Episode 7: Newborn Sleep Insights

Ep 7 newborn sleep audio
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[00:00:00] Speaker: Welcome to the Sleep Edit, a podcast devoted to helping tired kids and parents sleep better. We focus on actionable evidence-based sleep advice, so everyone in your home can sleep through the night. Now, a quick disclaimer, this podcast is for general informational purposes only and does not constitute the practice of medicine, nursing, or other professional healthcare services, including the giving of medical advice.
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[00:01:09] Craig Canapari MD: Well, welcome back to the sleep edit. I am Dr. Craig Canapari.
[00:01:12] Arielle Greenleaf (2): And I’m Arielle Greenleaf.
[00:01:14] Craig Canapari MD: We are going to talk today about a challenging topic for a lot of parents, which is specifically newborn sleep In the first three months this is very top of mind for me because my brother and his wife just had their first baby
[00:01:28] Arielle Greenleaf (2): Oh, congratulations.
[00:01:30] Craig Canapari MD: I’m an uncle now five times over, which is pretty
[00:01:33] Speaker 9: Yeah.
[00:01:33] Craig Canapari MD: I know I’m an expert uncle at this point. Top uncle uncles.com.
[00:01:40] Arielle Greenleaf (2): That’s great. I think you’d be a great uncle.
[00:01:44] Craig Canapari MD: I am a great uncle, honestly, I give good gifts, like the sorts of gifts that the parents don’t really want to give for their
[00:01:51] Arielle Greenleaf: right.
[00:01:52] Craig Canapari MD: Like Nerf guns and stuff like that. Do we do cool stuff when I get some testimonials on here from my nieces and [00:02:00] nephews?
[00:02:00] Arielle Greenleaf (2): We’re gonna talk about newborn sleep, specifically sleep in the first three months of life for infants. A challenging and confusing time for parents who are frequently sleep deprived and have a lot of support,
[00:02:12] Arielle Greenleaf: Yeah. And I think, the number one thing that I like to share with newborn parents is just that newborn sleep is erratic. And it’s, it can be frustrating because you may see programs or google schedules or methods of, scheduling your newborn and it’s just not biologically like it’s normal for a baby, a newborn sleep to be erratic.
[00:02:42] Some people have unicorn babies and they bring them home from the hospital and they sleep through the night right away. And others, like my own they are waking every one to three hours, day and night to feed and. That’s normal. So I think it’s really important for us to [00:03:00] set expectations when it comes to newborn sleep in that it is slowly, actually, it quickly matures.
[00:03:06] A lot happens over the first three months when it comes to a lot of things, but certainly with sleep.
[00:03:13] Craig Canapari MD: Yeah, I think that, things will get better with time, even if you’re really struggling. It’s funny, my older son was one of those babies that we took him home from the hospital.
[00:03:22] My wife had a c-section the first night. And he slept six hours overnight. And I woke up in the morning and I was worried that he was dead, and I ran to his room and he was okay. But I think that there’s a massive range of what is normal sleep in a 24 hour period.
[00:03:38] So for a newborn, that could be anywhere from 13 to 14 hours per or 20 hours within a 24 hour period. So if you have a baby who’s natural, Sleep needs at that point is 20 hours a day, you are gonna feel like a parenting genius. It is gonna go so smoothly for you. [00:04:00] No matter what you do, your baby is going to sleep well.
[00:04:02] Now these high sleep need babies. You might have struggles later on when they’re say have to, if they’re going into childcare or something like that, they can’t nap as much as they want to. But in the newborn period, they’re very easy to deal with. The children who are on the low end of the spectrum tend to represent a real challenge for parents because I can guarantee you those 13 or 14 hours are not happening in a row.
[00:04:27] And they’re scattered throughout the day. these are the parents who really struggle quite a bit. There’s a typical pattern of newborn sleep.
[00:04:36] Arielle Greenleaf (2): So what we know about newborn sleep was clear, probably pretty early on. There’s actually a famous book I got right here. It’s A Sleep and Wakefulness by Nathaniel Kleitman. And Kleitman graphed out his newborn daughter’s sleep periods in the first three months of life. And what he saw was that essentially there’d [00:05:00] be a period of sleep, which could be anywhere from one to two hours.
[00:05:05] Craig Canapari MD: The baby would wake up, cry, want to feed. Parents would change their diaper, et cetera. And then pretty soon after that, the baby would start to get tired again, need to get put down again or fall asleep in a parent’s arms, fall asleep in a lot of different places and the cycle would just repeat itself.
[00:05:25] So there’s this sort of inherent rhythmicity to it with a cycle length of like probably two to three hours, maybe a little bit shorter in the immediate newborn period.
[00:05:34] Arielle Greenleaf (2): I’ve always seen that newborn, like one single sleep cycle for a newborn is shorter than an adult. But I always have seen it as 30 to 45 minutes as a single sleep cycle.
[00:05:47] So I think what you’re referring to is the ultradian cycle, and that is when we look at measurement of brainwave activity during sleep. So we will see people, most adults and children older than six months of [00:06:00] age, we will see them cycle through non REM sleep, then REM sleep, and then maybe have a brief awakening out of REM sleep, then fall back asleep again.
[00:06:08] Craig Canapari MD: In an older child or adult that is two or three hours in an infant that is typically 60 to 90 minutes. And one thing that I think is important for parents to understand as well is that the way that infants cycle through sleep, especially young infants and newborns, is different than the way that older infants do.
[00:06:28] Older infants and adults, they have this slow wave sleep, which is fairly deep. Then they go through REM sleep where the breathing might be a little bit irregular, but every muscle in their body is otherwise paralyzed except for the diaphragm, the main breathing muscle in the eye muscles. In newborns, this is inverted.
[00:06:44] So newborns enter sleep through the analog of REM sleep, which is called active sleep. And what’s interesting about this is newborns don’t have that complete paralysis during REM or dream sleep. So they will commonly cry out, move, grunt, [00:07:00] smack their lips, et cetera, and do all this weird stuff right when they’re falling asleep.
[00:07:04] That is often alarming to new parents, and this is normal. Then they’ll go through a period of what is called quiet sleep, and then that’s analogous to slow wave sleep and then often wake up to feed. So it’s inverted right at birth. And then once kids get to three or four months, you’ll see that sort of flip of that cycling there and you’ll see a more. Traditional is not the right word. What for the rest of the lifespan, which is non-REM sleep and REM sleep cycling over and
[00:07:33] Arielle Greenleaf (2): I think you make a really interesting point there. And I think one of the biggest things I wish I had known back in the day was I didn’t know really about active sleep. And so I think when she was, si, you mentioned like a long, a 60 to 90 minute cycle, actual sleep cycle. I think what I did, and I know other parents have done the same is as she was [00:08:00] coming, she’s going through that, what did you call it?
