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Respect, don’t fear, Sudden Infant Death Syndrome

You needn’t be too worried about Sudden Infant Death Syndrome, or SIDS – if you stick to a few basic rules.

SIDS, or cot death as it’s sometimes called, is the unexpected death of a baby who’s younger than one year, without a clear cause. There’s still a lot we don’t know about SIDS, but here’s what we do know…

The risk factors for SIDS are:

  • Multiple birth babies  or prematurity
  • Babies who have a sibling who was lost to SIDS
  • Babies of teenage mothers
  • A short time in between pregnancies
  • Exposing babies to cigarette smoke, both during pregnancy and afterwards
  • Mother’s use of illegal drugs in pregnancy
  • Not breastfeeding
  • Respiratory infections
  • Shaken baby syndrome and other child abuse
  • Allergies and respiratory infections caused by mattresses or fluffy bedding
  • Exposure to botulism, which is most likely caused by giving Baby contaminated honey in his first year

What research indicates

Up to 65% of babies in SIDS deaths were found sleeping on their stomachs or sides. This doesn’t mean that was the cause though, and one must take into account that this typical ‘fetal position’ is pretty normal for most babies. Some 15 - 20% of infants are found with bedclothes covering their heads, which might cause death by overheating or by forcing the infant to re-breathe expired gases.

While co-sleeping is often discouraged in the West, for the vast majority of non-Westerners bed-sharing is the predominant sleeping arrangement.  A study conducted in Cape Town found that 94% of black infants slept with their mothers, compared with only 4% of white babies. The SIDS Family Association in Japan conducted a survey on risk factors related to SIDS, and found that 93% of babies slept in the same room as an adult, with most of them sleeping at the adult’s side. The SIDS rate in Japan at that time was 0.48 per 1 000 live births, among the lowest in the world, and the Association believes that co-sleeping should be promoted.

What are the causes of SIDS? 

We’re not quite sure what the exact causes of SIDS are, but here are some possibilities:

  • Accidental smothering, using pillows before two years and any form of overheating of Baby, especially while he sleeps – for example, fully clothed and sandwiched between  parents instead of all wearing fewer clothes and covered with less bedding.
  • Undiagnosed low blood sugar and undiagnosed whooping cough.
  • Recent research shows that all SIDS babies had a brainstem abnormality, and didn’t produce enough serotonin, which is the hormone that helps coordinate breathing, blood pressure and temperature during sleep.

Sister Lilian Centre tips to prevent SIDS 

Official recommendation is that babies should sleep on their backs, but if your baby prefers a different position, there’s not much you can do about it! Common sense and the hints below will help ensure sleep safety:

  • Breastfeeding exclusively for the first six months, and continuing to breastfeed for as long as possible, is the best anti-SIDS investment a mom can make.
  • Keep Baby in a smoke-free environment.
  • Don’t give Baby honey before one year.
  • Avoid fluffy pillows and stuffed animals at night.
  • Don’t overdress Baby, especially if co-sleeping.
  • Don’t use heaters overnight.
  • Treat mucus problems promptly (use MucoCare for safe homeopathic help).
  • Solids, especially potential allergy foods, shouldn’t be introduced before six months.


Some people think that babies who sleep in their own cots are less likely to get SIDS than those babies who co-sleep. But, when a co-sleeping baby is lost to SIDS, it’s usually because of the parents’ drug use, smoking, formula feeding, obesity in the main caregiving adult, or the bedding used. Breastfed babies who sleep close to or alongside their mothers, breastfeed occasionally through the night and aren’t exposed to the factors mentioned above, have the lowest overall incidence of SIDS.

Sister Lilian’s five top sleep tips

Did you know that of all the concerns parents have, sleep – or more correctly, lack of it – tops the list? I’ve been getting a steady stream of sleep queries since the mid-1980s. It’s no surprise, really; sleep deprivation is a well-recognised form of torture!

Right from the start I need to tell you that there’s no ‘magic’ way to make a baby sleep exactly when, or for as long as, you’d like. However, a compassionate, sensitive approach will lead to more rested parents, a happier baby, and a harmonious home – that’s the basis of my Sleep Recipe.

If you do these five things, you’ll find that sleep – or even lack of sleep – won’t be the main talking point in your home.

1.       Don’t pursue sleep as if it is a milestone

The most important thing to know is that ‘sleeping through’ shouldn’t be the goal. Babies are individuals, just like adults, and all have differing sleep needs.

