Is White Noise Safe For Your Baby's Ears?

I use white noise in my children's bedrooms. I recommend it to my clients to help their little ones get to sleep independently and stay asleep all night.

But is it safe?

Here's the short answer: probably, but it depends.

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White noise - like ocean-wave sounds or a fan - can help block out household noise that either prevents babies from falling asleep or wakes them prematurely.  Some say it's a soothing sound that can help lull them into sleep. I'm not so sure about that - we can't ask the babies.

But how much is too much?

It's not clear whether a baby's threshold for noise-induced hearing loss is lower than that for adults, but as a conservative measure, neonatal intensive care units (NICUs) are recommended to keep ambient noise levels to 50 dB-A (a-weighted decibels) or less. (FYI that’s really quiet – the ambient noise in my home with computer on and refrigerator humming is higher than that.)

A recent study published in the medical journal Pediatrics found that of 14 infant-sound machines tested, all of them were able to reach noise levels over 50 dB-A. No surprise there – it has to make some noise.

But what's concerning is that several of them, when placed on the crib rail, were able to produce sounds exceeding 85 dB-A at baby’s level. That's over the limit for adult occupational noise – the level at which hearing damage is known to occur on chronic exposure (picture the guy who spends 8 hours a day operating a jackhammer).

Before you panic and run to turn off the fan in your baby's room, 85 decibels is really loud.

When I first read this study, I did panic, and I did run to turn off the running-water-sound device in my daughter’s room. At the time I read it, she had been suffering from obvious hearing loss (which we had initially thought was selective toddler hearing, until we started testing her by offering chocolate and videos, to no response). Turns out she had a middle ear full of fluid; her hearing resolved as her head cold cleared, but not before I brought up my concerns about white noise with my family doctor.

His immediate thoughts were that a) I was crazy, and that b) the white noise would have to be insanely loud to cause hearing damage. A few days later, he bumped into a colleague specializing in Pediatric Ear Nose Throat and asked her about it.  Her answer was that there was no way my daughter’s hearing loss could have been caused by white noise.

Sigh of relief (and shedding of massive amounts of useless guilt).  But I still turned our white noise down, and I follow the Pediatrics article’s recommendations of keeping the machine on the opposite side of the room from our child’s bed and turning it down or off when my husband and I go to bed and the house is quiet. (See below for the researchers’ recommendations.)

Now, what about creating a dependency on white noise?  I get this question a lot when I recommend it in seminars or to clients.  White noise is not what we call a “prop” – an external person or object (like a pacifier or Mom in the rocking chair) that baby doesn’t know how to sleep without.

It’s also easy to wean.  Once babies have solid sleep skills – they can fall asleep independently and soothe themselves right back to sleep as they stir in the night – you can gradually turn the white noise down over the course of weeks or months.

In the meantime, I am still recommending it. My doctor can probably find lots of other reasons to think I’m crazy.

 

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Not sure how loud your white noise is?  Download a decibel-meter app on your phone and place it next to your sleeping child while your white noise is on.

Recommendations from the Pediatrics February 2014 study:

1. Place the ISM as far away as possible from the infant and never in the crib or on a crib rail.

2. Play the ISM at a low volume.

3. Operate the ISM for a short duration of time.

An End To Bedtime Battles?

Is it 7:00 yet?

This is the question I asked my other half as we sat at the dinner table the other night with our two children.  We love them dearly, but honestly, we don’t always love their company.

Each was refusing to eat in their own way – the one-year-old wanting to bang the spoon and fling food with his new-found motor skills, his older sister unnervingly exhibiting behaviour that friends have described to me as the “threenager”.

It was all run-of-the-mill parenting stuff, with a few things we could probably work on (okay, we’re actually failing miserably at French parenting à la “Bringing Up Bébé”).

But I look forward to bedtime; it’s the easiest part of my day. Since we embarked on sleep training our first child (we hired a Sleep Sense consultant three years ago), bedtime has been pretty much a cakewalk.  I’m not bragging here  we did way more than our share of late-night laps around the neighbourhood. Also see previous paragraphs.