[00:08:02] When she was going through that and she was cycling through the REM sleep, I mistook that as she needed me. She needed to be fed, she needed something, she needed to get up. So I always tell newborn parents, don’t rush. They will tell you if they need you. They will, they have lungs and they can scream.
[00:08:21] And so if they’re just twitching or grunting or even crying out a little bit, give them a little space and see if they then cycle back into quiet sleep. Because I think one of the biggest problems is we just don’t know this stuff when we come home from the hospital. And
[00:08:41] we inadvertently create a habit of, going over to the baby when, anytime they make a squawk or a movement. So I think that’s really something that a lot of my newborns, newborn clients in the past have said, wow, I didn’t know that.
[00:08:58] Craig Canapari MD: [00:09:00] There’s a book, I think it was like, came out seven or eight years ago, called Bringing Up Bbe, which was by Pamela Druckerman, I believe. And it talked about she was raising her infant in France which, again, it’s a western country, but there are a lot of different behaviors around sleep.
[00:09:16] And a lot of the French babies seemed to sleep pretty well. And she talked about this idea that French parents tend not to rush in the first sign of trouble.
[00:09:26] Was it le pause or something? Yeah. She called it La p which my French friend thought was terrible.
[00:09:32] And that’s true in this situation too, if you hear your baby stirring in the monitor, just wait a moment. You again, like you are, you do need to be responsive in these first three months of life. Children don’t know how to self-soothe. They obviously need to feed frequently, but, if you hear a little bit of noise coming from your child, you don’t have to rush over, pop the pacifier in the cry hole or immediately start changing their diaper.
[00:09:56] You can just wait a moment and see what happens. Not, I’m not saying [00:10:00] wait 30 minutes till they’re screaming, but like you’ll get a feel for how these rhythms work. I think the fact is babies don’t, this sort of pattern of. Sleep, wake feed sleep is pretty hardwired into them.
[00:10:15] Like you’re not, the cycle lengths may be shorter or longer. Sometimes they’re gonna be more frequent during the day. Sometimes they’re gonna be more frequent at night. If your baby is sleeping some of the time feeding, you’re doing it right. It’s, if it feels chaotic, it is a little bit chaotic because the natural maturation of cycling through different stages of sleep, the lengthening of sleep at night having more sleep at night during the day takes a little while to kick in.
[00:10:41] Arielle Greenleaf (2): I think one of the tricky parts too, is again, you and I were talking about how in the United States we don’t have maternity leave for very long. At the same time, the AAP recommends room sharing for, up to six months, but babies are [00:11:00] loud and they do cycle into loud, phases of sleep and it affects parents.
[00:11:06]
[00:11:07] Craig Canapari MD: I think it’s challenging because a lot of parents, a lot of moms have to go back to work after six weeks. Paternity leave is short, and it’s very stressful because there’s some urgency, right? To get things on track. And the fact is that there’s only so much you can control.
[00:11:25] And if you’re maternity leave is three months long there’s a good chance your baby’s still gonna be waking up during the night. But you what, why don’t we start talking about the sort of sleep cycles that, in the first three months, what you would expect and at different stages of the game and what parents maybe should be focusing on.
[00:11:43] Arielle Greenleaf (2): Yeah, absolutely. I think it’s really important in the first month of life again, to give yourself grace and get used to this new reality. [00:12:00] Even if it’s your second, third, fourth baby, it’s going to be different. Assume we’re going to just fall into this role of knowing what to do and pray that our baby knows how to sleep.
[00:12:11] But I think having some grace with yourself is really important. But as far as sleep goes essentially your baby is probably going to just be, eating, sleeping, waking up, pooping, eating, sleeping, It’s very normal foranywhere from 13 to 14 hours or 20 hours in a 24 hour period.
[00:12:34] It’s very common. Their number one job of a newborn is to gain weight and to grow. Waking frequently to eat is normal and should be expected, as frustrating as it might be.
[00:12:48] Craig Canapari MD: So let’s see. First month of life. How frequently do you expect baby to be feeding?
[00:12:53] Arielle Greenleaf (2): Would say anywhere from every one to three hours. It depends, I’ve had some [00:13:00] clients in the past whose newborns have just needed to, especially if you’re establishing breastfeeding. So supply and demand is essential. And so in some cases, some breastfed babies might need to be fed every hour or 90 minutes.
[00:13:15] But in general, it’s probably every two to three hours. I’m just giving extremes there. So they’re definitely waking at that point. I think it’s important to understand too, like I think some parents think that they need to start keeping them awake or trying to keep them awake. And I think it’s important to follow your baby’s cues at this stage because.
[00:13:37] You don’t wanna keep a baby up ’cause it’s just gonna make them uncomfortable and grumpy and then it’s going to make you uncomfortable and grumpy.
[00:13:45] Craig Canapari MD: So why don’t you review some of the sleep cues that parents should be looking for in a very young infant. It might signal that the child is, needing to be soothed to sleep?
[00:13:56] Arielle Greenleaf (2): I think by the time they’re yawning big [00:14:00] yawns it’s definitely overdue. You gotta get ’em down right away. But I think, pulling on ears or like any sort of rhythmic movement to attempt to soothe I’m trying to think of other things that
[00:14:11] Craig Canapari MD: No. I think that’s good. Because these things can be very subtle
[00:14:16] Speaker 9: Very
[00:14:16] Craig Canapari MD: I feel like you don’t miss much by trying to put your baby down and to them put them down, right? they’ll let you know if they’re not ready to go to
[00:14:26] Arielle Greenleaf (2): Exactly. And that’s why I think following cues and especially in that first month of life is probably your best bet. Do not try to look online for newborn sleep schedules at that point because you are just going to drive yourself crazy and you’ll be expecting something that is not biologically normal.
[00:14:49] Craig Canapari MD: Yeah. I think this is the biggest challenge of the first month is parents just learning their baby’s rhythms. I think something that’s very important to think about immediately in that first month is safe sleep
[00:14:59] [00:15:00] and I cannot overstate the importance of this because. Young newborns and young infants are vulnerable.
[00:15:08] And again, this is always a difficult topic to talk about because it’s stressful, but infants are at risk for suffocation and they’re also risk for something called sudden Infant death syndrome. So I just wanna quickly review the American Academy of Pediatric.
[00:15:22] Recommendations for safe sleep. And I’m gonna go primacy is back to sleep. That means having your baby being put down on their back and on a sleeping surface that is separate from any other human beings with no soft pillows or blankets nearby. You can have your baby swaddled, you can have your baby in a sleep sack, but not with loose pillows, blankets, stuffed animals or bumpers.
