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As your baby’s first birthday approaches, you probably have “all the feels”. How did this helpless newborn just turn into an active toddler?! Where did the time go? The amount of change that happens throughout the first year of life is truly mind-blowing. It’s like, just when you think you’ve got this whole parenting thing down, you’re hit with yet another challenge or transition to navigate. You’ve likely already gone through many milestones that are both cute and challenging throughout your baby’s first year of life. But one big change, that is often not talked about until right before it happens, is the transition from formula or breastmilk to cow’s milk (or a cow’s milk alternative). Common questions you may ask when transitioning your baby to milk: 1. When to make the formula to milk transition? 2. How to make the transition? 3. Should you wean or go cold turkey? 4. How much should your child be drinking? 5. And what about bottles or toddler formula? In this post we are going to tackle the answers to all these questions and more! When to Introduce Baby to Milk? The AAP recommends giving your child cow’s milk around their first birthday. You can introduce dairy products such as yogurt and cheese after 6 months, but most pediatricians hold firm to the recommendation of holding off on actual milk until at least 10 months old. This is because we want to be sure that baby can handle the amount of sugars and proteins in cow’s milk until babies kidneys are more developed. Also, cow’s milk is not a great source of iron. Formula and breastmilk provide most of your child’s iron until regular table foods take over. Does a Breastfed Baby need Cow's Milk? If you’re breastfeeding your baby, you are free to continue to give breastmilk for as long as you desire! Your baby doesn’t necessarily need the addition of cow’s milk to his or her diet, however they DO need the added nutrition of calcium and vitamin D. Dairy is the easiest way to provide that, however there are certainly alternatives as well. How to Transition to Cow’s Milk? My #1 tip here is don’t overthink it! You have two options: 1) Offer 50% whole milk mixed with breastmilk or formula for a few days to a week, then switch to 75% whole milk and 25% breastmilk or formula before finally landing at 100% whole milk. 2) Simply go cold turkey! Over the last year, your little one has been taking in milk protein from your breastmilk or formula already. Additionally, you’ve likely introduced foods that contain dairy/milk products in them (as long as there was no medical reason to avoid dairy), therefore your child has likely been exposed to some cow’s milk already. You may not know this, but once you start giving your baby some solid food, the weaning process has officially begun. You may notice that your baby will start drinking less formula or breastmilk once solids are established. It is natural for your child to drink less formula or breastmilk as they near a year old. How Much Cow’s Milk Should Your Child be Drinking? The AAP recommends that 1-2 year olds drink 16-24oz of milk which is equivalent to 2-3 cups. Remember, once your baby is a year old, any milk they take in is now a “supplement” to their diet, instead of the “main source” of their diet. It’s important to not go over the 24 oz recommendation in order to hold space for solid food in your child’s diet. Also, you want to avoid them getting too full off of milk as it will hinder their ability to take in enough solid food. It’s all about balance! Milk Alternatives It’s important to note that as long as your child is receiving calcium and vitamin D from other sources, whole milk is not required. If your child has a milk protein allergy, is lactose intolerant or simply doesn’t like the taste of whole milk, we encourage you to talk to your pediatrician about what forms of milk alternatives to offer your child. Examples of milk alternatives are: almond milk, soy milk, pea milk, or oat milk. How to Drop Baby or Toddler from Using Bottles? Typically, around 7-8 months old we see babies drop down from four formula/breastmilk feedings to three. The feeding after the second nap can be replaced with a snack and water in a sippy/transitional cup. Classically, this coincides with the 3-2 nap transition. This is an easy way to begin the transition, as well as get them used to drinking from something other than a bottle. It's okay if your child rejects it at first. KEEP PRACTICING! Some of our favorite cups are listed here. Bottle to Cup Transition The next bottle to go can be the mid morning bottle. Again, offer a snack and water instead. After that, replace the morning bottle with a hearty breakfast (including dairy), and the shortly after 1 year old, drop the evening bottle. These can all be replaced with your milk of choice in a transitional cup. Bottle Use with Toddlers The AAP recommends weaning your child completely off bottles by 18 months of age. There are 2 main reasons for this: 1) Dental Health – serving milk in a bottle leaves your child’s teeth in contact with the sugars in milk, therefore allowing the chance for cavities to form. 2) Oral & Motor Development- Baby bottles can interfere with your child’s development of oral motor skills which are important once your baby starts saying their first words and eating more table foods. You can avoid this by offering whole milk in a sippy cup or straw cup early on and doing it before 18 months. It may be easier to offer a new drink in a new cup to avoid having to go through yet another transition at a later date. That would look like this: Bottle with breastmilk/formula ---> sippy/straw cup with whole milk However, you know your baby best! And if you think, they would have a smoother transition taking a more gradual approach, then do what is best for you and your baby! That could look like the approach below. Bottle with breastmilk/formula --> bottle with whole milk --> sippy/straw cup with whole milk If your toddler is using bottles currently, let them help you gather all the bottles together to 'give away'. You can give them to the trash man, for example. Milk & Bedtime Routines Prior to 1 year of age, it’s important to keep the milk feeding at the beginning of your bedtime routine. Checkout out our suggestion bedtimes per age here. Once your baby turns a year old, we recommend moving that feeding outside of the bedtime routine, meaning milk would be given with dinner, or shortly thereafter. Can I Give my Baby other Types of Milk? Skim milk as well as 1% & 2% cows milk are not recommended in children under age 2 due to their low fat content. If your child can tolerate cows milk, then whole milk is the best recommendation until after 2 years old. If your baby has a milk allergy or intolerance, we recommend speaking to your doctor about which type of milk to offer them. What about Toddler Formula? Most experts would agree that toddler formula is simply a marketing tool. It sounds good on paper, but it’s full of added sugars and unhealthy sweeteners. It’s really not necessary, especially if your child has a healthy and well-rounded diet. We are in favor of skipping over toddler formula completely. Final Tips to Transition Your Baby to Milk! The bottom line is to transition away from formula around 1 year of age. Don’t make the transition more complicated than it needs to be. Transitions of any form can be difficult on babies and adults. However, with a clear plan, the transition can be pretty seamless! Pick a method and stick with it. Your baby will likely really enjoy their new milk and you’ll likely enjoy watching them experience yet another new milestone! As always, make sure to talk to your child’s pediatrician regarding personal recommendations about transitioning from breastmilk or formula. This is very important, especially if your child has a milk protein allergy or is lactose intolerant. Stellina Ferri is the author of this article. Stellina is a certified pediatric sleep consultant and mom of three. She supports families through the journey of better sleep as a sleep consultant with Tweet Dreamzz Sleep Consulting. She lives in the Boston, MA area with her family. Find out what solutions she has for you by Booking a free call!

