Swaddling and SIDS

As if parents don’t have enough to worry about these days: Now they are worried about swaddling and SIDS. I am sure that parents all across the world saw the news come across their Facebook feed and were sent into a panic.

Does swaddling your baby increase the rate of Sudden Infant Death Syndrome? You would think so, to read media accounts of a paper published recently in the journal Pediatrics. Here’s a link, and the reference for those who want to read it.

Pease AS, Fleming PJ, Hauck FR, et al. Swaddling and the Risk of Sudden Infant Death Syndrome: A Meta-analysis. Pediatrics. 2016;137(6):e20153275

Here are some headlines from some of our most respected media outlets. Almost all of them misunderstood the paper’s findings:

New York Times: “Swaddling May Increase the Risk of SIDS”

Washington Post: “Swaddling babies is tied to heightened risk of sudden infant death syndrome”

Yahoo! News: “New Research Suggests Swaddling Could Increase Risk Of SIDS”

Thank God for the Atlantic Monthly and to science writer Adrienne LaFrance.  LaFrance is the only medical and science writer I’ve read so far who detected the flaws in the paper. Here’s the headline:

“About That Scary Swaddling Study: A new meta-analysis seems to link infant swaddling with a higher risk of SIDS. But there’s more to the data than that”

Indeed there is more to the story. Let’s get to the bottom of that study on swaddling and SIDS.

Why Even Study Swaddling and SIDS?

In the early 2000s, there was just as much uncertainty as there is today about the causes of SIDS.  The famous Back-to-Sleep campaign in the US was already succeeding in dropping SIDS rates. Our success was similar to results seen in other countries.  Researchers were stumped. Was it really as simple as all that? How could a silly little change like having the baby sleep on her back reduce the risk of SIDS? Many studies were performed looking at body functions like heart rate and breathing in babies. It was known that swaddled babies were generally calmer and less sensitive to waking up suddenly. The question was asked whether being quiet and less sensitive put a baby at risk for SIDS.

A Look at the Studies

Many studies were done, but most of them were lousy. Pease, et al., who wrote the paper that got all the headlines, decided to perform a “meta-analysis” of all the studies they could find on the subject of swaddling and SIDS. A meta-analysis is considered to be the highest form of scientific study. It looks at all scientific studies of a particular question and sort of pools the results. The idea is that many different groups looking at the same problem collectively get to the truth better than any one study does. It’s never a good idea to rely on only one study to answer a question. The more investigators who come up with the same result, the closer to the truth you are probably getting.swaddling and sids 3

They looked at a lot of studies. Since the 1950’s there have been almost 400 studies asking the question: Is there a link between swaddling and SIDS? Of these studies, Dr. Pease and her colleagues could find only 4 that met a standard rigorous to be considered worthy. And one of these had never been published the data on swaddling. When they were done with their analysis the investigators discovered that they could not easily compare the results of all four studies. So to present their final results they needed to eliminate one study, leaving them with three. Out of 400.

What Did They Find?

After pooling all these data, the investigators found that swaddling increased the risk of SIDS very slightly if the baby was put down on her stomach or side. In other words, it was riskier to violate the “back-to-sleep” rule. It was also riskier to swaddle a baby older than 6 months of age. The most confusing part of the study showed that there was a slightly increased risk to swaddling if you lay the baby on her back. It’s confusing because even so, many more SIDS deaths occurred in un-swaddled babies than in swaddled babies. The so-called “increased risk” was only compared to the comparison (“control”) group.

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More Problems

There were other problems with the meta-analysis. The investigators could not be sure that all the studies used the same definition of “swaddling”. Swaddling means different things in different places. Some of the studies lumped together swaddled and “wrapped” babies. It isn’t entirely clear what was being compared. Perhaps more damaging, the pooled studies were so different from one another that it was impossible to eliminate all the features that could confound the results. In other words, they couldn’t really be sure that swaddling was the thing that increased the risk of SIDS!swaddling and sids 2

The Bottom Line on Swaddling and SIDS

  • It’s okay to swaddle, but if you do, lay the baby on her back. Swaddling is only risky if the baby is face down or on her side.
  • Older babies probably shouldn’t be swaddled, but that’s okay, since it’s really difficult to swaddle a six-month old baby anyway. They fight out of the swaddle too easily.
  • Learn to swaddle a baby correctly. There are lots of terrific videos on YouTube that show you how. Here’s one:

Guest Post: Pam Edwards – How the Wonder Weeks Affect Sleep

Today we feature a guest post from sleep consultant Pam Edwards. Pam is a Certified Infant & Child Sleep Consultant and founder of Wee Bee Dreaming Pediatric Sleep Consulting in Grande Prairie, Alberta. Healthy sleep is addicting and she has made it her life mission to help families all across the world get the sleep they deserve – a good night’s sleep doesn’t have to be a dream!

