Nightmares and Night Terrors... whats the difference?

During the course of a night's sleep, your child will go through different stages of sleep. Initially they will fall into a deep sleep, often referred to as NREM (non-rapid eye movement). NREM sleep consists of four stages. Stages one and two is where the body shifts from drowsiness into sleep, and in stages three and four, delta waves increase, signalling a deeper sleep (or slow wave sleep), where the body relaxes its muscles, lowers body temperature and decreases the rate of respiration. Also note that the growth hormone increases during NREM sleep. It is during NREM sleep your child may experience night terrors, usually one to two hours after falling asleep. If your child is experiencing night terrors, they may appear awake but they are not. They might start walking around and appear anxious or confused. If this happens with your child, it is recommended that you stay with your child but do not try to wake them. Instead guide them back to bed and stay with them until they appear calm and sleepy. In the morning they usually wont remember the night terror.

What you can do to help:

• talk to your child about any problems, issues or worries they may have

• keep a regular bedtime ritual

• make sure they don't go to bed too late (keep a reasonable bedtime)

• a massage whilst they are lying on their bed before sleep to calm their body and mind

• if the night terrors continue, seek advice from your G.P.

• avoid chocolate and sugary foods prior to bed

• use a night light if it helps to relax your child (on a dim setting)

Non REM and REM sleep occurs approximately every 90 minutes, in a cyclical pattern. As the night progresses, your child will spend less time in non REM (deep) sleep and more time in REM (active) sleep.

Nightmares, on the other hand, occur during rapid eye movement (REM) sleep. They are usually frightening dreams that your child will wake to. REM sleep accounts for approximately two hours sleep per night (or 25% of the time your child is asleep). Nightmares are quite common in young children. About one quarter of children have at least one nightmare every week. Talk to your child about any worries they may have. Sometimes for the younger children, getting them to draw their nightmare will help. It is important to remember that children experience stress too and that this may be impacting on their sleep. Follow the above points on what you can do to help your child if they experience a nightmare.

Has your child experienced a night terror or nightmare? What are some ways that you have helped your child?

References:

Australian Family magazine, winter 2011 "Night Nasties" by Gill Canning, p 10-12

Burton et al Psychology, 2nd ed. 2009. p 190-192

Rosenzweig et al Biological Psychology, 1996. p 502-504

Sharing Birth Stories

You may be wondering why I want to share my birthing stories. To be honest all three births (three boys!) were wonderful, but different in their own ways. To summarise in one sentence... yes I had three vaginal deliveries, yes they were all relatively short labours (seven hours, four hours and just under four hours for my third) and yes they were all without drugs or gas. Reflecting back on my birthing experiences spanning the past eleven years, I look back with fond memories of the birth's of my three sons.

But what if your birth experience was traumatic? Have you read other women's birth stories and thought 'why wasn't my birth experience as good as that'? or have your heard 'horror stories' that make you fear childbirth? As Dr Kathleen Kendall-Tackett quite rightly says "The birth of a child, especially a first child, represents a landmark event in the lives of all involved. For the mother particularly, childbirth exerts a profound physical, mental, emotional, and social effect. No other event involves pain, emotional stress, vulnerability, possible physical injury " (1). Dr Kendall-Tackett offers some great advice on what you can do if you have experienced a traumatic birth experience in her article "Making Peace with Your Birth Experience" (2). Given this powerful statement you wonder why 'debriefing', 'counseling' or 'sharing your birth experience' are not a standard part of postpartum care, or at least offered to women after childbirth (whether that be by the midwife, obstetrician, clinical psychologist one to one or in a group environment). Would the incidence of Post Traumatic Stress Disorder (PTSD), Post Partum Depression (PPD), or anxiety related disorders decrease? (3). What about social support whilst you are pregnant? Studies have suggested that women who have had social support during pregnancy have gone on to have an 'easier childbirth'. Not only that but during the postpartum period as well (4).

