Sunday, December 4, 2016

Travel tips for the holidays

Traveling with small children is sure to cause roadblocks in your child's sleep patterns.   In order to navigate these obstacles, create a road map around them so that you don’t bring all your good sleep habits to complete halt.

Having a plan will aid you and your family so you can enjoy your holiday travels without loosing precious sleep. The key to a successful plan is to have some flexibility when traveling with young children. When you're flexible you can adjust your plans to adapt to your children’s sleep needs so you all stay well rested.  

Extra support is normal


You can also expect that your child will need more assistance at sleep times, even if they don’t need it at home.  It is normal for children to need extra help to fall asleep in a new environment, so add that into your plan.  Take extra time with your bedtime routine and allow your child time to get used to the new sleeping space before bedtime arrives.  
At sleep times, if needed sit by your child’s bed or by the door to give them the extra assistance and comfort they need to fall asleep.  That is much better than regressing back to your old habits of rocking or feeding to sleep.

If your child is verbal you can explain what the sleeping arrangements will be and how they are different than at home.  Be sure to let them know in advance that when you return home everyone will go back to their own bed or what ever is your normal routine.   Follow through with that statement and get right back to your normal the first day you are at home.  This will make it easier on everyone in the long run.

Plan arrangements in advance


Find out in advance where everyone is going to sleep and what the family's holiday plans are for each day.  Ask yourself what aspects of your child’s sleep needs are you willing and able to be flexible about. Some things, like where your child sleep’s might not be negotiable to you and perhaps a hotel might be better.  

Nap times or bed time might be another aspect that you feel is not negotiable.   Perhaps one member of your family can step away or take a break from the activities so your child can get the sleep he needs. Whether that’s a room at grandma’s house or returning to your hotel or a stroll around the neighborhood.  

Can you politely request that dinner is early or have a lunch celebration so that your children can stick to the usual bedtime.  Planning ahead in these ways can prevent your child’s sleep schedule from getting completely off track.

Packing List


Don’t forget your child’s favorites and these key items you should not leave home without:

  • Travel crib or reserve a crib
  • Security object
  • Favorite bedtime books
  • Sound machine and/or white noise app on your phone
  • Night light (ideally small and no brighter than a 4 watt bulb).
  • Sheets and if age appropriate bedding (use the sheets from your child’s bed instead of freshly washed one so that they will have that familiar smell) 

Tip for the car or air travel


Plan for the drive or air travel by bringing age appropriate activities (music, audio books or books to read or games to play).  Children (and adults) don’t sit well for long periods of time so if driving play with your child when she is awake with age appropriate games.  For the younger baby peep-a-boo, tickle games or car toys.  Older children can color, play electronics, listen to books or watch a movie.

Be sure to stop frequently to allow your children to move around and stretch or for air travel allow them to move around before/after the flight as much as possible.

If sleep times should happen during while in transit go ahead and do a small version of your pre-sleep routine if you can. Then if try to make the environment darker (with window shades) and quieter (turn down the radio and turn up the white noise or play the familiar song your child uses at home before sleep).

Adjusting to Grandma’s or the Hotel


If staying at a hotel request a crib when making the reservation and the day before you arrive call again to confirm that they will have a crib for you.  Alternatively you can bring your own travel bed.

For younger children, have them in the room with you while you set up your child's sleeping room.  For an older child allow them to explore the room or hotel.  This will help your child get accustomed to the new sleeping environment and settle more easily at sleep time.  Give him some play time in the travel bed or crib, before you actually put him down for sleep.

Crib or room acclimation activities before sleep are great ways to help your child create a positive association with this new place.  While he is in the new crib, play games with him like peek-a-boo, read books or toss a soft toy back and forth. You can also both get down on the floor and allow him to explore the space together.

Try to avoid staying up past bedtime even though grandma (and your child) are having fun.  An overtired child will have a harder time settling at bedtime and often have nightwaking.

Get back to your normal


It’s common for children to have a small sleep regression when traveling and that is to be expected. The key is to not let the regression become a complete roadblock.  

When you arrive back home get back to your ‘normal routine’ - including your child’s usual bed, your normal bedtime routine and typical sleep schedule during the day.  Give your child a few days to adjust back to normal, if things were thrown off while away.  

