Infant safe sleep

safe sleep, baby with pacifier

NICHD, Flickr. Public domain image.

Did you know that Governor Rick Snyder declared September 2018 as Infant Safe Sleep Awareness Month in Michigan to highlight the importance of preventing sleep-related infant deaths?

Here are some fast facts:

  • Sleep-related deaths are those where the sleep environment likely contributed to the infant’s death, including those ruled SIDS, SUID, suffocation, and other causes.
  • In Michigan, a baby dies nearly every other day due to sleeping in an unsafe sleep environment. That’s over 150 babies each year.
  • Sleep-related infant deaths are the leading cause of death for infants between 1 and 12 months of age.
  • Sleep-related infant deaths in Oakland and Macomb counties are lower than the average rate in Michigan, but Wayne county deaths are higher.

Help protect the infants in your life

The American Academy of Pediatrics (AAP) recommends:

  • Placing baby on his or her back for every sleep time (i.e., nap time or bed time).
  • Putting baby to sleep in a safety-approved crib, bassinet, or portable crib (pack-and-play) with a firm mattress and tight-fitting sheet.
  • Keeping items out of baby’s sleep area. That means no blankets, pillows, or toys. Use a sleep sack if baby is cold.
  • Offering a pacifier when putting baby to sleep.
  • Baby sleeping on a surface separate from adults or other children.
  • Room sharing (not bed sharing) for at least the first six months. Pull baby’s crib, bassinet or pack-and-play next to the adult bed for quick and easy feeding and comforting.
  • Keeping baby’s sleep space free from smoke.
  • Breastfeeding if possible; it is associated with reduced infant deaths.
  • Practicing supervised tummy time to build strong neck and shoulder muscles.
  • Ensuring everyone caring for the infant knows how to keep baby safe while sleeping.

For more information on infant sleep, visit the American Academy of Pediatrics’ sleep sectioncheck out the resources from the Michigan Department of Health and Human Services, or learn more about the Safe to Sleep campaign from the National Institute of Child Health and Human Development.

Sleep tips for kids

Sleeping preschooler sucking his thumb

Unaltered image. Summer, Flickr. CC license.

As our children grow it’s no surprise that their sleep needs change. Along the way, sleep challenges often surface at one time or another. With a look at sleep norms by age and a few tips for dealing with sleep battles, here’s looking forward to a restful night ahead for everyone.

How much sleep does your child need?

The best rule of thumb is that a happy, healthy child is usually a well-rested child. With that in mind, some suggested norms are as follows:

  • Babies under 4 months often sleep 16 – 18 hours/day, which is usually evenly divided between day and night.
  • After 6 months of age, a baby’s sleep rhythms gradually become more predictable. A baby should eventually be able to sleep between 8 – 12 hours at night in addition to typically taking a morning and afternoon nap.
  • Most babies combine their two naps into one single nap between 12 – 15 months.
  • Toddlers between the ages of 1 and 3 will sleep 12 – 14 hours in a 24-hour period.
  • Preschoolers between the ages of 3 and 5 usually sleep 11 – 14 hours per day and drop their naps by 5 years of age.
  • School-age children between the ages of 5 and 12 need 10 or 11 hours of sleep.
  • The average adolescent will sleep about 9 hours a day as their sleep physiology changes.

Tips for a better night’s rest by age

Newborns – 1 year

Most people encounter challenges at one time or another during a baby’s first year. With developmental milestones, teething, and tripling birth weight all in one year, not to mention the occasional cold or other illness, it’s no wonder that this can be a challenging time for sleep. That said, with some simple steps you can help your child form a good sleep foundation.

  • Safe sleep is the prime focus.
    • Always put your baby on their back to sleep.
    • Make sure even if they are sleeping away from home that they are still in a safe sleep environment.
  • Nightlights, white noise and a consistent sleep schedule are very helpful.
  • Self-soothing is the foundation for good sleep at this age.
  • The ideal time to sleep train babies is between 4 and 6 months of age.
    • Choose a method both partners are comfortable with and, most importantly, be consistent.
    • Teaching your child to self-soothe can be difficult but will pay dividends in the long-term.

Toddler sleep

As you move out of the newborn stage, separation anxieties can surface again and the bedtime battles can persist.

  • Keep a consistent sleep schedule and routine.
  • When toddlers stop napping, a quiet time of about 30 – 45 minutes is still helpful for most children.
  • Be consistent with the routine; toddlers can be very specific and it often helps to have the same number of books read, the same amount of songs, etc.
  • Try not to give attention to bedtime whining.
  • Avoid adding steps to the routine at the child’s request after saying goodnight.
    • For example, “But Mom I need some water.” Respect the wish the first night, but the next night offer a sip of water after brushing teeth instead of after saying goodnight.
  • Comfort kids in their room instead of inviting them into yours.

School-age children

School days are long and a good night’s sleep is helpful to meeting the academic demands of the school year.

  • A consistent bedtime during the week and weekends is helpful. Avoid changing weekend bedtime by more than 30 minutes if possible.
  • A 30-minute downtime free of electronics before sleep is helpful.
  • A bedtime routine is still essential at this age and consistency can make falling asleep easier.


