Sleep Training

Well, I know I've blogged about this topic already and I also know there are hundreds of websites out there on this topic.  However, since we are currently sleep training my little one I figure I'd document the occasion.


I'm super tired and should be sleeping since my kids are currently sleeping.. so here is the quick and dirty.


Basic idea of sleep training is to teach the child that he/she can fall asleep on his/her own.  Therefore, if he/she happens to wake up in the middle of the night due to whatever it is, he/she can then fall back asleep without crying and needing to be rocked or nursed.


I love this analogy I read in a book about how even adults have sleep associations.  For instance if my pillow falls to the ground in the middle of the night and I happen to wake up I will look for the pillow and put it back in bed with me before falling back asleep.  In the same way if a child is used to falling asleep while nursing or while being rocked, then he/she will want that comfort if he/she wakes up in the middle of the night.


So what is our strategy/plan?  Yes.. there is some crying involved.  However, I check on her and make sure she is alright.. 5 min, then 10 min, then every 15 min after that.  Based on the type of crying, I can actually tell if she will fall asleep soon.  So if she is not screaming her head off I may just let her cry.  Otherwise, going in there sometimes make her cry even harder.


Plus, what really helped is having daddy going in there to comfort in the middle of the night instead of me because then she cannot look to nurse.  When I go in there, I tend to give in and just nurse because it is so much easier to get her back to sleep that way!


The other challenge to sleep training our second child is I am so fearful of waking up my toddler that I actually delayed this for a really long time.  My child is 8 months already!  In retrospect, I probably could have started this sleep training when she hit 6 months and was taking solids.  Because then I know that she can last through the night without starving...


So at the end of the day, it is an art.  I do not think there is a magic formula.  Every kid is different and therefore I think the exact method needs to be adjusted somewhat.  My older daughter was a real tough one.  I had to almost lay on top of her in the crib and pat her butt so that she feels me real close (but I wasn't holding her).  Then I transitioned to just patting her butt... then to just sitting near her and singing.. then to sitting farther away.. then to outside her door.  Now she sleeps great from 8ish a night to 8ish in the morning just about every night!


My younger daughter does not seem as determined and I'm real hopeful that in about a day or two she will have this down.  Boy.. my other daughter was almost 15 months before she finally slept through the night.  It will be so great if I can get this second one to sleep through before she hits 1 year old!


So here are some books I read on this subject:


No Cry Sleep Solution
Ferber Method
Happiest Baby on the Block

Separation Anxiety

Today marks the first official day of my training for the Philadelphia Marathon!  Unfortunately, my run at the gym was cut short because one of the childcare workers came running to me while I was on the treadmill to tell me that my daughter was "screaming".  She was not just crying... she was "sss-creeee-ming"!  Uh oh... she is hitting 8 months which means she could be developing stranger anxiety.  She just took a one hour nap and it was not quite feeding time yet.  My suspicion is confirmed when my little one started smiling and blowing bubbles at me the minute I put her in her usual play area at home.

So stranger anxiety is fairly common and can be a part of normal development.  Some babies get it much worse than others.  Usually it starts at around 8 months and can last well into the toddler years.  Before this stage, babies are pretty oblivious to what is new and what is usual in their environment.  They become accustomed to their caregivers familiar faces and new faces and/or new surroundings can cause fear and anxiety.  In order to get over stranger anxiety one must be able to:

• feel safe in their home environment
• trust people other than their usual caregivers
• trust their caregivers will return

Now to accomplish this is no easy task.  I think some kids just get over it faster because of their personalities in addition to what they are exposed to.  A child who has the same caregiver all the time in their own home will likely have a harder and longer time adjusting than another child who goes to daycare.

Now my kids get a combination of me at home about fifty percent of the time and a rotation of 2-3 other caregivers the other times.  So my two year old is pretty outgoing and fearless right now.  She can probably run off in a crowded place without looking back and lose me.  However, I do remember she also went through a period of much crying and distress when I used to leave her at the gym child care center or even the church nursery.  Now for me, what was difficult was feeling bad for the workers and fearing that my child may get hurt or slighted in some way if the workers got too annoyed.  Of course, I felt bad for my stressed out child as well, but I figured she would get over it eventually and this was all part of the process of learning to cope.

So.. here we go again.  I sure hope it will not be as bad with this second child but I'm bracing myself because this second child sure has a set of lungs!  She does not usually cry and is very happy and smiley almost all day long.  However, when she gets upset... she just screams and screams.  There is no in between for her.  So this should be fun...  ah parenting... does it ever get easier?

Is ringworm contagious?

So I think we got it!  First it was my older daughter... small circular red rash on her left forearm.  I have no idea where she got it from.  Since incubation is around 10 days after exposure, it may be hard to pinpoint.  The rash went away in a couple of days after treatment with topical antifungal cream.  Unfortunately, my younger one got it too but more widespread so it is taking longer to completely go away.  Plus, I think she is rolling around too much and we probably should have done a better job washing all her bed sheets and clothing when we initially found the rash.  Now that we are nearing 2 weeks of treatment, it is mostly resolved and I think the lesions left are actually eczema.  In fact, children with eczema are more prone to ringworm.


So what is ringworm?  Some may actually think has to do with worms because of the name.  Not the case. Ringworm is a fungal infection that is fairly common especially in children.  Itchy red, raised rash that is usually circular... usually found on the extremities and sometimes the scalp.