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Have you guys heard of the ‘Wonder Weeks’? The Wonder Weeks is a book that was written by two doctors and describes ten developmental growth spurts that baby goes through in her first 82 weeks of life. These developmental growth spurts aren’t the same as the physical growth spurts, although they do occasionally overlap. During these developmental growth spurts, or ‘Wonder Weeks’, baby is putting so much effort into learning new skills that she begins to act out of sorts (what they describe as the 3 C’s – clingy, crying, and cranky). Not surprisingly, and what I want to talk to you about, is that these Wonder Weeks can affect baby’s sleep. Read on for a description of the different Wonder Weeks and how they can throw a wrench in your baby’s sleep schedule.

 

Wonder Week 5 – The World of Changing Sensations

Previous to this leap, your baby’s perspective of the outside world is soft and undefined – in other words, it hasn’t changed much in his mind from life in the womb. Suddenly, he is able to make more sense of this new world, and this is very overwhelming to him.
How does this affect sleep? This is the age where the evening fussy period begins to develop. A big cause of this evening fussy time is overstimulation from the day, and over-tiredness. The evening is often the busiest time of the day in a family’s household – dinner is being prepared, older kids have activities and need to do their homework, mom or dad is just coming home from work. That means that sometimes baby can be kept up awake much longer than he should be (remember, at this age it shouldn’t be any more than 1 hour max). To help combat this fussy time, make sure baby is still soothed to sleep every hour, even during this busy time. Try to keep the house as calm and relaxed as possible, to make the transition from day to night easier on baby.

Wonder Week 8 – The World of Patterns

Babies at this age are now experiencing the world in a whole new way. They start to recognize simple patterns (not just visually, but things like ‘I have 2 hands!’ or ‘I can move my leg like this!’) Baby starts to be able to focus on things for longer periods of time, and becomes more curious about the world around her.
How does this affect sleep? This increasing alertness makes it all the more important that baby’s environment is conducive to sleep. If her sleeping area is too bright, she may have trouble shutting off her brain. If it’s too loud and chaotic, she may have a hard time powering down for sleep. Ideally, baby’s bedroom should be pitch black, and playing white noise can help reduce stress and help baby sleep better.

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Wonder Week 12 – The World of Smooth Transitions

One of the big physical milestones that baby will have hit around the 8 week mark is the ability to bat at and kick objects with her arms and legs. These movements were often very jerky and clumsy – which is normal for a baby who is just learning how these limbs work! But approaching Wonder Week 12, baby’s movements become smoother, more precise. As well, baby is also starting to perceive more changes in the world around him – how moms voice goes higher when she’s singing a song, how the room becomes dim when the sun goes behind the clouds, how the dog always barks when the doorbell rings. The world is becoming a more organized place to baby!
How does this affect sleep? Around this age, as baby becomes stronger, he may start to break out of his swaddle. Many parents take this as a sign that baby no longer wants to be swaddled, but at this age most babies still do have at least a touch of the startle reflex and thus swaddling is still necessary. Oftentimes, we need to switch up our swaddling technique so that baby isn’t able to break-free. Check out this video below for the most amazing swaddling technique out there (and trust me, my baby was a Houdini and I tried everything!)

Wonder Week 19 – The World of Events

As adults, there are a lot of things that our brain does that we just don’t think about, such as our ability to predict the outcomes of certain events. For example, we know that when someone jumps in the air, they will come down. This is what baby’s brain is working on during this Wonder Week – learning very simple sequences of events (I drop my toy, mom picks it up, I drop it again, mom picks it up again – fun!)
How does this affect sleep? Now that baby is able to (somewhat) predict what will happen next in certain circumstances, having consistent routines becomes even more important. Babies do not like surprises, they thrive on routine and predictability. Your baby is now able to understand that a warm bath means it’s bedtime soon, or that when mom sings ‘Twinkle Twinkle’ it means it’s nap time. Click here for ideas on how to begin a flexible routine with baby. Wonder Week 19 also coincides with the ‘4 month sleep regression‘. Read up here to prepare yourself for this change in your baby’s life.

