Dr Alison Mooney MBBS FRACGP DCH Clin Dip Pall Med
Having a new baby is an extraordinary time of life. While we spend time preparing for the birth itself, there is often less thought put into what happens when the baby comes home! You may find that in the midst of delighting over your baby there are many challenges to face. Excessive crying, lack of sleep, feeding problems, feelings of isolation….no one tells you it’s so tough! They also say ‘it takes a village to raise a child’ but many struggle for support, especially in recent times when we may unfortunately be separated from our loved ones.
‘Are they a good baby?’
A question new parents will be asked on a daily basis! Our society has adapted to the conclusion that a ‘good’ baby is one that sleeps through the night. This can put a lot of pressure on families when faced with sleep issues such as catnapping, frequent night waking and taking a long time to go back to sleep. It is only natural for them to think that either something is wrong with their baby or that they are terrible parents! In fact, it is perfectly normal and natural for a baby to wake every 2-3 hours until they are approximately 12 months old. Most breastfed babies will need to feed 8-12 hours in a 24-hour period (you do the math!) to maintain their mother’s milk supply and formula fed babies will also wake. They may be searching for more than simply nutrition. However, it is now understood that different babies have different sleep needs. Some will need 9 hours sleep out of every 24 hours while at the other end of the spectrum some will need 18! Within this range all babies are developmentally normal but clearly when you have a low sleep needs baby the nights can become challenging.
All too often parents are put under pressure to ‘sleep train’ their babies at a young age. There is endless, well-intended but conflicting advice which can be overwhelming at such a vulnerable time in our lives. Common approaches tend to involve steps such as putting your baby down at first tired signs, not feeding to sleep, using feed-play-sleep cycles, ‘teaching’ your baby to self-settle and avoiding over-stimulation. Day to day life quickly starts to revolve around a strict routine we are told fits the age of our baby. You may have also heard that it is possible to ‘spoil’ your baby if you respond too quickly. The best research has shown that these behavioural, routine-based approaches from the 1950’s and 60’s do not actually help families in the first year of life. Parents may also find ‘cry it out’ methods highly distressing.
But what if there was another way? A way that invited you to rely on your intuition and trust your baby’s cues? A way that allowed you to parent with your baby’s biology rather than against it?
The Possums Approach
There is now an alternative, evidence-based approach to try and improve night sleep for you and your baby. This approach may actually seem to be the opposite of traditional methods! Rest assured that it is based on over 20 years of medical research and is known as the Possums Program or Neuroprotective Developmental Care (NDC). Studies confirm it provides the best possible start for your baby’s developing brain and gut while strongly promoting healthy emotional attachment. This method is also highly beneficial for parental mental health due to increased sleep and the ability to focus on enjoyable day to day activities with your baby while making the nights as easy as possible. The Possums approach can also assist with unsettled infant behaviour, breast/bottle feeding problems and the emotional well-being of caregivers.
The Circadian Clock
Put simply, we cannot teach a baby to sleep. The Possums approach focusses on two main areas to try and align your baby’s night sleep with your own sleep needs. Firstly, your baby may need some help figuring out day from night which we know as resetting their circadian clock. It can take up to two weeks for this adjustment (similar to recovering from jet lag) and for them to realise that days are for living. We invite you to trust your baby to take the sleep they need, when and where they need it. This can be in the same bright room as you at home or on the go-in the carrier while you cook dinner, in the pram while you enjoy a walk with a friend or in the car when you pick up their sibling from school. In fact, a rich and changing sensory environment is encouraged to nourish your baby as in this approach there is no such thing as overstimulation. Have you ever noticed that a crying baby may magically stop when they are taken outside? Babies are often bored!
The second strategy is to work on building your baby’s sleepiness, otherwise known as sleep pressure. Only taking the sleep they actually need in the day is enough to take the edge off their sleepiness rather than put it back to zero. Sleep pressure then continues to build, reaching a peak at bedtime so they are easy to put down and more likely to take a large block of sleep (which means more sleep for you!) Studies have shown that breast-feeding pairs actually get more sleep than formula fed babies. This may be due to the fact that the hormones that mother and baby receive during a feed promote sleep and usually both go back to sleep quickly. If a baby is waking every 2-3 hours overnight, issues only arise if the baby or parents are struggling to return to sleep.
As parents, you are best placed to know your own unique beautiful baby. Many of you will have tried the traditional approaches and maybe they haven’t worked, they are not in line with your parenting values or they have made life harder. The Possums approach can help by offering alternative strategies that are simple, flexible and easy to understand. You are in charge and I encourage you to experiment with different approaches to find out what works best for you and your family.
Originally from Scotland, Alison achieved her Medical degree at the University of Newcastle upon Tyne in 2008 and has lived and worked on the Central Coast since 2010. She is currently working part time as a GP with special interests in women and child health. Following several years of fertility problems and IVF treatment, Alison and her husband are now delighted to have two very energetic boys! Alison has recently undertaken further rigorous training and is proud to be the first NDC accredited practitioner on the Central Coast and is thrilled to share her knowledge with families in her new service, The Moon Clinic.