If you're here to learn more about our daughter's clubfoot relapse, be sure to visit and read part 1 of her journey. You can find out more there about how we were diagnosed and what the first 4 years of clubfoot correction looked like. If you just starting to research the condition or you are preparing for ATT surgery, you are welcome here. Please drop me an email if you have any questions you'd like to ask. Clubfoot Relapse in 4 Year Old You last read that our daughter was released from boots and bar wear by her pediatric orthopedist, and it was a big day of celebration and relief to have the treatment behind us. What was once a truly stressful diagnosis and daily maintenance ritual, was now in the rear view mirror. Everything seemed great with her foot until we went on a vacation about 4 months after we had discontinued all boots and bar wear after her 4th birthday. We were vacationing in a warm climate (February) and it was the first time I was seeing her barefoot and running/playing frequently. I immediately made a mental note that something seemed 'off'. The foot was naturally pulling up and in while running, and even walking, if I looked really closely. This had me a little concerned, but we enjoyed our vacation nonetheless. I would call her doctor to make an appointment when we returned. We were advised to come back at the 6 month mark anyway. To be honest, I was not even slightly worried. I was very naïve in this moment. We got on her doctor's schedule at St. Louis Children's Hospital. At this point, we were being treated by Dr. Pooya Hosseinzadeh. Our previous doctor, Dr. Matthew Dobbs, had relocated to Florida. We did not continue treatment with Dr. Dobbs as we thought we were only in maintenance care at this point. Dr. Hosseinzadeh made me feel terrible, honestly. He looked at me and asked "What happened?" even though he had seen her 5 months prior and had no concerns at that time or instructions for continuation of treatment at home. I was taken aback by this, and only then had a small feeling that something was wrong. Waiting to be seen at St. Louis Children's Hospital At the appointment, we were told we needed to start facilitating a series of stretches to the foot, daily, in addition to fitting her for a night time splint to stretch the foot while she slept. The consensus was that her foot was all around TIGHT. Specifically, her dorsiflexion range of motion was highly compromised. I thought, okay not so bad, we can do this. We got her fitted for the splint and went home with a new appt to come back in a month or so. This was April 2022. I would later cancel both the appointment and procurement of the splint. Reaching out for help (second opinion) I immediately went home and posted in Dr. Dobb's Facebook group. There was a public facebook group started many years ago and it's been an invaluable resource for us and so many parents. You can ask questions, post concerns and gain some insight about what others have been through. Dr. Dobbs is even known to comment and support parents. Did you know his DM's are always open? More on that later! The general consensus when I posted the photo above was the it 'didn't seem right', and that I should reach out to Dr. Dobb's directly. I didn't waste a minute, and after hearing back from him via Facebook Messenger, he requested these two videos. As you can see, the right foot is coming up and in when walking and running. Until the foot was corrected with surgery, she would also walk on her toes (right foot only) and generally never have the heel fully flat on the ground when walking, jumping and playing. Once we got over the shock (me), we setup a Zoom meeting with Dr. Dobbs. Dr. Dobbs is located in West Palm Beach, FL at the Paley Institute. We live in the metro St. Louis, MO area, so to go see him is a 2.5 hour plane ride or a 17 hour drive! Picking a doctor to perform ATT surgery Dr. Dobbs is the best of the best when it comes to Clubfoot treatment in children. You can learn more about him here. If our daughter was to have surgery, we wanted the best for her and we felt implicitly that Dr. Dobbs was the guy to treat our daughter. On the zoom, he examined her virtually and confirmed that the foot would require a corrective surgery called Tibialis Anterior Tendon Transfer. Essentially the tendon on the inside of the foot is transferred to the outside of the foot and held in place with a string and button mechanism. The transferred tendon will keep the foot pulling out instead of turning in, which is what a clubfoot naturally wants to do. In addition to the tendon transfer, he also released the heel cord again with a series of cuts down the Achilles tendon. Why did her clubfoot relapse? There is no straight answer here. As humans, we want to know the why, and in this case, there wasn't one. Maybe it was her genetics, maybe she wasn't ready to come out of boots and bar or maybe it was the combination of many things. I think the best thing to do to avoid relapse is to stretch the foot as often as possible, and wear boots and bar until you are cleared to be done. Also, understanding that ATT surgery is actually part of the Ponsetti Method for full clubfoot correction. They've perfected this surgery over time as there is always a chance of relapse. If your child is experiencing a relapse, know that you have time to process this information and what to do about it; which may include getting a second opinion. There will be a lot to process, here, both emotionally and financially. We spoke to Dr. Dobbs in May 2022 and scheduled her surgery for September 2022. We were able to enjoy the summer as it wasn't critical that she was treated right away. Timeline for ATT Castings and Surgery We chose to fly for all of her appointments: 6 times total. From St. Louis, we flew into Ft. Lauderdale International Airport and either flew out the same location or went out via Miami International airport. Luckily, these were all direct flights. My husband and I alternated taking her. Only for the surgery did we both travel to Florida together. With another child at home and careers, this is what made sense for us. First Casting: August 31, 2022. We flew in on the 30th, stayed overnight at the Hyatt Place Downtown West Palm Beach. We went to the appointment, and returned back to the airport to head home. Second Casting: September 7, 2022. My husband flew with her to stay at the Hyatt Place Downtown West Palm Beach. They went to her appt the next morning and headed back to the airport for their flight home. Third Casting: September 14, 2022. We stayed at the Hilton Garden Inn near the outlet malls. This is where we would stay for the remainder of our visits. The GM, Mike, even realized we were with Paley and gave us a discounted rate on our room. They have a nice breakfast in the morning and I found this hotel to be conveniently located to the medical office/hospital and near restaurants and shops. The Hyatt Downtown was noisy both from street traffic and construction within the building. At this point, we would fly out of Miami going forward. Miami had a flight that got us home earlier (delays not withstanding). Surgery: September 22, 2022. The three of us flew into Ft. Lauderdale airport the day before. We had a nice family meal and got our daughter to bed early after a shower and a snack. We were to arrive at the hospital by 7AM to be checked in. Post-Operation appointment and cast removal + short leg cast: October 26, 2022. My husband took her for this appointment. As usual, they flew the day before to make their appointment the next morning. The surgery cast was removed and the wound was inspected before a short leg cast was placed. Our daughter had a large wound on her foot, a wound that none of us were expecting. It wasn't covered with stitches or tape or anything. It was expected to heal from the inside out. Be advised to bring something to distract your child at this appointment like a tablet or eye mask or comfort item. They also removed the button under the foot which seemed a painless procedure. We returned the wheelchair after this appointment, which made it difficult for my husband within the car rental return, etc. Removal of short leg cast and fitting for AFO/SMO & night brace: November 2, 2022 This appointment took about an hour or more. We had to see the orthotic specialist for both the AFO/SMO and the night brace. We also saw Dr. Dobbs again to review the wound and its care. He showed us the stretches to be used at home and at therapy. I was sure to take a video and I am glad that I have it! The nurse gave me two packages of medical grade adhesive foam. Be sure to ask for two. We ended up using every bit of it and it was hard for me to locate extra, but I eventually found this on Amazon. Tips to make this process as easy as possible Get to know Kathy, Angela and Katy at Dr. Dobb's office or wherever you are receiving treatment. They are incredibly talented and kind. If you need something, email them. They will get back to you and get you taken care of during this stressful time. I had best success reaching Angela and Kathy by both phone and email. Katy we got to know the day of surgery and she will help guide you through the post-op physical therapy process. Be an advocate for your child. Take videos during the consults, ask questions and speak up if you feel like you need more support. Things to buy to prepare for ATT Surgery & Recovery We rented a pediatric wheelchair from Garden's Drugs in West Palm Beach. They had it ready and waiting for us during her first casting appointment. It is rented per month and was less than $300 total for the entire time we kept it, which was x weeks. Shower cast cover. We found showers to be easiest with a cast on. We also borrow a shower chair from a family member. Your child will spend a lot of time sitting down. A lap desk for activities and eating came in handy. My mother in law also made a fabric cover for her cast while she slept. This is something that was homemade but made a world of difference since both legs were exposed when sleeping. The pre-surgery casts are made of plaster and super scratchy. Our daughter was unilateral clubfoot. Child's walker. We used this very briefly from Amazon and then returned it. Billies shoes. We had two pairs of high-top Billies shoes. They zip around the toe and work great with AFO/SMO wear. We sized up and went with wides. All items can be found here Day of ATT surgery The order of surgery will go by age. We were scheduled to check-in at 7AM at St. Mary's Medical Center in West Palm Beach Florida. Our daughter was 4 years old at the time. The hospital required an upfront fee at check-in. It was somewhere around $2,000. I won't be talking about cost of the surgery/treatment too much as that will vary widely according to your health insurance coverage. We had a high-deductible plan and quickly met our max out of pocket during this time. Paige was brought back to pre-op where she changed her clothes and got comfy in a bed. Dr. Dobbs came around to mark her foot and we also spoke to several nurses and another doctor of anesthesiology. Post-Op Recovery We said our goodbyes and went to the cafe and waiting room to wait for a phone call from Dr. Dobbs. I would say he had called us about two hours later to tell us everything went great and the foot was fully corrected. Another 30 minutes went by and we were then called back to see her! She was VERY sleepy. Her favorite comfort item and popsicles helped. From that point on, we were managing her pain around the clock. She was given a dose of fentanyl post-op, and then had Toradol intravenously and oxycodone orally every 3 hours rotated while we were there. The Doctor came to see us early the next morning and we were discharged around lunchtime. One parent is allowed to stay overnight. I brought a pillow from the hotel and our own sound machine and sleep mask. We both slept terrible and were VERY ready to be discharged. We tried our best to keep the foot iced at all times; even while she slept. If you haven't gotten surgery yet, I advise to purchase a leak-proof ice pack to use while traveling. Once home, we used wrap around gel packs, as well, that were changed out frequently. Dr. Dobb's office will arrange post-op medications. I was a little overzealous and didn't think we would need the full oxycodone prescription, especially after the pharmacist told us that our insurance company only covered three days. Listen up, get the full 5 days. You WILL need it. Recovery at Home Our daughter's recovery was ROUGH. It seemed like the pain and muscle spasms were all encompassing and around the clock. She required medications like muscle relaxers and prescription pain killers for a total of 9 days. I was very discouraged with her level of pain and was anxiously waiting for it to gradually get better. Like magic, on day 8/9 the pain went from a 10 to a 2 on the pain scale. I felt like I could finally breathe. There is nothing worse than seeing your child in constant pain. To keep on top of her meds, she slept on a mattress in our closet for about a week so we could set times to keep her comfortable over night. During the evening and leading up to bedtime seemed to be the worst pain-wise. After those 9 days, she was kept comfortable with over the counter pain relievers. Some medications to have on hand are Benedryl, Zyrtec, Ibuprofen & Tylenol. She was able to return to school 12 days after surgery. The school nurse and teachers were all aware of her procedure/care and were willing to help. We looked into getting a 504 plan, but it wasn't needed as there were plenty people there invested in her care. The wheelchair made it doable and she was able to get back into a normal routine at school. Wound care: Her wound finally closed right before the New Year 2023. It took about 8 weeks. Once it closed completely, we've been sure to keep it hydrated and have also used scar cream. Overall, she has 4 scars on the foot for various reasons. One was a pressure sore from the AFO. Physical Therapy after ATT Surgery Physical therapy for anterior tendon transfer surgery started 2 days after the last cast came off. Her foot was still in rough shape, but the therapist took it like a pro. She measured the foot and leg and took a baseline for everything. This first appointment was to develop a game plan, teach us how to help at home and most importantly, get her walking again. Physical therapy protocol Wean from AFO to SMO in 6-8 weeks Wean from SMO in 4-6 weeks. Strengthen to full weight bearing Full range of motion We would do 3 visits per week for 12 weeks. We then went down to twice per week, and now at 8 months post operation, we still visit once per week. Exercises include: Peroneal strengthening heel cord stretching forefoot eversion exercises gait training. As I write this, our daughter is active in swim and gymnastics. This surgery and clubfoot has NOT held her back. She keeps up with her peers and twin sister just fine. Long term, we worry about overall biomechanics of the foot/leg and its overall range of motion, etc. Right now, we are working on plantar flexion (pointing toes) and strengthening the ankle and foot. Because she has family history of the defect, we can see first hand some of the complications that may arise as an adult. Thank you for reading, if you made it all the way here. I hope this blog helps you feel more at ease if you are going through tendon transfer surgery in addition to gathering a few tips and tricks for your experience. If you would like to ask a question, I am more than happy to answer! Lindsay Loring is the author of this article. She lives in the St. Louis, MO metro area with her family. She is the owner and founder of Tweet Dreamzz Sleep Consulting.

