Ready to Land? Handling Baby Jet Lag

Ready for Baby Jet Lag? - Dietitianmom.com

Ready for Baby Jet Lag? – Dietitianmom.com

This summer I traveled back from Asia with my husband. Like the other trips, this involved a long total flight time of about 16 hours with an additional 2 hour layover in Japan. This time though, I traveled with two children, one being just four months, and the other being three and a half years old. That was a challenge in itself, but I was preparing myself for the bigger challenge: that of adjusting my four month old to the time zone changes, and readjusting my infant’s bio-clock. In a previous post, I had described the excruciating process (involving nearly 2 weeks) of converting my oldest daughter (then 4 months of age) to Eastern Standard Time (EST) after we returned from Singapore in 2013. What my husband and I ended up doing was to move our child’s bedtime half an hour to one hour later every night, so that her long stretch of night-time sleep could be preserved each night. Eventually after about 12 days we got her bedtime to where we wanted it (see post Baby Jet Lag…It’s Real). However this method meant that we as an entire family had to follow her schedule, down to eating our meals at night and having black out curtains.

This time, traveling back with our second daughter to the western hemisphere, I was open to trying a different method. The baby would be sleeping in a crib in the master bedroom and the idea of the whole family following our infant’s pace of time adjustment just didn’t seem feible with a toddler. The toddler would be used to playing in daylight hours, so would be very noisy and may interrupt the baby’s sleep during daytime. It is also likely that the toddler won’t be able to sleep with a baby crying several times at night. So I decided to try a different method: going cold turkey.

So what happened? The first day we arrived home, as our baby ended up staying awake most of the daytime hours. Then that first night she woke up at least 4-5 times at night, about once an hour. Each time she started to cry I had to quickly scoop her up out of the crib and then shush her by feeding her, as I was afraid to wake up my toddler. She would feed a little bit each time and then go back to sleep. In the end I put her in the same bed as me, as it was easier to breastfeed that way since I felt so exhausted from the day’s traveling. In the morning the baby passed some gas so I suspected she was waking up and crying at night more from gas in her tummy, and was really feeding more for comfort since she didn’t feed for long each time she woke up.

The second night she woke up about 3 times. Once it was about an hour after she had slept and seemed to be more from gas or an unresolved burp. I was able to quickly pat her back to sleep. Then she woke up again about 2 hours later. This time I made sure she drank at least 10 minutes on both sides in the breastfeeding session before putting her down, in the hopes that this would settle her the rest of the night. However, I really felt I needed a place to put baby without having to worry about the baby’s crying waking up our toddler. I ended up using a spare room that was away from our toddler’s room and putting an infant bath tub with a pillow for the ‘mattress’ cushion at the bottom. When the baby then woke up a few hours later, I was able to then scoop her up quickly and take her to this other room. I could then close the door. Even though I still fed her via my breast, I noticed she didn’t seem as hungry. The spare room (in this case we used a storeroom) provided some insulation of her crying from our toddler and other neighbors in the surrounding apartments.

The 3rd night, baby woke up about 2 times. The moment the baby awoke and started crying, I took her to the spare room. There I breastfed her only 5 minutes on each side as I wanted to slowly wean her off of being fed breastmilk at night. This seemed to satisfy baby and baby went back to sleep for 3 more hours.

The fourth night was when I went cold turkey. I decided she needed to cut out feeding altogether. I made sure I fed her a lot during the day (about every 2 hours and offered both breasts each session). The baby ended up sleeping quite well, though she did wake up with brief crying spells twice in the night. When she did wake up, I put her in the bed in the storeroom, and closed the door. She cried about 10 minutes the first time and then went back to sleep. Then she awoke briefly an hour later but was able to put herself back to sleep with only a few cries before waking up another hour later this time wide awake and hungry. So by the 4th night, our infant managed to sleep a 7 hour stretch relatively well, and was able to put herself back to sleep without much intervention on my part. In the end our infant got over her jet lag in just 4-5 nights…truly a miracle! The dark storeroom and the white background noise I created likely also helped.

