Hand Yoga or Hasta Mudras

 Sleep and Sleep Problems

Duration of sleep

A newborn baby seems to sleep most of 24 hours of the day, except when he is hungry, wet or uncomfortable. for some or other reason. As he does not yet know the difference between day and night, he may sleep more during the day and less at night. While this may not be convenient for the mother, she will  then herself choose to sleep more during the day while the child sleeps and learn to feed the baby in a lying position (safe in breastfed babies) in bed without having to get up to feed. People at home should support her by restricting visitors.

Some babies may demand extra attention. They are rather fussy and can give anxious moments to an unprepared moments to an unprepared mother. Most (but not all) babies seems to sleep better after their morning massage and bath, especially if they are swaddled or wrapped up.

Around 3 months of age, the pattern of sleep is more likely to change, and more babies sleep for longer hours at a stretch during the night. They are more awake during the day and may have a nap for an hour or two in the  morning and again in the afternoon. This pattern continues until the first birthday.  They may then have a nap  only in the afternoon until the age of three., when they may stop having a nap during the day. At this age, most children will sleep for about 10-12 hours at night.

Teenagers need 9 to 10 hours of sleep each night. Sleep deprivation can affect academic performance.

The difficult first months

The newborn's sleep period begins with drowsiness, leading to light sleep and followed by deep sleep.  A baby is likely to wake up more easily from a light sleep.  Another may put a child passing through this stage of sleep down on the bed with the impression that  he has gone to sleep, but he is likely to get up  soon after the start of crying because he has not yet gone into a state of deep sleep.. Therefore it is important that we continue to give the child body contact till he crosses the barrier of light sleep and move into the realm of deep sleep.

The good news is that those mothers who respond promptly to baby's need in  the first few months are rewarded in the long run. As they grow older, babies thus reared are quieter, calmer and more secure compared to babies who are left to cry. They start trusting people around them, which helps in personality development.

The so called 3 months' colic is another problem that bothers quite a few babies in their early months.

After having made the point that a crying baby should not be left crying, I must sympathize with mothers who have to spend sleepless nights in this process. 

Some tips :

• Get into the habit of sleeping while the baby sleeps.
• Do not switch on the lights when the child gets up at night. The idea is to gradually let him  learn that nights are meant for sleeping and not for playing. Feed him in a lying position if he is hungry. Pat him to sleep if he is not squirming. Give him body contact if he has moved away from you.
• Do not get up to burp the child. Raise him while you are lying down Let him lean him against you to burp. If he does not oblige, do not worry. Quite a few babies can manage without burping. If you are still concerned, let him lie on the right side; in this position the child is more likely to burp on his own.
• If the child has wet his diapers, see if he can remain asleep without it being changed. After the few weeks, quite a few babies can tolerate a wet diaper without getting upset and without getting diaper rash. If the baby does not get annoyed or if the whole bed gets wet, try putting a double diaper on him. Tie it firmly. This may work. If not keep such diapers handy which do not need to be pinned and can be tied easily in the dark. The important rule is not to spend too much time in changing the diaper so  that both you and the baby can go back to sleep as soon as possible.
• All noises do not wake up a child. Many babies sleep quite well with some background music or human conversation.  Of course sudden loud noses may startle them, especially if they are in a period of 'light sleep'.

Where should your child sleep ?

Decide with your husband what will work best for you and your baby. The baby can sleep next to you in your bed or in a cradle or in a cot kept in your room. Toddler can sleep on a mattress in your room or in a bed. Older children can sleep in a bed or on a mattress.  Baby who sleeps in his mother's room soon after birth has less sleep. problems and behavioral problems later in life. In the hospital one should insist that your baby sleeps next to you and is not kept away in a nursery with other babies. Co-sleeping with the baby on a sofa is not advisable. You can if you want ask for a cot that can remain near your bed. The baby can be placed as per your convenience. Most mothers have been found to sleep better with the baby in their room once they understand that this helps in bonding with their baby. 

After going home many mothers have found the following sleeping arrangements quite practical. the baby sleep in your bed until he is one year old. In the second year, he sleeps on a mattress spread on a floor by the side of your bed. After he is 3, he sleeps on a separate room, on his own or along with his older brother or sister, in separate beds.

Teenage siblings of opposite sex  should sleep on separate rooms.

Children develop separation anxiety if they are separated from the mother figure. Between 1 1/2 years and 3 years, they learn that that the mother is around somewhere even if she is not to be seen. Hence it is important to give enough body contact to the child in his first year of life, meet his needs (vocalized mostly by crying) promptly, help him build trust in you  and gradually wean him from your bed to another convenient sleeping arrangement in your room and then to another room, preferably adjacent to yours.

