Transcription:
Will I Ever Sleep Again? Tips for an Infant's Safe and Happy Night's Sleep

Caitlin Whyte: [00:00:00] Sleepy parents. We are here to your rescue. Well, really Dr. Tiffany Kimbrough is. She is a pediatrician and the medical director of the mother/infant unit at Children's Hospital of Richmond at VCU. And, she's also a mom of two. She's here today to answer the questions every new parent has. Will I ever sleep again?

Welcome to Healthy with VCU Health, where experts from VCU Health, share their knowledge, cutting-edge research, and the latest innovations to help them help you achieve optimal health and wellness. I'm your host, Caitlin White.

So, Dr. Kimbrough, while sleep for parents and babies is of course important – safety is even more critical.

What are your top tips for infant safe sleep?  

Dr. Tiffany Kimbrough: [00:00:47] I think that easiest thing to remember is just the ABCs like we learned in elementary school. So if you break it down, the A stands for alone. Babies should always be in their own sleep space alone. They should not be sleeping with an adult or another caregiver.

The B – I think a lot of us know that babies should be placed on their back to sleep, but it's important that we do that for every sleep opportunity. And then once they're able to roll as they get bigger, if they roll onto their tummy, you don't have to flip them back over. Just still put them to sleep on their back every time.

And then C stands for crib. And this is what we probably don't talk about as much, but it's really important that we do. Babies should be placed to sleep in a safe sleep space, meaning that it's been certified by the CPSC. And that is either a bassinet or a crib. There's lots of products out there that are marketed, but really are not sleep certified.

So we want to make sure that babies are using something that's been deemed to be safe, and avoiding things like swings or car seats or other products during sleep time.

Caitlin Whyte: [00:01:53] Now you mentioned that safe sleep space. And that leads me into my next question. Tell us about building a good sleep environment and why that's so important.

What does a good space include?

Dr. Tiffany Kimbrough: [00:02:04] So that means no extra pillows or blankets or soft bedding in that sleep space. So you want to make sure it’s a firm mattress, unlike our adult mattresses that are super cushy, you know, we want babies to be on a firm space. And then generally where your baby is. We recommend for babies to be room sharing, but not bed sharing.

So in the same room with their parents, at least through the first six months, and then during sleep times, you know, low lighting, low stimulation, you can use white noise machines if that's helpful to kind of drown out extra sounds. How we would want to sleep, you know, with low stimulation around them. 

Caitlin Whyte: [00:02:40] So we hear a lot about co-sleeping. Can you tell us more about what you advise here?

Dr. Tiffany Kimbrough: [00:02:46] Yes. We know being a new parent is hard. And so I always talk to my families from a nonjudgmental place, but we want to make sure what we do in the middle of the night is to set ourselves up for success. There are spaces you want to avoid. So believe it or not, sofas and armchairs are actually the most dangerous to accidentally fall asleep with your baby, or even dropping. Babies can fall out of parents' arms on the hard floors or hard surfaces and get injured, or we unfortunately see wedge injuries where babies might get stuck between parent and then those sofa cushions, and that's another suffocation risk. So I like to tell my families to try to set yourself up for success at night. If you know that you're going to be doing, you know, a lot of nights feeding determine where that space is going to be to try to make it as safe as possible and believe it or not, the bed may actually be the safest place to be doing your night feeding for those reasons. And if you’re up calming a fussy baby, do that standing so you're as awake and alert as possible to help set yourself up for success. And really, you know, parenting is a team sport. So use your partner. If you're doing all the nights feeding as the mom who may be breastfeeding, ask your partner to be on the lookout.

If they find that you've nodded off, or you are falling asleep, go ahead and take the baby and put them down in their safe space. And same thing with parents. If they find that they've accidentally nodded off, it's important not to stay in that spot. Don’t think, oh, I'm awake now and baby looks like they're calm and resting, I’m just going to nod back off again, go ahead and put baby in their space at that time because accidents can and do happen. And want make sure that you're not intentionally nodding off with your baby either.

Caitlin Whyte: [00:04:30] Now you mentioned breastfeeding, does what a newborn eats affect their sleep if they are breastfeeding or not. 

Dr. Tiffany Kimbrough: [00:04:36] We know that it's important for babies to feed frequently, especially in the beginning for them to help maintain mom's supply. So it's not uncommon for our breastfeeding babies to be doing more night wakings in those early weeks to try to help mom to build her stash. So I try to talk to my breastfeeding moms, not to think of those night wakings as if somehow baby's not getting enough, it's actually physiologic. It's how the baby is trying to help mom's body respond to what they need for growth.

Caitlin Whyte: [00:05:07] Now, every parent of course, wants to know just when their baby will sleep through the night. I mean, can you share more information on when it's appropriate to kind of have that sleep schedule down for the most? 