The 2-3-4 or 2/3/4 nap schedule is popular because it’s easy to remember. It's as simple as that. But just because it’s popular, doesn’t mean it’s the best. Read on to find out why we don’t LOVE it. The 2/3/4 nap schedule refers to wake windows for baby between sleeps and depicts a 2 naps per day sleep schedule. Baby is awake 2 hours in the morning before they take their first nap. Then, baby is awake 3 hours between nap 1 and nap 2, and then 4 hours before bedtime. This allows for 9 hours of wake time which is standard for a 6-8 month old newly on a 2 nap schedule. Here is the issue. Two hours awake in the morning is rather short, and 4 hours awake before bed is REALLY long. We find that babies cannot handle 4 hours before bed until they are 9-11 months old. Keeping baby up longer before bedtime doesn’t result in a later morning wakeup. Instead, it backfires, and baby can wakeup even earlier than their typical morning wake time. Cortisol is responsible for this. So, keep the wake window before bed a tad on the conservative side. The 2-nap schedule we recommend instead of 2/3/4 What if we balanced those 9 hours of awake out a bit more? How about 2.5/3/3.5 wake windows. We know 2.5 hours in the morning can be a comfortable sweet spot and 3.5 before bed will make sure baby isn’t overtired; resulting in early morning wakeups or a false start. 3 hours in between the naps is just right. We sound a little like Goldilocks and the Three Bears, but trust us, this nap schedule will feel like a fairy tale. Our favorite two nap schedule You may notice that our favorite 2-nap schedule depicts times on the clock and doesn’t show wake windows. Well, that’s because we are giving you the permission to stop physically counting wake windows once your baby is on two naps per day. Feel free to do a little dance! Clocked schedules vs wake time schedules can work for babies 6 months + and on a 2 nap schedule. Instead of counting wake windows, you will go by clock only. This can work for those babies and caregivers who live and breathe by a schedule. How to know if your baby is ready to take two naps per day? Here is a quick checklist to help you spot the warning signs of a nap transition: · Baby is 6-8 months old. · Naps are naturally getting longer to push out the cat nap. · Naps are chronically short, so a schedule change is needed. · Baby wakes up early in the morning in an effort to acquire more awake time. This may also manifest into night wakings. How to establish a clocked nap schedule? Start by choosing a desired wake time. We like 7:00am. Then offer the naps at 9:30 & 2:00 PM every.single.day. Bedtime will become super consistent and so will nap lengths and morning wake time! If sleep still feels like a giant struggle at your house no matter what you try, we can help. Talk to a certified baby sleep specialist today by booking a FREE introductory call. Lindsay Loring is the author of this article. Lindsay is passionate about sleep and helping families get it! Get to know Lindsay and her team on Instagram.

Sleep training twins can be a complex journey for parents, but it's not impossible. In fact, better sleep is closer than you think! If you're the parent of twins seeking the best sleep training methods, look no further. Our latest blog delves into effective sleep training strategies specifically tailored to support twins on their sleep journey. Discover the secrets to nurturing healthy sleep habits in your little ones below. No time to read the full article? Here are quick Links to each sleep training method option for twins. Stay in the Room/ Chair Method/Sleep Lady Shuffle Timed Intervals/Leave & Check/Ferber Pick up/Put Down Cry it Out/Extinction Sleep training your twins may seem overwhelming, and putting the information into action might leave you feeling paralyzed. Especially when Michelle down the street said how “easy” it was for her one baby. Let’s start by walking through things to take into consideration before starting one of these sleep training methods. Your twins are individuals Identical twins and fraternal twins are all their own unique, individual selves. You may feel one is ‘better’ or ‘worse’ at sleeping than the other, and this is common. Twin parents sometimes get stuck in the comparison game, myself included. So, knowing that you are working with two separate babies at once, this may help you choose a method that works for both. How to know if your twins are ready for sleep training Generally speaking, 16 weeks is the minimum age for sleep training. Not sure if your babies are developmentally ready? We’ll answer that for you in this article. A few other markers we look for are: Average wake windows throughout the day are 1.75-2 hours long Babies are showing signs of self-soothing abilities during wake times and sleep times. Examples of self-soothing are sucking on fingers, rubbing head, changing body position & even mild protest/crying before baby puts themselves to sleep or becomes content again. Keep in mind that sleep training does not mean night weaning! Night feeds can be kept as long as you and your babies are needing to keep them. You may be thinking, ‘well doesn’t sleep training mean sleeping through the night?' Find out here what sleeping through the night really means. How to set your twins up for successful sleep training Consistent bedtime routine, optimal sleep environment, age-appropriate schedule. You can read more on those topics here. Sleep Training Methods for Twins Stay in the room/ Chair method/Sleep Lady Shuffle The main concept here is that you are ‘camped out’ in your twins room while sleep training. Bring a chair in from the home like a kitchen or office chair and place it near both of the cribs. Ideally you can reach out with both arms and touch both but it’s okay if you cant. Just try and state equally distanced from both. Having two parents in the room can be overwhelming, so we just suggest one parent at a time. You may alternate or take turns as you see fit. This sleep training method allows you to soothe your twins consistently and without taking breaks if you don’t want to. Soothing can look like rubbing back/tummy, loud shushing and hand holding to name a few. We suggest giving louder crying more attention and softer crying less attention. Timed Intervals/Leave & Check/Ferber This sleep training is the most popular choice for most parents, especially with twins. This method allows parents to step out right after bedtime to give babies time to understand the transition to separation at bedtime and also a chance to calm themselves and soothe before parents intervene. We recommend starting at 10-minute intervals and responding using soothing techniques like belly rubbing, loud shushing and key words. Parents will then step out again and start an additional timer before entering to soothe again. Pick up/Put Down This method can be used in a combination with Ferber method or Chair method. This sleep training method adds in pick-ups as a means to soothe baby. Pickups are short (10-15 seconds) and are intended to interrupt crying if there is any and allow their self-soothing to kick in. Sometimes pick-ups don’t work, and that’s okay. Use your intuition as to what is helping and what is not. We don’t recommend pick up/put for babies older than 6 months old. It’s also okay if one twin responds to this method and the other doesn’t, their individual needs may be different! Cry it out/Extinction This method means that there is no interaction from parents after the initial bedtime routine and put down despite the child’s signaling or crying. Parents will stay out of the room until morning time. How to interpret crying when sleep training twins We don’t believe all crying is the same. A baby who is slightly fussing or complaining isn’t the same as a baby who is screaming or hysterical. It’s important to be in tune with your babies signaling. If they are signaling less, this means self-soothing is also taking place. You may not want to interrupt this beautiful process  This article was written by sleep consultant, Lindsay Loring. Lindsay is the owner of Tweet Dreamzz Sleep Consulting. Collectively, our consultants have helped sleep train over 150 sets of twins worldwide. Visit us at www.tweetdreamzz.com

