Friday, September 27, 2013

Our Top 5 "Sleep" Blogs!

Infant sleep is by far the most popular topic on our blog. So, we decided to find out which sleep posts were the most popular (highest number of page views). Here is what we found:

#5: The Science of Infant Sleep Part II: Big Changes in Sleep Patterns (6 to 16 weeks)
In this post we talk about the big changes in sleep patterns that occur between 6 and 16 weeks of age. Babies’ sleep starts to get more predictable and parents may be giving a sigh of relief that the 1st 6-weeks are over! The biggest change is that babies start falling into deep sleep instead of light sleep around 4-months of age. They also start sleeping for longer periods.

One of the behaviors that can mislead parents is that some babies wake up every time you try to put them down for a nap after a feeding. This post explains why that happens.
In this post, we explore the topic of sleep training and explain why we don’t agree with the concept. We encourage parents to understand normal infant sleep patterns and talk about why babies need to wake up at night for their own health and safety.

Here we introduce how babies sleep during the 1st 6-weeks and the 2 types of sleep. We talk about dreaming and brain development and how to help newborns sleep a little better.
And the top infant sleep post…with almost 3 times the number of page views than the second place post is…

#1: Why Do Some Babies Hate Being Drowsy?

Our most popular post addresses the baby who gets very fussy and upset every time he or she is drowsy. You may know one of these babies! We explain why this happens and provide tips for dealing with a baby who hates being drowsy.

What is your favorite post? What post has been the most helpful to you?

Tuesday, September 24, 2013

Postpartum Fatigue: Part 3 -Tips to Fight Fatigue

In part 1 of this series we introduced postpartum fatigue, complete with how common it is (VERY common!) and what can contribute to it. In part 2 we covered how fatigue effects parenting specifically. Now in the final part of this series we will share evidence-based tools to help you deal with postpartum fatigue. 

First you’ll want to rule out common postpartum causes of fatigue such as anemia, thyroid dysfunction, or infection (such as urinary tract infection, gynecological infection following delivery or mastitis). (Corwin 2007)
Now we’ll share some other tools. Feel free to pick and choose which will work best in your life. The key is to do things every day to take care of yourself, even if you don’t feel like you have the energy to do so. Remember, this time will not last forever. Your baby (and you) will sleep longer as he or she gets older. We promise! We’ve been there!

Tips to Fight Fatigue

·       One study reported that the Chinese practice of zuo yuezi (intensive family support to prevent fatigue) should be considered as a tool to reduce fatigue. This practice includes social seclusion and regulated rest.(MCQueen 2003)

·       Learn about what to expect from your baby’s sleep patterns. When you know what to expect you can work your sleep schedule around theirs.

·       Conserve energy. How? Here are a few ideas:

o   Have others make meals or run errands for you

o   Restrict any unnecessary activities or get help with them

o   Prepare meals ahead of time and freeze for later

·       Take time out, away from being a mom, to do a favorite activity on a regular basis. We know this is easier said than done, but it will leave you feeling more refreshed and ready to give 100% to your kids when you return.

·       Improve your diet. Eating a well-balanced diet with small frequent meals will give you more energy!

·       Increase your exercise. Exercise will increase your energy and decrease fatigue symptoms. One study found a decrease in physical and mental fatigue with an average of about 124 minutes a week of exercise. That's about 4-30 minute sessions. (Drista 2009)

·       Reduce your normal daily demands. Re-ordering your priorities prenatally can really help you prepare for life after baby.

o   Consider which tasks are essential vs. non-essential and limit the non-essential ones. What is most important for you to get done?

o   Establish routines to save time and energy

o   Prepare meals in the morning so you can rest in the afternoon or evening)

·       Maintain regular sleep routines.

·       Allow time for rest every day. Limiting visitors so you can rest is important. Discuss best times for visits that don’t interfere with rest periods.

·       Get real. Having realistic parenting expectations about taking care of your baby and your household is helpful! Remember, things don’t have to be perfect during this challenging time. Also, expect less sleep! Then you won’t be disappointed when it happens.

·       Get help! Enlist support before it is needed, when you are pregnant.

·       Lie on your side to breastfeed while in the hospital.  One study showed that this helped moms get more rest.

Sleep deprivation and fatigue should be taken seriously. They effect your physical and mental well-being and how you parent. Be patient with yourself if you are currently experiencing fatigue and please try the tips above. They can make you feel at least a little bit more rested. Let us know which of these tips or others have worked for you in the past. You may just help someone else!