If you are consistent with your normal routine at home, within a few days everyone should be back to ‘sleep as usual’ or where you were at before your trip.

Happy Holidays!

Written By: Michelle S. Donaghy

Tuesday, September 6, 2016

Postpartum Depression - Bring Awareness

I had the great pleasure of interviewing my dear friend Tanya Newbould.

Tanya is an actress and producer who lives in Los Angeles with her husband and daughter.  Tanya produced When The Bough Breaks, a feature length documentary about postpartum depression (PPD) and perinatal mood disorders.  

When Tanya experienced PPD with her daughter, she did not understand what was happening to her or even how to get help. 

Tanya teamed up with Director Jamielyn Lippman to begin the journey to better understand this illness that affects one in five new mothers. One of the woman they interviewed was Lindsay Gerszt.  Lindsay agreed to let the cameras document her treatments and condition in order to give the audience an in depth look at her path to recovery.

This film features stories from singer Carnie Wilson, celebrity chef Aarti Sequeria and Peggy Tanous from The Real Housewives of Orange County. When The Bough Breaks is Narrated and Executive Produced by Brooke Shields.

My goal with this blog and interview with Tanya is to create awareness for PPD and help women/families who are effected, find help and the resources to begin the healing.
               

Question: What made you decide to make this film?


Answer: When I was pregnant with my daughter, at four and a half months I noticed I was fighting (antenatal) depression which made no sense to me, so I began therapy.  After she was born, I began to feel lost, scared, alone but didn't understand what it was. A good friend of mine sat me down and told me "something's wrong with you".  My reply was "I'm tired, I had a baby".  She said "no, it's more than that".  I was still in therapy, but even the therapist didn't put the label of PPD on me. This shows me there is such a lack of understanding and training on this subject.  I continued on and at four and a half months I read Brooke Shields book "Down Came the Rain".  For the first time I realized I had Postpartum Depression and Postpartum Anxiety.  I then began to seek knowledge on this subject but really couldn't find anything. It was then that I knew there needed to be a documentary on this subject.  I had the honor of being interviewed for a documentary "Die Trying" about actors, directed by Jamielyn Lippman. I was very impressed with her and asked her to team up with me to direct and be a Producer of "When The Bough Breaks" a documentary about Postpartum Depression.

Question: You bring up so many good points, postpartum depressions is under-diagnosed and there is such a misconception about what it is and how many women-mothers suffer … sadly alone.  In my practice I often see Mom’s who suffer from postpartum, which is the term most often used.  There are actually several forms of illness that women may experience.  Can you share a little bit about the different types?  It important to note that women who have had a baby within the last twelve months are at risk for postpartum.   


Answer:  Baby Blues-  It's not uncommon for all mothers to experience Mood Swings or a form of baby blues which is the least severe form of PPD. Many women feel confused about struggling with sadness after such a joyous event of having a baby.  The best way to cope with this is to talk about these emotions, changes and challenges.

Postpartum Depression
  1. Feeling Overwhelmed.  Like "I can't do this and why did I become a mother".
  2. Guilt for not handling this better.  Fear of the baby feeling your guilt or sadness or lack of connection.  You may wonder if the baby is better off without you.
  3. You don't feel bonded to your baby.
  4. Confused and scared about being a new mom.
  5. Feeling irritated, angry or no patience.  Feelings of rage.
  6. Feelings of sadness to the depths of your soul.  You can't stop crying.
  7. Feelings of hopelessness, feeling like a failure or disconnected from everyone.
  8. Can't really eat or sleep, even when the baby sleeps.
  9. Feelings of wanting to run away or that the baby/family would be better off without you.
  10. You know something is wrong. That you're no longer yourself and this will never shift.
  11. Afraid if you reach out for help, you will be judged or your baby will be taken from you.