To read more birth stories, I encourage you visit Dr Bronwyn Harman's blog http://drharmanmodernfamily.blogspot.com/2011/08/my-birthing-story.html?spref=fb

How you feel emotionally and mentally about your birth experience can have a direct impact on your relationships, including the relationship with your baby. Negative thoughts about your childbirth experience can affect the mother-infant bond. Activities such as participating in infant massage classes can help strengthen the bond between mother and child, in a nurturing and supportive environment.

So without further ado, here are my birth stories.... all three of them (grab yourself a cuppa!).

Master 'E' is eleven nearly twelve years old. I had just turned twenty four when he was born the following month. My pregnancy was wonderful, I enjoyed every minute of it. I had little morning sickness (a couple of days I recall), was fit and healthy. We went for many walks and I continued my mainly vegetarian diet but included fish for the omega 3 benefits for both me and my unborn baby. I kept a diary, something I did a little with Master 'D' during my second pregnancy but not so with my last pregnancy. I guess that had something to do with being too busy looking after the kids and running the household! Master E was a week past my E.D.D. (my due date) and feeling a little desperate to meet my baby, I consulted with a naturopath who prescribed Caulophyllum homeopathic tablets. To this day I will never know whether it was this or that I took castor oil mixed with orange juice to help get things happening (or maybe both!). After nearly passing out on the floor with diarrhoea, contractions started in the early hours. Then my waters broke, I remember it gushing out on to the cushions I was sitting on and it was all happening! My partner was passing me hot face clothes for my back whilst I was rolling around on the beanbag, trying to stay focused and in control. We drove to the Family Birth Centre (KEMH) around 7am. When we got there I promptly banged my fists on the reception counter declaring "Im here. Get me in the bath NOW!!" (or something to that effect. You could tell I was going through transition as the contractions were coming on fast and strong!). The midwife examined me and I was 7cm dilated. Wow, I thought, I had done most of the hard work at home! My birth plan included being in water as 'pain relief'; luckily no one was using the spa/bath at the time. During the later half of my pregnancy I had done a fair bit of reading about labour and what alternative therapies I could use for pain relief. Water was one of them (not that I was totally against using gas/pethidine or an epidural or even a Cesarean should it be required). Aromatherapy was also another option (via massage or in an essential oil burner). I had an aromtherapist, Rosemary, at the birth, as well as my partner and mother. Rosemary acted like a doula in a way; an extra support person which was fantastic. I had got to know Rosemary quite well as I received a monthly massage from her throughout the whole pregnancy. Ooh that was bliss, my hour of total relaxation! Combining regular massage with some pregnancy yoga and I felt that this was good preparation mentally (and somewhat physically) for the impending birth. Reflecting back, I do believe this helped me to focus throughout the seven hour labour. I even had my eyes closed for the majority of it, as this helped me to focus within and go with the flow (not to fight the pain). So, getting back to the final stages of labour, after I got out of the bath, I felt the urge to push. The midwife suggested sitting on the toilet as the angle was favourable for my baby to 'pop out'... and there he was, with a little bit of pushing, Master E was born! (Eleven years ago you were not permitted to have a water birth so I had to get out of the bath). The funny this is, that I cannot stand pain. Even paper cuts make me feel woozy. So it is truly amazing to think that for someone who feels faint with the sight of her own blood or paper cuts, I could go through seven hours of labour and deliver my baby boy.