2.       Be humane!

Small babies need to be comforted and held close for optimal development and emotional security. If this need is met, Baby (and Mom!) will sleep better and more. A great way to do this is to co-sleep – safely of course.

3.       Don’t keep a tired baby awake

Don’t try to keep Baby awake during the day, thinking that he’ll sleep better at night. This usually just makes night sleep more disturbed.

4.       White noise is good!

Don’t strive for absolute silence when babies sleep. Normal background sounds can be very relaxing and reassuring for babies of all ages.

5.       The power of practical planning

Plan ahead for wakeful nights: have everything that you might need at hand, including nappies, bottles, formula, remedies, etc. and do what you have to right there in your bed. That way, you don’t have to wake totally and can cuddle down together with Baby to keep sleeping.

I have written a special Baby and Toddler Sleep Guide filled with lots more about little ones and their sleep patterns. This guide will help you understand babies’ sleep patterns, show you how to interpret their cues, and give you heaps of tips for just about any sleep concern you may have from birth to the pre-school years.

Sister Lilian’s Basic Sleep Recipe

The problem with developing a sleep recipe is that babies and toddlers are completely different from one another… it’s almost impossible to develop an actual sleep recipe.

Instead, you need to build up your own flexible, kind, realistic routine around your child’s own natural rhythms instead of following a prescribed, rigid bedtime routine.
However, try Sister Lilian’s Basic Sleep Recipe below – it was formulated to maximise happiness at the end of a long day with the result of improved sleep. While not all babies will sleep through every night from dusk till dawn when you use this, nights will improve dramatically.

Sister Lilian’s Sleep Recipe:

17:00 Take your little one for a 30-minute walk.
17:30 Play boisterous, physical, age-appropriate games for 20 minutes – Dad might enjoy getting involved with this!
17:50 Supper time! Offer your little one supper, but allow her to feed herself, and don’t insist on eating. Milk is the only important meal for the first six months of life, and is still very important up until your baby is one year old.
18:10 Bath time, and you or Dad should take the opportunity to hop in the bath with Baby, or play lots of different water games.
18:30 Give Baby a massage all over.
18:45 For about 15 minutes, take the time to play quietly indoors. These games should also be age appropriate.
19:00 Story time – read to Baby, recite nursery rhymes or sing lullabies.
19:15 Goodnight hugs and kisses… and then lights out. 

By all means, lie or sit quietly alongside Baby until she falls asleep, as leaving a baby to cry is wrong and harmful.

Want my tips on hand? Why not buy my Baby and Toddler Sleep guide for R80? It's a 56 page downloadable PDF that you can enjoy whenever you need more tips for baby sleep. 

What’s the big deal about co-sleeping?

Co-sleeping, bed sharing, the family bed – no matter what the latest name is – forms part of attachment parenting and basically means letting Baby sleep in bed with you. Just like skin-to-skin and kangaroo mother care, co-sleeping has sound scientific backing and isn’t just a fad. Unfortunately, it’s got a negative reputation because people don’t fully understand babies’ sleep patterns.

Bed sharing is one of the most ‘natural’ ways of sleeping and, if you think about it, is basically expected by Baby from birth! You see, Baby has been cradled in your womb since the moment of conception, and after birth he’s happiest when he’s close to you and surrounded by your familiar smell – what a comfort! It’s particularly beneficial if you need to provide a bit of extra emotional security for Baby because you’re away at work all day.

Co-sleeping also incorporates another important physical and emotional therapeutic tool: touch. Both massage and co-sleeping are excellent ways to give Baby the advantages of this. Plus, co-sleeping provides emotional security and comfort for little ones – and you! How many moms let Baby sleep in bed with them when Dad is away on business because they feel lonely? Sleeping together provides comfort for the whole family and everyone will probably sleep better.

Other benefits of co-sleeping include:

·         Better bonding because Mom and Baby aren’t separated for any significant amount of time

·         Better sleep for Mom and Baby

·         The best neurodevelopment for Baby

·         An improved breastfeeding experience

·         Minimised crying and stress for Baby (and therefore Mom!)

·         A happier family life

·         Parenting becoming easier and more enjoyable

·         Communication being better in the long run

You can continue co-sleeping right into toddler years; the best approach is to let Baby decide when he’s ready to move to his own bed. The longer you do it, the more emotional advantages there are! It’s even possible to co-sleep with more than one child; although you might need to do some shuffling so that everyone fits. Alternatively, once your youngest is a few months old you can move him and your older tot into a bed together – they’ll get all the same benefits of co-sleeping.