Postpartum Anxiety, Panic & Obsessive Compulsive Disorder
  1. You can't quiet your mind, settle down or relax.
  2. Feel like you have to be doing something all the time i.e. Cleaning bottles, cleaning clothes, cleaning the house, checking on the baby constantly.
  3. Worried about everything from sleep, eating, somethings wrong with the baby, somethings wrong with me, etc.
  4. Disturbing thoughts. Thoughts of physically harming the baby or yourself.
  5. Afraid to be alone with the baby because of the scary thoughts.  Afraid of objects that could harm the baby i.e. Scissors, knives, etc.
  6. Need to constantly recheck what you've already done. i.e. Check the baby, is the baby breathing, is the oven really off, etc.
  7. Panic attacks, nausea, headaches, no appetite, can't sleep, etc.
  8. Afraid of the nighttime coming and that you will never sleep.
  9. You know something is wrong with you and this is your new reality.
  10. Afraid to reach out for help for fear of being judged or having the baby taken from you.

Postpartum Psychosis
  1. You have more energy then you've ever had in your life. Nothing like you've ever experienced.  Or you are beyond exhausted and want to sleep but your mind won't let you.
  2. You feel like you have a NEW understanding of everything that no one else can relate to.
  3. You keep hearing/seeing things that no one else does.  You may have voices in your head that won't stop no matter what you do.
  4. You feel you can't trust anyone including people you've always trusted prior to this.  You may also feel like people are going to harm you or your baby.
  5. You may feel like you are being controlled by some outside source. This source is telling you to do harmful things to yourself or your baby.
  6. You may have the sensation that things are crawling on you.
  7. You are getting into conflicts with everyone around you with the feeling that no one understands you.
  8. You feel the best thing for everyone is to kill your baby or yourself.
  9. You feel like you will never get better. You may even feel the only way to get out of this or to protect the ones who love is to commit suicide or abandon your family.

It's very important that everyone be aware there is help for all of these situations! 

The most important thing to do is to talk about how your feeling either with a professional or ones that you love, so you are able to get the help you need. 

Thank you Michelle for helping families and women understand the difference between baby blues and different forms of postpartum along with what signs to look for, that will be so helpful.  Most women don't even realize there are different forms of postpartum. 

Question:  Yes, that is very true.  Most are not aware there are many forms of postpartum.  In my practice I often work with women who have postpartum or are anxious.  Those suffering from Postpartum Anxiety have difficulty being consistent in a sleep program and therefore they don't make progress or improvements in the baby's sleep, as the anxiety makes Mom question her every decision.  The anxiety can lead to a great deal of inconsistency and for sleep learning to be a success, consistency is a must.

I often talk with families about the warning signs of postpartum depression and encourage them to seek out a professional or a loved one, so that they can get help and support. Do you have other resources that we can direct these families to?


Answer: There are many resources available, a very good one is -  http://postpartum.net/  Here you can find groups, telephone support, and reliable services that are available for no charge.  At this site you can also learn more about the possible signs of the many different types of PPD.

Our documentary "When The Bough Breaks" is a documentary about Postpartum Depression covers and covers all aspects of the spectrum and stigma surrounding PPD which is estimated to affect one in five women worldwide.  You can see more about this film and the trailer at this link: http://www.whentheboughbreaksfilm.com/#/    If you would like to learn more about Tanya Newbould, you may visit her website.  http://www.tanyanewbould.com/about-me.html


Closing: Thank you very much Tanya for your time and for making this film.  I hope that more awareness is brought to the illness and more women, families and baby's are helped.

Additional Resources:
I had advanced training on postpartum from Dr. Shoshana S. Bennett.  "Dr. Shosh" has several books and also a private practice which specializes in postpartum depression and perinatal mood disorders.  All of these resources can be found on her website. http://drshosh.com/private-consultations/

Books:
  • Postpartum Depression for Dummies by Shoshana S. Bennett PhD and Mary Jo Codey
  • Beyond the Blues: Understanding and Treating Prenatal and Postpartum Depression & Anxiety by Shoshana S. Bennett PhD and Pec Indman EdD MFT





Friday, July 1, 2016

Sweet dreams: How to create a baby sleep plan

Article featured in-

OC Family Magazine

July 2016, Page 50

By: Michelle S. Donaghy







After months without sleep, you’re ready to help your baby learn to sleep through the night.  Getting better sleep for your baby, and you, is one of the best things you can do for your entire family.  If your child is 6 month or older and still waking during the night, it’s time to make a sleep plan.  

Sleep 101: 

Sleep is learned!  Sleep is a learned skill and teaching a brand new skill to your baby is no small task.  But you want the best for your baby and are willing to help your child learn this life-long skill.


