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Sleep has a number of key health benefits for children and is important for their growth and overall development. Sleep is important for muscle growth, tissue repair and growth hormone release. Sleep is also critical for learning and memory consolidation, making sleep important for children to perform their best in school. Sleep is necessary for maintaining the overall health of our immune system and our metabolism.

The amount of sleep a child needs really depends on the age of the child. Newborns typically require the most sleep, which can be up to 14-17 hours per day. As children get older, their sleep requirements decrease so that by adolescence their sleep needs are similar to adults.

The National Sleep Foundation recommends that toddlers get 12-15 hours of sleep and preschoolers 10-13 hours of sleep per day, including their daytime nap. The National Sleep Foundation recommends 9-11 hours of sleep per night for school-aged children, 8-10 hours of sleep for teenagers and 7-9 hours of sleep per night for adults between 18 and 64. Adults aged 65+ need 7-8 hours of sleep.

Unfortunately, we know that many children and adults do not get the recommended amount of sleep each night. A 2004 National Sleep Foundation poll found that children of all ages got less than the recommended amount of sleep. Our sleep deprivation gets worse as children get older, with teenagers usually being the most sleep deprived age group.

A 2006 National Sleep Foundation poll found that 45% of adolescents got less than 8 hours of sleep per night, with high school seniors averaging only 6.9 hours of sleep on school nights. Adults do not usually fare much better, with about 40% of adults getting less than 7 hours of sleep each night.

Insufficient sleep is associated with daytime consequences, in which children can be very different than in adults. Most adults will present with symptoms of sleepiness such as falling asleep at work, while reading or watching TV. Children, on the other hand, can present with increased energy (hyperactivity) or problems with focus/concentration. They can sometimes look very similar to children with ADHD. In fact, children are sometimes misdiagnosed with ADHD when in the symptoms are really due to poor sleep.

Children can also present with more behavior problems or poorer school performance. Daytime sleepiness is also seen in children. For example, children may have a harder time getting up in the morning and may even be late for school as a result. They can also be more likely to fall asleep in the car or on the bus ride to school. Or, they can even fall asleep in the classroom, which can affect their ability to learn.

The National Sleep Foundation estimates that about 25% of teens fall asleep in the classroom at least once per week. Some children who are chronically sleep deprived will try to catch up on their sleep at home either through an after school nap or “sleeping in” on the weekends. If your child takes regular naps, especially if they are 45 minutes or longer, or if they “sleep in” more than 2 hours on the weekends, then your child may not be getting enough sleep.

If you have any concerns about your child’s sleep patterns, particularly if your child snores, pauses in their breathing during sleep, gasps for air, has mouth breathing, has frequent night awakenings or restless/sweaty sleep it is important that you talk to your child’s doctor as these could all be signs of obstructive sleep apnea. Difficulty falling asleep or staying asleep could also be signs of other sleep problems that you should discuss with your child’s doctor.

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As pediatricians, we are frequently asked why a child needs a yearly physical, even if they seem perfectly healthy. At each well visit, your provider will ask questions, examine your child and discuss any recommended vaccines. At each age milestone, different screening tools and tests may be recommended in addition to the traditional physical exam.

Children are constantly growing and a lot can change in a year. We measure height and weight to ensure adequate growth. We plot these measurements on a growth curve which shows projected growth patterns. Variations in this curve can indicate nutritional deficiencies, hormone deficiencies, as well as other major medical problems.

Between two and six-years-old, children grow at a faster rate than almost any other time during their development. During this time, we can monitor their growth rate, size, weight and blood pressure to help determine if early action is needed to combat issues that may arise later in adolescence. Children who are overweight at age five have a much higher percentage of being obese in adolescence and later in life.

When your child hits the “tween” age, around eight to 12-years-old, growth patterns and timelines for development can vary. Because your child is starting toward puberty, getting a yearly physical can help us prepare them (and you!) for hormonal changes as well as other physical and emotional changes that occur during these times.

These yearly physicals allow us an opportunity to address important topics such as ways to ensure your child's safety, healthy sleep habits, goals for adequate nutrition and more. Through these visits, we work to identify any physical, emotional, developmental or social concerns and begin to address them. The "sick visit" is a time to address an acute illness or check in on an ongoing specific condition. In contrast, the well visit (or physical) is a time for the provider to do a more thorough evaluation. It also gives the patient, family and provider an opportunity to work together to ensure quality overall health.

Additionally, if your child plays a sport, the state of Michigan (MHSAA) requires that students receive a physical AFTER April 15, 2017 in order to play sports in the 2017-2018 school year. Act now to schedule your child's physical for this spring/summer. You can schedule online or by calling your child's office. We look forward to seeing you!

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Typically, when your baby is about six-months-old, their circadian rhythms stabilize and they start to wake up less and less during the night. This is a great time to work on sleep-training, or trying to get them to learn to fall asleep on their own and stay asleep during the night. There are a variety of commonly used methods, however, one that worked for your friend or coworker may not work for your baby.

 

The most common are:

Pick-up-put-down: this is a gentle technique that is exactly what it sounds like. When a baby is fussy and it’s time to go to sleep, pick them up and comfort them until they’re calm and drowsy, but not yet asleep. Put them back in their crib to sleep, and repeat until they’re finally asleep. This requires a lot of patience, and not every baby will like this method. For some, it’s overstimulating and can make them fussier, rather than coax them to sleep.

Fading sleep: this method consists of helping your baby fall asleep by rocking or feeding, but shortening the amount of time you rock/feed each night, which allows your baby to do more to get themselves to fall asleep. This also requires a lot of patience, but this works very well for families who want to minimize crying.

Chair method: This method doesn’t involve picking up your baby at all. Begin with your normal bedtime routine and put a chair very close to the crib while your baby falls asleep. The goal is to reassure baby that you’re nearby, but you don’t help them calm down or give them any attention after you’ve put them to bed. Each night, you move your chair farther and farther away until you’re right outside the door and no longer need the chair at all. This method can be very difficult on parents and baby, but for some, it can work well.

Ferberizing (check and console): This technique allows you to check the baby at timed intervals while allowing them to learn to console themselves. Your goal is to reassure baby that you’re nearby while reassuring yourself that they’re ok. When you check on baby, don’t pick them up, simply tell them that they’re ok and pat or rub their back for two-three minutes before leaving. Over time, increase the amount of time between checks. Start with 10 minutes between checks and increase by five minutes each night. This method helps baby learn to fall back asleep in the same environment they wake up in each night.

Cry it out (sleep extinction): This is the most commonly known method. The idea is you do your normal bedtime routine and put the baby to bed, but do not check on them again, instead of letting them fall asleep on their own. This can be hard for parents to not console their child when they’re crying, but the idea is that if you go in after a certain amount of time, your child will expect you to do that every night.

There is no “one-size-fits-all” method of sleep training. You may find a hybrid of these methods works best for you, or something that’s not listed here at all. If you need help finding a way to sleep train your baby, or talking through some of the ideas listed here, talk to your pediatrician. They can offer some helpful suggestions about what to try and what might work for you and your baby.