Wonder Week 26 – The World of Relationships

Babies at this age start to be able to perceive distance between objects (or between people). To baby, the world is now a very big place and he is so very tiny. Things he wants are out of reach, and when mom leaves the room, there is no way to get her back! Therefore, babies at this age begin practicing ways of getting to these things that they want – by crawling, scooting, or rolling!
How does this affect sleep? As you can imagine, this new-found realization of how big the world is can bring with it some anxiety. Unless you are co-sleeping with baby, sleep times are a time of separation, and baby may begin to fight them! Help baby to realize that just because you’re not right there beside her, doesn’t mean you are gone forever. Play peekaboo, or practice leaving the room for short periods of time and then returning with a big smile on your face. Soon she will realize that you are still there for her even if you’re not next to her 24/7.wonder weeks 2

Wonder Week 37 – The World of Categories

Babies at this age love to start experimenting. They like to see the way food feels when you squish it, but that’s it’s different from the way yogurt feels. He is now able to group people, objects, animals, sensations into categories.
How does this affect sleep? Baby may start to experiment in other ways, perhaps in how acting a certain way affects the way his parents react. When I wake up throughout the night, how do my parents react? Does my mom rush in with a bottle or a boob and help me back to sleep? Or does my crying at night not serve much purpose, perhaps mom pops her head in to say ‘it’s okay, go back to sleep’. Baby may start to test these limits to see what will happen, and if baby gets what he wants, then these tests not become new habits (or if baby has always awoken many times at night, these habits continue or become worse). Obviously there are times when baby’s cries can signal a need vs. a want, but if these cries are occurring 8 times a night every single night, then it is no longer something a baby at this age needs.

Wonder Week 46 – The World of Sequences

During this Wonder Week, baby is now learning that there is an order to things in life. There is a certain pattern of events that needs to occur before he is successful at something (big block goes on the bottom, then the smaller one goes next, then the smaller one goes after).
How does this affect sleep? While some parents may have become more relaxed with baby’s routine, it is still so important at this age. If nothing else, make sure you continue a consistent bedtime routine with your child. Repetition and structure help children feel safe. Bedtime declares that the day is over. When you are loving and firm about when it is time for bed, you are building your children’s confidence in their world. Repetition for young children is comforting — ever wonder why they want the same story over and over? The repetition of the getting ready for bed routine (getting into pajamas, brushing teeth, a drink of water, a story, a hug, goodnight) lets your child know what to expect and helps him or her feel secure.

Wonder Week 55 – The World of Programswonder weeks 3

This Wonder Week begins your baby’s journey into toddlerhood. He has made so many big discoveries in the past year but he still has so much to learn about the world around him. This Wonder Week brings with it the understanding that there are multiple means to an end (in other words, different sequences can accomplish the same thing).
How does this affect sleep? Lots going on around this time! Many babies may just be learning to walk, weaning from breastfeeding may occur around this time and a lot of moms (or dads!) may be returning to work. Not coincidentally, this is also the age where separation anxiety is at its peak, and it can most certainly affect sleep. So what can we do to ease the anxiety that your toddler may be feeling during this time (keep in mind too that separation anxiety can hit at any time throughout baby’s life and often seemingly comes out of nowhere):

I know you’re tired of me saying it but…consistent and soothing nap and bedtime routines are increasingly important during the throws of separation anxiety.
Check yourself. Your baby can feed off of your emotions and if you’re anxious, tense, upset, or worried, then chances are your child will feel those emotions right along with you. When you’re putting baby down for sleep, be relaxed and confident, and it will help your toddler feel that way as well.
Help him feel better about good-bye. Sneaking away is one of the worst things you can do and will only compound your child’s feelings of anxiety. The last thing you want an anxious child to think is that by letting you out of their sight, you’re gone forever (well, it feels like forever to them!) Say a loving, confident, firm good-bye and let your child see you leave. He will learn that when you say good-bye, it still means you’ll come back.
Comfort your child but don’t create new (and bad!) habits. If your child is fitfully protesting at naptime, or waking throughout the night in tears, then you should absolutely comfort them. Your child’s psychological needs must be met as well! But keep these interactions short and sweet – this is not the time to sing songs, read books, turn on a TV show, bring baby into bed with you, or lay on the floor in baby’s room (guilty of this one!) New habits are created at lightning speed, so even after the separation anxiety is gone, the new habit is here to stay.