Sleep Associations:

What are they?  Do you rock or feed your baby until they are completely asleep?  If yes, this is your child’s sleep association.  Sleep learning begins with changing your baby’s sleep association.


Here's how to create a plan:


1 New bedtime routine.   A calm and predictable routine will help your baby, prepare for sleep.  If a pre-bedtime feed is a part of your routine, move the feed to the beginning of the routine - with lights on.  Then continue with the rest of your routine.  Your routine could be pajamas, feed (but not to sleep), followed by (pick one or two): reading books, singing a song, massaging, baby yoga or story time.


2 Ideal bed time.  Identify your child’s ideal bedtime.  For most children it's between 6 and 8 p.m.  Look for sleepy signs such as yawning, rubbing eyes, or fussing.  


3 Sleep training method.  Will you use a gentle method, where you stay with your child while she learns and you gradually fade out your assistance?  Or will you leave the room, to give your child a few minutes unassisted, then every 5 or 10 minutes (when crying) go in to reassure?  Keep each visit brief and do not pick up or touch to sleep.  


4 Start at bedtime.  Bedtime is the easiest time for children to learn to put themselves to sleep!  Put your child into bed while awake - this step is critical to your success!


5 Night feed or none.  Decide if you will feed your child during the night.  Check with your child’s doctor and ask if he needs to eat at night.   If yes, keep it brief, with lights off and right back into bed.


6 Plan Naps. Skipped or short naps will create more night waking and come bedtime, an overtired baby.  Well-napped children sleep better at night!  Children need a nap often in the day and the timing is based on age.  Follow these guidelines to plan your child’s naps.  6-9 months – nap every 2 ½-3 hours, 9-18 months – nap every 3-4 hours, 18-36 months – one nap at noon or 1 p.m.


7 Be consistent.  Once you have started your sleep plan, it is absolutely critical to be consistent!  Every time you give in and assist your child to sleep, expect more tears tomorrow night, success to take longer and your baby to learn to cry more.  


Expect huge improvements in week one and the entire plan to take two weeks – if you have been consistent! 


Michelle SDonaghy is a local baby/ child sleep consultant and certified Gentle Sleep Coach. She is the founder of MSD Baby Sleep Coach (msdbabysleepcoach.com) and has two children.

Tuesday, May 3, 2016

Newborn Sleep Myths

Becoming a new parent is such an amazing time in your life.  But it's also full of questions and advice from well meaning family, friends and strangers.  I wanted to share with you some questions I had when my first daughter was born and common concerns of new parents.

Newborn Sleep Myth #1

Baby's instinctively know how to sleep - FALSE!


This fact is a surprise to new parents as most don't realize that your baby is not born knowing how to instinctively put them self to sleep.  Which means, it is okay to help your newborn fall asleep - you can nurse, rock, shush, pat (or anything else that is safe and works) to help your baby fall sleep.  You are not going to create any life long sleep habit.  In fact most sleep issues can be resolve after 6 months of age very, very quickly.  

Newborn Sleep Myth #2

Never waking a sleeping baby -  FALSE!


Newborns need to eat every 2-3 hours during the day.  If your baby is sleeping longer than 2-3 hours at a nap, wake your baby to eat during the day.  

Many baby's also need help learning the difference between day and night, to do this ensure your baby:
  • get lots of natural light during the day
  • wake baby from a nap if sleeping through a feed (as above)
  • keep night feeds quiet with no talking, dim or no night and definitely no electronics such as TV, Ipad, etc.  - this light can wake baby and you up more.  Tip - nightlight with a 4 watt bulb is all you need.

Newborn Sleep Myth #3

Most baby's sleep through the night at around 3 months - FALSE!


Waking to feed or for a change is perfectly normal for infants under 6 months.  Below reflects the current research showing the average number of times young babies wake up between 10:00 p.m. and 6:00 a.m.

  • 1 month: 3-4 times
  • 2 months: 2-3 times
  • 4 months: 1-2 times
  • 6 months: 0-1 times
Babies will vary and some will wake up a little more or less, but the important message is that young babies do wake during the night.

Newborn Sleep Myth #4

Baby can sleep anywhere - FALSE!