My friends nicknamed me “The Routine Queen”, because seriously, what is better than a good routine? Without a routine I am LOST. I plan everything out to a tee. With three kids 2 and under, it is the only way I can thrive as a parent. Although a set schedule/routine may sound rigid, it can actually be pretty flexible! When kids know what to expect, it makes bedtime easier. But what is a bedtime routine? How do you implement one? And what does it look like at different ages or with multiple kids? What is a Bedtime Routine? A bedtime routine as it relates to babies and toddlers is a sequence of events that happen leading up to bedtime every single night. Following a bedtime routine is an important first step in teaching your child healthy sleep skills. The bedtime routine should start at roughly the same time every night. When practiced consistently, it can help your child fall asleep faster and have fewer night wakings. At What Age Should a Bedtime Routine Begin? The sooner the better! You can start a loose bedtime routine as soon as you bring your baby home from the hospital. While we understand newborns don’t usually have a set schedule, the predictability and consistency can still help them wind down. Around 4 months old can be the perfect time to create a concrete bedtime routine since that is when your baby’s development lines up better with sleep. If your baby is older and you have not implemented a bedtime routine yet, it’s never too late to get started. Bedtime routines will inevitably change with age; however, a few things will always remain constant. A good bedtime routine always has the following two elements: · A consistent sequence of events · A soothing ritual That’s it! It’s up to you and your family to decide how long the routine should be, as well as all the components in between. Your bedtime routine could be as short as 5 minutes, or as long as 40 minutes. The timing usually depends on your child’s age, how many kids you are working with, and if you have activities such as a bath built in. Example Bedtime Routines by Age 4 Months – 1 Year · Feeding (formula or breastmilk) · Bath OR clean up routine (sponge bath, wipe down of hands, face & feet) · Diaper & Pajamas · Brush teeth (if applicable) · Sleep sack on · Book/Song/Quick Cuddles or chats about the day · Sound machine on · In bed awake with a kiss goodnight · Lights out *For infants and children up to 1 year of age, the feeding will take up much of the routine. We advise moving the feeding to the beginning of the routine to eliminate any feed to sleep association. Easy Toddler/Pre-School Age Bedtime Routine · Milk or milk alternative (either with dinner or shortly thereafter) · Bath OR clean up routine (sponge bath, wipe down of hands, face & feet) · Diaper OR potty · Brush Teeth · Sleep sack on (if being used) · Book/Song/Quick Cuddles or chats about the day · Sound machine on · In bed awake with a kiss goodnight · Lights out *For toddlers, more time is added to the hygiene routine and ritual to allow for more choices as independence is established (allowing them to put on their own pajamas, brush their own teeth, pick out which book to read). *For preschoolers, even more time is added to the quiet time/activity time before bed as their sleep onsets naturally take longer. Tips For an Easy Bedtime with Twins Everything is harder with twins, including the bedtime routine. Don’t panic though, I’ve been going through a bedtime routine with twins for over 2 years now and have come up with some time-saving tips below. 1. Do it On the Floor My biggest tip for a twin bedtime routine for the first year is to do a lot (if not all) of it one the FLOOR. I have found that at this age, this is the safest way to go about it. Being on the floor ensures that your hands can be on both twins, and no one is left unattended in another room. 2. Don’t Do a Bath Every Night You do NOT have to bathe your child every single day/night! You certainly can if you wish, however, a simple hand & face wash is good enough on days when the twins didn’t have a battle with spaghetti sauce at dinner or didn’t go running around outside in heat or mud. If there is no bath being done, the routine could be cut in half. I find that a lot of parents put pressure on themselves to make sure that a bath is ALWAYS part of their bedtime routine. It doesn’t have to be if you don’t want it to be! I personally don’t include the bath as part of my twin’s bedtime routine. My twins are bathed around 4PM before dinner every other day. It’s just what works for my family. I like not having the added pressure of including it in their routine and my twins love that their bath can be a little bit longer since I am not held to a bedtime time constraint! 3. Eliminate Parts of the Routine that are not Essential This might be going against the grain, but you may be surprised to hear that I don’t read my kids a book before bed. I just never got into the habit of making it part of their routine. We read books during the day. This way, I never have to deal with the “just one more book please!” stall tactic. If you like reading your kids a book before bed, please – be my guest, just don’t feel like you HAVE to make this part of your routine. Instead, you could sing a song, say the same words or phrases, rub their backs for a few second before saying goodnight. The options are endless. Bedtime Routine with Multiple Kids of Different Ages Doing a bedtime routine with one baby can be manageable once you get the hang of it. Even doing a bedtime routine with twins becomes less challenging once everyone knows what to expect. But what about if you have multiple children of different ages? Perhaps an infant and a toddler? Or twin toddlers and an infant (my exact situation)! Who do you put to bed first? Do you do the routine all at once? And what if you’re by yourself? See my top tips below on how to navigate these types of tricky situations. Ensure All Your Kids Can Fall Asleep Independently When you have independent sleepers, life is good! You don’t want to have to be rocking your younger child to sleep while your toddler isn’t being tended to in a different room (scary!). Routines like laying with your child before bed or helping them get drowsy may prolong the routine and make it very difficult to put multiple kids to bed. If you need help teaching your child how to fall asleep independently, we can help you with that! Book a free discovery call here to learn more. Generally, we suggest putting the kids to bed from youngest to oldest (in that order). Unless you have a newborn – their bedtime typically falls later than the average 7-8PM, which means they are the last ones to put to bed. How to Prepare for Baby’s Bedtime in Advance Do anything that you possibly can in advance to ensure a seamless bedtime routine. Sometimes that means laying out your children’s pajamas, diaper & sleep sack ahead of time, pre-picking out a book and having the blackout curtains already closed. Do anything that you can ahead of time (especially if you’re solo) so that you aren’t rushing and looking for specific items when you should be helping your kids wind down. Tips For a Quicker Bedtime Routine with Kids Where can you overlap your bedtime routines? Maybe you’re able to read everyone the same book in one room or give them a bath at the same time… Can you feed your baby while reading to your toddler? Multi-task in any way that you can! Don’t forget that toddlers and bigger kids love being given a job to do. Have them help by giving them a specific task to do. For example, your preschooler could pick out a book while you put your infant in their crib. Your toddler could be in charge of shutting the lights off or turning on the sound machine in the infant’s room. If you’re willing to get creative, you can merge bedtime routines in a way that makes sense for your family. Just be consistent with how you choose to do this! At the end of the day, just remember to follow the same pattern of events leading up to bedtime every night. Kids thrive off routine and predictability. If done consistently, a concrete bedtime routine cues the brain and lets the child know that sleep is coming. Ultimately, all humans need dedicated periods of transition and that’s why a bedtime routine is so important. Stellina Ferri is the author of this article. Stellina is a certified pediatric sleep consultant and mom of three. She supports families through the journey of better sleep as a consultant with Tweet Dreamzz Sleep Consulting. She lives in the Boston, MA area with her family. Find out what solutions she has for you by Booking a free call!