The rest of the family survived relatively unscathed. My eldest daughter managed to get over her jet lag within 3 days. This involved some intentional steps of not allowing her to have an afternoon nap or a minimal one at best, lots of physical activity and waking her up in the mornings at the desired time. I think she would have gotten over it faster if her sister didn’t wake up wailing at certain times in the night the first few nights causing her to wake up and then have difficulty falling back asleep. My husband had broken sleep the first few nights but was able to sleep well by the 4th night, and quickly resumed his working during the daytime. As for me, I ended up just having a few sleepless nights!

I am writing this post to share my experience. Of course every baby is different and the age of the baby as well as the traveling circumstances (e.g., how long the flights are and the duration of travel) will also affect how quickly he/she gets over jet lag. Hopefully as you travel during this winter season, your baby will be able to adjust smoothly to each location and time change! Merry Christmas!

Qn of the Month: What Are The New Sleep Guidelines for Children?

A: In June 2016, the American Academy of Sleep Medicine released new guidelines to guide parents and health care professionals on the recommended amount of sleep that infants, children and teenagers need to receive for optimal health. This came after a 10 month process of an extensive scientific literature review, and multiple rounds of voting amongst a Pediatric Consensus Panel of 13 experts. The findings from the literature research found that those who followed the recommended daily sleep hours regularly tended to have overall better health outcomes such as improved attention spans, as well as better behavior, learning, memory, emotional regulation, quality of life, and mental and physical health. However, sleeping more or less than the recommended hours on a regular basis tended to be associated with adverse health consequences.

Supported by the American Academy of Pediatrics, here are the recommended sleep hours by age in the consensus statement:

  • Infants four to 12 months should sleep 12 to 16 hours per 24 hours (including naps) on a regular basis to promote optimal health.
  • Children one to two years of age should sleep 11 to 14 hours per 24 hours (including naps) on a regular basis to promote optimal health.
  • Children three to five years of age should sleep 10 to 13 hours per 24 hours (including naps) on a regular basis to promote optimal health.
  • Children six to 12 years of age should sleep nine to 12 hours per 24 hours on a regular basis to promote optimal health.
  • Teenagers 13 to 18 years of age should sleep eight to 10 hours per 24 hours on a regular basis to promote optimal health.

According to the experts, besides having enough total hours of sleep regularly, reaping the benefits of healthy sleep also require having appropriate timing, daily regularity, good sleep quality and the absence of sleep disorders.

(Sources:

  1. Recharge With Sleep: Pediatric Sleep Recommendations Promoting Optimal Health. American Academy of Sleep Medicine. http://www.aasmnet.org/articles.aspx?id=6326. June 13, 2016. Accessed September 30, 2016.
  1. HealthDay. “How much sleep children need by age.” Chicago Tribune. June 13, 2016. http://www.chicagotribune.com/lifestyles/health/ct-child-sleep-recommendations-health-0613-20160613-story.html. Accessed September 30, 2016.)

Saying Goodbye to that Last Overnight Diaper (Part 3) – The Experience

Having described my background fears and the process of weaning off that last nighttime diaper (see previous posts 1 and 2 in this series), what was my experience? Not knowing what would happen, I decided to try just one potty waking at night first, before adding in a second one. The initial goal I had was really just to get her used to getting up 1-2 times at night to pee and then to learn to put herself back to sleep. It was not so much to achieve a dry diaper every night. Here’s my experience:

First Potty Waking (each night I put my toddler to bed before 9pm):
Night 1
I went in about 6 hours after her bedtime. This was too late as her diaper was already wet. I woke her up gently, but she told me she didn’t need to go. I still carried her and put her on the potty briefly.