Varcho MS, Hill PD, Anderson M. Evaluation of the Tiredness Management Guide: a pilot study. Appl Nurs Res. 2012;25(2):123-8.

Kurth E, Kennedy HP, Spichiger E, Hösli I, Stutz EZ. Crying babies, tired mothers: what do we know? A systematic review. Midwifery. 2011;27(2):187-94.

Dritsa M, Dupuis G, Lowensteyn I, Da Costa D. Effects of home-based exercise on fatigue in postpartum depressed women: who is more likely to benefit and why? J Psychosom Res. 2009;67(2):159-63.

Corwin EJ, Arbour M. Postpartum fatigue and evidence-based interventions. MCN Am J Matern Child Nurs. 2007;32(4):215-20.

McQueen A, Mander R. Tiredness and fatigue in the postnatal period.J Adv Nurs. 2003 Jun;42(5):463-9.

Friday, September 20, 2013

Postpartum Fatigue: Part 2 - Effects on Parenting

In part 1 of this series we talked about postpartum fatigue, how common it is, and also things that can increase the risk for or contribute to it. Now in part 2, we’ll explore how fatigue can affect parenting.

While postpartum fatigue may be an inevitable part of parenting a young baby, it’s important to be aware of how it affects you as a parent. Fatigue can result in forgetfulness, irritability, lack of physical stamina, and an inability to concentrate. (McQueen 2003) Studies also show how fatigue can impact parenting specifically. Here’s how.
Fatigue can:
  • Increase parental stress
  • Limit patience in dealing with infant crying
  • Decrease parenting satisfaction
  • Decrease parent confidence in the ability to interact with the child
  • Cause parents to become more irritable and easily frustrated with child’s behavior (and expectations of behavior, behavior seen as more demanding)
  • Result in parents being less warm and affectionate
  • Decrease involvement with child, as in shared activities
  • Make it harder to plan and problem solve
We understand this might sound a little depressing, but knowing is half the battle, right? Just being aware that fatigue can affect you and how you parent in these ways will help you have more patience with yourself and maybe even convince you that postpartum fatigue is a big deal, maybe a bigger deal than most people realize. Hopefully that will encourage you to get help from family and friends during this challenging time and rest whenever possible. In our next post we will share tips and tools to help you fight fatigue! There are definitely some things you can change that can make your life a little easier.

McQueen A, Mander R. Tiredness and fatigue in the postnatal period. J Adv Nurs. 2003 Jun;42(5):463-9.

Monday, September 16, 2013

Baby Behavior in New England!

We're on the road again, this time in beautiful New England conducting trainings in New Hampshire, Massachusetts, Connecticut, and Vermont! We'll be back next week with new posts. Have a great weekend.

Tuesday, September 10, 2013

Postpartum Fatigue: Part 1

Today, we will start a new series of posts about postpartum fatigue. The newborn period is challenging and often parents’ fatigue is underemphasized because it is a normal part of having a new baby. Fatigue is also often overlooked by healthcare providers because it is seen as a normal stage that parents go through that resolves when the baby sleeps better. However, when you are the one experiencing the fatigue, it is extremely difficult to function through!

So what is fatigue? It’s defined as persistent exhaustion and lack of energy not easily relieved by sleep or rest. (Dunning 2013) It is “an overwhelming sense of exhaustion that is accompanied by a decreased capacity for physical and mental work at the individual’s usual level.” (Taylor 2010) You may be wondering what the difference is between fatigue and tiredness. Tiredness is relieved by resting whereas fatigue is a more persistent state that is not relieved by rest.

How common is postpartum fatigue? This differs by study but about 50-64% of women consider postpartum fatigue a significant symptom. Researchers reported in one study that nearly 70% of women had fatigue at 1-2 weeks postpartum compared to about 40% 12 weeks later. (Corwin 2007) Fatigue in fathers is common as well. One study found no significant difference in reported levels of fatigue among fathers and mothers, though mothers had more disrupted sleep, and less night sleep. Fathers, however, had less total sleep postpartum compared to mothers and less daytime sleep. (Gay 2004)
Several factors either contribute to or increase fatigue in the postpartum period. 