[00:15:51] And I can tell you, I used to use a photo on my website and presentations was of my three or four month old holding a teddy bear and sleeping. And I’m like, that’s so cute on the side. And I’m like, [00:16:00] that’s so cute. it doesn’t really scan that well. And those of us who are sleep professionals, it is really common to look at stock photos and product advertisements with infants in terribly unsafe sleeping environments.
[00:16:13] Arielle Greenleaf (2): Have a picture of Ashley sleeping in the rock and play.
[00:16:17] Craig Canapari MD: Yeah. I think that’s now off the market. there’s also an recommendation for room sharing, but not bed sharing. And to be honest, I used to be a little skeptical of this because when the recommendation first came out, I thought the evidence it was based on was fairly weak.
[00:16:34] But with the most recent iteration of the safe sleep guidelines, which we’ll link to in the show notes, there was some research that was fairly compelling, that room sharing, at least in the first six months, which is the AAP recommendation, does reduce the risk of SIDS. I think there’s one important caveat to offer here, which is that if room sharing with your infant is resulting in unsafe sleep behaviors, which is.
[00:16:59] Most [00:17:00] commonly taking your baby up, falling asleep with them on a chair, a sofa, et cetera. Then you’re probably better off speaking with your pediatrician and maybe having them sleep in a separate room. I was just at a sleep conference where they were talking about you can have your baby in your room, but it is okay to use a visual barrier so you are not staring at your baby and rushing it every time they stir or move.
[00:17:22] Also, when they get a little bit older so they’re not staring at you and wondering why you aren’t rushing over and giving them attention when they’re doing something cute.
[00:17:29] Arielle Greenleaf (2): That’s helpful for toddlers too. So I think that visual is, that’s a really good point.
[00:17:34] Craig Canapari MD: and just to hit a couple other safe sleep things using a pacifier in the first six months. Breastfeeding, avoiding tobacco exposures co-sleeping and bed sharing are can be a hot button topic. And again, at the conference I was just at. Some parents, they had a survey of parents who were co-sleeping and said, and the title of the talk was, don’t judge me ’cause I’m co-sleeping.
[00:17:55] And I think that the challenge is that there is a suffocation risk [00:18:00] with co-sleeping. There are ways to reduce risks somewhat, having no other adults or children in the bed having the mattress on the floor so there’s no risk of entrapment against the wall or the child falling off of the bed.
[00:18:14] Having the parent. Basically, you can’t have any blankets or pillows anywhere near the baby. I think the best thing for parents and again, often you have, you’re breastfeeding a lot during the night. do like those bassinets that are directly attached to the side of the bed. I think those are safe.
[00:18:31] the cos sleepers that go in the bed in the sleep positions. Those aren’t safe. Don’t recommend those. But I think certainly what I’d say for parents is talk about this with your pediatrician, especially if you feel like you need to deviate from these guidelines.
[00:18:45] They’re there for a reason and that’s the reason is to prevent something tragic from happening.
[00:18:49] Arielle Greenleaf (2): some of these recommendations are hard to follow.
[00:18:51] Yeah. one of the things that’s in the news right now, but was part of the new Safe sleep guidelines is [00:19:00] avoiding weighted sleep products. So no weighted swaddles, Sleep sack. And there’s a push right now. Some, big retailers are pulling them off the market because of the evidence that they are not safe.
[00:19:15] This one is a big one to me because, the marketing is slick, and they know that you’re tired. They know that parents are looking for anything that might help their baby sleep. And look, this weighted swaddle will help your baby feel cuddled while you’re not cuddling them.
[00:19:33] Avoid, co-sleeping or whatever it is. Buy this product and your baby will magically sleep. Now, I had one sent to me, actually, I’ve had two sent to me. Different companies and one of them was almost a pound and it was for an infant, and I was shocked at how heavy it was. Shocked. So
[00:19:57] Craig Canapari MD: Yeah. And I think I just wanna [00:20:00] amplify that and say that when you under, I’m a pulmonologist by training, we know that babies actually have weak breathing muscles. There’s a lot of different reasons why infants are vulnerable to compromise in breathing. Their chest wall is soft, their ribs are soft, and their, the, also, the way that their diaphragm, their main breathing muscle inserts into the rib cage is just not as mechanically advantageous.
[00:20:24] Really. Yeah, I avoid the stuff like the plague. Swaddling is okay, and swaddling gives that pressure cue. A nice tight swaddle is great. my older boy had to be swaddled, and if he was not swaddled sufficiently well, he would start getting his arm out, like Houdini, and then he would start hitting himself in the head and wake himself up.
[00:20:45] So I think that, we really were very careful about that. my other kid hated the swaddle, didn’t like the swaddle. You don’t have to swaddle if your kid doesn’t like it, but if it helps swaddle them up. But when they start to be making progress towards rolling, that’s when you [00:21:00] gotta stop
[00:21:00] Speaker 9: yep.
[00:21:00] Craig Canapari MD: and usually that’s a little bit later, but some kids roll early, so if they look like they’re about to start rolling, you gotta stop the swaddle.
[00:21:07] Speaker 9: Yeah.
[00:21:08] Craig Canapari MD: but I wanted to add to month one. day and night confusion. So if you wanna talk about the science behind that, I always find that very interesting.
[00:21:17] Sure. So we’ve talked about the ultradian cycle. There’s also the circadian cycle. Circadian refers to a cycle that’s about the length of a day and a night, a 24 hour period. And there’s a reason that even in my world, Arielle’s world, the first month or two, even the worst sleepers, they sleep most of the time at night.
[00:21:40] They’re awake most of the time of day. And that’s because this emergence of the circadian cycle, and there’s a lot of hormones which are signaling chemicals in the body which drive this. the primary one is melatonin, which you may have heard of because it’s frequently used over the counter.
[00:21:55] Melatonin is the hormone of darkness, and it, you start to secrete about an hour [00:22:00] before you go to sleep at night, and that’s called the dim light melatonin onset. And then you have an offset about an hour after you wake up in the morning. And that’s but even like individual cells in the body have circadian pacemakers that sort of govern things.
[00:22:12] But maybe in the technical term is entrained by phenomenon like melatonin being secreted at certain times. Babies at birth do not have a mature melatonin secretion. They do not have normal circadian rhythms. It is quite common for your infant’s longer periods of wakefulness may be occurring in the evening or at night when you are trying to sleep.
[00:22:36] And they may be sleeping much of the day. And yeah, it’s not a great, as much as you love your baby, you don’t necessarily wanna be partying with them at two in the morning, although they may have a strong preference for that, which will not return until they are in college, hopefully. Do you do with a parent who’s dealing with this?
[00:22:56] Arielle Greenleaf (2): How do you help them Always like to be realistic [00:23:00] with timing because it’s not something that’s gonna be fixed overnight. I think when we talk about adjusting sleep or learning, sleep learning and things like that, we think that, there are gonna be immediate results. But when it comes to newborns, you can try things and sometimes they’ll work within a few days, sometimes it’ll be a few weeks.