Nearly eight years later and I was due to give birth to my second baby, another boy, except this time my circumstances were different. I did not have my partner beside me, throughout pregnancy or for the birth. My wonderful mother was with me again (thank goodness). So it was just mum and I. Master 'D' was born at a public hospital closer to me, purely for the fact that being by myself at the time I felt safer in the knowledge that should I require an ambulance, I was literally five minutes from the hospital. Second time round and this pregnancy was pretty much trouble free, except for a week or so of the dreaded morning sickness. I also had a bleed at around fifteen weeks, enough to have another scan to check that the baby was okay. At full term they offered me a 'sweep and stretch' which I declined. I was hoping labour would start by itself as with my first son. I lost the mucous plug/show at thirty nine weeks so I was thinking it would be any day now... well that was not to be! I knew things were starting to happen around my due date as I had been feeling very mild period-like pains. A close friend and I had been talking about how her waters had started to leak, and it was probably a good thing we had as that is what happened to me (although I did not know at the time). I called my parents to look after Master E who was asleep at the time. I said to my mum 'oh dont worry lets just go in for a check up' and I even told her to leave the hospital bag in the car! Well, the midwife did a quick test to determine if my waters had broken and yes, they had (to my surprise!). Holy... I thought, Im going to have my baby tonight!! After she broke my waters, about thirty minutes later my contractions started. This was the early hours of the morning. At one point I said I wanted an epidural but the nurse told me it was too late for that (thank goodness because I knew I could get through it, I just had to stay focused and in control). I believe that by not having a supportive partner by my side I was not relaxed as much as I wanted to be, as much as I love my mum its just not the same. It took about an hour to push my baby out and they did use the forceps, hence the cone head look when he was born! What I didnt like (I should have written a birth plan) was that they had me on my back pushing with my feet in stirrups. Totally against an active birth which is what I prefer (that is, standing, using gravity to assist, squatting and on all-fours) and I had a drip in my hand 'just in case'. But apart from that, there he was, another beautiful baby boy!

Fast forward nearly four years to the present and here I am, with Master 'B', the newest member of the family. Blake was born eleven days early in June 2011. My labour was just under four hours. He was also born at the Family Birth Centre, KEMH, even though I now live hundreds of kilometres away in the country! The saddest part of my labour with Blake is that my partner missed the birth by one hour. He was due to drive up four days after Blake was born, but because he came early it caught everyone by surprise (its roughly a six and a half hour drive to Perth). On the other hand, I got to experience a water birth, something I really wanted with Master E eleven years earlier. I was walking back to my bedroom at the house we were staying at in Perth when my waters broke, this time well and truly! Ethan was still awake but Darcy was in bed asleep. It was just after nine pm. I tried to keep calm but started shaking, knowing that my partner would probably not make it as I seem to have fairly quick labours (I phoned him straight away along with the midwife who was on call). I managed to stay in bed for nearly two hours, relaxing as much as possible, with a hot wheat bag. The contractions were like strong Braxton Hicks, nothing too painful, more annoying as I was trying to sleep. Just before midnight they started coming on quite strong, so my dad stayed at the house with the boys while mum drove me to the Birth Centre. It was a thirty minute drive, in this time I had had a few more contractions. We arrived sometime before one am. I had another quite powerful contraction while kneeling on all-fours on the door mat outside the Birth Centre! Now what a sight that would have been if you were driving past! The midwife arrived shortly after as there was no one roster on at the birth centre. Lucky for me the spa/bath was all mine! The midwife examined me and I was eight centimetres dilated. Once I was in the water, ooh it felt wonderful. The warmth of the water helped me to relax and focus. I remember thinking 'go with the flow', the analogy that a contraction is like a wave, it builds until it peaks then it subsides. Dont get me wrong, contractions ARE painful but the water helped take the edge off the pain. My mum was fantastic, giving me my drink so I could have little sips to keep hydrated, and providing a hand to squeeze tight. His head and shoulders were born under water, then I stood and the rest of his little body slid out. It was amazing. I sat down in the bath while the water drained and cuddled my little man. I did it.... again!

References

(1) http://www.bestthinking.com/articles/medicine/psychiatry_and_neurology/psychosomatic_medicine/the-psychological-impact-of-birth-experience-an-underreported-source-of-trauma-in-the-lives-of-women"

(2) http://www.infantrisk.com/content/making-peace-your-birth-experience

(3) Raphael, B., Preston Wilson, J. Psychological Debriefing: theory, practice and evidence. 2000, Cambridge University Press. p 272-276.

(4) Dewar, G. http://www.parentingscience.com/childbirth-trauma.html "The psychological effects of childbirth stress"

Remotely Happy "Happiness" Club and Identifying your strengths

Have you heard of a new field in psychology, called Positive Psychology? I currently participate in the Remotely Happy Happiness Club which involves meeting monthly on Skype with a group of like-minded people. Here we discuss the principles of positive psychology:

http://www.thehappinessinstitute.com/freeproducts/

(there is a free eBook you can download called "20 Simple Tips to be Happy Now" by Dr Tim Sharp).

