Below is an exerpt from the full article which can be viewed at: http://www.medscape.com/viewarticle/471909_1 Sleep-Promoting Strategies Normal, healthy sleep/wake patterns are dependent on consistent daytime and nighttime routines that match the child's physiologic and developmental sleep requirements. Adhering to a consistent routine in preparation for bedtime and "lights out" time, as well as consistent morning wake time, naptimes, and feeding/meal times, are of particular importance. These routines help strengthen the child's circadian and homeostatic processes and reduce the likelihood that the child will suffer from insufficient sleep. Children thrive on consistency and routine, and if firm limits are set, bedtime struggles will be unusual. The child's bed should be treated as a place for relaxation and sleep. Therefore, play should not be allowed in the bed and the bedroom should not be used as a place of punishment. During the day, caffeine intake (ie, chocolate, tea, and cola) should be limited, especially after lunchtime. Caffeine can delay sleep onset, reduce total sleep time, and increase the amount of light sleep. These effects of caffeine can last greater than 8 hours (Mendelson and Caruso, 1998 and Roehrs and Roth, 1997). Near bedtime, active play, exercise, and stimulating television and computer programs should be avoided. Bedtime routines such as bathing, reading stories, and brushing teeth in a calming, unhurried manner with a loving yet firm and consistent approach that includes some "one on one" special time with the parent fosters security and promotes the child's ability to fall asleep independently. If positive interactions with parents occur at bedtime, children will often look forward to this time rather than struggling and resisting. The bedroom environment is also important; the child's room should be as dark as possible, the temperature comfortable (not too warm), and noise kept to a minimum to enhance sleep onset and maintenance. Of course, if the child feels more comfortable with a night light, one should be provided, and many young children enjoy the comfort of a transitional object such as a special toy, doll, or blanket. Co-sleeping is a topic that has sparked passionate debates for many years. The prevailing medical opinion in the United States is that co-sleeping is to be discouraged, despite research that is unable to clearly demonstrate that co-sleeping is universally unsafe (American Academy of Pediatrics Task Force on Infant Positioning assnd SIDS, 1997). This medical viewpoint reflects American culture, which places a high value on early childhood independence. However, co-sleeping is prevalent worldwide, particularly in non-industrialized countries, and is recently becoming more widespread in the United States. Between 1993 and 2000, the percentage of co-sleeping infants more than doubled from 5.5% to 12.8% (Willinger, Ko, Hoffman, Kessler, & Corwin, 2003), and 65% of surveyed caregivers stated that sleeping with children was acceptable (Weimer et al., 2002). Co-sleeping has been found to be a relatively normative practice in low-income households (Brenner et al., 2003). Co-sleeping has also been reported to be two to four times as common in Asian and African-American families, respectively, as compared to Caucasian families (Willinger et al., 2003). Given that the practice of co-sleeping is prevalent and appears to be influenced by cultural factors, health care providers must be aware that their recommendations should be culturally sensitive, openly discuss the risks and benefits of the practice with parents, and include safety advice if parents choose to co-sleep. See Table 2 for talking points for practitioners to use when discussing the risks and safety considerations of co-sleeping with parents. *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(R) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html