Are the days of a seamless, 2-nap schedule a thing of the past? The average age for a child to drop their second nap of the day is around 15 months old. Some keep it as long as 18 months and some drop it as early as 12 or 13 months. Keep in mind, that a child who holds onto 2 naps longer, may experience disrupted sleep at night and overall shortened night sleep. As you near the 2-1 nap transition, there are warning signs: Short naps. (45 minutes to 1 hour) Baby is having difficulty falling asleep for one or both naps. Early morning waking's consistently for 5 days or longer. 45+ minutes earlier than your desired wake time. Taking a long time to fall asleep at bedtime. Not sleeping through the night anymore. Just like the other nap transitions, the 2-1 nap transition will also take some time. Generally, it takes 4-6 weeks to truly settle into the new schedule. Especially if you are doing it at the younger age of the average. Tips for 2-1 nap transition Here's how to start the 2-1 nap transition! Delay morning nap by 30-60 minutes and settle there for 5-7 days before adjusting again. That could look like 11am-1pm nap with an early bedtime. Eventually settling at 12PM. Wake windows on a 1-nap schedule are 5/5. Keeping in mind they broaden as your child gets older. Going to 5.5/5 then 6/5.5 wake windows. Example of a 1-nap clocked schedule 6:30/7 wake 12:00-2/2:30 nap 7:00-7:30 bedtime By keeping the nap at a set time, the morning wakes and bedtime will become settled without much variation. Catnaps will happen in the afternoon by the way of a car ride, and sometimes that can't be avoided.... This is okay. The main thing to remember is that when you get to 11AM (or a 4 hour first wake window) You won't offer a second nap on those days, instead you will offer an early, early bedtime. Sometimes, as early as 6PM. Bedtime will need to be moved earlier during the transition as your little one adjusts to these longer awake periods during the day. Total wake time may drop from 10 to 9 hours temporarily. Before moving to a one nap a day, check that your baby's day can't be stretched out even further. Something like 3/3/4, for example. Or even 3/3.5/4. Once your baby's total wake time for the day is close to 11 hours, it is TIME to drop the 2nd nap. A common two-nap schedule your baby may be on before dropping their second nap of the day could look like: 7am Wake 10-11am Nap 3-4pm Nap 8pm Bedtime *Check that your 2-nap schedule doesn't have some room for manipulation first i.e. capping nap lengths and lengthening wake times. Many times I feel parents are anxious to lose the 2 nap schedule, but what lays ahead is a dedicated LONG afternoon nap. It really was one of my favorite nap transitions for my twins'. I got my nap time hustle done and even took many naps myself on the weekends. Enjoy! Looking for an experienced sleep consultant? Lindsay has helped over 100+ sets of twins to date and countless singleton babies and children. Book your free call with her today! Lindsay Loring is a certified pediatric sleep consultant and Owner of Tweet Dreamzz Sleep Consulting. She lives in the St. Louis, MO metro area with her husband and twin girls. Join her online community of parents here.

Babies come into the world craving security, warmth, rhythm and comfort. Swaddling your baby is proven to promote sleep as one of the S’s in Dr. Harvey Karps '5-S’s to soothe a fussy baby'. But, soon enough, it will be time to stop using it, and that will seem a little daunting. Take note of my key things to remember when it comes to unswaddling your baby. What age should you transition your baby out? As your baby nears 8-12 weeks of age, you will notice the traditional swaddle will stop working for them. They will repeatedly bust out of it, or they become too big for it. You will also need to recognize that by 3 months, babies can and will start to roll, so the swaddle will no longer be safe for them. But, good news! They will now have more freedom to move about! And, at this age, babies love to use their hands to suck as a self-settling mechanism. Don't be afraid if hand sucking seems to 'wake' them. Let your baby explore their hands and attempt to soothe themselves in this way. Okay, but, now what? I remember being petrified about this transition. It seemed their hands and movements woke my babies up MORE. How could I possibly drop the swaddle? Not to mention that this age is full of hiccups and roadblocks when it comes to sleep. Swaddle transition, 4-month sleep regression, night-feedings, short naps.. you name it. Plus many parents wonder if baby is too young to implement gentle sleep training methods. Want to build a sleep foundation starting at bedtime? Download my night waking guide! Before I get into how to transition out of the swaddle, I want to share what worked for us first. My story: How the magic sleep suit helped my twins sleep. Just when I was feeling helpless as a first time Mom to twins, a dear friend of mine saw my Facebook post about sleepless nights and immediately suggested I try the Magic Merlin Sleep Suit with my little girls. The only thing I had heard about it previously was when she said her baby slept in a “Moon Suit”. LOL! So, naturally I was willing to try something that I knew worked for someone else. I checked my daughters’ weights to be sure the sleep suit would fit them and then made the purchase. You guys, I’m here to tell you that they slept so much better that very next 1-3 nights. Each night just got better and better. They settled easier at bedtime and we were able to reduce the number of wake-ups entirely. I was severely sleep deprived during those first few months, and any extra sleep I could get was crucial. An added bonus for us was that the sleep suit worked great for my daughter who was sleeping in corrective foot wear for her club foot called boots and bar or Dobbs bar. She had recently been taken out of her casts and was then wearing her brace, so having the suit for her gave me extra comfort that she was staying comfortable when trying to sleep. How to dress your baby in the magic sleep suit. Dress baby in a diaper, short-sleeve onesie and socks. We were using the sleep suits from February to May (in the northern hemisphere) and they were comfortable in socks and a short sleep onsie. My twins wore the sleep suit for almost 3.5 months. They LOVED that suit. Putting them in it cued their brains for sleep, and it became part of our routine for night sleep and nap sleep. They even traveled with us to Florida! In the hotter climate, we just did diaper underneath and made sure to keep the ceiling fan on. They worked great and they sleep like angels on our vacation. Even though there are quite a few transition products out there, I genuinely feel that the sleep suit option is great for those babies who have a very strong startle reflex, and the suit can be a perfect solution for some babies. In addition, the suit can be SO helpful for babies who are used to sleeping in someone’s arms and are hanging onto those 4th trimester snuggles a little longer. Also, Premie babies who have hit the weight requirement would be a great candidate to wear the suit as they may hold onto the reflex even longer than full-term babies. Please double check your child for any signs of torticollis or plagiocephaly, as the suit doesn't allow baby to sleep any other way but on their backs. If you notice positional preference of the head or neck and head asymmetry, contact your child's pediatrician or reach out to Baby Begin for early intervention. Thinking about sleep training? The Magic Merlin Sleep suit can assist wonderfully when parents are implementing independent sleep routines especially for naps. Visit magicsleepsuit.com and use code TWEETDREAMZZ15 at checkout! How to size the Magic Merlin's sleep suit I don’t recommend sizing up as it’s intended to be a snug, secure fit to work properly. How you will know if it is a good fit: · Scooped neckline will lay flat on baby’s chest away from face · Baby should not be able to wiggle arms and legs out of the openings or pull their legs into the trunk area · Follow the recommended sizing chart Testimonial I was working with a client once who had a 4-month old little boy. He struggled so bad to get any time of consecutive sleep periods. He would literally jerk himself awake after 20 minutes. I almost didn’t believe this was possible as most babies can typically achieve the 30-minute sleep cycle. My client took a video of him doing it, and low and behold his startle reflex was REALLY strong. Thankfully, my client was only 10-minutes away. I drove my daughter’s old suit straight over to her house. And, BAM, the very next day he took an hour + nap. He wore the suit for about 2 months, and then transitioned seamlessly into a standard sleep sack. So, if you are wondering if Merlin’s Magic Sleep Suit works, here is proof it does! Are you just ready to drop the swaddling cold turkey? What if you don’t want to invest in another product, or your climate isn’t right for it? Here are some tips for how to drop the swaddle and get into a standard sleep sack or Zipadee-Zip. You can find sleep sacks at any price point and in all fabrics. Fleece for winter and cotton for summer. I always welcome the idea to use a sleep sack. It’s basically a wearable blanket, and it something else to cue your child for sleep. Plan of action to drop the swaddle looks like this: · Night 1- right arm out · Night 2- right arm out · Night 3- right arm out · Night 4- left arm out · Night 5- left arm out · Night 6- left arm out · Night 7- both arms out! Or maybe you are a “cold turkey” kind of person! Ditch the swaddle, and don’t look back, but expect an adjustment period that could include some crying and disrupted sleep. Takeaways on how to transition out of the swaddle! Signs your baby is ready to drop the swaddle 1. Breaking out of it 2. Rolling over 3. Getting too big/long + plus age 4. Showing signs of other self-soothing mechanisms. Example: finger/thumb sucking or face rubbing. When using the Magic Merlin sleepsuit, always ensure it has a proper fit according to the guidelines above and the recommendations listed here. Not sure how to start implementing independent sleep strategies? You'll want this guide! Lindsay Loring is a certified pediatric sleep consultant with Tweet Dreamzz Sleep Consulting located in the Metro St. Louis, MO area. She helps families all over achieve sleep again after baby(s) is born.

