Hammocks for baby sleep

It is said that – “Learning lasts for life – from cradle to grave”. Cradle symbolizes the beginning of life. A cradle is associated with a new-born and is one of the first items on the essentials list of parents while getting ready to welcome their little one.

Courtesy : Wikimedia
Courtesy : Wikimedia

The practice of using a cradle for baby sleep is very ancient.  Mahabharata, an Indian epic which dates back to ~1000BC is an encyclopedia of early Indian culture. Krishna who is the most worshipped Indian God, is one of the main characters in that epic. There are references of a swinging cradle used by his mother for baby Krishna.

Krishna_cradle
Mother Yashodha using a cradle for Krishna. Courtesy : Pinterest

Cradles are of different types and vary from culture to culture. Here, I am going to focus mainly on cloth based hammock.

Typically a hook which available in the ceiling for hanging a fan is used to suspend the cloth. The cloth is typically a cotton sariThe sari is around 5m in length and 1.2m in breath. This perfectly suits the purpose. No special stand is required and the height can be adjusted as per the individual needs.  These hammocks can hang just over the beds of the parents. This makes it easy to access the baby, keep a watch and swing the baby. The images below give an idea of the arrangement of the sari based hammocks.

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Typical cloth based hammock used in India

 

Child_in_Indian_Sari_Hammock_by_Etan_Doronne
Child sleeping in sari hammock. Courtesy : JPGMAG

Cloth hammocks are popular because of the ease to set them up. In the following picture a Sari is tied across two poles in the frontward of the house. The baby is sleeping peacefully inside it on a sunny afternoon as the sari provides good aeration while light summer wind blows.

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Sari tied across two poles to make a hammock

The other kind of cradle used is having a four legged stand. The horizontal rod that connects the legs of the stand is used for suspending the cloth hammock. This type of swing is called a Ghodiyu and has it’s origins in Gujarat, a state in West India. The cloth hammock has a string attached which can be used for swinging the baby to sleep.

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Ghodiyu swing with a cloth hammock

The common ideology here is the place where the baby sleeps is a cloth which can take the shape of the baby. The cloth hugs the baby and gives a cozy feeling experienced in the mother’s lap or arms. The baby feels the warmth around itself because of the cotton cloth surrounding it. The cloth keeps the baby warm and snug.

The cloth cradle differs from the bassinets or cribs that have a firm base for the baby to sleep as shown in the pictures.

Fisher Price bassinet
Fisher-Price bassinet. Courtesy : Fischer-Price
east-coast-angelina-cot-bed-140-x-70-cm
Crib cot. Courtesy: birdcourage.com

Babies sleep for longer durations in the first 3 months of their life and sleep on their back all the time. Sleeping on a firm flat mattress causes the back part of their head(occiput) to flatten. This is also known as Flat Head Syndrome or positional plagiocephaly. Newborn period between 2 to 4 weeks is when the skull is maximally deform- able. Also if an infant favors sleeping in the same position most of the time or spends too much time with his or her head flattened against a crib mattress, repeated pressures causes that area of head to flatten.

More information on flat head syndrome and it’s prevention can be found here.

Using a jholi or a cloth hammock naturally prevents flat head. It distributes the pressure equally and gives a nice round form to the head. Also the problem of infant favoring sleeping with head rotated to either right or left side does not occur.

This concept of hammock is key to a bed designed by a company called UbiMED. They have designed a “hammock mattress” which cradles the baby’s body and redistributes pressure away from soft spots. This mattress needs to be placed on a regular crib mattress. The place where the baby rests is made up of netted material. This adds springiness and the cuddly feeling of an hammock.

Ubimed Lifenest hammock mattress
Ubimed Lifenest hammock mattress. Courtesy: Ubimed
Ubimed Lifenest hammock mattress
Ubimed Lifenest hammock mattress prevents Flat head syndrome. Courtesy: Ubimed

 

I realized that India is not the only country with the tradition of using cloth based hammocks. I found a post on  Facebook page for all lovers of Native American cultures.  This post describes the swings used by Native Indians for babies. They are hammock based swings with 2 ropes, 2 wooden pieces and a soft blanket as shown in the picture here :

Native Indian swing
Native American Indian swing. Courtesy : Drema Keesickquayash

This blog discusses why the Native Americans preferred the usage of hammocks.

Native American baby swing: greatest tradition ever!

The comment’s section of Facebook post from “Like Native American Traditional” contains  some very nice pictures shared by parents who have used cloth based hammocks.