[00:23:17] Other times they just don’t ever work until you’re able to do more formal training. But with this particular problem I recommend getting baby outside into the light or if you can get them into the sunshine, if they’re awake long enough, that’s great. Otherwise, I keep daytime bright and at a normal noise level, and then keep nighttime darker.
[00:23:42] And quieter. So we’re trying to promote, because social cues do play a role as well in developing this. So if we are able to signal those things, then we can slowly work toward having them distinguish between day and night. Newborn naps can be [00:24:00] anywhere from 20 minutes to five hours.
[00:24:02] But what I would say is a lot of times parents will say baby is taking five hour naps during the day and then up every two hours overnight. And so what I try to do is have them wake baby after two hours during the day, offer a feeding. It can be hard in the beginning, tickling feet, things like that, trying to get them to wake up, but this, putting a cap on that daytime sleep, even if you feed them and they go right back to sleep, at least you’ve gotten them up and they’ve fed and you’re changing the fact that you want to push those longer stretches overnight.
[00:24:38] Those are the two things that I recommend, and also I like parents to understand that it does rectify itself within about six weeks or so, give or take.
[00:24:52] Craig Canapari MD: Yeah, we did. Personally, we didn’t struggle with this with either of our kids, but it can be really difficult to handle. One [00:25:00] thing I wanna talk a little bit about is sleep in motion versus sleepin a crib. When I lived outside of Boston there was a, well-known Starbucks, and the Starbucks had a drive through.
[00:25:09] So if a mom was desperate for their child to sleep, they would hop in the car and drive to Starbucks and drive back. And that from where we lived, that duration of drive was, about 40 minutes. So sometimes if you were desperate to get your kid to sleep, you’d go get yourself a cappuccino or something.
[00:25:27] Certainly a lot of devices like swings are very popular, taking babies in strollers driving in the car. And I think that For older kids. We talk about sleep onset associations, like having associations with sleep that parents can’t reproduce during the night lead to night wakings. I’m less concerned about this in this age group.
[00:25:48] But I do think it’s important that it also means attended sleep. Like you should not leave your child sleeping unattended in a car seat
[00:25:58] Arielle Greenleaf (2): There have been, [00:26:00] cases of kids getting the straps, getting malpositioned, suffocation, et cetera. So if your child is sleeping in a swing, and we did this a lot with our older son, it, he was in the living room where we were now.
[00:26:11] Craig Canapari MD: We didn’t have to stay there every second watching him, but we didn’t stick him in a swing in his bedroom, and then just. Not come back for three or four hours. So I think that’s an important distinction. ’cause it is it can be really useful for children that are, have struggling to settle. I don’t have a problem with it, but just again, the swing is fine, but don’t put your kid in there for four hours and
[00:26:34] Not look at them
[00:26:35] Arielle Greenleaf (2): Absolutely. The other thing talk about the witching hour. You Do you see that developing more in the first month or in the second month?
[00:26:43] Craig Canapari MD: I think we talked about those in the past. Yeah, why don’t you go with the witching
[00:26:46] Arielle Greenleaf (2): Yeah, so the witching hour, I always say it’s a misnomer. It reminds me of morning sickness because it’s like morning sickness is not limited to Morning. Oh, Craig, you don’t even get [00:27:00] to know these joys. But anyway so the witching hour,
[00:27:05] usually comes on right when dad’s coming home from work or the other parent is coming home from work. Someone’s been home all day with a newborn and the other parent comes in and baby decides that They aren’t very happy and they can be extremely fussy and or cry for a couple of hours, honestly.
[00:27:27] And it’s really, I remember thinking I was never ever going to dinner with my husband again because every night I was just spending that time trying to help her feel comfortable again. With this, it’s very difficult to give solutions. I think it’s very individual. Sometimes you’ll find if you’re a nursing parent.
[00:27:51] There’s cluster feeding going on at night in this time. And they can be eating very frequently in the first month, like every 30 minutes or [00:28:00] something during this witching hour time. And the witching hour can last anywhere from an hour to three, four, sometimes five hours, unfortunately. But it is something that they grow out of, and generally it’s better by six to eight weeks.
[00:28:16] So there is hope. It doesn’t feel like it when you’re going through it. It feels like six to eight weeks is six to eight centuries, but it does And I would just do what you can to get through it. Ask your partner for help if you have a partner or family member or friend who can come over to just trade off because it can be very difficult and stressful.
[00:28:38] Craig Canapari MD: Yeah.
[00:28:38] Arielle Greenleaf (2): I.
[00:28:39] Craig Canapari MD: and this ties into the period of Purple Crying, which a program that’s put together for the National Center on Shaken Baby Syndrome. Obviously Shaken Baby is a form of child abuse, where parents get very frustrated and shake their babies, which can be devastating.
[00:28:53] And it’s hard to imagine yourself in this situation until your four week old has cried for three hours and nothing you’ve [00:29:00] done has worked. And it is incredibly stressful. Purple is actually an acronym. P stands for Peak of Crying.
[00:29:06] U is for unexpected. The crying comes and goes. R is for resists soothing. L is for long lasting and E is for evening.
[00:29:13] So this ties into this idea of the witching hour. I would say to parents when your child is going through this, and really the peak is four to six weeks of age. At this point you’ve seen your pediatrician a bunch. If your child is feeding well, growing well, et cetera.
[00:29:27] You go through your checklist. If your baby’s crying, is their diaper clean? Are they hungry? is their clothing wet? For some reason you take a look at them, you make sure they’re well and you know it is okay to put your baby down someplace safe if you’re feeling frustrated and let them cry.
[00:29:46] No matter what some people say crying is not dangerous for babies. Sometimes they cry. It’s a natural developmental phase that we’re going through here. And, it can be challenging, but you will get through it [00:30:00] and then you’ll move on to month three when things tend to start to go a little bit more smoothly.
[00:30:04] Arielle Greenleaf (2): I wonder a little bit about, colicky babies and that diagnosis in general, but ‘ cause I feel not every baby has purple crying. I had a friend who ha her son had it and it was just five hours every day. And I think the witching hour, most many babies go through, but purple is a little more extended.
[00:30:30] Wouldn’t you say that? It’s more the just distinction or,
[00:30:34] Craig Canapari MD: I think what they’re trying to get at is there is a phenomenon of increased crying developmentally at this period. And for a lot of parents, it’s alarming, And I’d say, yeah, the kids in the purple cryingthey have this diagnosis of colic, which is really just, you’re on the more extreme end of this developmental phase.
