Mental health articles

Infant devlopmental guidance in the first year Newborn Wrapping, snuggling in mother’s arms, ‘wearing’ in a sling or patting may assist transition from REM to NREM sleep. A degree of maturity is needed before an infant can develop self-comforting means (such as sucking hands) to assist frequent transitions between REM and NREM sleep.

One month
The infant continues to need assistance to move between different sleep states.
Wrapping, rocking, and allowing sucking hands, thumb or dummy for comfort
will help settle the infant to sleep. Wearing in a sling is particularly successful
in aiding transitions.
Three to four months
Help to resettle overnight may not be needed as capacity for self-comforting
increases. Infants can hold hands together and suck fingers for comfort.
Peripheral movements have decreased so often less wrapping is needed. For fullterm
healthy babies, four months is the optimal time to begin to encourage selfsettling.
This may mean being able to tolerate a small amount of grizzling at
appropriate times for the infant to develop self-comforting methods.
Older infants—from six months
Many infants are able to self-settle to sleep from six months. If not, and
assistance is sought, assessment involves establishing whether the infant has had
an established satisfactory sleep rhythm and there has been a change, or whether
a rhythm has never been established. Assessment also focuses on when the
change in sleep pattern occurred, what event or change in circumstance
coincided with the change in behaviour, and how the parents responded. Very
often parents are not aware of how their behaviour might cause anxiety in the
infant or how the anxiety might find expression in the infant.
Intervention aims to help the parents understand the emotional effect of the
event or change on their infant. The age of the infant influences what advice is
given to parents on responding to their child. The parents may need to return
to a settling pattern that was appropriate when the infant was younger, for
example, being more available at bedtime or when the infant wakes through the
night, until the infant is reassured and feels safe to sleep again.
For the older infant, changes or events that may be contributing to sleep
disturbances should be discussed, with sensitive reassurance that the child is safe
and loved no matter what has occurred. If the child can talk, allowing him to
express his concerns can be helpful. Providing opportunity to play out family
interactions without judgement can also help children adjust to changes in
family constellations. This play can occur at home, in day care or preschool.
Parents and staff may need guidance and support to understand the importance
of the play to the child and allow its occurrence.
When developmental guidance does not solve the presenting sleep problem,
then other interventions may be required.

Tags: infant