Helping your baby sleeping through the night can seem like an impossible feat. But it can be achieved much sooner than you think! You may just have to fully understand what “sleeping through the night” means for babies first. What is Considered Sleeping Through the Night? At Tweet Dreamzz, sleeping through the night for a baby means the following: 6-8 hour stretches of sleep with minimal to no wakeups. The baby is in their crib for 10-12 hours a night. The baby can put themselves back to sleep independently after a nighttime waking. How does night weaning affect sleeping though the night? If you don’t wish to night wean just yet, then sleeping through the night has a slightly different definition. You CAN sleep train without night weaning! In this case, we define “sleeping through the night” as: The baby wakes up in middle of the night for ONE nondisruptive feeding, but promptly returns to sleep afterwards. You may have been surprised to learn that none of the above definitions state that your baby is physically sleeping from bedtime to morning without waking at all. Not making any noise whatsoever throughout the night is an unrealistic goal for most children. Night wakings are a biological norm for humans of all ages and should not be considered the enemy of a good night’s sleep! Instead, our focus should be making night wakings less disruptive by working through the problems that may be standing in the way of having our children falling back to sleep. How to Help Your Baby Sleep Through the Night Optimal Sleep Environment for Baby Your baby’s room should be cool and dark and have continuous white noise playing. A temperature of 68-72 degrees Fahrenheit (roughly 20 Celsius) will ensure that your baby is not too hot or too cold. Make sure baby’s room is SO dark that you cannot see your hand when it’s in front of you (even in the daytime!). This will ensure that light will not be the culprit of your child’s waking. Lastly, playing continuous white noise will drown out any external sounds that could wake your baby such as pets, siblings or vehicles outside. Following an Age-Appropriate Day Time Schedule can Help Your Baby Sleep Through Check out this post for examples of baby nap schedules throughout the first year and beyond. A lot of the time, what happens during the day can directly impact what happens at night. A baby who is overtired may wakeup frequently, and a baby who’s had too much daytime sleep may have split nights. Here are our recommended wake windows per age: Newborn: less than 1 hour 8-12 weeks: 1 hour - 1hr 15 min 3-4 months: 1hr 15 min- 1hr 45 min 4-5 months: 1 hr 45 min - 2 hours 5-6 months: 2hr 15 min - 2hr 30 min 6-8 months: 2hr 30 min-3hr 30 min 9-12 months: 3-4 hours Bedtime Routine to Help Baby Sleep Through the Night Create a bedtime routine that involves repeating the same set of activities starting around 30-45 minutes prior to bedtime (lights out). The bedtime routine is a sequence of events your baby learns to recognize that signals sleep is coming. For Example, A Baby’s Bedtime Routine May Look Like this; Feed Bath time Pajamas & sleep sack, Reading a story or singing a song plus a few keywords or phrases. Once done repeatedly, these activities will cue your baby’s brain into knowing that sleep is on the way. All children need a bedtime routine no matter how old they are, so starting early with your baby will help them have healthy sleep habits to last a lifetime! Full Feeding before Bed will Help Baby Sleep Through the Night Following an age-appropriate feeding schedule during the day will allow baby to take a full feeding before bed. Ideally the feeding should be closer to the beginning of the bedtime routine to break any “feed to sleep” association. This will ensure that if they wake during the night, it is not due to “true hunger” or bottle/breast dependency. Sleep Training Helps Baby Sleep Through the Night Some parents choose to sleep train to help their baby sleep through the night, and that is a perfectly acceptable option for a lot of families. Most babies do NOT naturally sleep through the night, or even have long stretches of sleep. A parent-led sleep routine, like sleep training, can help you and your baby get the sleep that you need. Keep in mind, that we cannot train away all night waking for our kids or make them stay quiet during middle of the night wakings, but we can teach them the tools and give them the opportunity to fall back to sleep without our intervention, and that is exactly what sleep training looks like. When sleep training, it is important to remember that the goal isn’t always for your baby to “sleep through the night”, but instead to allow your baby to have the necessary self-soothing skills, so that when they have a normal biological waking, they are able to put themselves back to sleep on their own without your help! At what Age do Babies Sleep Through the Night? It’s important to note that, what is considered sleeping through the night can look different depending on the age of your child. Let’s breakdown what sleeping through the night looks like for various ages. 0-3 Months A newborn is not capable of sleeping through the night. Babies at this age need to eat every 2-4 hours, including during the night. This is completely normal and nutritionally necessary for a baby to be taking in calories all throughout the day and often throughout the night. At this age, you can work on getting in all the baby snuggles while also loosely starting a routine and practicing some naps in the crib so that your baby becomes familiar with that environment. 3-4 Months At this age your baby may be able to sleep longer stretches. Anywhere from 5-8 hours is common and should be considered an accomplishment! It is common to still have at least one night feeding at 3 months old. At Tweet Dreamzz, we accept our earliest clients at 4 months old. At this age, baby’s sleep pattern will permanently change from newborn sleep cycles to adult sleep cycles, thus allowing us the opportunity to be successful with sleep training! With a pediatrician’s approval we can begin the night weaning process at 16 weeks. However, we understand and fully support if you’d still like a night feeding to be part of your routine. 4-6 months At this age, baby is capable of 0-1 nighttime feedings (pending there are no growth or medical concerns). If baby is taking a feeding at night, ideally it should be one quick feeding and then easily resettling until morning. This is a very common age for parents to reach out to us as sometimes it is difficult to get babies to settle quickly at nighttime without the proper skillset. It’s a great age to begin to teach good habits that will carry your baby through childhood if consistent. 6-12 Months If baby is taking a night feeding it is likely due to habit and this point and not true hunger. With the appropriate daytime nap and feeding schedule baby can sleep a consolidated 10-12 hours at night. Unless advised against by your child’s medical provider, completely dropping nighttime feeds can be achieved. 12 Months & Beyond At 1+ years old baby is totally capable of sleeping through the night without any feeding, but don’t beat yourself up if you’re not there yet. This is still a great age to begin sleep training. As much as we love to help our clients teach healthy sleep habits as early as possible, we understand how difficult it can be in those early months & years. Sleep training after 1 years old can be very successful. The added element of having a child who understands more, gives us some different options and techniques that we can use in the training process. Summary Most babies will be able to sleep through the night with 0–1 night feeds by the time they are 4 months old. However, every baby is different, and it’s important to look at all the factors in order to set your baby up for success. Creating a bedtime routine and age appropriate feeding schedule can aid in the process, as well as setting your expectations based on your babies age. All humans briefly wake while sleeping. The difference between an adult and a baby, is that if a baby has not yet learned the essential self-soothing skills needed to fall back to sleep independently, then they will naturally wake up and call out for their caretaker (usually in the form of crying). Sleep training can help your baby become comfortable and confident with how they fall asleep, so that when they wake up in the middle of the night, they are able to check-in with their surroundings and then quickly fall back to sleep, which is exactly what “sleeping through the night” means! Stellina Ferri is the author of this article. Stellina is a certified pediatric sleep consultant and mom to three. She finds joy each day spreading her wealth of knowledge to tired families. Book your free evaluation call today!