[00:30:55] And it can be a lot. And I always encourage, kids, they’re [00:31:00] drawing up their legs their abdomen is stiff. And the way you can differentiate this is usually the colic episodes. They may be prolonged, but they usually have a predictable rhythm to them. Of course, if you are ever worried that your baby is doing something out of the ordinary, you should call your pediatrician.
[00:31:17] If you’re worried there’s something wrong with your baby, call your pediatrician and go to the emergency room. You should also recognize that there are gonna be cycles of crying, You’ll have checked everything. Your baby is growing and developing normally.
[00:31:30] It’s just gonna be, difficult. This is happening at night when you’re exhausted and you’re trying to sleep.
[00:31:35] Arielle Greenleaf (2): is there a reason why these babies need to go through this period?
[00:31:40] Craig Canapari MD: I feel like there’s a lot of voodoo around it. And again, please reach out to us if I get this wrong. But my understanding is there is people try things like gripe water. They may try switching formula, protein allergy or something like that. Try things like gavascon drops.
[00:31:58] I don’t think there’s a lot robust [00:32:00] field of evidence about this, or it’s understood. Of course there are children who actually have GI issues, et cetera, which can mimic this. But that’s why you need to work with your pediatrician. I think colic is what we call this when we don’t have a good reason
[00:32:15] Speaker 9: Yeah.
[00:32:17] Craig Canapari MD: So let’s talk about month three, maturing sleep cycles.
[00:32:23] Arielle Greenleaf (2): I wasn’t done with month two.
[00:32:25] Craig Canapari MD: I didn’t mean to rush you.
[00:32:26] Arielle Greenleaf (2): That’s okay. Yeah, I think the thing I love about month two is that you’re getting out of those really stressful things that like day and night confusion, the purple crying and stuff that starts to get better by the end of month two. And the other thing that happens and what I’ve seen it may not be medical.
[00:32:51] Craig Canapari MD: I have a question
[00:32:52] Arielle Greenleaf (2): Yeah.
[00:32:53] Craig Canapari MD: So are you saying about the best thing about month two is that it’s a maximum 31 [00:33:00] days?
[00:33:00] Arielle Greenleaf (2): Yeah, I know. it’s generalized, right? And if a baby is early or they’re in the NICU and, I’m just,
[00:33:08] Craig Canapari MD: Yeah.
[00:33:09] The good is it doesn’t last more than a
[00:33:12] Arielle Greenleaf (2): Yeah, exactly. But I would say that one of the positive things about it is that many times in this month, we start to see a longer stretch of sleep at the start of the night.
[00:33:22] And often we see more of a pattern starting to develop about the day, what does our day look like? This pattern usually does not stay the same for the next month and a half. There are many growth spurts that happen during this time. And the three month growth spurt is one of the biggest ones.
[00:33:43] And parents will call me and they’ll say, oh my gosh, I think my baby’s hitting the four month sleep regression early. And I always say, how old is your baby? And their baby is around three months. So three months is a huge growth period. [00:34:00] And it’s important to know that growth spurts don’t last forever.
[00:34:02] There are a few days your baby may wake more to eat ’cause they’re growing. But backing up for a positive in the second month, I often see babies start to consolidate that first stretch of the night.
[00:34:15] Craig Canapari MD: Yeah. No I would agree. But I think it was, we segue into month three. That’s honestly, I think I remember that being a pretty exciting time. You’re starting, in month two is when you get the emergence of the social smile, your baby does become more interactive and you start to see more mature day night cycling, the night awakenings, they’re not gonna go away in month three, but you’re gonna, it’s gonna, all of a sudden, like for most parents, it starts to feel more manageable. In month three. You get a lengthening of that nighttime sleep period. You get a transition to the baby’s entering sleep by this deeper sort of non-REM sleep and cycling through REM sleep. my, one of my hobby horses here is what can parents control?
[00:34:55] And I think one of the things you can control is developing a really good [00:35:00] bedtime routine. And to be frank, in the first two months it’s nice and if it’s your first child and if you live in a two parent household or there’s other adults, often you’ll have some very elaborate parenting routine with the singing of songs and the application of lotions, the reading of stories,
[00:35:17] Arielle Greenleaf (2): sound like a sleep consultant.
[00:35:20] Craig Canapari MD: Yeah. The but I, I remember with my first son, we’d have these long bedtime routine and it would be so great. And here’s what I’d say to parents is, have a bedtime routine. Your ideal bedtime look, enjoy your baby’s company as much as you can, but your, the structure, the under scaffolding of your bedtime routine should be such that.
[00:35:41] One parent can do it, right? Because I get it, it’s your first newborn, maybe you’re nervous around the bath or something like that. But the fact is, if you are going to have other children you are gonna have to learn to get more efficient at this. Say for most families, a basic template is if they need a bath again, [00:36:00] people don’t need a bath every night.
[00:36:02] We’ve talked about what happened when I was a child in this podcast. Which, go back through our social if you want to, our social if you wanna see that. But you may or may not bathe your child. Change them into their pajamas, sing them a song. You rock them to sleep.
[00:36:17] Still at this age, they’re, you don’t really them to fall asleep, drowsy, but awake at this, you can try the end of month three, month four, but there’s no urgency to this. But again, do your routine every night. Feel comfortable with it. Feel a sense of mastery. The first couple times you’re gonna do it, you’re gonna be like, what am I doing?
[00:36:32] You’re gonna feel like a poser. Like you don’t know what you’re doing. The fact is your baby doesn’t know any better. Your baby thinks you’re the best no matter what you do. Keep it simple. keep it as something that’s manageable and not exhausting to you. You should feel a little bit of a lift with your bedtime routine.
[00:36:46] You shouldn’t feel like a sense of dread that it’s this tremendously elaborate process that you have to get through
[00:36:52] Arielle Greenleaf (2): yeah. Because if you keep a consistent like order of things, babies start to understand those [00:37:00] routines, I’m always surprised at how smart babies are and how quickly they catch on when we provide the right environment and the right behaviors ourselves.
[00:37:12] So I think having that predictable routine that, that’s simple, that anybody can do even, grandma or grandpa or whoever read, bathe the baby, read a book, all these little things. Keep it simple. It does help a baby to start to settle. ’cause they know what’s coming next.
[00:37:29] Craig Canapari MD: A short bedtime routine consistently is way better than an elaborate bedtime routine that you’re struggling to get through on a consistent basis
[00:37:37] basis
[00:37:38] The fact is it your baby will learn to be consistent if you’re consistent, and there’s a certain amount of chaos that gets introduced when we’re sleepy, right?
[00:37:48] you don’t have to do it at the exact same time every night. It’s not, you don’t need a checklist. It’s keep the same template. Do it at the time. That seems to work, which you’re gonna have to feel out a little bit. [00:38:00] Arielle, I think this is something that a lot of people who haven’t had their first baby don’t realize too, which is the timing of bedtime can often be quite late for babies that are napping multiple times during the day.
