I love a good swaddle! Settling your crying or fussy baby can be difficult and swaddling (tightly wrapping) helps.  I know wrapping to be a wonderfully effective tool for parents and babies in the first few months of life and I share this with new parents in hospital. Many other health professionals do, as well.

Swaddling is an age-old child care practice that has been used across countries, continents, cultures and communities. Even the infant Jesus Christ was wrapped in ‘swaddling cloths’. There is a great deal of medical research and evidence that proves the benefits of swaddling, including:

·         Swaddled babies wake up less and sleep longer

·         Swaddling keeps sleeping babies on their backs and reduces the risks of SIDS

·         Swaddling helps babies feel safe, secure and calm

Babies can be swaddled from birth until the time when they can roll over independently (usually between 4 and 6 months of age), so it is a useful tool for those early, unsettled months. Swaddling has calming and soothing effects on babies and promotes a feeling of warmth, safety and security. It has the capacity to do this for several reasons:

·         Swaddling mimics the confined womb environment (remember, your new baby is used to a pretty confined space in the womb!)

·         Swaddling reduces arousal from the startle reflex (Moro reflex) and external stimulation. (Babies often wake themselves with sudden jerking movement of their arms and legs. Swaddling helps keep things all together!)

·         Swaddling reduces your baby’s irritability and crying. (In medical studies, swaddling has been associated with significant reduction irritability and crying and was shown to be more soothing than massage or sucking.)

·         Swaddling results in better sleep for your baby – and then for you! (Experience and research clearly demonstrates that swaddled babies arouse less and sleep longer.)

A common misconception of swaddling is that it should not be too tight. Not true! Feel confident to swaddle your baby very snugly to ensure the wrap does not come undone. To be sure that your wrap is just the right tightness, a good rule to follow is to think of sliding your hands inside your jeans pocket. Your baby’s wrap should be firm, fitting and secure, just as your hand feels when inside the pocket of your jeans.

Answering recent concerns, the hot off the press editorial To Swaddle or not to Swaddle, from the reputable Journal of Paediatrics, looks at the currently available information on swaddling. It concludes that the advantages of swaddling outweigh the risks, if any.

When combined with recognising your baby’s tired signs swaddling is one of the easiest and most rewarding of settling strategies. Together with sound and movement, swaddling will not only helps your baby, but it will give you confidence as well. When you can successfully calm and soothe your baby with a swift, snug swaddle; take a moment to congratulate yourself!

Did you know eczema affects 10 to 20% of children? I see many children in my Pediatric practice who are suffering from its effects. Not only is eczema a common condition, but it’s distressing and prone to complications (such as infection and bleeding). Children with eczema (and their parents) will also know that it is often associated with other difficulties such as poor quality sleep due to constant itching, scratching and bleeding.

These issues make life difficult and I believe both the community and health professionals understate the impact of eczema on children and their families. Affected children often scratch at night and therefore sleep poorly. This in turn can lead to impaired growth, development, concentration, appetite and even learning.

Our management of childhood eczema has been somewhat ‘light on’. We tell each other that he’ll grow out of it or its ok she won’t develop any scars. While this is true, what we should also be doing is working hard to treat the condition effectively, and ensuring that sleep and lifestyle are minimally affected.

We know the following are triggering factors for an eczema flare up:

·         Overheating

·         Dryness

·         An illness, like the common cold or gastro

·         Emotional stress

·         Sleep deprivation

·         Secondary bacterial infection of the skin

·         Irritants (such as soaps or nylon)

·         In some children, exposure to certain allergens

       such as egg, cow’s milk, wheat

All children with eczema respond differently, however I always recommend the following treatment guidelines:

·         Moisturize, moisturize, moisturize…paraffin or sorbelene are good

·        Keep your child cool. Try not to over-clothe them and, where possible,  keep their environment cool

·         Use bath oil rather than soaps

·         Avoid or reduce exposure to allergens if you can

·         Treat secondary bacterial infection aggressively with antibiotics (infection is suggested if the lesions have become weepy)

·         Don’t be afraid to use corticosteroid ointments (rather than creams) prescribed by your doctor. Better to treat the condition aggressively from the outset and then complications and chronic problems less likely to occur. Continue steroid ointments for 3 days after resolution of eczema inflammation.

·         Consider using wet dressings at night to for severely affected areas to reduce inflammation. This will keep the skin cool, moist and protected from scratching

If you are a parent with a child who has eczema you’ll no doubt be familiar with many of these suggestions. Other useful information can be found here. You may even have some of your own strategies that you could share? I’d love to hear.

While the outlook for childhood eczema is variable (children with multiple allergies generally have more severe and longer lasting eczema) the good news is most infants and children grow out of eczema by primary school. Also, long-term complications (such as scarring) are rare indeed. So hang in there everybody, there is light at the end of the eczema tunnel.

Good question!

Last blog on tired signs, Annabel asked how much sleep should she expect her 9 week old to have? While specific advice is not possible in this format, there are some guidelines which can help parents figure out the answer to this all important sleep-question for their baby.