Dr. Tiffany Kimbrough: [00:05:21] Totally. This is probably my most commonly asked question – when will my infant sleep through the night. I encourage families to start asleep routine early. It doesn't hurt for your baby to know that sleep is coming in terms of doing a bath or a lot of parents encourage reading to your child.

So bedtime is a natural time to start, you know, sharing that love of reading together or doing some songs. Your baby generally won't start to integrate that information in terms of being ready for sleep until about four to six weeks of age. That's when they can start to have a little bit of a rhythm to their day.

And then, it's generally not till closer to, you know, three to four months before your baby is really able to start learning how to self soothe which is how they're able to put themselves down to sleep on their own. So just setting the stage for sleep, every baby is different. I also tell families that while you may have a friend or two whose baby is sleeping through the night early on, not to think that that should be the rule or that every baby's doing that still at six months of age, even half of babies are still waking up once a night. So just trying to set clear expectations that every baby is different. And, if your baby's not that golden egg of, you know, an early night sleeper that you're somehow doing something wrong. You’re not.

Caitlin Whyte: [00:06:38] Of course, newborns sleep a ton. Let's talk about their awake windows. What are those? And how can they help a new parent know when it's time for a nap?

Dr. Tiffany Kimbrough: [00:06:46] That's a great question. And if you never heard that term before, a week window is kind of a sleep medicine term. And it basically just as referring to how much wake time do you have to get in your bank before your body's ready for sleep again. For adults, that's all day, you know, we're awake most of the day and then bedtime rolls around and we're ready to go to bed. But a newborn's wake window is only about 45 to 60 minutes. So after that their body's ready for another sleep cycle. They generally have six to seven sleep cycles for a day. In the beginning, babies can cue you that their sleep wake window is ending with some sleep signs. So that might be yawning or they'll starting to fidget or older babies will start to kind of rub their eyes or they'll even rub the outside of their ear. You want to avoid letting your baby get overtired, which is kind of a crazy thing to think about. Babies can be too sleepy and then they actually fight sleep. They're overstimulated and everybody's stressed and crying trying to get the overtired baby to go to sleep. So paying attention to your baby's wake window, your baby's early cues for being sleepy and trying to jump on those before you kind of miss the boat and you get into over tired territory, it's trying to hit that sweet spot.

Caitlin Whyte: [00:08:01] Now let's talk about the parents. Why is self-care for parents so important? And what are some ways that new parents can incorporate some, you know, me time into their lives.

Dr. Tiffany Kimbrough: [00:08:10] Totally. And I think this is another good thing to think about. I tell my families all the time that, you know, you can't pour from an empty cup. So the best way to take care of your family is actually to take care of yourself. In the beginning for parents, you know, I think trying to figure out what that looks like can be a little bit hard, but what we are learning more and more is that. Postpartum depression is incredibly common in women, but it's also actually common in men. So the more that we take care of our overall physical being is also helping to take care of our mental health. I encourage families to try to sleep when they can. I know that that adage or that cliché of sleep when the baby sleeps, but your baby may have their nights and days mixed up for a few weeks. They're trying to nap during the day is really something that I encourage our families to do. If they're able take turns, working shifts, and then to make sure they are eating healthy food, trying to get outside or any kind of, you know, physical activity to help with their own body. Strength is really important to just help keep a healthy and well caregiver for healthy and well babies.

Caitlin Whyte: [00:09:13] And wrapping up here, how can your pediatrician help new parents at this time? 

Dr. Tiffany Kimbrough: [00:09:17] So we absolutely want to be a resource. We're passionate about how we help empower our families make this transition. You would think, you know, babies should come with a manual or they should be intuitive, but every baby is so different. What works for one family might not work for another. So a lot of us get parenting advice from our friends, which is awesome, but it might not be all created equal and it might not work for your family. So your pediatrician really is there to be your partner and to help you figure out some of these things that may not come as intuitively as we should.  

Caitlin Whyte: [00:09:47] Great, Dr. Kimbrough, is there anything else, any last minute tips that parents should know?

Dr. Tiffany Kimbrough: [00:09:51] I think just the big take home point really is, is ABC’s. And going back to that safe sleep. So especially in the middle of the night, we can get desperate and sometimes we kind of child the things to figure out, you know, how are we going to get this baby to go to sleep, but fall back on those safe sleep measures and really protect your treasure, protect your baby in the middle of the night. If things just aren't working well, reach out to your health care provider so we can help you to troubleshoot.  

Caitlin Whyte: [00:10:15] Well, thank you so much, Dr. Kimbrough for taking the time to share these tips with us, and hopefully we can get some sleep deprived parents the sleep they need. And it sounds like if there's one other takeaway from this podcast, it's that back is best. For more news, knowledge and healthy fun chrichmond.org. This has been Healthy with VCU Health. I'm Katelyn White. We'll see you next time.