[00:38:10] Arielle Greenleaf (2): Yeah.
[00:38:11] Craig Canapari MD: Yeah. Talk about that a little bit? ’cause I think that’s maybe a sort of a through line in these first couple months of the timing of napping, the timing of the nighttime sleep,
[00:38:21] Arielle Greenleaf (2): yeah. It’s interesting because. Again, I am not a medical professional, so what I share with you is completely anecdotal. It’s based off my experience of, I’ve actually worked with thousands of parents at this point, but I have actually found that many parents are struggling in that bedtime, around the bedtime hours, right?
[00:38:51] So even if the crying has stopped they’re struggling, or baby is fighting sleep. And what I’ve found is for some babies, not all [00:39:00] moving bedtime earlier actually helps them avoid a prolonged witching hour or avoid fighting sleep.
[00:39:09] And I can’t say it across the board for everybody. I knew a baby that was consistent. He had to go to bed by six, which is not what people think when it comes to newborns. Newborns, everyone is always saying eight o’clock, nine o’clock, 10 o’clock, 11 o’clock. And that’s just because they’re getting used to their routine.
[00:39:29] As far as daytime goes, it can start anywhere between 6:00 AM and 8:00 AM really. And then at, in the beginning, your baby is not gonna be able to stay awake for long periods of time. And I always like to explain that the wake time, the time that they’re awake.
[00:39:51] Includes the feeding and the diaper changing. It’s not like you feed, you change the diaper and then they have an extra 45 minutes [00:40:00] to play. It’s really that 45 minutes includes all that. And so for some people, especially a nursing mom who child is cluster feeding, whatever it is, it might take 30 minutes to feed them and then, 10 minutes to change them and do put on a clean diaper and then you’re back asleep.
[00:40:18] So again it’s especially in the first month, unpredictable there, you just have to follow their cues. But I think bedtime starts to back up for most babies by the third month.
[00:40:32] Speaker: I think bedtime becomes apparent that the child is ready for bed earlier.
[00:40:38] Arielle Greenleaf (2): Say seven or eight o’clock or something like that by around the third month. And I feel like if parents are consistent with bedtime and they’re following things, usually the baby gets used to it. And because their rhythms are starting to become established, and I was gonna say about the third month too.
[00:40:56] This is, again, this is not all babies, but [00:41:00] some babies develop, they start to consolidate their daytime sleep. And those 20 minute cat naps can suddenly become an hour long, throughout the day. ’cause cat naps are normal in newborns. Cat nap is anywhere from 20 to 45 minutes. And they can be very frustrating if you wanna get something done.
[00:41:21] And it’s like you put the baby down, they’re awake by the third month. Some babies are ready to consolidate that sleep. Not all. But if you, if we look at their day and then we offer that pause before going in, I’ve had good success with some babies who then put themselves on their own schedule.
[00:41:44] It’s usually about four naps by the third month before that, anywhere to, five to seven naps before that.
[00:41:51] Speaker: It’s all naps,
[00:41:51] Arielle Greenleaf (2): Yeah, it’s just naps all a 24 hour naps. But in the third month you’re usually looking at four, maybe five naps throughout the [00:42:00] day. And then by the fourth month, four naps is usually what, three to four naps.
[00:42:05] ’cause again, some babies are consolidating into two, two hour naps and an hour long cat or third nap or whatever. So definitely the naps drop quickly as they get older.
[00:42:17] Craig Canapari MD: Yeah. And certainly there are other factors here. If your child is entering childcare at three months of age, often they will adapt surprisingly well to the schedules there. It’s just, the baby’s learning. So if you don’t have anything else in this, I thought we could talk about sleep tools and technology.
[00:42:35] Arielle Greenleaf (2): Such as,
[00:42:38] Craig Canapari MD: so there’s lemme offer the caveat that when my sons were little, we had a audio monitor. And we didn’t have a video monitor for lots of different reasons. It didn’t really feel particularly necessary to me.
[00:42:52] And now we’re in a kind of a different era of technology. So there are smart monitoring technologies. I’d say the Nanit is the [00:43:00] most popular of these. But there are others as well. Which I’m appreciative of. ’cause like they really have both provided technology and paid for a lot of research, not research that I’ve done. I don’t have a conflict here, in the community they’re very involved in like sleep research. And then there are there are applications like you had mentioned, huckleberry, which is one that purports to offer.
[00:43:23] Idealized nap intervals for people. And then there are technologies, like I’d say in the sort of the most famous of these sort of responsive bassinets is the SNOO, which is designed by Harvey Karp so let’s start with monitors.
[00:43:38] my take on monitors is this, is that the main purpose of a monitor is to know whether or not your child needs you when you’re sleeping deeply or if you’re in another part of the house. Everything else is just gravy. if you are a person that likes data. You might find one of these smart monitors helpful.
[00:43:56] If you are a person who struggles with anxiety, you might find [00:44:00] this data to be overwhelming. And there’s a phenomenon in adult sleep called orthosomnia, which is people have sleep trackers, like I wear an Oura ring. And their sleep gets worse ’cause they’re obsessing about the data. And I’ve definitely seen that in a couple of different contexts where parents are really worrying about, say how their child’s proportion of REM sleep or something which is unclear what, how meaningful this data is.
[00:44:24] So if you find that it is, you’re struggling with this data and you feel like it, your pediatrician tells you things are going great, you feel like you’re, what you’re doing is working except, but the monitor is giving you data that suggests that’s not the case. I think you’ve gotta go with your gut.
[00:44:43] I also know that the way that the people get the data from the Nanit is by you having their smartphone by their bed and they use it as a monitor. I think obviously some people struggle with that, having their phone in proximity to their bed. ’cause obviously you may look at your phone and then look at other stuff on your phone in the middle of the night, like [00:45:00] Instagram or YouTube, and that’s can be counterproductive for your sleep.
[00:45:04] What’s your experience been with Smart Monitors?
[00:45:06] Arielle Greenleaf (2): Oh yeah, so I just feel there’s. We have access to so much information now, and sometimes that’s great and sometimes it’s horrible. And I feel as though a lot of the moms that I work with are dealing with some level of anxiety, and especially because they’re sleep deprived, which makes perfect sense.
[00:45:32] The two go hand in hand. So the problem that I have with it is that parents can get obsessive about watching the the child’s wake up just staring at it because they almost have PTSD from the child waking all night or something like that. Staring at it keeping it on. And then with the stuff that provides data, they’re like, oh my gosh, my child is moving so much throughout the night. And I say is your child crying [00:46:00] out? No. Are they, do they seem like they’re uncomfortable or whatever? No. Then why do we have, why is this important to us? Is your child well rested? Does the child seem well rested in the morning?