During the first Skype meeting, we discussed:

Tip #20- Live in the present moment,

Tip #19 - Control what you can control,

Tip #7 - Identify where your strengths lie

Tim's book is very thought provoking. Tip #7 'Identify where your strengths lie' is something not everyone can express easily.

Can you name at least five strengths that you possess (without asking others first??).

Tips on how to define your strengths include taking time to reflect on who you are, your talents, abilities, passions. Think about situations you have been in that have challenged you (mentally or physically), and try to come up with a list of strengths yourself, without being influenced by others. Be open and honest with yourself and be mindful of your everyday actions (live in the present moment). This can be a very empowering exercise that builds your self-awareness and confidence!

What is Mineral Oil?

Mineral oil is a colourless oil manufactured from crude oil (crude petrol). Otherwise known as:

• paraffin oil

• petrolatum

• paraffin wax

• liquidum paraffinum

It is a by-product of petroleum. Baby oil is 100% mineral oil usually with added (artificial) fragrance. Applied to the skin, it clogs the pores of the epidermis by forming a greasy film, interfering with the skin's ability to remove toxins. This can contribute to acne, allergic reactions and premature ageing, due to interfering with normal skin functioning and cell development. It has also been noted as a possible carcinogen due to the presence of PAH's (Polycyclic Aromatic Hydrocarbons) and a skin and eye irritant.

What is the concern with using 'baby oil' for infant massage?

As it is natural for babies to suck their hands/fist/thumb, the safety of a young infant ingesting mineral oil is an unknown risk factor. Mineral oil is not broken down by the body. Another concern is the added fragrance could interfere with the parent-infant bond as often the scent is over-powering for the baby.

Given the above information, I urge parents to:

• consider their baby's health and wellbeing

• seek safer alternatives

• inform family and friends

• question the manufacturers product information / labelling

Have you had any bad experiences using baby oil on your baby?

Further reading:

Pneumonia secondary to baby oil aspiration

http://journals.lww.com/pec-online/Abstract/1985/06000/Lipoid_pneumonia_secondary_to_baby_oil_aspiration_.7.aspx

References:

Farrow, K. Skin Deep. 2002, Lothian Pty Ltd, Victoria, Australia.

Michalun, N. Milady's Skin Care & Cosmetic Ingredients Dictionary, 2nd ed. Delmar Publishing, Canada

Essential Therapeutics (The Australian School of Clinical Aromatherapy). Aromatherapy and Regenerative Skin Care (Seminar Notes), May 2003, Perth, Western Australia.

Cherry Bond website http://www.cherrybond.com/oil%20for%20the%20neonatal%20unit.html

Online Toxic Ingredient Dictionary (mineral oil) http://myweb.westnet.com.au/ctarr/partyplan/toxicdictionary.htm

Wikipedia website (mineral oil) http://en.wikipedia.org/wiki/Mineral_oil

Gift ideas for the new Mum - Idibidi Kids Gift Certificates

Wow, we are into December already! Im thinking "where did the year go"?!

Idibidi Kids has some great products and services for the

new mum, or parents-to-be. Why not buy her an Idibidi Kids Gift Certificate?

Some ideas you could buy a Gift Certificate include:

• Christmas

• Mothers Day

• her birthday

• as a baby shower present

• after the birth of baby

We operate in Perth, Western Australia:

• Pamper mum with a Postnatal Massage for Mum!

This is a clothed, seated massage in an ergonomically designed, purpose built massage chair. When was the last time she had half an hour to herself, listening to relaxation music whilst given a massage in the comfort of her home? All mums should receive a Massage for Mum, especially in the first year after the birth of bubs. Natalie from Idibidi Kids has qualifications in both Indian Head Massage and Corporate Seated Massage and is fully insured, so you are in safe hands!

• how about a Gift Certificate for an infant massage course? Massaging your baby has many benefits. You have the option of Idibidi Kids coming to your home or centre in the Perth metro area. This way you can learn in the comfort of your home. Alternatively Idibidi Kids facilitates the infant massage course in Edgewater (max 5 parents & bubs).