Let's start from the beginning.. You may have landed on this page because your child is somewhere in the middle, beginning or end of their club foot correction journey. I welcome you here and hope our story can ease your worries after your diagnosis. Our clubfoot diagnosis I became pregnant with twins at the end of February 2017. My husband and I had been trying to conceive for about two years when we finally decided to seek out the help of a Reproductive Endocrinologist. We both went through a series of testing (more me), and only after one failed cycle, we had a positive pregnancy test from our first IUI. Six weeks later, I was told the unbelievable news that I was pregnant with twins! Fast forward to many ultrasounds later and my graduation to my OB, we were having our 16 week ultrasound when the technician made note to "check baby A's feet". Now to anyone without clubfoot history, this remark would have meant nothing to you, but to us, it meant something and we knew right away that we had a baby with clubfoot. How were we so sure? My husband was born with bilateral clubfoot, and it would only make sense that there was a high probability it would affect one of the babies. Turns out the diagnosis was correct. Until I delivered, we were never really sure which foot it was, but we knew it was baby A and only one foot. My twins were born at 38 weeks vaginal delivery, and at this moment, our guessing was over as we saw it was her right foot. Serial castings for clubfoot We met with our doctor while I was still pregnant. A quick Google search led us to one of the world's most renowned clubfoot orthopedic surgeons, and it turned out he was in our backyard! When I type that out, I realize how lucky we were in this regard. We immediately made an appointment with him to talk through what the diagnosis meant and what the treatment would look like. Our baby needed to be at least 7lbs (3.2 kg) to be initially treated. Knowing that we were having twins, we realized that it was unlikely she would weigh this a birth. Our Twin A, weighed 6lbs, 2 oz at birth, and with the initial weight loss that newborns go through, it ended up being an entire month before she had her first appointment with Dr. Matthew Dobbs at Children's Hospital in St. Louis, MO. Her foot was examined as unilateral talipes of the right foot, not complex. She was placed in a plaster cast to be worn for one week. We would come back each week for a new cast to be placed after the doctor manipulated the soft tissue and foot placement. Over the course of 2 months, she was placed in 4 separate plaster casts. The casts were relatively easy to care for. She couldn't wear standard footie pajamas, and we were inside winter months, so pants were out of the questions unless we cut a pant leg off. We bought pairs of baby leggings leg warmers, and they worked great. Sometimes there was a little poop or diaper creme that got on the casts, but nothing major. We tried to keep her legs covered when out in public to discourage questions, but looking back I am not sure that was the right thing to do. My husband was very sensitive to the topic, having gone through this himself, and he didn't want the extra attention. Plus, we were new parents to twins; one with clubfoot. We were very tired and overwhelmed. Tenotomy for clubfoot Her tenotomy (heel cord release) was done right before her last cast was placed. The tenotomy is an in-office procedure that involves the release of the tendon with surgical cuts. It was a very anxious moment to say the least. Anticipating that your baby is going to be in pain is a very difficult emotion to process. We weren't allowed to go back with her, but waited less than an hour to see her again. The nurse, Kelly, at Dr. Dobb's office was great with babies. She had our daughter sleeping in her arms when she came back out. That night, we were to follow a protocol of acetaminophen, if needed, and watch for any swelling or blood breakthrough. Thankfully, everything went perfect. She wore this particular cast the longest, and next up was boots and bar. Boots and bar for clubfoot baby Here is where the real clubfoot journey begins. Our doctor follows the Ponsetti Method. The method consists of serial castings, tenotomy under local anesthetic, and boots and bar wear paired with stretches for 4+ years. Physical therapy may be prescribed, but not always. If I could do one thing over, I would have had her go to physical therapy throughout the 4 years to have a professional continue to exercise her foot. We did have appointments every 3 months with her orthopedist for a couple reasons. For one, so he could monitor her correction and progress, and two, so that she may receive new boots and bar as she sized out of her current set. We initially were in a static bar with 23/7 wear, and then graduated into a reticulating Dobbs bar for 12 hour wear. Daily boots and bar wear for clubfoot Our protocol was 23/7. That meant for 15 minutes, 4 times per day, we could take the boots and bar off to administer her stretches. We could let her feet breath for a few minutes, check that there weren't any pressure sores, then put them back on. It was laborious at first, especially with twins. Once I was back to work, we relied on a caregiver to implement the stretches. I must stress, DO NOT fail to do these stretches. They are critical to the biomechanics of the foot. The heel cord needs to be exercised daily when the child isn't walking yet. Wearing boots and bar had it's limitations and restrictions, but clothing thankfully wasn't a huge issue. She could wear everything her sister wore including, the magic merlin sleepsuit and other sleep sacks for bedtime. We had to buy plenty pairs of thin cotton socks to keep handy, as well. Car seats were a non-issue, and strollers weren't, either. I could see how baby wearing would be difficult if you are using a wrap type sling. The backpack style carriers will work, though. Sleep & clubfoot: Sleeping in boots and bar Before I became a sleep consultant, I was just a mom to twins who was severely sleep deprived. I didn't know anything about bedtime routines, wake windows or even how to help my baby's sleep better. So, I will say that inside the months she was casted, we were not sleeping well. When she went into boots and bar, we had decided to sleep train shortly after, and that helped tremendously. The first few days after she was put in boots and bar, we would roll up a bath towel and place it under her knees in the crib. This seems to help take the pressure off the hips and ankles at first. Eventually though, she became a very good sleeper. She took all her naps and sleeps in the crib after 5 months old and was a very active sleeper, to say the least. There is so much gross motor development in the first year, that when you pair it with boots and bar, it's a little funny to watch. My daughter slept in an array of positions. Some as weird as sitting up with forehead on the bar pillow and even floating her legs over her body and resting on her head ( I am not making this up!) I recommend buying a cover for your bar. It will preserve damage to the crib, as well as people. Haha, I am not joking! The bar will really hurt once your baby is mobile during floor time. Since I had twins, it was an obvious purchase for us. You can buy one here. Continued boots and bar wear over the years. Our daughter continued to wear her boots and bar at bedtime. We were less strict about stretches over time, and to be honest, it wasn't something the doctor mentioned anymore at our follow-ups. She enrolled in gymnastics and swim lessons and was an overall very active toddler. During the pandemic, her doctor, Dr. Dobbs, left St. Louis Children's Hospital and moved to Florida. We were heartbroken, but also glad to be at the 'end' of our journey in the maintenance period. We saw a different provider until her 4th birthday when she was graduated out of boots and bar entirely. We were given nightly stretches to do again at this point along with maintenance appts going forward. It wouldn't be long before we were calling Dr. Dobbs again. Clubfoot relapse and ATT surgery The next part of our story will continue soon. I will cover our daughter's clubfoot relapse and experience with ATT surgery. Anterior tendon transfer surgery. TBC.. Lindsay Loring is the author of this article. She is a certified pediatric sleep consultant with Tweet Dreamzz Sleep Consulting and mother to twin girls. She lives in the metro St. Louis, MO area with her family.

The answer, is sadly not that much! As a sleep consultant, I get asked a lot about how much sleep pre-schoolers need. And honestly, it's not as straightforward as you might think. But don't worry, I'm here to break it down for you. In this blog post, we'll talk about how much sleep your little one needs, and why it's so important for their health and development. Sleep Recommendations for Pre-Schoolers: So, according to the American Academy of Sleep Medicine, pre-schoolers aged 3-5 years old need between 10-13 hours of sleep per day. And that includes naps, which are still super important at this age. But keep in mind, every kiddo is different, so some may need more or less sleep than others. Benefits of Adequate Sleep For Your Child: Now, let's talk about why it's so important for your little one to get enough sleep in the first place! First off, it helps them do better in school, improves their mood and behavior, and supports their physical growth and development. And, fun fact, sleep actually plays a big role in the consolidation of memories, which is super important for learning and retaining information. Signs of Sleep Deprivation: If your pre-schooler isn't getting enough sleep, you might start to notice some signs of sleep deprivation. Think irritability, difficulty concentrating, hyperactivity, and fatigue. If you do notice these signs, it might be time to adjust their sleep schedule (we've got a handy free-one on our site!) and make sure they're getting the right amount of sleep. So, there you have it. Pre-schoolers aged 3-5 years old need between 10-13 hours of sleep per day, including naps. Getting enough sleep is super important for your little one's health and development, and can really help them do their best in school and feel good overall. And hey, if you're worried about your child's sleep habits, don't hesitate to reach out to a professional sleep consultant like the certified experts at here Tweet Dreamzz. Lindsay Loring is a certified pediatric sleep consultant who is passionate about sleep. Lindsay has helped many families restore sleep balance in their home after a birth of a child. Join her online community

First things first: Does your baby have an adjusted age? Depends on who you ask and what article you are reading. Typically, babies are considered full term at 40 weeks. The 40 weeks is an average of 37 & 42 weeks. If your baby was born somewhere inside this gestation timeline, they can be considered "full term". When adjusting the age of your baby, a rule of thumb can be: If your baby was born full-term, but just 1-3 weeks early, you can use their actual age from their birthdate. If your baby was born more than 4 weeks before their due date, you can adjust their age from their due date; taking into consideration that your baby may be closer to the "full term" 37 weeks or "full-term" 40 weeks depending on how early they were born. For example: if your baby was born at 36 weeks, you may wonder if your baby is considered 1 week early or 4 weeks early. Technically, they are not considered full term, therefore you can consult your child's pediatrician for any adjustment of age. It may be confusing, and that's because it is. Even this article by HealthyChildren.org states that to calculate the corrected age of a baby, to subtract from 40 weeks, and then they go on to say that 39 weeks is considered full term. Okay, what? How to adjust sleep for a premature baby Babies born early may not be able to handle the typical wake windows that you see suggested. Once out of the newborn stage and your baby isn't sleeping the entire day, take notice of their most alert time throughout the day and keep watch of how long it lasts. For many babies, they become more alert after the 6-8 week growth spurt. If your child is still showing newborn tendencies and sleeping around the clock, this may be in indicator that their sleep windows will need to follow an adjusted age. This may look like shaving 30-45 minutes off the wake window for your baby's actual age. Prematurity & wake windows This graphic is a good one to save as it shows suggested wake windows by age. The age is calculated for a baby born between 37 & 42 weeks. If you notice your child's sleep does not line up, you may want to be more conservative with their wake windows. When do premature babies sleep through the night? Sleeping through the night can mean long stretches of sleep on either side of a feeding, for example. It's best to ask your child's pediatrician when your baby can be weaned or if they must still be woken to eat at night. In the early stages, your pediatrician will be keeping a close eye on their weights and growth chart to make an accurate suggestion for you when the time comes. Babies can drop their middle of the night feed early on, or keep a feed closer to 1 year old. To ensure your baby is getting adequate calories during the day, I suggest at least 5 full feeds in the daytime from newborn until about 6-8 months old. Premature babies can sleep through on the same timeline as a full-term baby if they are growing well, and again, you have permission to wean. What should premature babies sleep in? In the United States, the AAP recommends baby to sleep on a flat surface such as a crib or bassinet, without any loose blankets or clothing and on their back. The use of a swaddle for a premature baby can be really helpful to mimic the womb and help baby adjust to the big world. Note: discontinue swaddling at 3 months old or at first signs of rolling. In addition to a swaddle for your premie baby, use a sound machine for all sleep. The use of a white noise machine can also help calm baby as it mimics the sounds in the womb and can help trigger baby's calming reflex. Remember that it's white/pink/brown noise that's suggested for sleep, not raindrops or ocean sounds! Sleep training a premature baby When is the right time to start sleep training if baby was born early? Every baby is different, so this may mean baby sleeps long stretches of sleep before and after 4 months of age, or that they never, ever slept more than 2-3 hours and the 4-month regression wasn't noticed because baby's sleep was already terrible. I can attest to the latter scenario with my twins. Sleep training a premature baby can look similar to that of a full-term baby. Your baby can start sleeping better with any of the popular sleep training methods like chair method, or leave and check sleep training method. Want to get a head start on laying an independent sleep foundation? You'll want this guide for twins and this guide for a singleton! What age can you sleep train a premature baby? Once you notice your baby is having wake windows of about 90-minutes to 2 hours long, is a milestone I like to look for when deciding if a baby is ready. They will likely be taking 4 naps per day with indicators they are ready to go down to 3 naps soon. We also don't have to factor in weight or calorie intake, because sleep training, especially at 4 months old, doesn't necessarily mean night weaning. I hear the magic '16-weeks' as being the official time you can start, but I've helped twins, for example, who weren't yet 16 weeks adjusted but they did great because parents were super ready to get onto a schedule and sleep routine. What age can you STOP adjusting your baby's age for sleep? Again, it's a little fuzzy, but another rule of thumb is that you can stop adjusting your baby's age for sleep around 6-8 months, or when baby is transitioned to a 2 nap per day, clocked schedule. Then, there is the question about whether or not you have a high sleep needs or low sleep needs baby. This graphic below can shed some light on the averages and may tell you if your baby is sleeping more or less than the averages here. *These averages were provided by the National Sleep Foundation. I hope this article has helped make a little more sense about a question you may ask yourself a lot. Remember that each baby is different, and even fraternal and identical twins can have slightly different sleep needs. All feeding advice for your baby(s) should be directed to your child's pediatrician. Lindsay Loring is the author of this article. She is a mom to twins and certified pediatric sleep consultant in the St. Louis, MO metro area. She is the owner of Tweet Dreamzz Sleep Consulting. Book a call with Lindsay to find out how better sleep can happen for your baby.

