficit in a child makes for confrontational behaviour, poor concentration and increased irritability. Some children who have had a long history of sleep deficit are even occasionally misdiagnosed as having Attention Deficit Hyperactivity Disorder (ADHD). Yet, once a simple pre bed routine is introduced and maintained, all the irritations of living with a sleep deprived child dissappear and an altogether much more social and pleasant being emerges.

The greatest difficulty for adults seems to be the introduction and maintenance of such a routine. This is why it is so much easier to start building a routine with a young child, even at 3-4 months children can recognise the difference between night and day, which makes this is a very good time to start a pre bed routine.

If you have a child who has a sleep deficit contact Dream-Angus we can help you resolve the issues and improve your child's sleep.

Last snack to promote sleep.

2009-05-15T06:18:00.000-07:00

We give our babies a last feed before bed, and send our children off to bed, often with a last snack, to ensure that they do not go to bed hungry. After all a hungry child is unlikely to settle quickly to sleep. What we offer our children, and indeed what we choose for our own supper, can directly affect the nights sleep.
Recently it has been proven that a snack which is high in protein encourages us to stay alert longer than a high carbohydrate snack. This is because one amino-acid called Tryptophan, which calms the brain, promotes sleep is less available in some foods compared to others. When you pair tryptophan with carbohydrates and calcuim then you are offering the brain not only the calming effect of the tryptophan but the calcium which encorages it's uptake.

So, what does make a good bedtime snack?

Warm milk and half a turkey or peanut butter sandwich.
Whole grain,low sugar cereal with low fat milk (whole milk for children)
A banana and a cup of camomile tea
Granola with yoghurt

Odd Head shapes/Plagiocephaly

2009-05-15T05:50:00.000-07:00

Plagiocephaly or flattening of the head occurs when a baby always lies with his or her head in the same position. This does not impact at all on the child's development or learning abilites except in severe cases, when it may contribute to visual and hearing problems.

For most children this is a mild condition simply resolved by positioning and encouraging the child to turn their head.
With simple repositioning techniques, you can prevent and correct 'flattened-head syndrome' and help promote your infant's neuromuscular development. Repositioning involves changing the position of your baby's head while he or she is sleeping and during activities. Changing head positions also helps strengthen the muscles in the neck, which is important when babies begin to hold their heads and sit up on their own.

Very simple measures like making some time for "tummy time", puting visual stimui on the opposite side of the cot, seat or pram will encourage baby to turn his/her head so that everything is seen from another angle than the preferred view.

There has been some work done on special "helmets" which have to be worn daily for the first year of life and are then supposed to alter the baby's head shape. Recent studies have shown no real advantage, for children with mild plagiocephaly, to using these appliances.