Is it contagious?  Yes, usually by skin to skin contact or sometimes by contact with things like clothing, bedsheets, etc.  Wrestlers are known to transmit this back and forth because of close skin to skin contact and wrestling mats.  Kids are usually sent back to school/daycare after treatment is started and after 48 hours of treatment it is no longer considered contagious.


How is it treated?  Usually topical antifungal cream will do but sometimes may require an oral antifungal, especially if it is on the scalp.

Testing for food allergies

I just read another interesting article about a new method to test for food allergies that is supposed to be more accurate than the current skin and blood tests out there.   If anyone is interested in some nerdy reading, check this out at MIT news.  Basically, they are claiming more accuracy because this technique is measuring the amount of cytokines produced (which happens in an allergic reaction) instead of just measuring the antibody to a particular food (which can cause false positive results).  There still needs to be more clinical studies to make sure this works but it would be a neat tool to have especially in the primary care setting.  Right now, our office does quite a bit of allergy testing using Immunocap.

Fortunately, our older daughter has no food allergies that we are aware of.  We started our second daughter on solids a couple of months ago and so far she does not seem to have any allergic reactions to any of the foods.  This is fortunate because it is pretty common these days for children to have food allergies or food intolerances.  Common foods that can cause allergies include peanuts, milk, eggs, soy, and wheat.

So breastfeeding is supposed to help prevent food allergies.  Plus, there is a line of thought that delaying solids and introducing foods in a certain order will help.  Well, we shall see what happens with child #2.  I breastfed my firstborn a few months past her first birthday!  I'm not sure I can last that long with this second child...

Toothbrushing and heart attacks!

How many of you find it challenging to brush a two year old's teeth?  I think we got the routine down but I cannot be completely sure how well a job we're doing.  I get to brush her teeth first then I let my daughter brush herself for a few seconds.  We even have the "swish and spit out" down.  Sometimes it splashes everywhere and gets on her clothes.  There is always more messy-ness when a toddler is involved!  So initially we were just brushing with plain water but since around two years old, we've been using one of those toddler toothpaste gels.  Again, I'm not sure how well I'm brushing because I have to brush fairly fast and it is somewhat awkward brushing teeth that is not your own.  But at least we are doing it!

Now I've completely dropped the ball with my second child who just turned 7 months today!  There are those baby toothbrushes that you can put on your finger to brush the gums.  I did it with the first child and somehow in all the craziness, I've completely forgotten with the second.  I kept thinking that I'd just wait until she starts solids.  Well, she has started solids for almost 2 months now!  Oops.

I'm thinking about all this because I just read an interesting study that shows toothbrushing less than twice a day increases your risk for heart attacks!  It has to do with increased inflammation which can lead to atherosclerosis (clogging of your arteries).  The article broke down risk by those who brush twice a day, once a day, and less than once a day.  Boy, I have a hard time imagining how someone can brush their teeth less than once a day.  Brushing has become such a habit that to break that habit would feel really strange to me.

Well... gotta start good habits young...  

Sleep deprived mom

Today I was like a zombie at work because I've gotten such little sleep 3 days in a row.  After two nights of trouble, my toddler slept through last night peacefully.  However, my younger one had a rough night.  I spent from around 10pm to around 2am trying to soothe her to sleep.  I even gave her Advil and got blue medicine all over her white onesie!  Haha.. has anyone tried holding a squirmy fussy baby with one hand while trying to slip sticky medication from a dropper into the mouth of a screaming child?  Quite a challenge... Oh and it was also in the semi dark because I didn't want to overstimulate her with too much light!


So she finally went back to sleep around 2a but was up again at 4a.  Then back down by 5a and slept till 10a!  However, I had to get up by 7a.  Therefore, I only got 4 total hours of interrupted sleep.


Haha.  I thought residency days were hard being on call every 4th night and sometimes every 3rd night.  When you are on call in the hospital, you may get very little sleep if any sleep at all... however, with the new sleep rules now, you know you will go home by noonish the next day and will be able to sleep the following few nights!  There is no such predictability with kids.


I think my biggest struggle is the fact that I have absolutely no control.  I love control... I need to plan out my life... years at a time even.  Right now I am so disorganized and out of control, it is driving me nuts...


So deep breath!!  I'm learning to be more flexible.. to chill... to take it as it comes... and I'm trying to enjoy the little joys since I know this will be gone in a flash.  Though I'm so super tired and can hardly keep my eyes open when holding my little one in the middle of the night, I also have a hard time putting her down because she is so darn cuddly, soft, and cute.


So that is where I am right now... sleep deprived...  trying to function... going crazy and wanting the time to past at times... but then wanting to freeze the moment and just snuggle forever the other times...

Teething teething teething!

I believe my little one is teething.  She is gnawing on everything she can get her little chubby hands on.  For most of the day, she is happy and smiling and will crack up if you play with her and make funny sounds.  Then there are those moments at night where out of the blue we get high pitched screaming... not easily consolable.


So some myths about teething I want to dispell:

• teething does not cause fever > 100.4
• teething does not cause diarrhea
• teething does not cause rash

Now since she is chewing on everything, she is exposed to more viruses/bacteria and therefore may develop the above but teething alone is not the sole cause.

Oh boy, there she goes... may have to whip out the generic acetaminophen to soothe...