Kind co-sleeping alternatives

If you really feel that you can’t embrace co-sleeping, you can compromise by letting Baby start his naps and bedtime in his own bed and then move him to your bed the first time he wakes up. This meets his emotional needs and gradually gets him used to sleeping in his own bed.

By co-sleeping, you’re following your heart and letting your motherly instincts guide you.You can read my blog on Co-sleeping myths – busted so that you’re ready for critics, but the bottom line is that what happens in your house at bedtime with your baby is really nobody else’s business. Those critics don’t offer to help you out at midnight, do they?

The significance of sleep ‘incompatibility’ between parents and babies

 Research into both baby and adult sleep is plentiful. Although it isn’t essential to understand the sometimes complicated science of sleep, it does help those who find it difficult to simply ‘feel’ what might be right, or to leave it up to nature and intuition to guide them.

According to research on infant sleep:

•       The amount of Rapid Eye Movement (REM) sleep is very high in early development. This is because REM sleep facilitates early brain development and internal information processing.

•       Babies wake up frequently for survival benefits:

ü  For the first few weeks of life, a baby’s stomach can only hold 7–20ml of milk at a time, so Baby needs to feed more often.

ü  Breast milk is digested very quickly, creating an even greater need for frequent, small feeds.

•       Neuroscience has demonstrated that blood flow to the brain (and particularly to the area that controls breathing) almost doubles during REM sleep, which suggests that Baby experiences more of this type of ‘dream’ sleep for protection and survival benefits. So, while there is also a greater chance of your baby waking up during this stage, the benefits far outweigh this inconvenience, don’t you think?

•       During REM sleep, the body increases its manufacture of nerve proteins that are fundamental to brain development and growth.

•       Premature babies spend up to 90% of sleep in REM sleep, which relates to their even greater need for rapid brain development and maturing.

Why babies need sleep

Sleep is essential! Everyone knows this, but unfortunately this knowledge has led many parents to believe that babies who don’t ‘sleep through the night’ are doing something wrong, or will be deprived in some way. I hope this blog has helped you discover the truth and common sense that will help you put all this in perspective. Nonetheless, this is why restful sleep is important:

•       To rest and replenish physical and emotional energy

•       To allow many bodily functions to take place optimally

•       To mature neuron and nerve pathway activity and in so doing, aid cognitive (brain) development

•       To assist with sensory integration of environmental stimuli, helping babies make sense of their world

So, getting enough restful sleep will promote Baby’s brain development, growth and emotional well-being. This is indeed fact. The incorrect conclusion drawn from this is that if Baby sleeps through the night, he’ll wake up rested, happy and brainier! Which parent is not going to be influenced by this idea? My appeal is that you ‘hold that thought’ while you take another look at the research findings above. I am totally confident that the bigger picture will put your mind at rest and guess what – that’s the first step to better sleep, because your baby will pick up on this, relax, and sleep easier!

You can also read a lot more about the topic if you buy my 56 page downloadable Baby and Toddler Sleep Guide, for only R80.00. It deals in detail with just about any type of sleep problem you can name, and gives reams of sensible solutions!

Is there any harm in letting babies cry and self-soothe?


Quite honestly, I am exasperated by a number of mantras I constantly hear about how to deal with crying babies. Let’s be honest and see the bigger picture.

“Self-soothing” is the idea that babies should learn to comfort themselves using another device like a dummy so that Baby does not need his parents to comfort him. It almost inevitably involves leaving a baby to cry so that he can gradually learn to deal with his own emotional discomfort. Phrased like this, it almost sounds good, but in reality, it’s not at all. 

Read more...

Co-sleeping myths – busted!

Are you curious about co-sleeping, i.e. letting Baby sleep in bed with you? You’ve probably seen some good things about it on the Sister Lilian Centre Facebook page and blog and maybe even heard some good things from fellow parents. But, you’ve probably also heard lots of bad things about it. Rest assured (pun intended!), co-sleeping isn’t a fad, it’s a proven sleeping arrangement with quite some supportive evidence – and, some might argue, the most natural way of sleeping. You can read more about how it works HERE .These are some co-sleeping myths you’ve probably heard:

Baby keeps Mom and Dad awake

Actually, co-sleeping helps everyone to sleep well! Research has proven that families are comforted by each other’s presence, so when you’re together everyone sleeps better! Besides, how much sleep do you get when you’re constantly getting up to tend to Baby?