[00:46:15] Are there any behavioral issues? No. And so it’s stop stressing. And I tell parents this so much, I’m like, back away from the monitor. If your child needs you, it’s fine to have a video monitor, a monitor. I totally respect that. it’s your choice if you wanna have a monitor that is monitoring every single move.
[00:46:38] But I have a real problem with the fact that so many of the people I’ve worked with. it causes so much more stress, and especially the ones with the pulse ox on them because they can easily come off and then they think the child is, not breathing or there’s false alarms.
[00:46:58] And so that [00:47:00] talk about, it’s hard enough to get through the infancy stage. So that’s where I’m like, it’s great to have information, but do we really need that much information about our child’s sleep if they’re healthy and normally developing?
[00:47:18] Craig Canapari MD: I had say I have a huge problem with the cardiopulmonary monitors because there’s no evidence that any sort of monitoring prevents SIDS, right? And there are lots of studies on this. So first of all, it gives a sense of false security. I’d be like, oh, the monitor’s on, so maybe I could be a little bit more relaxed about safe sleep guidelines, or maybe I don’t need to worry about having blankets in the bed.
[00:47:43] ’cause I’ve got the monitor on, which is potentially dangerous these algorithms for this data, they’re proprietary. We don’t know how it’s determining alarms. There’s not a lot of transparency with devices like the Owlet. And then we’ll have parents coming in and be like, my monitor is saying [00:48:00] my kid’s desaturating.
[00:48:00] And now we’re looking at maybe doing like a in lab sleep study, which can be quite expensive
[00:48:06] Arielle Greenleaf (2): For an infant?
[00:48:08] Craig Canapari MD: Oh yeah, no, we do. And we study the infants all the time. The other thing is in the era of room sharing, yeah, you, maybe you need the monitor when you, your baby’s in bed and you are not, but when you’re in bed, you don’t need the monitor.
[00:48:19] They’re gonna wake you up if they need you. So again, if it gives you comfort. If it helps you feel confident in your parenting decisions, it’s great if you feel that the monitor is giving you data that doesn’t feel like it fits with what you’re seeing when you’re looking at your baby, or it’s making you feel bad about some of your decisions or less confident or anxious, then maybe.
[00:48:44] And again, it’s can be hard to have this self-awareness that you perhaps need to that it’s not the right thing. And I know that there’s tears of monitoring and technology to again, like I, I love technology. I would’ve totally been into this stuff where my kids were a little, there’s there.
[00:48:59] [00:49:00] Yeah I think a lot of times parents need permission to not be so hyper vigilant. Like I feel like a lot of times parents feel like they need to be solving all these issues that aren’t even issues which then causes more stress and anxiety. Yeah, anytime I have somebody who is just really stressing out over it, I tell them, I try to have a heart to heart and just tell them that they should probably back away from the monitor a little bit.
[00:49:37] I would agree. Now what do you think, because we were just talking today I do not have extensive experience with the Huckleberry app or anything like that. I feel like it’s funny, like I, we don’t have a Go-to sleep diary app that we use in our practice. ’cause none of them really quite export things in the way that we want them to though.
[00:49:55] I did see one recently that was cool called the [00:50:00] Snap D.
[00:50:00]
[00:50:00] Craig Canapari MD: Which is just a sleep diary app put out by a pharmaceutical company in Europe and I’ve been playing around with it. This is pretty good. I love sleep diaries. I think they’re useful for parents to understand their rhythms.
[00:50:12] Paper works well as well. What is your take on like these app diaries or like that, especially ones that provide guidance to parents about sleep timing?
[00:50:23] Arielle Greenleaf (2): If there’s not a human, be behind it. Analyzing the data for you, then. I don’t waste your money because AI isn’t going to I know for a fact because I get clients who purchase apps that supposedly tell you the best time to put your baby down. Again, they probably work for some people, otherwise the company would be outta business. However, if it’s not working, then you should probably talk to a human who could help you make [00:51:00] sense of the data.
[00:51:02] And I cannot do my job without daily logs and I wanna see sleep and feeding. It’s really
[00:51:10] Craig Canapari MD: so I think this does come into selection bias and I’d say to any parent, if you’re doing any of this stuff, using any of this technology that’s working great for you, that’s wonderful. Our practices are enriched for people where they try this stuff and it doesn’t work.
[00:51:23] Arielle Greenleaf (2): We’re not seeing the people who have to succeed because they’re still in business. These aren’t the people that you and I see. I,
[00:51:32] Craig Canapari MD: Well, so let’s talk about the SNOO and I know Harvey Karp who wrote The Happiest Baby on the Block, which is a very useful baby book for me when my older son was, in his period of purple crying.
[00:51:43] Speaker 9: yeah.
[00:51:44] Craig Canapari MD: so I’m grateful to him and he created this device called the SNOO, which sort of you strap your baby into it and it moves and shushes when they cry, and then it ramps down.
[00:51:57] And you can either rent it or buy [00:52:00] it. It’s I, I’ve talked to families who really like it and where it’s worked well for their kids. I’ve also talked to families. It wasn’t never helpful. According to their documentation, you’re supposed to use it for the first five to six months, which I would not recommend. And my concern with that is, even though it does have a weaning mode, is that you are really going to be generating a lot of sleep onset associations with this.
[00:52:22] And Again, this may be helpful for some families, especially families whose children are, whose parents have to go to back work early, but it runs the risk of being a little bit of a crutch if you’re using it long term.
[00:52:34] And again, like any of these technologies, if it is actively making your life worse, you do not have to use it. So if you’re ba you put your, I don’t know, in the first month or two when it’s hard if you put your baby in it and they sleep a little bit better. I don’t have a huge problem with it. But if you’re trying to put your kid in this and they don’t like it, you don’t have to use it.
[00:52:55] And I would say that for me personally, I would [00:53:00] be trying to wean babies off this as quickly as possible.
[00:53:05] Arielle Greenleaf (2): Yes, I was just gonna say about the third month would be the best time to do it. In my experience, I know they have a weaning mode. But again, we see the people who struggle and so I see and have worked with and have had to help many families wean off of the SNOO. And I have a problem with the fact that these four and five month olds are still being swaddled.
[00:53:37] Craig Canapari MD: And I think there’s some developmental concerns about swaddling as kids get older and wanna be using their hands more. But I would agree that I don’t know, it’s a, I think that the people who made it are well-intentioned and they’re trying to solve a problem that is very real, which is sleep deprived parents.
[00:53:54] I honestly don’t worry about sleep deprived babies. ’cause they’re gonna get the sleep they need. They are not necessarily going to do it convenient for you..
[00:53:58] Speaker 9: [00:54:00] yeah, exactly.
