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Live webchat with sleep expert, Dr Helen Ball - Tuesday 15th June 1 - 2pm

(180 Posts)
RachelMumsnet (MNHQ) Wed 09-Jun-10 14:52:42

Message withdrawn

helenball Tue 15-Jun-10 13:38:34

@ballstoit: first of all SIDS-risk is greatest around 2-3 months of age. On average in the UK the rate is 1 in 2000. For smokers the risk is increased 5x, SIDS-risk for sofa sharing is 20x; bed-sharing if you are a smoker or smoked in pregnancy is a 12x risk (different studies have produced different stats, but these are UK data). Bed-sharing if you are not a smoker carries no significant increased risk. Breastfed babies have a reduced risk of SIDS compared with nonbreastfed babies. No one has studied the relative risks for breastfeeding related bedsharing, but they have been estimated as maybe 1 or 2 per 10,000, compared to 1 per 2000 generally.

helenball Tue 15-Jun-10 13:38:46

@StealthPolarBear: this is an ‘interesting’ justification of sleep training! Yes, sleep is brain development time, particularly for infants. Newborns spend 20 hours or so a day asleep, and 50% of this is spent in REM sleep (so 10 hrs a day). REM is when neural connections are made, when learning and memories are consolidated. Adults sleep for 7-8 hours on average, and 20% is spent in REM sleep (so 1.5hrs). Babies brains grow rapidly in the 1st year, so they do need to sleep. HOWEVER – sleep training is a) inappropriate for babies because of the reasons mentioned above in my reply to Druzhok., and b) is often undertaken to try and modify when babies sleep, not to encourage them to get sufficient sleep.

helenball Tue 15-Jun-10 13:39:04

@EasilyConfusedIndith: an interesting story raising some good questions. I don’t know of any research on pnd and cosleeping, but I would hypothesise as you do that there may well be something interesting going on. One of the features of depression is fatigue, so it is unsurprising that you were unaware of your daughter during sleep, and did the right thing by keeping her in a separate sleep space. It is possible that your pnd and her sleep behaviour were related but I don’t think anyone has researched how it might happen (hormonally, behavioural cues??). I’d love to come for tea, especially if it will involve cakes... (we are very partial to cakes in our lab!)

countryhousehotel Tue 15-Jun-10 13:39:05

Hi Helen - My question is about self settling. Ds is 5 months old and falls asleep at the breast every night while I'm reading to dd, and gets put in to his cot once he's asleep. When he wakes in the night to feed I usually end up cosleeping for the rest of the night. Is this setting us up for problems longer term (the fact that he's not self-settling I mean, not the cosleeping!).

suiledonne Tue 15-Jun-10 13:40:02

Thanks Helen.

Lack of sleep due to 19 month old still waking for regular night feeds following on from dd1 who was a terrible sleeper and has only started sleeping well (co-sleeping) in the last few months.

I never wake feeling refreshed and often fall asleep at 8pm when putting the children to bed. I feel tired a lot of the time.

helenball Tue 15-Jun-10 13:40:31

@foxytocin/@thatbuzzingnoise: there are lots of people (women mostly) working within the health service to change this situation, and I think it is slowly changing. But we are turning an ocean liner here, so it is very SLOW. Health service staf need evidence though on which to justify changing practice and policy (and it is very frustrating to them that a lot of current practice is NOT evidence based, but because it is ‘the way things have always been done’ it doesn’t have to be rigorously justified, but anything seemingly ‘new’ is challenged every which way). This is why I started doing clinical trials – they’re certainly not the normal domain of an anthropologist – but they need doing so the ‘right kinds’ of evidence are available in the ‘right kinds’ of journals, and no-one else was getting on with them! The more the merrier for the tea-party

DidEinsteinsMum Tue 15-Jun-10 13:42:13

I have had years of sleep disturbance due to child with sleep problems. Now that he has been medicated his sleeping has improved over the last year, but mine is still really bad and I am constantly tired but unable to sleep. Reluctant to take meds as still need to be able to wake up if he gets up in the night for safety reasons (think 5yo escapologist who can unlock doors/windows and has no fear)

How long could it be before I am able to settle down to a sleep pattern that is cloesr to what i need rather then what my body had to become used to?

Druzhok Tue 15-Jun-10 13:42:24

Tanaz: I hope you see this!

I had a very similar experience with my DS. He is now 4 and we finally got him into his own bed at night when he was 3.5. DH took a mattress into DS's room for a week, so that Daddy was there to offer reassurance when DS woke up.

It took 4 days to get him used to the idea. I think DH got into DS's bed with him for a short period on the first night, but otherwise reassured him from outside the bed.

DS still comes into our bed sometimes: we praise the nights he is in his own room, but accept him into our bed when he feels the need.

We tried all this when DS was 2.5 and it didn't work: like potty training, it seems to be easier if you wait a bit longer.

I don't regret it for a minute. Actually, I rally miss the physical closeness, now that he's less willing to cuddle up.

Like Helen says: do what works for you x

helenball Tue 15-Jun-10 13:44:08

@Hermya321: yes, bedside cots seem to be a good alternative to having the baby in the bed if you would prefer. We would like to look at breastfeeding outcomes with these cots to see if feed frequency is similar to bed-sharing, but we haven't got the funding to do so yet. When we looked at similar side-car cribs in hospital on the postnatal ward there was much more frequent feeding than with rooming-in (which is good for bf inititation), but no difference in sleep for mother or baby.

thatbuzzingnoise Tue 15-Jun-10 13:45:54

Thanks for that. I just seem to always hear of the HVs who look like this: hmm when you mention co-sleeping.

One said to everyone at the surestart breastfeeding support group once: well we (British people) like to get them in their own beds as soon as we can. (I am obviously foreign.) When I mentioned to stimulate dialogue that breastfeeding babies and toddlers benefit from co-sleeping.