Night 2
I went in 3 ½ hours after she was put to bed, and found her diaper already a little bit wet. She let me pull her pants and diaper down, but I had to carry her to the potty. Once there though, she sat down and automatically took a piece of toilet paper and wiped herself. I asked her in a whisper, “Did you go?” (as I didn’t hear anything). She whispered back,” Yes.” Then she let me pull her pants/diaper back up and walk her back to bed. I gave her a kiss and left the room quickly!

Night 3
I went into her room at about 2 ¾ hours after she was put to bed. Her diaper was already wet and she didn’t have anything on the potty.

Night 4 & 5
I went in each of these nights at 2 ½ hours after her bedtime and found her diaper still dry! Each time I carried her to the potty (after pulling her pants/diaper down), helped her pee, and then helped her back to bed. She almost immediately went back to sleep!

After a few successful nights of waking her up at night about 1.5- 2.5 hours after her final potty break before bed, I decided to add in a 2nd potty waking. Here is what happened the first few nights:

Second Potty Waking
Night 1
I tried the first night to go in about 5 hours after the 1st potty waking. Her diaper was still dry! So I quickly pulled down her diaper and pants and carried her to the potty. She went, but I had to help her pull up her pants and get her back to bed. The next morning though, she had a REALLY hard time getting up (even though she awoke at a usual time), and didn’t want to get out of bed though she was awake, saying she was tired… Her diaper was still dry in the morning, and she didn’t feel the need to go to the potty until much later after she woke up!

Night 2
I went in again about 4-5 hours after the 1st potty waking, but I made the mistake of not taking away her security pillow from her hand, before waking her up and pulling the diaper/pants down. So when I carried her to the potty, she yelped as she was afraid her security pillow would get wet! Although I quickly took the pillow away, she had woken up a bit more by this point. So after I got her back to bed (after having her pull up her own diaper and pants), she didn’t want me to leave the room. I told her I would stay with her for ‘2 minutes’ and did this, and then she let me leave the room. The next morning, she was again didn’t want to leave her bed and lay in it for half an hour more, despite having woken up already!

Night 3
I went in for the first potty waking and while she went on the potty, I could tell she was EXTREMELY tired, and so I had to pull up her diaper/pants and help her back to bed. I decided to let her stay asleep the rest of the night and not wake her up for the 2nd potty waking.

After a few more nights of trying this method, I found that really only one potty waking a night was needed to maintain a dry diaper throughout the night, especially if the first potty waking was timed right at about 1.5-2 hours after her last potty break before bed. The key was to make sure my toddler went quickly to the potty the moment she woke up in the morning. Within a few weeks, my toddler started to wake up with a dry diaper consistently, and she also became more adept at going to the potty at night if she needed to and going back to sleep afterwards. In fact, after about 2 months of this process, she only had 1-2 nighttime accidents in terms of wetting her bed, and I even stopped having to go in to wake her up for the first potty waking at night!

So at the end of this process, I am glad to say, my worst fears were unfounded! I was so afraid my toddler would be screaming at being woken up, and would be extra clingy to me, take forever to put back to sleep, and no longer sleep well at night…but thankfully none of that happened. I was actually very surprised how smooth the process was, and how quickly my toddler got the concept of going to the potty herself at night!

Saying Goodbye to that Last Overnight Diaper  (Part 2) – The Process

toiletpaper

Welcome back to the world of potty training! In the first part of this post series, we looked at the background behind this whole rather ‘potty’ process of weaning off the last nighttime diaper and the fears I had (See post titled “Saying Goodbye to that Last Overnight Diaper (Part 1) – Background”). Here, in part 2 of this post series, I would like to describe the successful process I undertook. These are the main steps involved:

  • Have a small potty in her bedroom at ALL times, so that she gets used to using that during the day.
  • Install a small dim nightlight in toddler’s room, bright enough so that she can still see and use the potty.
  • Get toddler up earlier in the morning and earlier to bed in the evening. That way, you will have a chance to go in and do the first ‘potty run’ at night before you head to bed.
  • Give your toddler the last chance to drink water about 1-2 hours before bedtime.
  • Prepare the bed: have spare bedsheets and place disposable mattress pads underneath the fitted sheet. Some even wrap the entire mattress in plastic before attempting night time potty training!
  • As part of the bedtime routine, the last step is to have your toddler pee before being tucked into bed.
  • Do some initial investigating: the key is to know your toddler’s night time pattern: how often does he/she tend to pee in the diaper at night? Is it usually about 2-3 hours after he/she falls asleep? If so, you can time the first ‘potty run’ at that time to keep the diaper dry. Then once or twice at night, you can go in to check the toddler’s diaper to see if it is wet to gauge roughly when the next ‘potty run’ needs to be timed.
  • You can initially start with one ‘potty run’ a night first, to get you and your toddler used to the idea of waking up and getting back to sleep quickly. Then gradually add in the 2nd
  • First thing in the morning, when the toddler wakes, you need to get the toddler used to using the potty immediately (if she/he feels the need to). This may mean you waking up first earlier prior to the toddler waking up, until the toddler is used to going to the potty automatically after waking up.
  • Praise the toddler and give a big reward (e.g., she can sleep with a stuffed toy of her choosing, and/or a small surprise toy or roll of stickers) if the diaper stays dry for a few days in a row. Then when the child’s diaper stays dry for a week or more in a row, he/she can move on to a trial of regular underwear (with/without an outer pair of plastic pants) at night!

Note that this entire process may take slightly longer than the ‘cold turkey’ method, since it is a graduated approach, and involves some trial and error. Your toddler will also continue to use the diaper for a while.

An alternative method is to buy a pair of plastic training pull up shorts or pants, and to put on the underwear inside. Then if the child wets himself or herself, he or she will feel naturally uncomfortable and wake up. This will prevent much urine getting on the bedsheets, but may help the child get more used to waking up on his/her own to pee. The plastic training shorts apparently aren’t too expensive, and usually come in a set of 2-4 pairs. If you prefer this method, it may be worth a try with your toddler!

Saying Goodbye to that Last Overnight Diaper (Part 1) – Background

starry01Just as sleeping patterns seem to vary (see post Sleeping Patterns Do Differ), there appears to be different East versus West conceptions of the appropriate time to wean a child from the diaper. From what I’ve heard from relatives and friends living in Asia, there is a general more relaxed attitude towards toddlers who wear diapers (unless of course, you live in a country where it’s not a customary practice for infants/children to wear diapers in the first place). Usually children are allowed to continue to wear an overnight diaper until they are at least 5 or 6 years of age. The reasoning is that by this age the child would have gradually established better bladder retention and thus wake up with a dry diaper most nights of the week. In other words, children stay in diapers at night until they gradually wean themselves out of needing it. On the other hand, it appears that in most western cultures, there is the perception that the sooner a child is out of diapers the better, so more pressure exists to get a child completely out of diapers.

Our toddler was potty trained in the daytime at approximately 2 ½ years old, but didn’t really get the hang of ‘wearing a panty and not wetting the bed’ during the afternoon naps until she was about 3 years old. Then at 3 years and 3 months of age, I finally started on the last process of diaper weaning – getting her to stop using an overnight diaper. I admit – there is some maternal grandmother pressure on this front – but I also feel cognitively and developmentally she is probably ready for the challenge now. After all, she has been picking up other skills quickly like how to brush her own teeth, wipe her face, fold clothes, button her jacket, etc.