[00:54:03] Craig Canapari MD: And babies aren’t driving cars or jet planes. They’re not doing surgery, they’re not trying to prepare for big presentations at work. But parents have real world responsibilities. And, I applaud anyone who’s trying to make the world a little bit better and help parents sleep a little bit better.
[00:54:22] But I think like any of these things are tools and a tool can help you or it can hurt you. None of them are magic. it would be cool if there’s something that worked perfectly for everyone without any caveats, but that’s just not how things work.
[00:54:36] Speaker 9: Right.
[00:54:37] Craig Canapari MD: so I’d say to parents, be an informed consumer.
[00:54:40] Try things out. But if they don’t work, you don’t have to stick with them.
[00:54:43] Arielle Greenleaf (2): Yeah. I would also say one of the other things that parents come to me and they’re like, I’ve tried 15 different types of swaddles and or sleep sack, and they’re still not sleeping well. Sleep sack do not [00:55:00] help babies sleep. And I know that the marketing is slick and I know that they promise things or they at least allude to better sleep.
[00:55:12] But honestly, swaddles and sleep sacks are really just a wearable blanket. For your baby. And yeah, it’s just a blanket that’s safe. So don’t get caught up in, I’ve tried this swaddle, I’ve tried that swaddle and spending, I’ve literally talked to people that have spent hundreds and hundreds of dollars on swaddles and sleep because they think one of them is gonna magically make their child sleep better.
[00:55:38] Craig Canapari MD: So I think we covered all the questions we wanted to. What are the red flags when parents really should be worried about their newborn sleep? And why don’t I take the medical ones and maybe you cover the ones that are, when parents need, really need help with managing the sort of mechanics of and timing of sleep.
[00:55:57] Arielle Greenleaf (2): if you’re experiencing a newborn [00:56:00] that’s awake for hours and hours, or is not sleeping, just no matter what you do, I would then refer over to a pediatrician because something might be underlying there.
[00:56:10] Speaker 3:
[00:56:10] Arielle Greenleaf (2): I agree with you that if you ever are uncertain or questioning, call your pediatrician don’t ever feel like you’re bothering them. I think it’s better to be safe than sorry. Most likely your baby’s okay and just being normal, you never know.
[00:56:29] And so I’ll, toss it to you for the medical, because there are a lot of times I do just have the parent check in with the, the pediatrician, but if your baby is gaining weight appropriately and there are, normal bowel movements, normal diaper, wet diapers and they’re not sleeping great, it’s just normal for a newborn.
[00:56:53] Craig Canapari MD: Yeah I’d say the red flags are, look at what you expect babies to do, right? They’re [00:57:00] supposed to grow. So if they’re not growing, that is probably the most concerning thing that needs to be evaluated. And that’s why you see your pediatrician so frequently in the first couple of weeks of life. And then you, after that, every couple of weeks, and then a monthly tempo.
[00:57:12] Certainly if your baby is, it’s I don’t wanna say if your baby’s inconsolable at all, you should be worried, but I’d say certainly if it seems out they’re inconsolable in a way that is out of what you expect yeah, if your kid’s crying for two or three hours every evening, that’s normal.
[00:57:27] But what if your kid is crying for, and at a different time of day, or in a different way than you’re used to? I think certainly any problems with peeing or pooping if your baby seems weak or floppyI think that you’re not gonna miss bad stuff, honestly.
[00:57:43] But sometimes it takes a moment just to step back, take stock of things. Even you could say, okay, I’m looking at my baby. He’s vigorous. His last weigh-in was good. He’s had lots of peeing and pooping. He’s okay. He’s just fussy right now. Versus being like, he really doesn’t look like he normally [00:58:00] does something really feels wrong to me.
[00:58:02] Then you reach out because I, if there’s one thing I’ve learned is to always trust parental intuition. And if a parent is worried that there’s something wrong I’m worried too until I’ve done my due diligence and made sure that we’re not missing something
[00:58:16] Arielle Greenleaf (2): Yeah, I always feel best regardless of age. If something seems off, it’s just so much better to just get them cleared medically, just so that you’re dealing with something behavioral, but with newborns, that’s normal behavior. There’s nothing we’re gonna be able to do that’s going to magically fix them overnight.
[00:58:35] But certainly good routines. Trying to follow their cues, keeping them well rested as best as you can. that’s basically your job. That, and feeding them and helping them grow.
[00:58:46] Tummy time can help strengthen their core and their neck muscles. It’s, I believe it’s recommended for safe sleep
[00:58:55] Craig Canapari MD: Yeah, no, absolutely. Since it used to be kids before the [00:59:00] Back to Sleep campaign, which I think was in the early nineties. They’d have kids would sleep prone, they’d sleep on their bellies, which was, yeah. The reason is kids sleep better
[00:59:09] Speaker 9: yeah,
[00:59:09] Craig Canapari MD: rallies. Back to sleep is safer because they’re infants aroused more easily.
[00:59:14] It’s a feature, not a bug, but that’s the world we live in. They, we do see some developmental like delay and some motor milestones. My kid hated
[00:59:22] Arielle Greenleaf (2): yeah, mine
[00:59:22] Craig Canapari MD: My older son, oh my God, he just lay there and
[00:59:24] Arielle Greenleaf (2): Oh, yeah, she screamed and then I’m like, great. Am I totally screwing my kid up? She doesn’t even wanna do tummy time, and she’d just be screaming at me and I’m like, all I can’t do this anymore. So if you can’t do tummy time, don’t worry.
[00:59:38] Craig Canapari MD: yeah, guys feed your kids, put them down when they’re tired, cuddle ’em, love them, you’re gonna do fine. Make sure that they’re sleeping in a safe environment. Take care of yourself too. Ask for help. So I’m Craig.
[00:59:52] And I’m Arielle, What’s our email address again?
[00:59:55] People have questions. [01:00:00] thesleepedit@gmail.com And if you have topics you want covered, shoot us an email. Yeah, thanks for listening.
[01:00:05] Arielle Greenleaf (2): Thank you.
[01:00:07] Thanks so much for listening to the Sleep edit. You can find transcripts at the web address Sleeped show. You can also find video of the episodes at that address as well as in my YouTube channel. You can find me at Dr. Craig canna perry.com and on all social media at D-R-C-A-N-A-P-A-R-I. You can find Ariel at Instagram at Ariel Greenleaf.
[01:00:37] That’s A-R-I-E-L-L-E-G-R-E-E-N-L-E-A. If you like the flavor of the advice here. Please check out my book. It’s Never Too Late to Sleep. Train the Low Stress Way to high Quality Sleep for babies, kids, and parents. It’s available wherever fine books are sold. If you found this useful, [01:01:00] please subscribe at Spotify or Apple Podcast and share it with your friends.
[01:01:03] It really helps as we’re trying to get the show off the ground. Thanks.