A phrase I often hear with respect to children’s sleep is “bedtime battles.” I shudder at what that might look like for some families, especially with multiple children. But I don’t believe there are inherently good or bad kids; just well-rested ones and overtired ones. Battles ensue when overtired kids get wound up and just can’t co-operate. Often there’s just a subtle lack of routine or boundaries. And even the most energetic parents can hit the wall and not be at their best at 6 p.m.

Was sleep training hard? Yes. Were there moments of doubt while I sat beside my baby whispering to her as she learned to fall asleep on her own? Yes. Do I have any regrets? Hell no! I barely remember the one week it took to change all our lives. By all accounts, neither does she. There has been so much LESS crying ever since we sleep trained.

Before sleep training, our baby’s overtiredness from not having independent sleep skills – being breastfed to sleep, carrier-walked to sleep, car-driven to sleep – created ear-piercing wail-a-thons on a regular basis. That all pretty much ended after three nights on the job.

My second baby gradually learned how to sleep independently from the beginning with just a few simple ideas (we weren’t going down that exhausting road twice). He’s not been perfect, but putting him down for nap or nighttime is simple, gentle and easy.

So when 7 p.m. comes, I know that all will be calm and quiet, and my husband and I will get some time to relax, read, talk, work and – oh yeah – sleep.

So perhaps you’re thinking what I thought: “Fine for you but that would never work for my child!”

That’s what we've all thought ("we" being those on the other side of sleeplessness). Mine had a strong will, a set of lungs that would bring the house down and an apparent congenital disdain for shut-eye.

But all healthy babies have it in them to sleep well. Even those with physical or mental challenges can learn when given the opportunity and the right guidance.  As well-meaning parents, we often get in their way; then the well-meaning strategy becomes habit.

And then it stops working.

The number one mistake we as parents make is thinking our high-energy child isn't tired enough at 6:30 or 7 p.m. and so we keep them up later to "tire them out". When kids get overtired, they get wired (likely just the first of many ways they will yank our chains over the course of 18 years).

The second biggest mistake is varying the routine, or not having one, often because we're losing steam at the end of a long day. But cultivating your inner drill sergeant and keeping the list of to-dos ticking along before bedtime will do wonders if you keep it up.

And definitely no screen time at least 90 minutes before bed.

If after using these tactics you still have a nightly ritual of bedtime battles, whether they involve driving a baby around the block 45 times or wrestling a toddler into pyjamas, there is a way out. And everyone wins.

Call me and we’ll chat about it. 15-minute consults are free. 604-789-0850.

We've lost our village, and it's making us tired

We've lost our village, and it's making us tired

I just read a great article that cuts through the cultural attitude of "mommy martyrdom" around the issue of sleep deprivation and its effect on postpartum mental health.  

http://www.mamamia.com.au/torturing-new-mothers/

We've all joked about having "mommy brain" and falling asleep mid-feeding in the rocking chair at 4 a.m., but as a society, it may be time to wake up. Pardon the pun. The Canadian Mental Health Society names sleep deprivation as a contributing factor to postpartum depression - a condition 10-15 per cent of new mothers will experience, some to the level of psychosis.

Having a newborn baby is blissful, joyful and exciting. But it's also constant - not to mention critically important - work. If women are lucky, family members pitch in with meals and grocery runs in the first week. But then what happens? 

Typically, Dad goes back to work and Mom is up three to four times a night feeding and soothing baby so that her partner is well rested enough to function at the office. Then chronic sleep deprivation really starts to kick in - chronic because there's no time to catch up on lost sleep.

As new moms, we're often told to "sleep when they sleep". But that's assuming someone else is cooking, cleaning, doing laundry and taking care of your other children. (Notice there's no time in there for showers or relaxing with a heating pad around your shoulders.) Not many of us have a super-grandma down the road who gives up the next six weeks of her life to take care of household business while her daughter (or daughter-in-law) feeds and bonds with her new baby. And almost no one has a village to rally around them any more. 