Co-sleeping produces spoiled, dependent children

Many parents try to get their tot sleeping in her own room as soon as possible, to prove their parenting worth. However, co-sleeping provides Baby with emotional security and a healthy independence.

You won’t all fit

True, not everyone has a family-sized bed, but if things are a bit squashed you can try the puzzle position. Simply get Dad to sleep with his head at the foot of the bed and you’ll all fit in better! If you have a toddler and a newborn, let your toddler sleep at the bottom of the bed too. If necessary, you can also place a ‘bedroll’ on the floor next to your bed for Baby to sleep on, and if she needs you at night, you can easily reach down to her or move her into bed with you.

Your love life will be affected

Being parents means that you’re going to have to get creative anyway. There are many innovative ways to keep your love life on track while nurturing secure children and happy families! Lounge? Kitchen? Bathroom? Children’s room?

There’s more risk of Sudden Infant Death Syndrome (SIDS)

SIDS usually occurs linked to formula feeding, the wrong type of bedding, or the main caregiver being obese, a smoker, or a drug user. Statistically, breastfed babies who sleep close to Mom and aren’t exposed to these factors have the lowest chance of SIDS. For more on cot safety, see 10 Tips for cot safety.

Top five co-sleeping benefits

1.       You and Baby will settle into a healthy sleep pattern quicker and bond better, making parenting easier.

2.       Baby will be less anxious.

3.       Nightly breastfeeding will be easier.

4.       It can help Baby cope with stressful situations like moving house or going on holiday.

5.       It can speed up healing – both physical and emotional – after an illness or injury.

How a baby’s sleep works

Yes, restful sleep is important for everyone, including babies. This doesn’t mean that babies must sleep through the night, however! Let’s look at sleep itself in more detail, because this will help you understand what you can reasonably expect from your baby or toddler, and why your child’s sleep patterns might differ from what you were expecting.

There are two main types of sleep in humans:

1.       Non-Rapid Eye Movement (NREM) or quiet sleep

2.       Rapid Eye Movement (REM) or active sleep

There are also fairly repetitive, typical stages of sleep, which include:

Stage 1

This is a relatively light transition period, characterised by very slow theta brain waves. If awakened during this stage, it feels as though you haven’t yet slept.

Stage 2

In this stage, there are bursts of rapid, rhythmic brain wave activity, body temperature starts to decrease and the heart rate slows.

Stage 3

This is a transition phase from light sleep to very deep sleep.

Stage 4

This deep sleep stage is characterised by delta brain waves. Bed-wetting and sleep-walking both occur during this stage.

Stage 5

This stage consists of REM sleep. There is an increase in respiration rate and brain activity, but muscles are more relaxed. Dreaming occurs during this stage of sleep.

Sound insights for sleep sceptics

An electro-encephalogram (EEG) shows that we cycle through these stages four to five times each night, in fairly typical, but not fixed order. An EEG also shows that an adults’ sleep cycle is about 90 minutes, while a baby’s lasts only about 50 minutes. In addition, adults seem to enter deep sleep more easily than babies and children do. On average, babies spend 50% (or about eight hours in each 24 hour period) of sleep in REM sleep, and 50% (a further eight hours) in NREM sleep every day. In contrast, adults spend about 80% (or 6–7 hours in each 24 hour period) in NREM sleep and only 20% (about one hour) in REM sleep. All of this boils down to the fact that babies have more periods of light sleep than adults, and more dream sleep, in which they are more likely to be restless and wake up.

Given all this, it would be completely understandable if you think that adults and babies are not very compatible as far as sleep goes! In my blog ‘The significance of sleep ‘incompatibility between parents and babies’, I take a closer look at why this may be… and show you how to translate this information into a positive parenting experience.

You can also read a lot more about the topic if you buy my 56 page downloadable Baby and Toddler Sleep Guide, for only R80.00. It deals in detail with just about any type of sleep problem you can name!

9 top tips for building a baby routine

I hate the word ‘routine’. In my many years as a parenting advisor, I have seen more tears of frustration caused by the relentless pursuit of a ‘good routine’ than I have seen tears of joy! And when you think how many tears of joy are shed once a baby joins a family, that’s truly astounding.

You see, just as adults differ one from the other, so do babies. This concept is so important if you’re struggling to build a ‘routine’ for your baby. I’m sure if I was bold enough to tell you exactly how you should live – when you should go to bed, what time you should eat and when you’re allowed to relax – you’d tell me to get lost! Yet so many moms want me to prescribe something like this for their babies!