• we have a great range of products - how about a bottle of Cold Pressed, Organic Massage oil? Ideal for baby massage or for mum herself. You can choose from Sweet Almond oil, Sunflower oil or Sesame Seed oil. All oils do not contain any preservatives, are cold pressed and organic.

Save money... use any Idibidi Kids service and you will receive a discount off any bottle of organic massage oil!

Benefits of Infant Massage for mothers experiencing postnatal depression; an overview

Article feature for Mums on the Go http://www.mumsonthego.com.au/

Approximately one in seven women in Australia will experience postnatal depression, or nearly sixteen percent of women who have given birth. Mothers with postnatal depression often have problems interacting with their baby; they may seem over intrusive toward their baby, often interfering with their baby’s activities, leading to the baby becoming passive and withdrawn. Or mothers themselves may be withdrawn, not interacting with their baby (disengaged), smiling at or playing with their baby as much as other mothers. This may lead to baby becoming distressed, often indicated by excessive crying (Tronick et al 1998). Why is this of concern and what are the outcomes? Postnatal depression in the mother can interfere with the ability of the infant to form a secure attachment (to their mother) and compromises infant functioning (social, cognitive and emotional) in later years. Consequently, these infants may develop behavioural problems, a difficult temperament and elevated stress (cortisol) levels (Field 2007).

Ways in which infant massage may assist the mother-infant interaction include increasing a mother’s confidence, an understanding of her baby’s cues (non-verbal and verbal), relaxation for both mother and baby, and a release of the hormone/neurotransmitter oxytocin, which assists bonding (Glover et al 2002). K. Onozawa and colleagues (2001) in their study found that mothers’ who attended an infant massage course with the International Association of Infant Massage, reduced their postnatal depression EPDS (Edinburgh Postnatal Depression Scale) score and statistically improved the mother-infant interaction. In other studies, Tiffany Field PhD, director of the Touch Research Institute, has conducted research into the effects of postnatal depression on both mother and infant, as well as the benefits of (infant) massage ⁽¹⁰⁾.

Participating in infant massage classes has both psychological and physiological benefits. During infant massage classes, mothers are given time to observe their baby, and with the help of a certified infant massage instructor (CIMI), come to understand their baby’s cues, and how to massage their baby. The following are the four main categories of benefits (of infant massage) for the infant:

Relief: massage can help with colic, wind, constipation, growing pains, emotional stress.

Stimulation: stimulation of the Vagus nerve, which regulates the various systems of the body (circulatory, digestive, lymphatic, nervous, immune, respiratory), muscular development and tone.

Relaxation: improvement in sleep, increasing oxytocin and serotonin, decreasing stress hormones (cortisol and norepinephrine), regulation of behavioural states (sleep and awake cycle) and less hyperactivity.

Interaction: massage helps the promotion of bonding and secure attachment between mother and infant, verbal and non-verbal communication, feeling respected, loved and nurtured.

Although it has been suggested that further research and RCT’s (randomised controlled trials) with larger groups would be beneficial in testing more thoroughly the effectiveness of infant massage, it is certainly a positive activity that mothers with postnatal depression can do with their baby; one with many benefits.

Natalie is a certified infant massage instructor and state representative of the International Association of Infant Massage (IAIM). She is currently studying child psychology and her interests include perinatal and infant mental health research. www.idibidikids.com.au

References:

1) Black Dog Institute “Depression during pregnancy and the postnatal period” PDF

2) beyondblue website http://www.beyondblue.org.au/index.aspx?link_id=89

3) Benefits of infant massage for mothers with postnatal depression

Vivette Glover, Katsuno Onozawa and Alison Hodgkinson, Queen Charlotte's and Chelsea Hospital, Semin Neonatol 2002; 7: 495 500. http://www.careperinatologia.it/lavori/L32.pdf

4) K Onozawa, V Glover, D Adams, N Modi, R C Kumar. Infant massage improves mother-infant interaction for mothers with postnatal depression. Journal of affective disorders. 2001 Mar;63(1-3): 201-7