·       First time moms

·       Long labor or c-section

·       Increased postpartum blood loss

·       Maternal hormonal shifts

·       More depressive symptoms

·       Perceiving that your infant has a more difficult temperament

·       Less sleep or poor sleep quality (Even if it is the same amount of sleep as you received while pregnant, because of sleep disruption, you will feel less rested.)

·       Less social support

·       Poor diet and exercise

·       Persistent or high levels of infant crying (Mothers in one study reporting more infant crying than other mothers also had more fatigue. Crying can disrupt the mothers’ circadian rhythms and reduce chances to rest.)(Kurth 2011)
(Taylor 2010, Cooklin 2011, Kurth 2011)

Since infant night waking is normal, parents will inevitably have disturbed sleep in the postpartum period. It’s important to have tools to deal with the inevitable sleep deprivation and resulting fatigue. In our next post in this series, we’ll examine the effects of fatigue on parenting and then in the final post we will provide evidence-based tools to fight fatigue.

Dunning M, Seymour M, Cooklin A, Giallo R. Wide Awake Parenting: study protocol for a randomised controlled trial of a parenting program for the management of post-partum fatigue. BMC Public Health. 2013;11(13): 26.

Taylor J, Johnson M. How women manage fatigue after childbirth. Midwifery. 2010;26(3): 367-75.
Corwin EJ, Arbour M. Postpartum fatigue and evidence-based interventions. MCN Am J Matern Child Nurs. 2007;32(4):215-20.

Gay CL, Lee KA, Lee SY. Sleep patterns and fatigue in new mothers and fathers. Biol Res Nurs. 2004;5(4):311-8.

Cooklin AR, Giallo R, Rose N. Parental fatigue and parenting practices during early childhood: an Australian community survey. Child Care Health Dev. 2012;38(5):654-64.
Kurth E, Kennedy HP, Spichiger E, Hösli I, Stutz EZ. Crying babies, tired mothers: what do we know? A systematic review. Midwifery. 2011;27(2):187-94.

Friday, September 6, 2013

Divided Attention and Parents' Stress: Part 2

Last time, we let you know about the increased stress that results from “multitasking” or dividing your attention day after day. While we all spend a good part of our days doing two things at once (typing and listening to music for example), the stress comes in when we have two or more tasks that require first our attention and then, processing time. Things that you do so often that you literally do them “without thinking” like navigating around in your own house, don’t count. So, remembering, prioritizing, decision-making, negotiating, evaluating, and learning are all things done best one at a time. You may think that it doesn’t matter (don’t all parents tie shoes, read emails, and prioritize their days by rapidly switching app-like from one task to the next?) but all the processing power needed can leave you drained, making even mundane things seem difficult. No matter how hard you try, focusing and unfocusing on thoughts and tasks will leave some of them in the dust.  Over time, 18 hours a day of multitasking will take its toll on you and your relationships.

A Better Way

Having competing demands is normal and often out of our control, especially for parents! But we can decide how we handle those demands. Knowing that dividing your attention is stressful all by itself, you can take steps to minimize the need to divide your attention. You might think it is impossible given how little time you already have but focusing more often on one thing at a time will make you less stressed and more efficient.
Let’s do that morning again, this time actively working to focus on one thing at a time.

You know you have an important meeting and you find yourself thinking about it when you wake up. Because you know your kids will need your full attention, you take a few minutes to write down all the thoughts you have about the meeting on a notepad you always keep by your bed. You answer the texts you have received as best you can while letting your co-workers know that you will not be answering any more texts for 40 minutes (or however long you need). Your spouse asks you about adding the trip to the gardening shop to your errands and you ask that he or she send a text  reminding you to add it to the list you already have in your phone. You hear your preschooler wake up and you silence your phone before you walk in his room and start your morning routine. Because he has all of your attention (until the baby wakes a few minutes later) and you are following your normal morning routine, there is no tantrum, and you have a chance to pick out an outfit together while you talk about how many days are left before Halloween.  When you are ready to go (feeling calm but busy), you grab your notes and pick up your keys in the special dish set out for that purpose on the counter and head out the door. After you get both kids safely into the car, you stand outside your car for a moment and check your texts and messages, answering only the most urgent and letting your boss and your co-workers know that you are on your way (on time).
A fantasy? No. None of this is any harder than what you already do. The difference is that you chose to focus only on one thing at a time. You can so this by making 3 simple changes.