According to a Huffington Post article on birth traditions in other cultures, the Japanese have a concept around post-natal care called Ansei, or "peace and quiet while pampering." Um, yes please. Traditionally, Japanese women spend the first three weeks after the birth of their baby at their parents' house staying in bed, recovering and bonding with their baby.

In Nigeria, the mother, or mother-in-law, gives the new baby its first bath, symbolizing the care she will give in the early part of the newborn's life.  Maybe that sounds worse than labour to you; that depends on the mother-in-law. But we're talking about a concept here.

Just four decades ago, my mother spent a full five days in a hospital bed after each of her babies' natural, uncomplicated births. For one birth, she was sharing a room with an Irish-Catholic woman who had just delivered her 12th or 13th child. "I love coming in here," she said. "It's the only break I get all year." 

Another interesting read outlines the culture shock that a Korean nurse had when giving birth in the United States. In her article Postpartum Beliefs and Practices Among Non-Western Cultures, Yeoun Soo Kim-Godwin, PhD, MPH, RN says, "It is interesting that women’s status has been considered relatively higher in Western cultures than in non-Western cultures, yet paradoxically less recognition seems to be given to new mothers in the United States."

True - for baby showers and the postpartum period, the focus is most often on the baby.  Now, I'm not saying we should ignore the miraculous new bundle of joy, but we need to take care of moms so that moms can be fully present to take care of their babies. Don't get me started on the insanity of some countries that require women to be back to work after six weeks. 

So what to do?  Reach out. Make food - lots of it, and often. If you have a friend or family member who has just given birth, show up with two containers: one for tonight and one for the freezer. Ask the mom (and/or dad) if they would like you to watch the baby while they take a shower or have something to eat. Then bugger off. 

I'll never forget visiting my friend Jean a week after the birth of her first baby. Not yet a mom myself (and admittedly out to lunch on the whole thing), I brought flowers. You're welcome. And I stayed for an hour (total rookie). About a year later I had my own baby, so by the time Jean had her second, I had smartened up. I showed up with a big pot of nourishing soup, held her baby for five minutes and then left her in the capable hands of her husband-on-paternity-leave to rest.

That said, if you know someone who is really suffering, treat it seriously. Get them to talk to their doctor, and connect them with a local women's mental health or postpartum depression group. Make sure they're being followed by health professionals. And if they have a difficult baby who literally keeps them up all night, gather the troops, step in, and take shifts. She needs to sleep.

If you need a great platform for organizing postpartum meals or other support, check out Lotsa Helping Hands to make your own online signup calendar.

So what is sleep training?

So what is sleep training

This is the question a mom in the park asked me the other day when I told her what I do for a living. She had joked “we’ll sleep some time” as she gently pushed her seven-month-old in the swing for the first time.

There seems to be a lot of talk about it, but I realized there are probably a lot of new parents who don’t know what it means to “sleep train” their baby. I was one of those parents; although in the months after my first child was born, I dreamed of walking into the room with a clipboard and whistle to command her it was time to sleep. For the love of….

Simply put, sleep training is giving your baby (or toddler/child) the opportunity to learn self-soothing strategies.  We all have self-soothing strategies – I lie on my left side in the fetal position and pull the covers up to my shoulders. Ahhh… now I can fall asleep. And I stay asleep, all night. Even though it is completely normal to wake three to four times a night, we don’t remember waking because it’s so brief. Somewhere in our infancy, we learned self soothing. We wake, shuffle / turn over and go right into the next cycle of sleep without being consciously aware of it happening.

Babies need to learn how to fall back to sleep in between sleep cycles. It helps (or is essential, actually) if they’ve learned to fall asleep independently, meaning, not while breastfeeding, sucking a pacifier or being rocked in mom’s or dad’s arms.

So why do so many babies have a hard time putting that together? It seems an anomaly these days to have a baby that just sleeps through the night after the first couple of months of life. Often parents intervene too soon with baby's every fuss and cry; their little one doesn't have a chance to develop the ability to soothe themselves back into another cycle of sleep.