Teens are often busy with a full school schedule, after school activities and work, so it’s no wonder that teens often feel tired in their first class of the day. The tips below can help them to get more rest and feel brighter in the morning.

  • Ideally, get 8 – 9 hours of sleep at night.
  • A consistent sleep schedule is helpful.
  • Keep bedroom free of distractions, make it a comforting and quiet place.
  • Avoid electronics in the 30 minutes before bedtime and avoid caffeine after the early afternoon.
  • Exercise at any time of the day promotes better sleep.

As your child moves through the different developmental stages, good sleep can be a constant. For more tips on the benefits of sleep and parent-focused tips, please see my March article.

– Melissa Rettmann, M.S., PA-C, has a background in pediatrics and allergy. She is the mother of a toddler and newborn and volunteers with the Parenting Program.

Pass the Zzzzzzs Please

Young girl sleeping with stuffed bunny 

As we enter March, which brings National Sleep Awareness Week, most people reading this blog are likely now, or were in the past, acutely aware of the effects of sleep deprivation.

I remember when I first became a parent, I knew who had been in my shoes before because they always asked, “How is she sleeping?” It’s that one small statement that means “I totally understand” in terms of parenting. As we recently welcomed our second baby into our family and with the effects of sleep deprivation still fresh, I invite you to take a look at sleep health with me — from sleep deprivation to getting a better night’s rest, and the importance of it all for you and your little ones.

Sleep health is often overlooked. The National Institute of Health recommends adults get between 7 and 8 hours of sleep/night to continue good health, but an overwhelming amount of adults report getting less than 6 hours/night. This number has increased dramatically since 1985, before the mass production of electronic devices.

Benefits of sleep

During sleep, many different processes occur in the body, both physically and mentally. The brain stimulates itself with images gathered during the day, which enhances learning, memory and coordination. Cerebrospinal fluid is pumped and cleaned more efficiently during rest. The heart literally takes a load-off by slowing its rate and dropping blood pressure. Thanks to an increased production of growth hormone, muscles and joints are rebuilt during rest. And lastly, breathing rate slows and becomes very regular during sleep. So it’s no wonder that without quality sleep or enough of it, it’s hard to feel your best both physically and mentally.

Pitfalls of sleep deprivation

While the benefits of sleep are abundant, both physically and mentally, the consequences of sleep deprivation are too. An inability to focus, stress, muscle pain, and general feelings of lethargy are common. Sleep deprivation can extend the time required to recover from illnesses and increase the likelihood of being involved in an occupational or automobile accident.

Getting more sleep

Let’s face it. From cramming for that exam in college to waking to a new baby, most of us just accept that sleep is something we can’t control. But the good news is there are steps you can take to make sure you’re getting more rest when you can, even when you’re in the new parent trenches.

For starters, take note of how much sleep you are currently getting and identify reasons why that number isn’t at the 7 – 8 hour mark. While we can’t control a new baby’s sleep schedule before they are old enough to sleep train (and even some who have sleep trained and regressed), there are lots of other impediments to sleep that we can control:

  • Manage and adjust priorities, so that sleep can become a top priority.
  • Take a look at caffeine intake and try to cut it out by early afternoon. The effects of caffeine can last up to 6 hours post-consumption.
  • Look at your bedtime surroundings; limit distractions and technology in the bedroom. Technology is definitely a thief of sleep and a break from electronics as part of the bedtime routine can reap rewards.
  • Exercise, no matter what time of the day, can increase quality sleep.
  • And while we often focus on schedules for our children, it’s helpful for adults to stick to a rather consistent sleep schedule as well. It teaches our bodies when to rest and thus can help one to more quickly fall into quality sleep.

So if you entered March roaring from sleep deprivation like a lion, I hope you’ll take the time this month to make some changes so that you’ll be out like a sleeping lamb before it’s over.

 – Melissa Rettmann, M.S., PA-C, has a background in pediatrics and allergy. She is the mother of a toddler and a newborn and volunteers with the Parenting Program.

Getting rid of those monsters under the bed

Scared little girl sitting up in bed

Unaltered image. Ben Francis, Flickr. CC License.

Halloween is fast approaching and can be a fun and exciting time, but for some kids it can be very scary. Lots of kids have fears about monsters under their bed or in their closet, and sometimes the shadows at night make frightening-looking creatures that seem alive. With Halloween nearby, there’s a possibility that your youngster may see someone dressed up as a ghost, goblin or zombie. What can you do when the Ghostbusters’ voicemail is full or hasn’t been set up yet? Below are some tips on how to ease your youngsters’ fears and have fun this Halloween.