In recent times more and more baby products with hammock based designs for baby sleep are surfacing. A young father based on his parenting experience for his daughter created a hammock swing for safe sleep that can be attached to the crib. Crescent Womb swing is shown in the picture here :

Crescent womb hammock attachment to a crib
Crescent womb hammock attachment to a crib. Courtesy : Crescent Womb

Crescent womb lists  the advantages of using hammocks for sleep here. Specifically hammocks help babies sleep restfully and reduces wake-up because of startle reflex. This is because the hammock hugs the baby and even if they wakeup because of startle, they cuddle back to sleep as the hammock gives them a feeling that somebody is holding them in their arms. These hammocks are designed for providing good aeration. The base cloth is a netted material to avoid any SIDS risk.

Amby Baby is a company based out of Australia. They are making baby hammocks since 25 years. On their website they explain how the hammock is useful for restless sleepers and short nappers. The swaying motion of the hammock helps relieve colic for colicky babies and the slight incline towards the head helps in containing reflux.

amby-style-1
Amby baby hammock. Courtesy : Amby Baby

Another New Zealand based company called Natures Sway makes baby hammock based swings since 1993. They describe that these hammocks help make the transition of the baby from womb to the real world harmonious. The hammock encourages easy sleep with a gentle bouncing motion and curved line that will minimize pressure on your infant’s developing spine and cranial bones.

However, there have been some preconceptions about hammocks being unsafe for baby sleep as they do not have a firm sleep surface. Hence Natures Sway have conducted a study on the oxygen levels
in hammocks compared to a bassinet with the help of University of Auckland. Here is a blog post explaining their findings:

Baby hammock study shows safe oxygen levels

They observed, there were no differences in obstructive apnea or oxygenation in infants who slept in the hammock compared with the bassinet, suggesting that the hammock did not compromise the upper airway. Also since the hammock had soft mattress, it prevented flat head syndrome. The paper related to their findings can be found here.

Another good article on hammocks for baby sleep :

Traditional Baby Hammocks Trump Conventional Cradles

In Singapore and Malaysia (as well as other Southeast Asian communities), the yao lan or traditional baby hammock, is a popular choice among some mums for getting their little ones to sleep.

These hammocks are also known as  as sarung buaian or buai, cloth cradles or sarung cradles.

In Chinese, yao lan means ‘swinging basket’ — and this is literally what is is. It is basically a hammock made of cotton cloth or batik, attached to a spring, and hung from the ceiling or a door-frame.

Yao Lan - Swinging basket swing used in Malaysia and Singapore
Yao Lan – Swinging basket swing used in Malaysia and Singapore. Courtesy : The Asian Parent

Traditional hammocks are now finding their way in hospitals .Interesting read about how hammocks are used in incubator by nurses in Brazil. Instead of being placed in conventional cots newborns at the University Hospital of Marilia, Brazil are placed  snugly in miniature hammocks. The nurses believe the womb-like nature of hammocks make it an ideal bed for full-term and premature babies.

Even the modern bassinets from companies making baby gear are emulating the hammock feel. For example, SwaddleMe bedside sleeper  does not have a firm base and the place where the baby sleeps just looks like a hammock.

SwaddleMe Bedside sleeper by Summer Infant
SwaddleMe Bedside sleeper by Summer Infant. Courtesy : Summer Infant

 

 

In summary, it appears that all the cultures across the world used traditional hammocks a few centuries ago and now seem to be rediscovering the benefits in the current age through science.

Second time blues!

Three years ago, I had the privilege of holding the most precious and fragile gift I ever held, my newborn daughter whom we now dearly call ‘Anu’. Being the engineers we are, Bharath and I had made a custom hammock for her.  The first 2 days were straight from a happy movie. Everything seemed just perfect. Within the next couple of days though, Anu started to become weak. By the 7th day, she looked very sluggish and very very yellow. It was not something that we had no idea of; My family is full of doctors and  we knew that neo-natal jaundice is a very common occurrence. What we did not know was the slope of the precipice. Between the 6th and 7th day, Anu deteriorated to the point of not waking up for feeds. Neo-natal jaundice can at times set up a vicious cycle of low feeding and hence further worsening of the jaundice. The result was a 3 day hospitalization that was the lowest point in our lives. From the comforts of the custom-hammock that we had built with so much love, Anu was now shifted to a bed made of a glass bottom and a single layer of bubble wrap. Her blue-light treatment had begun.

Anu Sleeping on a bubble wrap for blue light treatment.
Anu Sleeping on a bubble wrap for blue light treatment.

I am not going to talk much about neo-natal jaundice itself. There are a zillion articles on the web already. I am going to talk about preventing it and my personal experience of fighting it with my second child.