Once the child is shifted to his room he can be brought to your room if he is not feeling well or if he feels scared for some reason, but he should soon be placed back in his room.

Ideally the older child should be taken to his room for sleeping by the mother or the father. You may read to him or tell him a story. Many mothers find it helpful to say a small, simple prayer together.The child is gently lulled to sleep. Older children are likely to go into a 'deep sleep' rather soon and can be left properly covered. Some children are happier if a dim light is kept switched on  all through the night.

If you want a child to go to sleep early, see that he does not sleep during the day. If he is in a habit of doing this  take him out  during those hours to an interesting place or a garden for a few days or break his habit of sleeping during the day.

In your bed, the infant can sleep between you and a wall.Otherwise you can get bed railing that can protect the child from falling down. For a very small infant, raising the edge of mattress by putting a pillow underneath it serves the purpose.

Do not worry that you will smoother the baby as he lies in your bed This can only happen if the parents are intoxicated or heavily drugged.

Another reason to have children older then toddler sleep separately is to avoid them been unwitting witness to their parents conjugal relations. Psychologist report that children who watch adults having intercourse either can become terrified or can develop undue curiosity about the same. More over children have to graduate from parents room to another room to prepare themselves for moving into the outside world.

Support from Others

Graciously accept the help of your husband, mother and mother-in-law or indeed any good relative and friend in helping to take care of your baby and relieve you. Let the child bond with your husband, and with his grandparents. Allow the baby to sleep with a close relative or a maid during a day, this will make it easier for the child  to sleep with such a person when the mother is not well or when the child must be weaned away from the mother during the night.

Work with family routines

Although it is ideal that the child  goes to bed early, this routine may have to be changed if the father come home from the work late in the evening and again leave for work late in the morning. A child must spend time with his father. In such a case, it may be essential to make the child to sleep during the day or allow him to remain asleep for a longer time in the morning.The presence of a father definitely helps in prevention as well as in management of common sleep problems.

Common sleep problems

• Getting up too frequently at night
• Nightmares
• Night terrors
• Sleep walking

Getting up too frequently at night

Most problem associated with sleep can be prevented by caring parents who promptly attend to the  needs of the child during the early months of his life and keep a watch on the factors that may contribute to sleep disturbance.

Breast milk is digested fast and so a child may demand frequent feeds in the early months Parents who do not appreciate this fact  may allow the child to cry unnecessarily. Flies and mosquitoes can be a nuisance. A mosquito net may be helpful. Extreams of temperature must be take care of. If a heater is used in a room, a kettle- full of water should be kept on the boil all through the night to maintain the humidity of the room. Otherwise the child,s nasal secretions dry up, causing discomfort. If the child has a stuffy nose, it should be cleaned and  nasal drops used.(saline nasal drops). Physical discomfort in the form of a wet diaper or during teething can add to the discomfort. Excessive activity during the day may also delay the onset of sleep. Any sickness must be attended to, especially ear infection and itching associated with eczema or thread worms, which comes out of the anus at night. and cause itching over the buttocks.

Children who slept well in the early weeks of life may suddenly give the mother sleepless nights around the age of 3 weeks, 6 weeks and 3 months. During these periods, some babies have growth spurts when they need to suckle more often to meet their normal demands of milk. On such occasions you should not presume that  your milk is not enough and that you must add artificial milk. This temporary phase passes as you let the baby suckle more often.

 Some mothers give a child a heavy meal at night, or a feeding bottle in a hope that he will sleep better.This may not be helpful. Outside the milk given in the early months of life can lead to rapid development of infections and allergic diseases. A heavy meal may come in the way of the child going to bed soon.

Any emotional factor at home or school should be attended to. Don't allow children to watch violent and scary movies on television.

Nightmares

These are seen mostly in pre-school children A child has a scary dream and then he gets up crying. He is fully awake and appears afraid. He may recount the dream and once reassured, go back to sleep.

Night Terror

The child again a pre-schooler, suddenly sits up in bed crying. He is not fully awake and is not aware of your presence. He screams as if terrified. He may be sweating and have a very fast heart rate. No efforts on your part calms him down. Fortunately, he settles down after 15-30 minutes and goes back to deep sleep. When he gets up, he does not remember any thing about the whole episode.

Sleep Walking

This is seen in mostly in children of school going age. While sleep walking, the eyes appeared glazed. They may mumble something that may be difficult to comprehend. Generally, they do not hurt themselves, but care should be taken to prevent injury. Most children are otherwise normal and the condition disappears within a couple of months. In rare case, it may continue to adulthood. No treatment seems to help.

In general most sleep problems are sorted out by common sense, by listening to the child, and by attending to his needs.

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