Wonder Week 64 – The World of Principles

Your toddler is now starting to think about different ways to accomplish his goals, and what the consequences of his decisions are. He may start to imitate others or role play his daily life. He may begin nagging/whining to get his way, or showing signs of aggressive behavior, and he is starting to figure out how to get someone to do something for him.
How does this affect sleep? When it comes to sleep at this age, you need to start thinking of your ‘baby’ as a toddler. Sleep issues at this age are not usually sleep-related, and are now discipline-related. A child this age is learning how to get his way, and what actions get him those things (crying at bedtime means I get to stay up later, crying throughout the night means I get mom’s attention, crying during nap time means I don’t have to nap!) Breaking the cycle of positively reinforcing negative behavior is key. Children learn from repetition, therefore just as soon as he can figure out that his negative behavior elicits a positive reinforcement, he can learn that his negative behavior does not elicit a positive reinforcement.

Wonder Weeks 75 – The World of Systems

During this final mental leap (which occurs around 17 months), your child is now able to perceive ‘systems’ (meaning your family is different from a friend’s family, etc.) He is also now understanding that he can choose how he wants to act; helpful, patient, careful, etc. His little conscience has begun to develop!
How does this affect sleep? We discussed limit testing during Wonder Week 37 but this Wonder Week is where it really comes into play. As written in the Wonder Weeks book, “You can’t spoil babies, but you can toddlers! By understanding what is happening inside that little head of your newly formed toddler – and remember, they are pretty savvy – you can shape the future behavior of your toddler and set values and norms that will carry him through life.” This can be applied to our child’s sleep as well – whatever he has come to expect with sleep times at this age will shape how he feels about sleep for the rest of his life. While setting limits is hard (nobody likes to see their child upset!) it is an absolutely essential part of parenting. The first limits that a child can test are those that come to sleep (and unfortunately, these are the limits that parents are often the most lax with!)

7 Things Your Baby Will Need to Come Home With

We’ve talked about things you’ll need to bring to the hospital with you when you have a baby. Here we discuss things your baby will need when she comes home.  I’m sticking to what I consider the bare essentials, because the truth is the baby doesn’t need very much besides you!

A car seat

Most “things your baby will need” lists leave the car seat off altogether. That’s a mistake.  If you’re having the baby in a hospital, you have to bring in an approved, rear-facing car seat or they won’t let you take the baby home!  I recommend the kind that has a base that remains attached to the back seat of the car.  Trust me, you’ll use many fewer swear words installing it if you do!

Diapers

Lots of them. But don’t go crazy.  She won’t be in newborn size for very long: A couple weeks at the most. You could go through about 50 of these per week, especially in the first week, especially while you’re trying to figure out how to put them on (though they’re “self-contained and fairly explanatory“)

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Baby clothes

things your baby will needDon’t go crazy on these either. She’ll need about 8 shirts and bottoms to go with it. It’s just that, well you know, newborns get their clothes dirty a lot, so these are more things your baby will need!  I say “bottoms” instead of “pants”, because though your baby probably has legs, she won’t be using them to get around with for a while. So it doesn’t make a lot of sense for you to stress about getting a newborn’s leg into a pant.  First time you try it you’ll see what I mean. You’ll want to wash her clothes in something gentle.  I like Dreft.

Avoid things with snaps. Why do so many baby outfits have so many snaps? There is no possible way to snap them up correctly when there are as few as three snaps: why do outfits have to have 15 snaps?

Avoid sleep wear that has textured bottoms on the feet. They’re just silly. YOUR BABY CAN’T FREAKING WALK YET!!!

A bassinet or “Moses Basket”

Since this blog is focused on baby sleep, you’d think I’d put this first. But the truth is your baby will fall asleep in the car seat before she ever sees her bassinet.things your baby will need

I prefer bassinets to co-sleepers. They’re much less hassle and just as easy to transfer the baby to. I definitely prefer the bassinet to her sleeping in bed with you (a topic for another post)!

Things your baby will need: a sleep sack!

