Promoting Child Development Series Part - 5, Self Regulation (crying and sleeping)

SELF-REGULATION

Infants generally are born with unstable

physiologic functions. With maturation and

sensitive caregiving, physiologic stability, temperature

regulation, sustained suck, coordinated

suck, swallow, breath sequences, and

consistent sleep-wake cycles will improve.

During the first year, the infant’s ability to

self-regulate (eg, transition from awake to

sleep) and modulate his behavior in response

to stress are influenced by the environment,

particularly by the consistency and predictability

of the caregivers.

The consistency and predictability of infant feedings and

encouragement for regular sleep helps establish

an infant’s diurnal pattern of waking and

sleeping.

The infant also develops ways to

calm himself and expands his ability to

selectively focus on a particular activity.

Large individual differences exist in self-regulatory

abilities.

Infants who are born with special

health care needs, such as those who are of

low birth weight or small for gestational age,

are at particular risk of problems with

self-regulation.

A major component of infant health supervision

consists of counseling parents about

their infant’s temperament, colic, temper

tantrums, and sleep disturbances. The “goodness

of fit” between parents and infant can

influence their interaction. Helping parents

understand their infant’s temperament and

their own can help them respond effectively

to their infant.

Crying is stressful for families and frustrating

for parents. Health care professionals will

want to help parents discover calming techniques

and understand that a certain amount

of crying is inevitable.

Parents should consider

who they can ask for help if they are having

trouble coping or if they fear they might

harm their baby.

SLEEP

Parents need guidance on differentiating

between active and quiet sleep because they

may assume their infant is getting adequate

sleep when taken to the mall, taken to a

party, or left in a carrier or swing all day.

During these times, infants are more apt to

be in active sleep. Active sleep alone is not

adequate for appropriate rest and often

results in a fussy baby. Health care professionals

should help parents understand their

infant’s need for a consistent, predictable,

quiet sleep location, including for nap time.

Key Characteristics of Various Infant States

  

1, Quiet sleep

Very difficult to awaken; regular respirations; little movements;

may startle

2, Active sleep

May awaken and go back to sleep; body movements, eyelid

movements; irregular respirations

3, Drowsy

Increasing body movements, eyelid opening; more easily

awakened for a feeding but may return to sleep with comforting

4, Alert

Alert expression, open eyes, surveys surroundings, especially

faces; optimum state for feedings

5, Active

alert Beginning to fuss and show need for a change; if needs are not

met, escalates to crying

6, Crying

Crying that lasts for more than 20 seconds; usually infant can be

comforted with holding, feeding, or diaper change; exploring the

duration, intensity, and frequency of crying is needed to determine

strategies for interventions