5) M Fujita, Y Endoh, N Saimon, S Yamaguchi. Effect of Massaging Babies on Mothers: pilot study on the changes in mood states and salivary cortisol level. Complimentary Therapies in clinical Practice 12, 181-185

6) M Weinberg, E Tronick. Emotional characteristics of infants associated with maternal depression and anxiety. 1998, American Academy of Pediatrics (Pediatrics)

7) V McClure, International Association of Infant Massage “Manual for Infant Massage Instructors” 2005

8) T Field (PhD). The Amazing Infant. Blackwell Publishing, 2007, p 104-8, 111-13

9) http://www6.miami.edu/touch-research/ The Touch Research Institute, Miami, U.S.A.

10) http://www6.miami.edu/touch-research/TRIDepression.html

11) Field, T., Grizzle, N., Scafidi, F. Abrams, S., Richardson, S., Kuhn, C., & Schanberg, S. (1996). Massage therapy for infants of depressed mothers. Infant Behavior and Development, 19, 107-112.

“The infants who experienced massage therapy compared to infants in the rocking control group spent more time in active alert and active awake states, cried less, and had lower cortisol levels, suggesting lower stress. Over the 6-week period, the massage-therapy infants gained more weight, showed greater improvement on emotionality, sociability, and soothability temperament dimensions, and had greater decreases in stress neurotransmitters/hormones (norepinephrine, epinephrine, and cortisol)”

Field, T., Diego, M., Dieter, J., Hernandez-Reif, M, Schanberg, S. Kuhn, C., Yando, R., & Bendell, D. (2004). Prenatal depression effects on the fetus and the newborn. Infant Behavior & Development, 27, 216-229.

Prenatal mood and biochemistry levels were assessed in women with and without depressive symptoms during their second trimester of pregnancy. At the neonatal period maternal and neonatal biochemistry, EEG and vagal tone levels were assessed, neonatal behavioral states were observed and the Brazelton neurobehavioral assessment was conducted. The mothers with depressive symptoms had higher prenatal cortisol levels and lower dopamine and serotonin levels. Mothers with depressive symptoms were also more likely to deliver prematurely and have low birthweight babies. The newborns of mothers with depressive symptoms had higher cortisol levels and lower dopamine and serotonin levels, thus mimicking their mothers’ prenatal levels.

Tips on improving your child's sleep

Sleep and your child: knowing what to look for and when.

As I sit here typing my blog post for the month, I wonder if my 2 1/2 yr old will go to sleep without too much drama tonight... as I reflect on last night's episode, it is important for new parents to be familiar with three factors that can effect your child's sleep, both quality and quantity:

1) hours of sleep your child should be receiving for his/her age

2) knowing what 'tired' signs (cues) to look for (body language)

3) diet

4) exercise/physical activity per day

I knew last night was a disaster because

• older brother gave him a small amount of chocolate (I discovered later... left over from Easter)

• limited exercise, mainly playing inside with toys

• exposure to tv (Im not proud to admit at least one hour to no more than two hours... that's two hours too much!)

DAYTIME NAP:

• did not have one. Too much stimulation as older brother had a friend over (noise and tv/computer games)

• dinner - ate only a small portion of chicken, mainly chips (salted - takeaway)

• bath - usual time ~ 630pm

• 'quiet time' leading up to bed as per usual (tv off, limited lights on, 3 books in bed)

• 715pm lights out

• 830pm - still awake; ate half a banana, small piece of cheese and small bowl of yoghurt (plain, no fruit)

DID NOT GO TO SLEEP UNTIL 915pm !

• In and out of bed, over-tired!!

I knew because of the day's events and what he ate during the day, bedtime was not going to be easy. Add to that the fact that he was over-tired AND over-stimulated, it was going to take him some time to relax and unwind and he was going to need me to help him!

