קשיי שינה משפיעים בעיקר על התינוק. אבל הם משפיעים גם על ההורים ועל הקשרים במשפחה. בשנים האחרונות החל להיות נפוץ ייעוץ השינה. כמספר יועצות השינה כך הדעות בעד ונגד ייעוץ שינה. אז הנה מאמר קצר על 'מאחורי הקלעים' של תהליך שינוי הרגלי שינה.הקשורים לייעוץ שינה, וחשבנו לעשות קצת סדר בדברים ולנפץ כמה מיתוסים.
- זה יקר ! נכון חלקית
המחיר של תהליך ייעוץ שינה נע בין כמה מאות, לכמה אלפי שקלים. המחיר תלוי ביועצת,בניסיונה,ובכמות השעות של הליווי.
ייעוץ שינה בדרך כלל מורכב מתשאול במייל (שעת עבודה) פגישת הדרכה (כשעתיים,לא כולל נסיעות) וליווי של חודש לפחות (כ15 שעות,לפעמים יותר לפעמים פחות)
בסה\"כ סביב 20 שעות (לפחות) לתהליך מלא.
אם מחיר ייעוץ הוא בממוצע 1200 ש\"ח- היועצת מרוויחה כ 60 שח לשעת עבודה!!
נכון, זה לא שכר מינימום, אבל בהחלט לא שכר גבוה במיוחד.
בזמן הליווי, על היועצת להיות זמינה. בשבוע הראשון – אפילו זמינה באופן מיידי. כשההורים מרדימים את התינוק ומחכים לתשובות היועצת מחוייבת לענות להורים בזמן אמת. גם אם 20:00 בערב או 22:00 בלילה.
חלק מהיועצות זמינות גם בסוף השבוע..
אז האם זה יקר? הכל עיניין של סדר עדיפויות… קשיי שינה של התינוק משפיעים בראש ובראשונה עליו.
הוא פחות נינוח,מרבה לבכות, פחות פנוי ללמידה והמערכת החיסונית שלו חלשה יותר.
ומה לגבי ההורים? מחסור שינה כרוני משפיע על המערכת החיסונית, על כישורי למידה,על הזיכרון, על התפקוד בעבודה, על הזוגיות ואפילו יש קשר בין מחסור בשינה להשמנה!
יש אפשרות להוזיל את העיניין- למשל לקחת סטז\'רית או יועצת מתחילה.
אפשרות נוספת היא להסתפק בהדרכה ולעשות את התהליך לבד,ללא ליווי.
- ייעוץ שינה אפשר להתחיל רק בגיל 5 חודשים_ לא נכון בכלל!
שליש מהתינוקות יפתחו קשיי שינה בשנתם הראשונה. יש תינקות שמרגע הלידה יתקשו להרדם, ולאחרים יווצרו קשיים, במשך הזמן.
קשיי שינה נובעים מסיבות שונות.
זה לא משנה מתי נוצרו קשיי השינה וכמה זמן הם נמשכים. בכל נקודת זמן אפשר להתחיל תהליך שינוי.
למעשה, האידאל לתפישתי, היה לפגוש את ההורים הטריים ,כמה ימים אחרי הלידה. ככה היו נמנעים חודשים ארוכים של סבל וקושי.
יועצת שינה והתפתחות בעלת ידע בפיזיולוגיה,באנטומיה ובעולם התינוק , תדע לטפל בקשיי השינה בכל גיל.
ולכן בכל מה שקשור להקניית כישורי שינה נכונים- כמה שיותר מוקדם-יותר טוב.
האם זה אומר שכל התינוקות עד גיל 5 חודשים יכולים להרדם לבד ולישון לילות רצופים?
התשובה היא לא!
למעשה ההפך הוא הנכון. רוב התינוקות זקוקים לתיווך בהרדמה ולארוחות לילה בחודשים הראשונים.
אבל תיווך אינו חייב להיות הרדמות ממושכות, יקיצות מרובות ועייפות כרונית. כיועצת,אני פוגשת תינוקות בני כמה חודשים שמתעוררים עשר פעמים ויותר בלילה אחד וגם תינוקות בני חודש ,חודשיים, שלא ישנים כלל במשך היום, ולוקח להם זמן רב מאד להרדם בלילה.
יש מנעד רחב מאד בין שיטות הרדמה שדורשות מעורבות הורית גבוהה(תינוק שחייב לינוק ,או להיות בידיים כדי להרדם) לבין הרדמה ללא תיווך כלל , כשהתינוק מונח במיטה ולא מקבל שום מענה לבכיו.
דרך הבייניים בה יש תיווך מושכל כשהתינוק שוכב במיטתו וההורה מלטף אותו מספר דקות ,עד שירגע וירדם תסייע לתינוק ללמוד להרדם עצמאית ותהפוך את ההרדמות לקלות יותר גם עבור ההורה.
התינוק ילך ויתפתח ובגיל 4,5 חודשים יהיה מסוגל להתהפך מהבטן לגב וחזרה, לארגן את גופו בתנוחת השינה הנוחה לו. הוא ילמד שאמא אינה חלק ממנו והוא יישות עצמאית ונפרדת. הוא ילמד לזקוף את ראשו ולהתבונן בסביבה בסקרנות ולהוריד את הראש הוא ילמד לעצום עיניים כשהוא זקוק למנוחה.
הוא ילמד לעשות זאת בעצמו.
