A baby sleeps in a crib (Photo: ShutterStock)
This is undoubtedly the subject that occupies new parents the most, even more so – those whose children do not really sleep well. And the truth is that it occupies them for a very good reason: sleep has many effects on the health of the baby, and also on ours.
During the baby's sleep (which spans most of the day), important brain processes take place and therefore it is very important for development in several ways:
development GH-growth hormone is secreted during sleep, especially during deep sleep (SWS - slow wave sleep). Sleep deprivation can impair the secretion of growth hormone and thus impair growth. From studies of sleep obstruction sleep disorder, we learn that the sleep disorder impairs the secretion of growth hormone and thus inhibits growth.
Another aspect of the effect of sleep on physical development is obesity. In the modern world, we see that children's sleep is getting shorter and at the same time there is an increase in the prevalence of childhood obesity. Several studies have found a link between too short sleep duration and childhood obesity. One explanation for this is that during sleep, appetite-regulating hormones Leptin ("satiety hormone") and Ghrelin ("appetite hormone") are secreted. If there is sleep deprivation, their secretion is disrupted and the feeling of satiety is impaired.
2. Cognitive development
Babies spend their waking hours constantly learning. They learn to know the sounds, sights and smells of their parents and their environment, they learn to use their bodies, make sounds and speak. During sleep, the brain digests and creates a memory of what it has learned. Many studies have shown the importance of sleep in creating learning and memory.
3. Mental development
An adult who does not sleep well at night will be tired and sleepy the next day. Children, on the other hand, react differently to lack of sleep and often become inattentive and hyperactive when tired. Permanent sleep deprivation can cause the development of behavior disorders as well as mood disorders.
Desired sleep duration
In 2015, the National Sleep Foundation issued guidelines for the desired sleep duration in children and adults, and the Israeli Pediatric Association adopted these recommendations. According to the recommendations, the normal duration of sleep in infants is:
- Age 0-3 months: 11-19 hours a day
- 4 months to 10 year: 18-<> hours a day
- 9-16 years old: <>-<> hours a day
- Age 3-5 years: 9-14 hours of sleep
- Age 6-13 years: 8-12 hours of sleep
- Age 14-17 years: 7-11 hours of sleep
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A sleeping baby (Photo: ShutterStock)
The range of "normal" sleep hours is large
It is important to emphasize that babies are different from each other, so the range of "normal" sleep hours is large. Even if the baby sleeps more than recommended or less than recommended, it can still be fine. As long as the baby is alert and calm during the day, growing and developing well, there is no cause for concern.
After birth, the hours of sleep are divided between day and night evenly, but gradually the secretion of the sleep hormone (melatonin) begins in the evening and the baby "learns" to sleep more at night and less during the day. To help the baby learn this quickly, it is recommended to observe from the beginning the differences between day and night - during the daytime, even when the baby is sleeping, it is recommended not to darken the room and avoid keeping quiet, and at night it is recommended to keep the room dark and quiet, even when the baby wakes up to eat, and return him to bed as soon as possible to sleep after a meal.
It is also important to develop an evening routine around bedtime, such as dinner, bath, and bedtime at regular times.
Sleep disorders in infants
The most common sleep disorder in infants is behavioral sleep disorder. The baby gets used to falling asleep only under certain conditions (for example, on the parents' hands, in the living room or in the car while driving) and cannot fall asleep in another situation, such as alone in bed. Sometimes the baby wakes up at night, sometimes multiple times, cannot fall asleep without these conditions and cries.
To avoid the development of this disorder, it is useful to accustom the baby from the beginning to fall asleep in his bed without the "help" of the parents.A baby who is used to falling asleep alone can also fall asleep alone during the night, when he wakes up, and will not cry and call for help from the parents during the night.
Another important sleep disorder is obstruction of breathing during sleep. Usually this disorder develops after the first two years of life, but sometimes it happens earlier. Signs that arouse suspicion of this disorder are snoring during sleep, a large number of awakenings during the night, fatigue and irritability during the day and sometimes the parents' impression of pauses in the baby's breathing during sleep.
SIDS is the sudden and unexplained death of a baby during sleep and is very rare. In Israel there are only a few dozen cases as if a year. The cause of SIDS is unknown, but we hypothesize that it is due to a combination of factors - genetic and environmental. Among other things, we hypothesize that there is a disturbance in the development of the brain's control over breathing during sleep, and although the baby has difficulty breathing and chokes (due to a pillow blocking his mouth and nose, for example), he does not wake up and extricates himself from the situation he finds himself in.
SIDS has risk factors and some of them can be prevented and thus greatly reduce the risk of death:
1. Sleeping on the stomach. Babies who sleep on their stomachs are at increased risk of SIDS. The unequivocal recommendation of the Association of Pediatricians is to place a baby on his back only. Since babies began to be placed on their backs, the number of cases of SIDS has greatly decreased.
2. Soft objects around the baby.Avoid any such objects in the crib/cot, such as head shields and fur dolls. In the baby's bed there should be only a hard mattress, a baby and a blanket and it is recommended to cover the baby only up to the height of the nipples and not above them.
3. Overheating.Keep the temperature in the baby's room 22-23 degrees Celsius and not heat the room any more.
4. Sleeping together in the parents' bed is dangerous! At night, parents fall asleep and cannot avoid rolling over the baby and suffocating him. In addition, the parents' mattress is soft and not suitable for the baby and there are other objects (such as extra blankets) that can choke the baby. Sleeping in the parents' room is recommended but not in the same bed.
5. Smoking. Smoking by the pregnant mother and exposing the baby to nicotine (even nicotine that sticks to the parents' clothes when they smoke, even if they do not smoke next to him) increases the risk of SIDS. Maternal alcohol and drug use is another risk factor for SIDS.
6. Sleeping in a baby car chair or basket. These chairs are not recommended for infant sleep and may increase the risk of SIDS.
There are other risk factors that cannot be prevented, such as prematurity, low birth weight, a previous case of SIDS in the family, and the birth of twins.
On the other hand, there are factors that protect a baby from SIDS, including pacifier use and breastfeeding. Regarding the use of a home monitor, such as Baby Sense - there is no evidence that it helps and lowers the risk of SIDS. On the other hand, if it calms the parents, there is no harm in it.
Dr. Gili Kadmon, a specialist in pediatrics, intensive care and pediatric sleep disorders at Schneider Children's Medical Center, will talk about sleep disorders, how to deal with them and answer questions in a lecture that will be held today, May 30, at 20:30 on Zoom, participation is free of charge.
- Child Health