International Sleep Study on Infants and Toddlers

I was doing my usual news scanning today when I came across this headline - "Bedtime Routine". As I click on it and read the article, I find the article very relevant to me as a mom to a 1 year plus little boy. You will find the article useful too if you have children around you who is between the age of 0-3 years old or even up to 5 years old. Read the article below which I have highlighted those important points in orange colour and some in bold too especially those that I find very important. In summary the study/article encourages a routine bedtime for children between 0-5 years old. Have a read on the article on why it is important to do so.

So do I have a routine for Ethan? I would say yes. Depending on situation - if we've been out and about, I will calm him down by dimming the light, giving him his last milk feed, pat his bottom or gently pat his head till he falls asleep before I wipe him down with wet towel (soaked in warm water) and change him. But if we're at home, I will calm him down by wiping him down first, change him into his pj, dim the light and give him his last milk feed which he will fall asleep. Sometimes I will give him his favourite toy to play till he tire himself out if he still very active after his feed (not sure if this is good practice though...can anyone tell me please?). I intend to start reading bedtime story to him soon and see if that works on him too. I will do all these on our bed before we move him to his baby cot. Oh Ethan's bedtime is between 9pm-10pm but normally around 9.30pm. Occasionally he will sleep earlier than 9pm especially when he is tired and didn't sleep much in the morning/afternoon.

Thursday July 3, 2008

Bedtime routine
By WONG LI ZA

As freatured in the Star Online

A regular routine helps children to settle down for the night.

IF you are a parent with young children but physically resemble a character from Night of the Living Dead, read on. Parents tend to be more concerned about their child’s nutrition and learning abilities rather than sleep.

A recent international study involving 30,000 children aged zero to three has shown that many parents feel their children do not sleep well, especially Asian children.

Completed last year, the International Sleep Study on Infants and Toddlers was conducted in 17 countries. It involved 12 Asian countries (over 20,000 children) and five Western countries consisting of the United States, Canada, Britain, Australia and New Zealand. In Malaysia, 997 parents and caregivers responded to the survey, which was conducted online.

The survey, jointly conducted by Johnson & Johnson and the Asia Pacific Paediatric Sleep Alliance (APPSA), is believed to be the largest of its kind.

“Sleep may seem like a natural process but many mothers neglect the importance of good sleep in their children,” said Joyce Lee, Johnson & Johnson Malaysia’s managing director.
Led by prominent US-based paediatrician Dr Jodi Mindell, the study showed that 26% of parents in Caucasian countries believe their child has a sleep problem compared to 54% in Asian countries. (Overall, results in Malaysia and the other Asian countries were very similar.)
Among the questions in the survey was whether parents practised a consistent bedtime routine with their kids.

“Only 53% of Malaysians practise the same bedtime routine with their child compared to 71% of Caucasians,” said How Ti Hwei, director of professional marketing with Johnson & Johnson Asia Pacific.

“In addition, 84% of Malaysian children sleep in the same room as their parents compared to only 35% of Caucasians,” said How, who was involved in the survey.

However, consultant paediatrician and paediatric pulmonologist at Hospital Serdang, Dr Norrashidah Abdul Wahab, advocates co-sleeping, but in different beds.

“The main reason for sleeping in different beds is safety. I also find that mothers do not really want to be separated from their young child.

“It is also easier to breastfeed a child who is in the same room and mothers can also tend to the needs of the child immediately,” she said.

The sleep survey also found that the average time children go to bed in Asia is 9.30pm but in Caucasian countries, it is 8.30pm.

“Caucasians have a specific, earlier bedtime for their children. On the other hand, most Malaysians are not aware of the importance of good (sleep) habits,” said Dr Norrashidah, who is a member of APPSA.

Dr Norrashidah believes that the time children go to bed is important.

“Malaysian children tend to sleep later and wake up late, at nine or 10am. They should sleep by eight or 9pm for the proper cycles of rapid eye movement (REM) sleep and non-REM sleep to take place,” she explained.

REM sleep is important for brain development while during non-REM sleep, physical growth takes place.

She said that non-REM sleep occurs from 8pm onwards; towards the early morning, more REM sleep occurs.

“The age between zero and three is a crucial period for growth, which happens during sleep,” she said.

To get children to sleep earlier, their afternoon naps should only be about one to two hours, she added.

Proven routine
Prior to the International Sleep Study, Dr Mindell carried out a clinical sleep study in the United States involving 58 mothers and their babies aged seven to 18 months over three weeks.

The study, conducted in 2005, involved practising a three-step routine before bedtime, which comprised a bath, massage and quiet activities like story time.

Results showed that babies slept faster and woke up in the middle of the night less. The longest sleep period in the night also increased by 23% and mothers reported that they were less tired.

“This study shows that a simple three-step routine can help both children and mothers sleep better,” he said, adding that the routine should not take more than 30 minutes.

Added Lee, “Many mothers know intuitively that a routine works. Now, we are sharing with them a practical and proven routine to follow.”

Asian parents who might not be open to bathing their children at night have an alternative – wiping them down with warm water.

“The warmness calms and relaxes the child,” said Lee.

Dr Norrashidah said a regular bedtime routine is important to teach the baby to unwind and go to sleep to maximise the restorative benefits of sleep to aid the baby’s cognitive, social and physical development.

“The lack of a bedtime routine and healthy sleep in the long term can affect a baby’s memory, learning ability and even well-being,” said Dr Norrashidah.

She stressed that the key points are to put a baby to bed early from the start and to continue practising a routine.

“Bathe or wipe them down, change them into their pyjamas, dim the lights, and spend time with them. Read them a book or sing a song. It’s also good to massage them because it is relaxing.

“A routine should continue until the child is about five years old,” she said.

She added that many Malaysian parents do not practise a set routine with their children due to their busy lifestyle.

“Understandably, most mothers work these days and come back late but they still want to spend time and play with their children at night,” she said.

Dr Norrashidah added that although a bigger study is needed, the clinical sleep study shows that a routine is effective in helping children sleep better.