Our top tips on transitioning baby from Magic Merlin Sleepsuit to a sleep sack It goes without saying that the Magic Merlin sleep suit is a favorite at Tweet Dreamzz. Both of Lindsay's twins and Stellina's twins were fan favorites! Stellina's twins in the magic sleepsuit In this article, Stellina is sharing her experience with the "magic" sleepsuit! With all 3 of my children, I utilized the Magic Merlin Sleep Suit. The “Magic Merlin” is a swaddle transition product – meaning it should be introduced when your child is transitioning out of the swaddle (typically around 3 months old). It’s a great product for so many reasons. It allows your baby to still feel snuggled like they were in a swaddle, however it gives them enough freedom to move their arms and legs, while allowing them the ability to use their hands for soothing. It also lessens their moro reflex, also known as their “startle reflex”. Not to mention how adorable they look while wearing the suit! Reasons to Transition Out of the Magic Merlin Sleepsuit 1. Once the fit is too small/tight 2. Once your baby is showing signs of attempting to roll in the suit 3. Once your baby can physically roll IN the Magic Merlin you MUST stop use immediately for safety purposes. 4. Read up on the founders safety tips when using the sleepsuit. Options to drop the Magic Merlin Sleepsuit Gradual method Keep the Merlin for naps and transition into a sleep sack for the first time at bedtime. Do this for a week and then transition to using only a sleep sack. The hope is that your baby will not be overtired due to potential nap protests because of an abrupt change from what they are used to. *To be used if your child has not rolled in the Merlin yet Cold turkey method Just what is sounds like. Simply switch to a sleep sack of choice. You may see a sleep regression here, but it should be rather short lived, especially if your baby has already learned independent sleep skills. The sleep regression may occur because the Magic Merlin has become a sleep prop for your baby, and they will need to get used having more freedom in their crib. My Experience Transitioning out of the Magic Merlin Sleep Suit I have experienced transitioning my own 3 babies out of the Magic Merlin sleep suit. I recently transitioned my six-month-old son from the Magic Merlin, into the Hudson Baby long sleeve sleep sack. With my son, it was a forced transition, since he rolled in the Magic Merlin sleep suit. One night, I looked at the monitor, and there he was, laying on his belly. I knew from that moment, I had to make the switch. The team at Magic Sleepsuit is dedicated on safety, so again, if you have questions about safe sleep while wearing the suit, visit their site to learn more! I was anxious about making this transition because I knew he relied heavily on the Merlin for uninterrupted sleep. It had become part of our routine, and it certainly lessened his startle reflex. Also, he was still unable to roll from belly to back during the day. He would constantly get “stuck” in tummy time, no matter how much I practiced during the day, or worked with him on how to roll back over onto his back. With that being said, I am happy to report that it has now been 2 weeks since transitioning him out of the Magic Merlin and he’s doing great! I kept a record of what happened in those first few days/nights. Our Transition out of the Merlin sleep suit Day 1: Bedtime It took him 40 minutes to fall asleep at night. He could definitely tell that he was not in the Magic Merlin anymore. He did get “stuck” on his belly, but instead of intervening immediately, I gave him some time to figure it out. He eventually fell asleep on his side. He woke two times throughout the night 1AM & 3AM (likely since he had the freedom to roll), however he did put himself back to sleep! Ultimately, he woke up and was out of his crib 30 minutes earlier than normal. Day 2: Naps It took him 20 minutes to fall asleep for each nap. There was definitely some protest in the form of crying, however ultimately, he fell asleep on his belly. His naps were shorter than normal, but he still slept so that was a win in my book! Day 2: Bedtime A much smoother night! He fell asleep much faster than night 1. It seemed like the “novelty” of being able to roll/being in a sleep sack had worn off. He did spend a few minutes rolling around; however, he ultimately fell asleep in 20 minutes without much protest. Day 2: Naps Naps were still a bit challenging, and it took him longer to fall asleep than it used to in the Merlin. This is likely due to the fact that naps are simply just HARDER than night time sleep. He didn’t have melatonin on his side to help him fall asleep. All in all, he did take his naps, but they weren’t as “heavy” as his usual Merlin naps. Day 3: Bedtime out of the merlin sleep suit Excellent night! He was definitely used to his sleep sack at this point. It seemed that he enjoyed the extra freedom of being able to decide his position of comfort. He also miraculously learned how to roll from belly to back now! If a baby is strong enough to roll onto their belly at night, it is safe for them to sleep in that position, however, it did give me comfort seeing that he DID in fact learn this skill. Yay! Day 3: Naps I decided to shift his schedule a bit and offer his naps a bit later than I previously was doing. I did this as an effort to increase sleep pressure. Since he was out of the Merlin, I knew I needed to make sure his schedule was perfect, and that he was indeed tired enough to fall asleep on his own since he did not have the added help from the Merlin. His naps were better on day 3. He did still spend some extra time rolling around in his crib, however, it’s important to remember that time in the crib is STILL restful even if your baby isn’t sleeping the whole time (especially if they are happy!) Baby Federico in the Magic Merlin's Sleepsuit for the last time! Best Tips during the transition from Merlin Sleepsuit to sleep sack Once your baby can roll in the Magic Merlin, they are developmentally ready for more freedom. Don’t overthink it. They are showing you what they are capable of. Don’t underestimate what your baby can do in his/her crib alone when given the time and space! Federico wouldn’t roll over during the day, but after a few nights of practice in his crib (by himself), he became a pro! Try not to compare your babies transition out of the Magic Merlin sleep suit to another child’s transition. One of my twins had a very difficult time transitioning out of the Merlin. Her transition took about a week to settle. Because of my prior experience, I automatically thought my son would also have a difficult transition out of the Merlin into a sleep sack. Luckily, I was wrong, and I was reminded to not compare my children because they are all so different (especially when it comes to sleep!) Don't overthink the next sleep sack. Our favorites around here are the Hudson Baby sleep sack, the Zipadee Zip & Halo sleeveless cotton sleep sack. You can find these all linked at on our baby must-haves shopping list. Stellina Ferri is the author of this article. Stellina is a certified pediatric sleep consultant and mom to three. She finds joy each day spreading her wealth of knowledge to tired families. If your little one struggles to sleep soundly, don't hesitate to reach out to me. Stellina@tweetdreamzz.com OR Book your free evaluation call today!