Creating a safe and positive sleep environment can be helpful in improving your baby's sleep to ensure they get restorative sleep both during the day and at night.  Your baby's sleep environment should be dark, quiet and cool.  Follow these tips for the ideal sleep environment:
  • use black out shades during the day and for the early morning
  • have soothing white noise with a consistent tone
  • keep sleeping space free of stimulating objects or mobiles
  • ideal sleeping temperature is 68-72 degrees.

Newborn Sleep Myth #5

Keep baby awake during the day and they will sleep better at night - FALSE!


In these early months your baby's day time sleep will very greatly, but around 4-5 months day time naps will begin to develop and lengthen.  Put your baby down for naps often as most newborns can't stay awake during the day more than 60-90 minutes.  The awake window will increase to around 2 hours at 4-5 months.   Putting your baby down for a nap often will ensure they are not over tired at bedtime and they will sleep better at night.


Sweet Dreams

Michelle S. Donaghy


Adapted from the "Gentle Sleep Coach - Baby Sleep Basics Workshop"  with permission.

Thursday, March 3, 2016

Spring is upon us and so is Daylight Saving Time

Sunday, March 13th we “spring forward”! 

Turn your clocks ahead 1 hour, before bed on Saturday night March 12th.

If you/your child(ren) typically wake at 6am, then they will likely wake 7am.  If you like this change then YEA!  Keep naps and bedtime on the new schedule (1hr later). To protect this new schedule and time make sure you use continuous white noise for all sleep periods and keep the room really, really dark.  You won’t achieve this without black out curtains or shades.

If the new time doesn’t work for you, below are some options to help your family adjust:

Gradually adjust:

This is ideal for children under 2 or those who don’t do well with big changes.  Go to bed 15 minutes earlier every night this week.  Each day, wake up your child 15 minutes earlier in the morning.  If napping, put her down 15 minutes earlier for each nap. 

Continue to adjust the schedule earlier in 15 minute increments (wake up, naptimes, meal times and bedtime) until you get to your goal according to the new clock time.
         

Adjusting all at once:

On Sunday, schedule your day (wake up, meals, naps and bedtime) on the new clock time.  But don’t start your day any earlier than 6am on the new clock time.

If you think the one-hour adjustment is too much for your child, split the difference and put her to bed at 7:30 p.m. (new time) starting Sunday night and for a few days.  Then shift bedtime earlier to 7:00 p.m.  Don't forget to adjust your entire schedule eg: earlier wake up time, nap time(s) and meal times.

The biggest challenge will be to help your child get to the new (later) bedtime without being overtired! That means you have to make naps a priority. Watch her sleep windows (look at my blog on the ideal schedule for by age), have a comforting pre-nap routine and get her down for nap time.

Don’t forget an early enough bedtime!  For most children that is between 7 – 8 PM.The adjustment to the new clock can take a few days, but it seldom takes more than a week!

Sweet Dreams!

Written by: Michelle Donaghy

PS: Ensure your child is going to bed awake, relaxed but awake.  On a scale of 1 to 10 and 10 is fast asleep your child should be at a 5 when they get into bed.   It should take them at least 5 minutes to put themselves to sleep.  If it takes less, your child was to sleepy and it is likely the cause of your night waking and also your early rising sleep issues (see my blog on Early Rising issues).

Monday, February 1, 2016

Is It Time To Move From The Crib To The Bed?

I always ask these questions first when a client is thinking about moving their child to a big kid bed:


  • Is your child over 2 1/2 years old (This is the typical age that most children have the cognitive ability to understand the rules such as "you must stay in bed all night").
  • Does your child fall asleep independently at bedtime from a relaxed but awake state and without assistance?
  • Does your child sleep through the night or put himself back to sleep when he wakes during the night without needing any help?
  • Does he want to move out of his crib?

If the answer is YES, to all of the questions above then it is likely a good time to make the transition.

As with most sleep transitions there are choices-


Gradual Approach:


  • If you can do it safely, remove the front rail from the crib so your child can get in and out of the crib on his own.   
  • If the new bed will fit in the room along with the crib, during this stage have your child nap in the big bed and have your bedtime stories on the new bed.
  • Then pick the big day where he sleeps in the big bed at night. Once he’s sleeping in his bed for naps and nights, you can remove the crib. 