The 411 on fears

  • Fear can be a good thing. It keeps us healthy by alerting us of dangers and keeping us safe. Without fear we might make poor choices.
  • It’s normal for toddlers and preschoolers to have nightmares and fears. Youngsters struggle with differentiating between what is real and imagined. School-age children are able to distinguish fact from fiction, but may have difficulty grasping the probability of an occurrence. Therefore keeping television and social media coverage of traumatic events to a minimum is helpful.
  • Your youngsters’ fears are real to them even though they may sound silly to you or not make any sense. It’s important to validate their fears and concerns.
  • Talking only to your youngster about their fears will not do the trick. Instead, you have to talk and treat. Kids’ fears can begin to subside when parents do something about those pesky monsters.
  • What if it’s more than fear? Some kids have anxiety, a mental illness that can involve both physical and emotional responses that are disproportionate to the situation. A key determinant if psychological intervention is needed is if there’s any impairment in functioning, such as resistance in going to school or inability to complete routine activities that previously weren’t difficult.

Spells and monster potion

  • Some parents swear by Monster Spray. Decorate an empty spray bottle and fill it with water. Mist your child’s room at night to protect from monsters. Another favorite is the Monster Swatter. Take a fly swatter and decorate it. At nighttime, swat the air a few times to make sure the room is empty. Kids can help with the decoration which can be empowering!
  • Create a spell with your child and say each night like “Hocus pocus, zoom zoom boom, no monsters allowed in David’s Room!”
  • Tie fairy dust (salt or sugar in a plastic bag) to the door knob. Monsters are allergic to fairy dust!

Mind tricks

  • Have your child draw happy pictures and put them all over his room to create a protective monster and all scary things barrier.
  • Pretend to give your child’s favorite stuffed animal magical powers that protects the entire bedroom and closet when your child snuggles close with that stuffed animal.
  • Pretend to tie a magic invisible cape around your child that protects them against all scary things.
  • Get a trash bag and pretend to put the monsters and all scary things in the trash bag while talking back to the monsters. “Get out monsters, you are not allowed in the house.” Then take the trash bag and place it outside the house. Your youngster can help too.
  • Use your pets! Sometimes it may help telling your child that your dog or cat helps protect the house at night and won’t let any monsters inside.

Other ideas

  • Read kid-friendly stories about monsters or watch a movie like Monsters, Inc. This will help prepare your child for Halloween and see that not all monsters are scary or bad.
  • Ask your child what will help make the monsters go away and then oblige. Sometimes your child will know what will work and you won’t have to spin your wheels so much of thinking what to do.
  • Using your religious affiliation may help as well. Reciting favorite scriptures or passages that empower and instill calmness can comfort your child.

Remember that your child’s fears are real and how you handle them is important. Helping your child to manage their fears can be a time to bond, teach great skills, be silly, and have fun all at the same time.

– Carnigee Truesdale-Howard, PsyD, ABPP, Pediatric Psychologist with Beaumont Children’s Hospital Divisions of Hematology/Oncology & Gastroenterology




Well Rested and Ready for a New School Year

School-age boy sleeping

Cropped image. SantaRosa, CC License.

As pencils are sharpened, backpacks are selected, and the last few trips to the beach are made, it’s no doubt that back-to-school season is upon us. While the longer summer days may have pushed bedtime back and the subsequent mornings have started a bit later, it’s not too difficult to get back in the swing of things with time in order to make sure that kids are well rested and at their best for the academic rigors that await them.

While experts recommend not moving the bedtime back by more than an hour on weekends, and the same goes for the waking time, it’s understandable if a new norm established itself over the summer. That said, it’s best not to wait until the night before the first day of school to adjust your child’s sleep schedule in preparation for the new school year.

Reestablishing the school sleep schedule

  • Try to adjust the bedtime/waking time gradually until the child is back to a regular school sleep schedule. For example, the bedtime and waking time can be moved in 30-minute increments every few days until the child’s schedule has returned to the appropriate school-year sleep schedule.
  • Keep the bedtime routine consistent and without stimulation just before bed. Books are great but avoid electronics and television 30 minutes prior to bedtime.
  • It’s best to avoid sugar and caffeinated beverages in preparation for a good night’s rest.
  • During the school year, it’s best to follow that hour rule of thumb for weekend bedtime and waking time.

Ensuring proper rest will assist your child in paying attention, learning and retaining new information. Studies show that a lack of sleep can hinder these processes, so making sure that your little one is well rested will certainly help the learning process in school.

How much sleep does your child need?

While the best rule of thumb is that a happy, healthy child is usually a well-rested child, some suggested norms are:

  • Toddlers between the ages of 1 and 3 will sleep 12–14 hours in a 24-hour period.
  • Preschoolers between the ages of 3 and 5 usually sleep 11–14 hours per day and drop their naps by 5 years of age.
  • School-age children between the ages of 5 and 12 need 10 or 11 hours of sleep.
  • The average adolescents will sleep about 9 hours a day as their sleep physiology changes.

With the increasing demands of a new school year and the extracurricular activities that go along with it, it’s never too early to prioritize sleep. August is the perfect month to get that back-to-school routine established in order to be well rested and ready for the new school year that awaits.

– Melissa Rettmann, M.S., PA-C, has a background in pediatrics and allergy. She is the mother of a toddler and volunteers with the Parenting Program.


Resources:  National Sleep Foundation and Nelson’s Essentials of Pediatrics