I admit, I’ve been putting off the process a little bit due to existing fears. The biggest one is: “What if I wake her up and she refuses or has trouble going back to sleep?” After having a toddler who sleeps soundly 10-11 hours at night without much fuss, giving you the parent much need time to relax and rest, it is intimidating to think that you can be now ‘disturbing the peace’. After all, why disrupt what is working well? Another thought is: “Now I will need to get up a few times at night to help train the child, so I will be losing my own long stretches of sleep, and may have trouble getting back to sleep!” A third thought is: “Great, now I will have to do more laundry and deal with wet bed sheets, clothes and unhappy toddlers…” I know, I know, these are all pessimistic and selfish thoughts. But I know that letting something continue just for one’s own comfort and convenience may not be in the best interest of the child from a developmental and psychological perspective. I’ve heard of cases where the child continues to sleep in the same bed as the parents though the child is over 8 years of age, simply because that has become what the child is used to, and is now difficult to change. I know I need to overcome my own convenience and fears for the sake of the child.

So what did I do? Instead of going immediately cold turkey with the diaper, I decided on a gradual ‘night time diaper weaning’ approach. Sure this method may take longer, but I think I can live with that. See the upcoming Part 2 post to find out the actual process I undertook!

As Toddlers Mature: Sleep Needs Change

sleeping-babyNo, I’m not talking here about the amount of sleep an older toddler needs and gets (this is likely another topic and post by itself). I’m talking about what I’ve noticed has changed in terms of what our toddler demands of us – the parents. Before this, the usual modified “cry it out” method seemed to work pretty well. We would let the young toddler cry for about 10 minutes or so, turn off all the lights outside the room, and the toddler will usually go back to sleep herself shortly afterwards. Back then, it seemed to be easier to slip out of her room in the dark as long as the door made no noise at the end of the bedtime routine, and she could usually put herself to sleep quickly soon after.

However, after our toddler turned 27 months, I noticed a change. It has become quite a paradox. On one hand, she has become more adept at being able to put herself to sleep for afternoon naps and at night, so that we do not need to be in there and wait until she falls asleep before leaving the room. On the other hand, she’s now more anxious in the sense that she wants us to be “ready and available”  and to respond ASAP. This means that if she calls out in the middle of the night, she wants us to respond immediately and attend to her needs. She is less willing to “cry it out”; instead she continues to wail LOUDLY and REPEATEDLY until someone comes. Once we do though, and attend to her needs (like going to the potty, patting her for 5 minutes, or giving her a backrub and hug), she is fine with us saying good night and then returning to our beds. The same thing happens at bedtime. If I try to slip out of her room in the dark 5 to 10 minutes after putting her to sleep, she somehow senses that I have left the room, and then immediately starts wailing until I come back. However, strangely enough, if I bid her good night after staying with her for 5 minutes, she usually just lets me leave the room. Or she’ll chase me out the room after a couple of minutes by asking me to leave!

In the morning, if she wakes up in the morning and starts to fuss and we don’t respond quickly enough, she goes into tantrum and then doesn’t want to get up. But if we respond quickly before she gets into a rut, she is usually more cooperative. I think her wailing is now more prolonged and louder because she has not only bigger lungs, but greater awareness and knowledge that we are around – we’re just not responding in a timely manner or choosing to respond her. That probably makes her more upset and determined to get us to come to her room!

Case in point: One night recently our toddler awoke at 6:56am screaming at the top of her lungs, with no sign of abating, and screaming, ”I want to pee!”. When I went to her and put her on potty, nothing came out of course. I then changed her diaper, and put her back in bed. I sat near her bed for 2 or 3 minutes before getting up and saying, “Mommy is going back to bed, because mommy and daddy need to sleep. See it is still dark outside!” She was lying down at this point in the bed, but she lifted up her little hand and waved ‘goodbye’ to me. So I left the room. And there was no crying since. It was actually already 7:20am, and the sky was starting to lighten up. I’m thankful for black out curtains and that she didn’t realize it was morning already! I ended up going back in about 45 minutes later, thinking she was asleep. However, she later told me when I came in that she didn’t sleep. I’m thankful she was still well behaved though (either that or she likes her crib too much)!