Cold Turkey Approach:


  • Take the crib out and replace it with the new bed.
  • Put the new bed in the corner of the room so 2 sides are against the wall.
  • Install a safety rail on the side of the bed, not against the wall or put a pool noodle under the sheet to support him from rolling out.

My final recommendations with either method:


  • Put some pillows on the floor in case he rolls out of bed during the night.
  • Inspect the room for safety now that he will have full access to the room unsupervised.
  • Consider putting a gate on the bedroom door for a period.  This will act as a training method to help him understand that he has to stay in his bed.  It will also be a safety measure to prevent him getting hurt if he decides to wander around the house in the middle of the night.
  • Get him involved in the process by letting him pick out new sheets or a new bedspread.  Have 2 or 3 Mom approved choices for him to select from.
  • Introduce sleep manners (rules) and explain that after lights out he is expected to stay in bed.
  • Make sure you are consistent and if he does get out of bed, walk him right back without a lot of talking or extra cuddling.  
  • Give praise in the morning for staying in bed and let him hear you brag about it to Grandma and friends.
  • Don't start any new habits, like laying down in the bed, if you don't want to do this every night ... start as you mean to go on!!

It usually isn't a good time to transition out of the crib because your child is climbing out of the crib and is under 3 years old.  Review the techniques outlined in my Tips to Keep your Toddler in the Crib blog before rushing into this transition too quickly.  If there are other changes coming such as sleep learning, moving homes, removing bottles or pacifiers, then it is best to work on those changes first and stay in the crib a bit longer.  

Sweet Dreams!

Written By: Michelle S. Donaghy


Monday, January 4, 2016

Tips to Keep your Toddler in the Crib

I often get calls from parents in a panic as their toddler has discovered a new
freedom … jumping out of their cribs! 

Their first reaction is to immediately move the child to a toddler bed.  If there is a sleep issue already occurring the extra freedom of a toddler bed will likely make the sleep issue worse as now they can get out of bed and their room.

If you are not ready to make the move to a bed, here are some tips I share with my clients to prevent a child from jumping out of their cribs and hopefully delay the transition to a bed for a bit longer.

Dress appropriately


Dress the child in clothing that limits or prevents lifting the leg up the railing.  A long t-shirt can work.  A sleep sack, put on backwards so the zipper is in the back, is very helpful.  You can also make pajamas to limit or restrict the legs just enough so that the child can’t lift it up the railing - very effective!

Catch them in the act


If you have a video monitor, you can watch the child and as soon as you see the leg
go up, enter the room and say “No jump, NOT SAFE” in a forceful voice.  Sometimes just getting caught and told to stop, a few times is enough to end the attempts.  If consistent for a few nights, the toddler will get bored and hopefully stop.

Lower the crib mattress, even lower


Make sure the crib is at the lowest setting to the ground.  Depending on the style of your crib, you may be able to drop the mattress to the floor – if you decide it is safe and there is no gap between the mattress and the crib frame.

Remove all items


Be sure to remove all items such as stuffed animals and the bumpers.  Keep only a small, safe security blanket in the crib.  Depending on the style of your crib frame -turn the crib around, so the back rail (if higher) is facing front.  Some frames will work better if put in the corner of the room.  I have seen some very creative 'fixes' on the internet to prevent children from climbing.  If you do find one that you feel is safe, please consult with your child's doctor to confirm they agree it is a good option.

I recommend, if you can, to delay moving a child to a toddler bed until at least the age of 2 ½ year old.  This is the earliest that most children have the cognitive ability to understand “stay in your bed quietly all night”.  

I do agree that crib jumping is a safety issue but so is the freedom of a toddler bed.  Imagine all dangers in the room from the electrical outlets to furniture.  Some child find the freedom overwhelming and become very upset with this much freedom when alone.  I always recommend a gate at the child's door to keep the child in the room, as it is scary to think of a toddler that roam the house alone at night.


In closing, try to wait as long as possible before moving a child to a bed.  The ideal age is when the toddler is over 3 years old.  Look for next blog where I will discuss how to avoid common mistakes when it is time to move a child over 3 years of age to a bed.

Sweet Dreams!
Written By: Michelle S. Donaghy