As a general rule, the following can be expected for how much sleep a baby may need:

• A newborn baby, in the first 2-3 weeks, will generally require 16 – 20 hours per 24 hour period. Feeding and sleeping are more predictable at this early age, but after 2 – 3 weeks things usually get tougher.

• After 3 weeks parents often find their baby sleeps less (approximately 16 – 18 hours) and cries more.

• 6 weeks may see your baby sleep around 15 – 16 hours each day.

• By 4 months babies may sleep 5 – 10 hours plus 2 naps of 2 – 3 hours each.

• A baby of 6 – 7 months can sleep through without an overnight feed, giving you anywhere from 6 – 12 hours, plus morning (1 – 2 hours) and afternoon (1 – 2 hours) naps.

• By 9 months the average sleep can be 11 – 12 hours overnight plus 2 naps, and by 12 months babies may sleep 12 hours with 2 daytime naps that may be shortening.

As you spend more time with your baby, you will understand more about your baby’s individual sleep needs, tired signs and patterns. It is useful to establish a routine for regular settling and sleeping. A Sleep Chart can help to get this started. Free here.

Remember, a fussy baby is extremely common… and when you are awake in the middle of the night with your baby – at 3 weeks old, 9 months or 19 years old – you are not alone! 

While babies cannot talk, when it comes to their most important requirements – the need for food, comfort and lots of sleep - they can communicate very clearly!

Ask any parent and they will tell you their new baby was soon able to tell them what they needed and when! Even the very youngest of babies can communicate when they are tired and need to sleep. And, no, it’s not necessarily through crying.

Most babies give quite clear signs and signals that they are tired. For new parents, recognising your baby’s tired signs is an important skill that will help you get your baby off to sleep with little fussiness.

Common signs young babies are tired include:

·         Changing facial expressions – relaxed to grimacing

·         Frowning and looking unhappy

·         Looking away from you or staring into space

·         Rigid, Jerky or tense arm, hand and leg movements

·         Fists clenched

·         Rubbing eyes and ears

·         Yawning

·         Crying, fussing, being unsettled – this is a late cue! Sometimes too late…

Early tired signs may be subtle and easy to miss. Certainly not as obvious as being completed unsettled, fussing or crying, crying, crying! Watching your baby and understanding their tired signs will help you know when it is best (and easiest) to put them to bed.

For babies, being tired and needing sleep is not just about the length of time they have been awake, so the signals that your baby gives you are a helpful and reliable cue that sleep is near! Observe your baby, trust your own knowledge and read the signs your baby is giving you.

When your baby shows some, or all, of the tired signs listed, it is sleep time! Some babies settle best when put to sleep at the first sign of being tired (such as staring into space) while others will need to be a little more tired before they are ready for bedtime. Trust yourself that you will learn and know your baby’s tired signs best.

Both you and your baby will be pleased that when they have ‘spoken’ about their tiredness, you have listened!

Baby with colic? High needs baby, crying baby, unsettled baby? Fussy baby? How do I soothe my crying baby? Baby not sleeping, helping my baby sleep, sleep deprived parents…

I could go on, but really it does not matter. Regardless of what label you put on it, or how you shape the question, this issue is the same. A fussy, crying baby is extremely common and for parents, this is hard, hard, hard.

Infact, infant irritability (excessive crying, colic, being unsettled) and sleep problems (difficulty settling, will not sleep, short sleeps) are two of the most common issues for which parents seek advice from their health professional. Almost all babies will have unsettled behavior at some stage and this presents an exhausting challenge for parents. Even so called ‘good sleepers’ will have fussy times. It’s true that if you are a parent pacing the floor with a crying baby, you are definitely not alone!

So how can we help? What do parents of fussy babies need? As a Pediatrician and father of four children all of whom cried alot as babies, I believe parents need uplifting reassurance as well as expert information. When it comes to matters of unsettled babies, there is much to be said and a wealth of useful (and not so useful) information to be sought. In fact, sometimes there is too much information! Complicated, contradictory and judgmental information. And so I have set myself a challenge…

To blog as many issues to do with sleeping, crying and fussiness as I can think of! Simple, clear, credible and relevant blogs just for parents. Here’s my list so far (but please let me know what you want to know):

·         Crying and colic (the causes of crying; controlled crying; myths about fussiness; excessive crying; managing colic…)

·         Settling issues (settling and burping; safe sleeping)

·         Sleep solutions (using a dummy or pacifier; crying babies and medication; settling a baby with sound, white noise, lullabies; swaddling a fussy baby)

·         Baby sleep information (your baby’s tired signs; baby sleep patterns; sleeping through the night; how much sleep is needed?)

·         Help for tired parents (crying and parental guilt; reassurance; parents intuition)

How’s that for a start? Pretty good, I think! Parents of fussy babies, watch this space for Dr Harry’s Crying Baby Chronicles!