  1.  Proactively make multitasking unnecessary. Instead of quickly switching from one thing to another, consciously divide your time based on your immediate priorities. Let others know what you are doing and why. They can learn from your example. Remember, your full attention (even for a limited time) is a powerful way to help your children live happier and healthier lives.
  2. Whenever possible, don’t rely on your memory. Retrieving memories on the run will divide your attention. Instead, take notes, make lists, and ask for reminders.  Choose to keep the most important objects (like keys, purses, wallets, cellphones) and notes in the same place so that you won’t be distracted by wondering where they are.
  3. Follow routines whenever you can. Remember, things that you do so often that you don’t have to think about them require very little processing energy so you can focus on important things, like counting the days to Halloween. We’ve already shared a lot of reasons why routines are good for babies but routines can make life less stressful for you too!
None of these steps require any money or extra time. But taking them can make a big difference in your stress level and your life.

  1. Nebel, K et al. On the neural basis of focused and divided attention. Cognitive Brain Res 2005; 5: 760-776.
  2. Petrac DC et al. Differential relationship of recent self-reported stress and acute anxiety with divided attention performance. Stress 2009; 12: 313-319.
  3. Wetherell MA and Carter K. The multitasking framework: The effects of increasing workload on acute psychobiological stress reactivity. Stress Health 2013; epub, ahead of print.

Tuesday, September 3, 2013

Divided Attention and Parents’ Stress: Part 1

The world we live in demands that we are constantly connected to our electronic networks for news, work, friends, and the latest trends on Twitter. We don’t just need to know…we need to know now. Parents, especially those with young children, also have to be constantly aware of their children in small ways (“don’t touch, that’s hot!) and big ways (“will she like the new babysitter?”). The divided attention needed to stay on top of everything seems to be no longer a choice for parents and has become a normal part of life. “Multitasking” is an expectation, and for most people, a source of significant stress. In the past, media messages and employers asserted that the human brain is limitless and that people, especially women, can manage a lot more work “simply” by multitasking (doing tasks simultaneously or switching back and forth between tasks very quickly). But, the latest research has demonstrated that multitasking has its price, in less focus, accuracy, and creativity, as well as increased stress.

You may be wondering why I’m bringing this up in a blog about babies.

If you are a Secrets reader, you are interested in understanding more about your baby’s behavior. You might be thinking that knowing more about your little one will help you feel less stressed. But knowing a little more about yourself might be more helpful. You may not be thinking of the ever-present need for divided attention as a source of stress but it is known to be so stressful, scientists use situations that require divided attention to induce stress for experimental purposes.

Here are some of the documented effects of divided attention:
  • Increased heart rate and blood pressure
  • Perception that common tasks are more difficult to accomplish
  • Mood changes
  • Interference with the ability to remember things, including future tasks
  • Interference with retrieval of memories and reduced accuracy of those memories
What do these effects mean in the real world?
Let’s say you’re late for work because the kids haven’t been very cooperative. The baby might be getting a cold and your preschooler had a tantrum when you told him that he can’t wear his Halloween costume. You have a meeting in the early afternoon and co-workers have been texting you about it since you first woke up. You had planned to run errands on the way home from work and your spouse asks you to make another stop at a gardening shop that you normally like to visit. You’re almost out the door when you realize you can’t find your car keys. You get a call from your boss just as your preschooler disappears into his room. What happens next?
  • Your breathing gets a little faster and you feel overwhelmed and even a little sick
  • Anything your boss asks about seems out of line
  • You resent your spouse for asking you to run his or her errands when you already have too many of your own (even though you can’t seem to remember what those errands are)
  • You feel overly frustrated with your preschooler for going back into his room. After all, he “should know” you need to leave
  • You are certain that you left your keys on the counter and can’t imagine any other place that they can be (even though you put them on the hall table without thinking earlier in the morning)
Does any of that sound familiar? Put sleep deprivation in the picture and everything gets worse. It may seem that there is nothing you can do about this but there is! A few changes and you can make even the busiest morning less stressful. In part  2, we'll share these changes. In the meantime, take a deep breath and try to relax!

  1. Nebel, K et al. On the neural basis of focused and divided attention. Cognitive Brain Res 2005; 5: 760-776.
  2. Petrac DC et al. Differential relationship of recent self-reported stress and acute anxiety with divided attention performance. Stress 2009; 12: 313-319.
  3. Wetherell MA and Carter K. The multitasking framework: The effects of increasing workload on acute psychobiological stress reactivity. Stress Health 2013; epub, ahead of print.