Another possible contributor is "back to sleep". This is the educational campaign that has literally saved babies’ lives. Since government programs have urged parents to put babies to sleep on their backs rather than on their bellies, as had been done for probably a millennium, the rate of infant deaths due to SIDS (Sudden Infant Death Syndrome) has dropped by 50 per cent. But when not sleeping on their bellies, babies will startle themselves awake more often (that jazz-hands-looking reflex present in early life).

Just to be clear, I strongly advocate putting babies to sleep on their backs. It is the single biggest factor in reducing cases of SIDS. But that means many of us have to work a little at helping our babies learn the critical life skill of independent sleep.

Sleep training can take on many forms.  A lot of people assume this means “Cry It Out” or CIO as it’s called in sleep literature. Many of our parents did this, and a lot of experts recommend it for exhausted parents and overtired babies, but it can be pretty hard on the heart – the parents’ figurative heart as they put their child down and close the door on their crying baby, not to open it again until 7 a.m. It can also have less-than-lasting success compared to other methods.

Then there’s increasing check times, often called “Ferberizing” as it was popularized in the 1980s by Dr. Richard Ferber. Using this method, you put your baby down awake and return at predetermined amounts of time to comfort them with gentle pats or rubs and a soothing voice; those intervals gradually increase in length until your baby falls asleep.

Then there’s “camping out”. This is the method popularized by Sleep Sense founder Dana Obleman; she calls it the “stay-in-the-room method”. This is the method I most often recommend to parents.  Using this method, you are beside your child for them to see and hear you, and occasionally feel your soothing touch.  The method then progresses and changes over the ensuing nights to allow your child to learn complete independence. In my experience, it’s a game changer.

If you Google 'sleep training', you'll find strong opinions from online moms on all sides of the discussion; everyone is absolutely entitled to an opinion. But one fact always remains: if you’re sleep deprived, you’re not at your best. At worst, you could be unable to properly attend to your child, unsafe to drive or even heading into depression. And parenthood is all hard enough.

We're all just doing our best

We're all just doing our best

I’m a sleep coach. It’s where I’ve decided to put my efforts and attention to help kids and families. Sleep training worked for me, and it’s worked beautifully for my kids. The research on the effects of sleep training on children’s future emotional health and well-being alleviates any second guessing I had about my decision. My kids sleep in their own cribs through the night and they fall asleep independently (i.e. no “props” like breastfeeding-to-sleep, rocking or pacifiers). That was my choice, and it’s worked for us.

Then there’s my friend C, whom I just bumped into on a beautiful, sunny Sunday morning – she with her two kids and me with mine. Both of us have relatively new babies. She said something about her littlest one napping for three hours every afternoon and my heart swooned.  “You hear that?” I said to my baby. “Three hours – want to give that a try?”  She said she puts her almost-three-year-old on one breast and her baby on the other and they all fall asleep for a family nap every day. Sometimes it’s one hour, sometimes it’s two or three. And it works for them. Her kids get sleep, she sleeps and she feels good about her parenting decision.

So who’s right?  The answer is, both. From what I can tell, my friend C seems wholly committed to the Attachment Parenting philosophy made famous by the Dr. Sears group. I was too until three or four months into my first child’s life when I had to admit the bed-sharing part wasn't working for us.  No one was getting enough sleep.  And if I breastfed my baby to sleep, she’d have a guaranteed, crappy 30-minute nap and continue the vicious cycle of overtiredness.  My baby and I were getting by on snippets of rest but we were both chronically sleep deprived.

While the Sears family write at length about the benefits of co-sleeping, demand-feeding and baby wearing, they also say very early in their Attachment Parenting book that the best sleeping arrangement for any family is the one in which everyone is getting a good night’s sleep.

So while my heart wanted the co-sleeping cuddles my friend C had, it changed its tune when I learned how much consolidated sleep my child was missing out on. And while C is happily feeding her babe to sleep, she’s recommending me to friends who need a sleep coach. She understands that every baby is different, every family is different. As mothers, we have to support each other and respect that each of us is doing our best and what we truly believe to be best for our children – it’s the one and only thing parents have in common.