This is such a strange turn of events: on one hand, she seems more needy and dependent and wants us to respond immediately to her. On the other hand, after we respond to her, she is fine to put herself to sleep. I guess she now only wants us for comfort, but less so to physically help her to sleep. I guess it’s good that she’s now more independent and doesn’t need us to be near her all the time, but I’m not sure how I feel about having to be perpetually “on call”!

Pre-Travel Considerations (Part 3)… Pros, Cons & Considerations of Bulkhead Seating

totbasketrabbitTo further help you in your decision making of whether to get a bulkhead with bassinet or row seat for your under 2 toddler, here in Part 3 of this series we examine the pros, cons and considerations of bulkhead seating:

Pro: Bulkhead seating with bassinets can offer many advantages especially when on a long haul flight. Besides sleeping in it, our toddler actually enjoyed sitting in it for periods of time with her toys and allowed us to spoon feed her from it. The bassinet then became multifunctional as a playpen and high chair! It seemed she enjoyed facing the other passengers so that she had more to see and observe (instead of just seeing the back of heads in front of her). When she became bored with her toys, we engaged her visually using the entertainment monitor (since this swiveled and so could be angled for her to watch from the bassinet). Just remember to immediately pull up the video monitor from the middle bulkhead seat after the plane takes off, before the bassinet is set up. Otherwise you will have trouble getting the video monitor out once the bassinet is set up!

Unexpectedly, the bassinet also became incredibly useful for putting personal and miscellaneous items like purses, jackets, meal trays, pillows, toys and blankets. Another plus was having more leg room in front to stretch our legs, and our child could stand up and walk a little bit in front of our seats before and after takeoff.  An air stewardess on one flight did approach us to say that the bassinet was meant more for sleeping and so hinted that we should not have the toddler sit in if she was awake, but in the end she let us keep the toddler in. (Why mess with a happy toddler?) Having a bassinet can also be advantageous if you have a young baby or toddler because it provides a place for the child to sit in if needed even if it is just a short while, and so helps to take a load off your legs.

Cons: One big disadvantage to using a bassinet is that often when there is turbulence, the  flight stewardesses will ask you to take the baby out (i.e., wake the sleeping baby/toddler up and potentially make it more difficult for the child to fall back asleep) when the ‘fasten seat belt’ sign comes on. This can be very annoying for the toddler/baby trying to sleep, so make this decision of whether you really want bulkhead seats or not. Even though Eva airline’s bassinet comes with a safety seat belt and a zipper up cloth tummy strap, we were still advised by the stewardess that we needed to pick up the toddler in the event of turbulence. We were also told to zip up the zipper when the child was in the bassinet, but this proved difficult to do if the toddler chose to turn on the side to sleep. So we ended up just covering our toddler with a blanket without zipping up the tummy strap, since we reasoned we would need to pick up the baby during turbulence anyway. Thankfully during one of our long haul flights, no one asked us to take the toddler out even though the fasten seat belt sign had come on a few times. Another disadvantage is that the middle armrests of the bulkhead seats cannot be moved, which was an inconvenience when our toddler wanted to lie flat across our laps. Finally, since it is bulkhead seating, all items needed to be stowed up into the overhead cabins for takeoff and landing so you can’t keep the important diaper bag or other items within reach during these times.

Considerations: Each airline has its own regulations, so check to see if you need to call 1-2 weeks ahead of time to the airline to obtain a bassinet seat, or if you need to arrive at the airline counter earlier on the day of the flight to obtain a bassinet seat. Note as well that not all bassinets are created the same! When you request bulkhead seating, first check that airline’s weight/age bassinet requirements to ensure your toddler will be able to use it. Thankfully the Eva airline bassinets allowed a heavier/older child than the Delta airline bassinet regulations, so we were able to still use the Eva bassinets for our 20 month (11kg) toddler. The Eva airline bassinet was also larger and roomier than the Delta airline bassinet (quite narrow even for a 4 month old). It had enough space that our toddler could curl up in a fetal position on her side, even if she could not stretch her body out all the way.