EasilyConfusedIndith Tue 15-Jun-10 13:45:59

Thank you Helen, great web chat

eastdevongirl Tue 15-Jun-10 13:46:26

my baby wakes once or twice each night. he is hungry so i feed him, but then he doesn't want breakfast - should i push for no feeds at night , if so how?
the second wake tends to be an early morning (5am) with no sleep afterwards. any ideas how i can improve this - lack of sleep is taking it's toll on me

helenball Tue 15-Jun-10 13:47:59

@countryhousehotel: what you describe is what we have called in our research 'combination bedsharing' where a baby starts the night in one sleep location and ends the night usually in bed with mum. This was the most common kind of bed-sharing we discovered, a third to a half of all breastfeeding mums do this. I know of no evidence that indicates this pattern of cosleeping prevents children from falling asleep by themselves as they get older.

helenball Tue 15-Jun-10 13:50:22

@DidEinsteinsMum: there are various treatments for poor sleep that don't involve medication. talk to your GP about referring you for CBT.It definitely helps some people.

Runningwithscissors Tue 15-Jun-10 13:50:57

Hi Helen,

My 2.4 year old has, for the last 6 months, been getting up and playing in her room once she's been put to bed at 8pm (after bath, milk and stories, plus quiet reading time by herself), and often stays up playing or reading until 9.30pm. We try sitting with her, but she gets up and starts playing as soon as we're gone!

She has 30 mins nap in the day at nursery. On days at the weekend when she doesn't have a nap, but runs round a lot, she can sometimes go straight to sleep...

I worry about her not getting enough sleep and jeopardising her development; I generally have to wake her up in the mornings at about 7.15am, and she can be a bit grumpy....

Should we just let her do her own thing as she's obviously not tired at 8pm, or should we be trying something else? Cut out nap completely in the day?

Would appreciate any thoughts smile

countryhousehotel Tue 15-Jun-10 13:50:58

Thanks Helen but what about letting him fall asleep at the breast ie not self settling?

helenball Tue 15-Jun-10 13:51:56

@eastdevongirl: how old is your baby?

LindenAvery Tue 15-Jun-10 13:52:36

Helen - I have another question if there is time - if you are breastfeeding and wish to co-sleep in a bed but your baby actually prefers to sleep alone in a cot is this just one of those individual things or does it mean that there could be something wrong with your baby?

Hermya321 Tue 15-Jun-10 13:52:56

Thank you Helen, I do plan on Breast feeding so I would intridged to see the outcome of that particular study.

DidEinsteinsMum Tue 15-Jun-10 13:56:51

Thankyou. I think i was wondering whether or not you can change your body's need/demand through bad habits but i suspect that this is not the case. Will ask but know that gp is keen on the med route.

helenball Tue 15-Jun-10 13:57:26

@countryhousehotel: you'll eventually stop breastfeeding him to sleep and he'll fall asleep without it at some point... why do we want to encourage babies to self-settle? Again this is a very culture-specific parenting requirement in our society and doesn't reflect babies evolved needs i.e. to ensure closeness with caregiver at vulnerable periods (such as the transition into sleep).

Carriemumsnet (MNHQ) Tue 15-Jun-10 13:57:31

Hi there

My sister has 8 month old twins - in a one bedroom flat. dd sleeps through from 8 til 7. Ds is awake two or three times a night. Sleep training is obviously tricky in a confined space - even if she wanted to do it and I doubt she would - and she often ends up feeding him to keep him quiet, but is worried this is perpetuating the habit/ problem. Do you have any other suggestions?

helenball Tue 15-Jun-10 13:58:49

@theboobmeister: What’s your view on Cancer Research UK or the British Heart Foundation? They exist to raise awareness of a particular health issue and provide support for people affected by that issue. FSID is no different to any other medical research charity in that respect – to be successful at what they do (raise awareness of SIDS and raise money for various research, support and education programmes) they need to publicise that issue and keep it in the public eye (media interest is good for fundraising). Their focus is on reducing/eliminating unexpected infant death, and their recommendations on co-sleeping stem directly from that. Their remit isn’t to promote breastfeeding or mother-infant attachment. I might wish their stance on cosleeping/bed-sharing was more nuanced and took these other things into account – but the statement they make that ‘the safest place for an infant to sleep is in a cot’ is not wrong – it is just (from my perspective) limited. On a population level, considering all the dangerous things some people do when sleeping with their baby, if it was compulsory that all babies slept in cots at all times then some babies would undoubtedly be prevented from dying. The issue is, would all the other babies suffer in some way in order to save the lives of a handful? And what’s more important? Where do we draw the line between preventing death of a few and promoting health and well-being of the many? All of us are going to draw that line in a different place! I do wish that people would realise that all organisations issuing ‘guidance’ have an agenda of some kind, and think about whether that agenda is relevant to them.

helenball Tue 15-Jun-10 13:59:03

@bedlambeast: Thanks for the kind words! there really are no SIDS risk studies that have considered breastfeeding babies who bed-share separately from other babies who bedshare. And to do one now that the rate of SIDS is so low (and it is really low for breastfed babies) would take years, and require thousands of participants, to get enough deaths in breastfed babies with no other risk factors (eg no smoking etc) to ascertain whether those that bed-shared were at greater risk than those in a cot. This is one of the reasons it is a difficult argument to ‘win’ one way or the other – the data simply aren’t available (and probably never will be) to give a definitive answer.

eastdevongirl Tue 15-Jun-10 13:59:03

sorry - he is 6 1/2 months old.
he is predominantly breast fed - but takes a bottle at bed time after refusing to feed at all for a few days (i think he had earache) about a month ago.

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