The first mistake is to listen to the grandmas. Don’t get me wrong here. Grandmas are great! They are right 99% percent of the time. But, times have changed. For whatever reason, neo-natal jaundice is a bigger problem now than it was. Neo-natal jaundice is supposed to naturally disappear through the passing of stools. More milk means more stools and hence better recovery. But not everything is straight forward; The gut bacteria ecosystem (gut biome) that helps in this process of cleanup may not form efficiently. No one knows what exactly causes this issue, but our modern lifestyle may have something do with it. When our grandmas say that mother’s milk should be the only milk given to the baby, they may be wrong. They are remembering their experiences from a time when things were probably better. Breast milk consumption is not easily measured. The baby may not feeding well. Even if it is feeding well, the rate of removal of bile may not be sufficient. Top feeding for the first 10-15 days significantly improves the removal rate of bile. But top-feeding has it’s own risks. One careless feed, and your baby is going to have  a terrible tummy. One cannot be paranoid enough about maintaining hygiene.

Neo-natal jaundice is measured using the bilirubin count. The total count is a sum of two counts – Direct and Indirect. Neo-natal jaundice is a physiological jaundice and this results into a higher indirect bilirubin count. The direct count usually remains within safe limits. If the direct count is higher, the issue may be a different one and the details of other types of neo-natal jaundice are not covered here. If the indirect count goes beyond 15, it is a sign of concern. A value beyond 20 usually means hospitalization with blue-light treatment. The serendipitous discovery of this treatment is its quite remarkable.

There are several logistical issues with blue-light treatment. The first one is that it involves hospitalization. Specially, in a CSec, a re-hospitalization when the mother is barely recovering is extremely painful. Moreover, making sure that the baby’s eyes are not exposed is a big task that requires someone to watch-over 24×7. Many hospitals do not allow any help other than the mother and the father to accompany the baby. The already over-stressed parents are further pushed.

Fortunately, their are some options for home treatment available these days (Not common in India though). The Biliblanket is one such comfortable option –

Courtesy : Wikipedia
Biliblanket. Courtesy : Wikipedia

Given the dreaded experience with our first child’s treatment, I was not going to take any chances with the second (there is a family history of all neonates suffering from jaundice). Due to the non-availability of easy home treatment options in India, I decided to make one in advance. Turns out that making one is quite simple, but making sure of the safety requires a reasonable knowledge of electronics, optics and a lot of common-sense.

The first step was to study the irradiance limits. I found some online publications and also read specs of existing medical products. This one gives a good comparative study. I got some Phillips blue LEDs from the Phillips Lighting Store, but it was important to make sure that they do not emit UV. The LEDs claimed they did not emit UV, but we did not want to take chances. We have many kids toys that are phosphorescent when exposed to UV, so the verification was pretty straightforward.

Phillips LEDs - Blue light with no UV
Phillips LEDs – Blue light with no UV

As per the specs and irradiance calculations, 5 LED modules were needed to get to about half the dosage of a standard medical device used in the hospitals. The 5 modules were connected in series to make sure the same current flows through all of them. The next step was to get a suitable power source. I bought an adjustible boost converter from here and wired it to a regular USB power bank. For making sure the power is monitored and within limits, I used a USB power meter that is readily available here. The boost converter’s voltage was adjusted till the USB power meter read 2A@5V.

Battery
Battery
DCDC Boost Converter
DCDC Boost Converter
USB current meter
USB current meter

Since we had made a cradle for our baby (which also happens to be our start-up), rigging up everything to the cradle was easy.

Blue light is particularly harmful to neonates’ eyes and genitals. Adequate safety precautions were an absolute must. Diapers are sufficient for protecting genitals. We got an eye protection band meant for the purpose from a local medical store.

We still lacked one critical thing! We did not have a way of measuring bilirubin. We got the permission of a doctor to monitor bilirubin levels on a daily basis using a non-invasive transcutaneous bilirubinometer that was available at the hospital we used to consult with.

The ends results were great! With about 5 days of moderate treatment as per our conveniences, Samyak was out of Jaundice while sleeping cozily in a hammock with music and swinging to sooth him. About 10 hrs of advanced preparation saved us 72 hrs of agony we would otherwise have had to go through.

Our son Samyak sleeping in blue light in the cradle we made.
Our son Samyak sleeping in blue light in the cradle we made.

This is how the baby would see the lights from the cradle (if he were allowed to).

Phillips LEDs - Blue light with no UV.
Phillips LEDs – Blue light with no UV.