The only good way to build a routine is to take your child’s individual nature into account. I understand why you want your child to have a predictable day and night; it will make your life easier. And absolutely, yes – parenting should be as easy as possible – as long as it doesn't harm your baby or child. 
No matter the nature of your child, these tips will help you to build a flexible routine, while sticking to the spirit of ‘sensitive parenting’: 

Tip 1:

Watch your baby carefully in the first few weeks of life; this will give you a good idea about Baby’s sleep needs, feeding patterns and when Baby’s tummy needs to work.

Tip 2:

Build a routine around these natural patterns or rhythms, rather than following a prescribed routine (many clinics and doctors hand these out).

Tip 3:

Feed your baby when he’s hungry, and note the times; this will form a pattern, even if it’s not as regular as clockwork. Don’t feed on a schedule, even if you’re using formula milk.

Tip 4:

If Baby swaps night and day around, gently wake Baby half an hour earlier than you think she would naturally wake after each daytime sleep. This will soon make night sleeps longer and deeper.

Tip 5:

Never wake a sleeping baby at night unless there are serious health problems or weight gain is very bad. Babies have a ‘core sleep’, usually pre-midnight, during which time they sleep, well, like babies. A full night’s sleep gradually ‘grows’ from this core sleep, and if this rhythm is broken, it will take longer for Baby to sleep through.

Tip 6:

Late afternoon and early evenings are notoriously difficult, so keep Baby busy at these times; go for walks, play ‘touchy’ games, give short feeds, dance with Baby. Minimise the household tasks for this hour by preparing the evening meal earlier in the day.  Read Sister Lilian's basic baby sleep recipe for more tips on planning for this time of the day.

Tip 7:

Stick to a wind down ‘routine’ at the end of the day, as this will send healthy signals to Baby, helping to relax him and you. See my Sleep Recipe for a good example of this routine.

Tip 8:

If Dad, Mom or both parents return home from work in the middle of the wind-down phase, take care not to introduce boisterous play again, as this will affect the rest of the evening.

Tip 9:

Babies and toddlers will always try to kick against the limits imposed on them; this is how little ones learn. It doesn't mean that your rules are wrong, but stay quietly confident in your approach and your child will reap the benefits!
I hope you will think of routine in a totally new light from today on – it truly is liberating and makes parenting far more enjoyable!
If you want all my tips on-hand, why not buy my Baby and Toddler Sleep Guide for only R80? 

10 Tips for cot safety

When it comes time to kiss your little one goodnight, there are a few things you need to keep in mind with regard to cots:

1.       The cot must be deep enough that your little one can’t climb out, and shouldn’t have any steps or cut-outs in the headboard or footboard which Baby’s limbs could get stuck in.

2.       The distance between each bar should be at least 2.5cm and no more than 5cm – if you can fit a cold drink can between the bars they’re too far apart and Baby’s head could slip between them

3.       A second hand cot should be stripped and repainted with lead-free paint just to be on the safe side, as Baby could get lead poisoning if she breathes in lead fumes.

4.       Baby’s mobile or any toys hanging over the cot should be removed when Baby can push up on her hands and knees, and her mattress should be put in its lowest position once Baby can pull herself up.

5.       The mattress should fit snugly, with no gaps which Baby can slip into.

6.        The cot should be positioned away from direct sunshine, windows, heater, lamps, wall decorations, furniture, curtains, and anything else which Baby can use to climb out of the cot.

7.       Baby should sleep on her back with her feet at the bottom of the crib to reduce the risk of Sudden Infant Death Syndrome (SIDS).

8.       There shouldn’t be a pillow in the cot, as a firm, flat surface is the safest.

9.       When the cot mattress is at its lowest height and the top rail reaches below Baby’s chest, it’s time to move her to a bed.

10.   The drop side of the cot should always be up and locked when you leave Baby alone in the cot.

Many of these considerations and risks are reduced if you practise co-sleeping – plus, the whole family will sleep better! To find out more about safe co-sleeping, see my other blogs .

How are newborn babies supposed to sleep?


While most newborns spend much of any 24 hour period napping or sleeping, they only do this in a truly healthy and developmentally optimal way if they do not feel insecure, unhappy or distressed in any way.

I think the reason this question is so often asked is because there is a lack of understanding about a baby’s natural sleep cycles. Babies’ spend more time in dream and lighter sleep than adults do, which means they wake more frequently. 

Read more...

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