For sleep these are the best.  The kinds with velcro, as shown here, double as swaddlers as well as sleep wear!  Remember the baby has legs and feet but she really just does not have to use them for a couple months. Rather than repeat my pet peeve about snaps, here’s a good word for the zipper: Zippers are great. Zippers are awesome. Zippers are way better than buttons, which are almost as bad as snaps.things your baby will need

Avoid sleep wear that has textured bottoms on the feet. They’re just silly. YOUR BABY CAN’T FREAKING WALK YET!!!

Sleep sacks are warm, they’re comfortable, and they’re effortless to put on. When you’re exhausted you’ll appreciate them so much more.

A baby bath

Pro Tip: when you bathe a boy, you’ll need to place a wash cloth over his “nether regions”. Think about it…

Now, truthfully this isn’t something your baby will need, necessarily.  It’s perfectly okay to bathe the baby in the sink. It’s just sloppy.  There’s all that splashing. And some sinks just can’t accommodate a baby and water and your hands.things your baby will need

To go along with the bath she’ll need her own wash cloths. Pro Tip: when you bathe a boy, you’ll need to place a wash cloth over his “nether regions”. Think about it for about 10 seconds and you’ll figure it out if you haven’t already. To bathe, you’ll need only Johnson’s Baby Shampoo.  This stuff is the best.  You can wash baby’s hair and body, and if you get it her eyes it doesn’t sting! It’s like a miracle substance! I bathed both my boys exclusively in Johnson’s Baby Shampoo for the first two years of their respective lives.

A breast pump

things your baby will need
this is not a breast pump

This one is obviously for your breast feeding moms. If you plan to breastfeed exclusively, this isn’t necessarily one of the things your baby will need when she comes home from the hospital. But it’s a good thing to have for a couple reasons: If, like a lot of new moms, you get breast engorgement in the first few days after birth, this device can be a life-saver. Sure, you can manually express breast milk, but I find that the devices do a better job.  You don’t have to spend a lot of money on the electric types with all the fancy bells and whistles. A simple, mechanical pump will do nicely. Also, if you will be storing milk for whatever reason, you’ll need 4-ounce bottles and nipples to go with the pump. Breast milk freezes great. You can store frozen breast milk for up to 9 months.

 

Getting Baby to Sleep: A Case Study

The following is the story of a couple that sought my advice to help get their baby to sleep. I’ve changed all information that might identify them in order to preserve their privacy.

Baby Name: Darcy, age 4 months, is the healthy baby girl, product of an uncomplicated pregnancy, labor, and delivery. Darcy has been exclusively breast fed since birth

Mother: Melanie, 26 years old married, first child, living in Framingham MA.  Married three years to Jim.

Melanie is a graphic designer who runs her own business.  Jim is an attorney at his first job post-law school. Melanie would like to return to working but is not taking new clients until Darcy will be at least a year old. Then her mother (Darcy’s grandmother) will assist with child care during the day.

The problem

Melanie and Jim cannot sleep.  The sleep deprivation is creating an enormous amount of stress for Melanie, for Jim and for their marriage. They fear it’s negatively affecting their daughter and her relationship with them. They are worrying now that they are not enjoying parenthood as much as they were. Melanie describes feeling “like she’s at the end of her rope”.

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They are begging for some help getting the baby to sleep long enough for the parents to get some sleep themselves and regain their sanity.

Melanie and Jim filled out an Intake Form and made some guesses as to what they chose as their SMART goals. They scheduled a consult with me. I spoke with

baby to sleep
Sleep. Something Melanie and Jim were not getting

both parents together.

After explaining again the stresses, physical, emotional that they were feeling, I asked Melanie to walk me through a typical day for Darcy.

We talked about her feeding schedule, how often and for how long. The baby had just been to the pediatrician to be weighed, so we knew that Melanie’s milk supply was adequate. The baby was peeing and pooping normally.

baby to sleep
Darcy nursed a LOT

She was feeding on demand, but Darcy “fed like clockwork” every two hours, including at night. Lately she’d been waking up every 90 minutes at night, adding further stress.

I asked Melanie specific questions about how she fed Darcy before bed and naps. Melanie told me that Darcy would fall asleep at the breast. Always. Melanie would then put Darcy’s pacifier in her mouth, swaddle her, and put her down in her crib.

Darcy would sleep well as long as she had the pacifier in her mouth. Sometimes it would fall out and she would stay asleep. But lately she would root and “look” for her pacifier, rouse herself and cry, about 90 minutes after falling asleep.