אבל אם הוריו לא יקנו לו את הידע הבסיסי הזה, הוא ישאר תלוי בהם בתהליך ההרדמה וההרדמות ילכו ויעשו קשות!
- הרדמות עצמאית תלויה במלטונין שמופרש רק בגיל 5 חודשים. לא נכון בכלל!
השינה היא פעולה פיזיולוגית שלוקחים בה חלק הורמונים.
את ההורמונים הלוקחים חלק במשחק אפשר לחלק בצורה שטחית להורמונים המעורבים בפעילות (קורטיזול, אדרנלין, היסטמין, )להורמון השינה המפורסם-המלטונין.
לתינוק בן יומו רמות נמוכות של מלטונין ואלה הולכות ועולות עד לגיל 5 חודשים.
המלטונין מופק במוח בתגובה לחושך ומייצר תחושת נמנום.
לכן מגיל 3 ,4 חודשים דפוס השינה הופך כזה שרוב השינה מתרכזת בשעות החשיכה ובשעות האור התינוק פעיל יותר. אין קשר בין הרדמות עצמאית למלטונין. הוא משפיע רק על ריכוז שעות השינה העיקריות בשעות החושך והארכת שעות הפעילות במשך היום!
מאחר והתינוק ער זמן רב יותר, יש לו זמן להתפתח והוא לומד להתהפך, לתקשר, להושיט ידיים לחפצים..
במקביל מתפתחות הקוגניציה והמערכת הרגשית. התינוק מתחיל לפתח עצמאות ,לסגל הרגלים,להבין התניות ומסוגל להתחיל את התהליך הבריא של הפרדות מאמא.
למעשה ,תינוק שיוקנו לו כישורי שינה והתפתחות נכונים בחודשי חייו הראשונים יגיע לגיל 5,6חודשים כשהוא מפותח בהתאם לגילו ומסוגל להרדם באופן עצמאי ולישון כ 6 שעות רצופות.
- ייעוץ שינה פוגע בהנקה בכלל לא!!!
ההפך הוא הנכון.
ראשית, תינוק שישן די צורכו , יאכל טוב יותר מתינוק שסובל מעייפות וממחסור כרוני בשעות שינה.
מנוחה מספקת חיונית גם לאם ולייצור החלב.
פעמים רבות אני פוגשת תינוקות בגיל חצי שנה ( זוכרים?הגיל בו מתבססים ההרגלים)שאינם מכירים דרך אחרת להרדם, פרט להנקה. הם מנשנשים כל הלילה(לוקחים שלוק וחוזרים לישון),קמים עם בטן מלאה, ועייפות יתר בגלל הייקיצות המרובות ואוכלים פחות במשך היום (בגלל העייפות ונישנושי הלילה). ברגע שאנחנו מרווחים את הנקות הלילה,האכילה במשך היום משתפרת והתינוק עולה במשקל!
ולפעמים זה בדיוק להפך- לאחר אבחון ברור שהתינוק מתעורר בלילה כי הוא רעב! אנחנו מוסיפים הנקות בלילה, כחלק מתהליך הייעוץ והתינוק ישן טוב יותר, אוכל טוב יותר ועולה במשקל!
אף פעם לא ניתנת לאם הנחייה להפסיק להניק כחלק מהתהליך. למעשה מי שקובעת את מערכת היחסים עם ההנקה היא האם בלבד.
- אני לא מוכנה לתת לתינוק שלי לבכות ובייעוץ שינה הוא לא מפסיק לבכות! נכון חלקית
כל מי שניסה אי פעם לשנות הרגלים ( להפסיק לעשן, להתחיל לאכול בריא, לעשות ספורט) יודע כמה זה קשה. כשאנו משנים את ההרגלים של תינוק קטן, בתהליך ייעוץ שינה ,הוא מוחה ומתנגד!
הדרך של התינוק להביע מחאה היא בבכי. לא קל להורה לשמוע את התינוק שלו בוכה.אבל האם אין סיטואציות אחרות בהן התינוק בוכה? לדוגמא-יש תינוקות ששונאים לשבת בכיסא בטיחות ברכב. ברגע שהם מוכנסים לכיסא-הם לא מפסיקים לבכות. האם הורה יעלה על דעתו לוותר על כיסא הבטיחות? ברור שלא.
בתהליך ייעוץ שינה איננו מאלצים את התינוק לבכות שעות ארוכות. להורה ניתנים כלים שונים כיצד להקל על התינוק (ועל עצמו) בהתמודדות עם השינוי. התינוק נתמך באמצעות מגע ונוכחות קרובה של ההורה במיוחד בימים הראשונים לתהליך. זה לא תהליך קל כלל וכלל.
אבל גם לא קל לתינוק ולהוריו ,לילה אחרי לילה לישון שינה קצרה וקטועה ויום אחרי יום להעביר שעות ארוכות בלי מנוחה.
לסיכום-כישורי שינה טובים אפשר וחשוב לרכוש בכל גיל. כישורי שינה טובים מסייעים לתינוק לא רק לישון טוב יותר אלא גם להתפתח טוב יותר. אם תינוקכם סובל מקשיי שינה אתם יודעים כמה סבל נגרם לכם ולו.
הדרכה נכונה והובלה הורית מדוייקת ועיקבית תביא להתקדמות יעילה ומהירה בתהליך שינוי הרגלי השינה של המשפחה.
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