Some important points to consider for your child:

1. FOOD: What your child eats during the day will effect their quality of sleep: Foods that are highlighted in purple, such as chocolate and chips contain high amounts of saturated fat, sodium and sugar. Foods that are highlighted in green, such as bananas, cheese and yoghurt, contain tryptophan, an amino acid that the body uses to make serotonin and melotonin. Serotonin (a calming and relaxing neurotransmitter) and melotonin (a sleep-inducing hormone in the brain) help to regulate our mood, appetite and sleep. Note however that it can take up to one hour after you have consumed tryptophan rich foods for it to have an effect. There are plenty of foods containing trytophan; a good reference is http://www.askdrsears.com/html/4/T042400.asp "Foods that help you sleep". To look at the carbohydrate to protein ratio, a good reference is http://en.wikipedia.org/wiki/Tryptophan It is important to include a meal that contains complex carbohydrates as well as protein (proteins contain amino acids), as it is the carb's that make the trytophan more available to the brain.

2. Exercise / physical activity (especially for older babies and toddlers): Increasing the amount of exercise or activity your child has throughout the day will help to tire them out physically and prepare their body for sleep. Exercises for your baby include tummy time and playing games such as peek-a-boo and clapping hands, to promote skill development through movement. When they are a little older, taking them to a playground suitable for their age. For toddlers, parks and the beach can be lots of fun; chasing bubbles and kicking a ball in the backyard or at the park, including games where you jump, hop or skip! My kids love to dance to music, and that is something we all do as a family. A 2007 Canadian review suggests at least 60 minutes of physical activity a day for preschoolers (ie 2 to 5 year olds) and according to the National Association for Sport and Physical Education, America, toddlers should receive at least 30 minutes of structured play and at least 60 minutes of unstructured play; an important point is that toddlers should not be sedentary for more than 60 minutes at a time. Interestingly, the Physical Activity Policy of the City of Wittlesea, Victoria, 2009, states that "No Australian guidelines for physical activity for 0- 5 years currently exists."

3. Exactly how many hours of sleep should your little one be getting in a 24 hour period? According to many pediatricians and infant/child health experts, age appropriate sleep can be divided into the following:

0 to 3 months - 16 to 17 hours of sleep total in 24 hours

3 to 6 months - 15 to 16 hours of sleep total in 24 hours

6 to 12 months - 13 to 14 hours of sleep total in 24 hours

1 to 2 years - 12 to 14 hours total sleep in 24 hours

2 to 5 years - 12 to 13 hours total sleep in 24 hours

Obviously the amount of sleep required will vary between day or night time sleep. As someone who has now assisted many parents with sleep concerns, I believe that parents need to become more educated about sleep, as well as combining this with knowing what to look for when your baby is tired. Knowledge = Power = Improved confidence!

4. TIRED SIGNS: Otherwise known as 'cues', referring to your child's body language (more-so for babies). So what are some tired sign, or cues that your baby is showing to let you know that they are tired and in need of sleep:

Clenched fists

Losing interest in surroundings

Looking/turning away (gaze averting)

Glazed eyes (like he is looking through you)

Grizzly

Rubbing eyes

Jerky movements

Fussy with food

Demanding

Facial grimacing

Losing interest in toys

Fussing

Clumsy

Yawning
and Crying (by now over-tired and over-stimulated!!

Look for OTHER TIRED SIGNS FIRST & be aware of how long he has been awake).

As I finish writing this blog post, my 2 1/2 year old went to sleep without too much fuss, and certainly no where near last night's episode. 15 minutes is all it took... aaaah, back to 'normal'!

Natalie offers parents G.U.E.S.S Parenting workshops and Sleep Consults (Guidance, Understanding, Education, Sleep Support) which consists of an initial 2 hour consult. Here Natalie will discuss your confidential Client History form, providing useful and practical tips and techniques, as well as information and support regarding your concerns. This will form part of your personalised support guide, unique to your own circumstances, as well as Natalie being available for a follow up phone call or email, for ongoing support. Please visit http://www.idibidikids.com.au/sleepconsults.htm

References:

http://www.aahperd.org/naspe/standards/nationalGuidelines/ActiveStart.cfm

http://www.whittlesea.vic.gov.au/files/3338_Physical%20Activity%20Policy.pdf

http://article.pubs.nrc-cnrc.gc.ca/ppv/RPViewDoc?issn=1715-5320&volume=32&issue=S2E&startPage=S122