I wondered aloud if part of the problem might be that Darcy’s falling asleep at the breast was causing her to associate sleep with breastfeeding. In other words, maybe nursing was becoming a sleep association.

baby to sleep
A cat nap before heading back inside

Getting Baby to Sleep

Darcy was four months old now, and she was a normal thriving full-term baby, so I felt it was possible that she was now able to develop her own internal self-soothing mechanisms. I speculated that Darcy might be developing a more mature sleep-wake cycle. I explained that this would mean that Darcy was now cycling between deep and shallow sleep. When she would arrive at the shallow stage, she would arouse briefly, look around for the breast or the pacifier, not find it, and become distressed and cry. It could be the case, I explained, that if Melanie and Darcy could make some space between breastfeeding and falling asleep. For the baby to sleep, she would have to develop her own abilities to self-settle.

Melanie, Jim, and I began to develop a sleep plan. They both felt that if bad sleep associations were interfering with Darcy’s ability to stay asleep, then they would be willing to tolerate a bit of crying on Darcy’s part if it meant she’d be able to fall asleep on her own.

We developed a schedule based on the schedule Melanie was already following. The only difference was that Melanie would try to keep Darcy awake through the end of the feed, first for a minute, then gradually up to ten minutes before putting her down. We would do this over 5 days.

We discussed ways to keep Darcy more stimulated so that she wouldn’t sleep while feeding. We talked about keeping her baby clothes open so that the baby could feel some cooler air on her skin. Or Melanie could play with Darcy’s feet or blow gently on her face.

Then Melanie would swaddle Darcy and place her, awake, in her crib, stroke her a few times, and leave the room.

Based on this plan, Melanie and Jim wrote up a SMART goal for Darcy. She would sleep four hours straight at night, and she would accomplish this goal in seven days.baby to sleep

We also decided that we would try to go without the pacifier, as this might also become a sleep association for Darcy.

We followed up by email and phone several time over the next few days. The first two days were rough, according to Melanie.  Darcy would cry and fight her way out of the swaddling blanket. Melanie confessed she’d put the pacifier in and Darcy would fall back asleep.

The good news was that Darcy was indeed settling herself to sleep.  It turned out that she would cry for about 3-4 minutes after being put down, but she’d fall asleep.

baby to sleep
Blessed relief

Then at day four the magic happened.

At 7 PM Melanie nursed Darcy, put her down in the crib awake, and left the room.  Darcy fussed for a few minutes and settled.  On the baby monitor, Melanie could see Darcy sleeping quietly.

And she stayed asleep until 11 PM.

She started to stir. Melanie took her out, changed her and breast fed her again for 10 minutes.  She struggled to keep Darcy awake because the baby was so sleepy. She isn’t sure Darcy was awake when she put her down. But the baby slept again until 3 AM.

Two four-hour stretches in one night!

Over the next few weeks, Melanie worked on making sure that she put the baby to sleep surrounded by all the things that would be there when she had her periodic brief awakenings every 1 ½ – 2 hours. Darcy was developing good sleep associations.

baby to sleep
Almost normal

By five months she was sleeping from 11 PM to 5 AM, a six-hour stretch.  Se was feeding more often during the day to compensate, but Melanie did not care: she was ecstatic because everybody, baby and parents, were sleeping better at night. Melanie said she was starting to feel “almost normal again”.

Now that they were both better rested, Melanie and Jim told me that they really felt good again about being parents. The admitted that they had feared they’d turn out to be terrible parents and they’d hate the whole experience. Now they were both feeling confident and competent to handle anything that parenthood might throw their way.

Melanie and Jim were able to restore their sanity and begin to enjoy being parents because I helped them drill down into what Darcy’s real sleep problem was: she had begun to associate being at the breast with falling asleep. Together we worked out a plan to dis-associate nursing and sleeping, and it worked!

This all occurred a few years ago. Melanie and Jim had a second baby, another girl. This second baby had no sleep problems at all. Melanie stayed wary of negative sleep associations and made sure #2 daughter didn’t develop any.

baby to sleep
Happy ending

They referred Melanie’s sister to me when Darcy’s aunt was having trouble getting her baby to sleep. And Jim told a few associates at his firm about me and I ended up being the unofficial “sleep consultant to [Jim’s Firm]”