Sleep

 

Sleeping Problems Solved

Teaching your child to sleep.

Often children lose their sleep routine due to travel, illness or other disruptions. The following 4 approaches are neither right nor wrong but these approaches may assist you.

What is a sleep problem?  Does my child have a sleep problem? 

New babies sleep exactly the amount that their personal physiology tells them to sleep. There is nothing that you can do to make your baby sleep more than this amount and nothing that the baby can do to sleep less.  Unless he is ill, in pain, or extremely uncomfortable he will do his sleeping wherever he finds himself and under almost any circumstances. So your power over his actual hours of sleep is very limited. By making him comfortable you can ensure that he sleeps as much as he wants to, but you cannot put him to sleep.  On the other hand if you are somewhere where you cannot make him very comfortable – in a bus, for example- you need not worry about him being kept awake. If he stays awake, it is because he does not want to sleep.

Separating sleep from wakefulness:

At the very beginning of life the baby often drifts so gradually from being awake to being asleep that it is difficult to tell which state he is in at any given moment. He may start to feed wide awake and ravenous; suck himself into a blissful trance so that only his occasional bursts of sucking tell you that he is still at least a little awake; and then drift into sleep so deep that nothing you do will wake him.

This kind of drifting does not matter at all from his point of view. He is simply doing what he needs to do when he needs to do it. But from your point of view it is a good idea to help him gradually to make a more complete difference between being awake and being asleep.  it will be much easier for you to organize your life later on if you know that the baby is either awake (and therefore bound to need some attention and company), or asleep (and therefore unlikely to need anything at all for a while). Babies who do learn early to be either fully awake or fully asleep are likely to be the ones sleep for reasonably long periods at night, too.

So, rather than letting him drift and doze on somebody’s lap, it is a good idea to start from the very beginning to “put him to bed” when he needs to sleep and to “get him up” when he is awake. If he is always put into his pram or cot when he is really sleepy, he will soon come to associate those places with being asleep. if he is always taken into whatever company is available when he is awake, he will make that association too.

Disturbances to sleep

A sleepy baby need not mean a hushed household. Ordinary sounds and activities will not disturb him in his early age. But if everybody creeps about and talks in whispers while he is asleep, there may come a time when he cannot sleep unless they do.  It is therefore important to let him sleep through whatever sound level is normal for your household sp that he does not come to expect a quietness that will make all your lives a misery.

At this stage he will be disturbed most often by internal stimuli. Hunger will disturb him; being cold may disturb him if he is not in a very deep sleep; pain will wake him and so may passing a bowel movement or burping. Sometimes the jerks and twitches of his body as it relaxes towards deep sleep will disturb him too.

Of course, outside stimuli can disturb the baby, but when they do it will usually be because they change very suddenly. He may drop off to sleep quite happily with the television set on, but wake when it is switched off. A toddler playing around the room will not keep him awake but one coming in may wake him.

Bellow are 4 approaches taken with permission from;

“The Sleep Book for Tired Parents – Help for Solving Children’s Sleep Problems. Rebecca Huntley. Parenting Press Inc. Seattle USA”

Family Bed Approach

Parents welcome the child or children into the parental bed for shared sleep.  Children spend as much or as little time as they need in the “family bed”.

Philosophy

Parents want to be available for children during the night as during the day.  They can meet the needs of children without leaving their own bed, so sleep is minimally disturbed.   The infant and mother develop a mutual sleep cycle; and the infant can nurse as desired.  An older child need not face separation at sleep time.  Fears are calmed by the parents’ presence.  Father is nearby.  Arrangements are highly individualized.  They range from all members sleeping together all the time, to children welcome only in special circumstances.

Procedure

Decide on a sleeping arrangement that allows everyone to sleep most comfortably.

  • Who will sleep where?
  • What are the special circumstances or conditions?
  • Does the child also have his own room and bed? How and when will it be used?

Make the necessary arrangements – an infant can simply be brought to your bed; older or multiple children may take more planning. Options may be:

  • Buy or build a bigger bed
  • Set up cots or sleeping bags nearby

Establish ground rules:

  • How will bedtime be handled?
  • When are children allowed in parental bed? (always, when frightened etc.)
  • How will parents’ need for privacy be met?
  • What is the time frame? (until infancy passes, until child decides, etc.)

Two Families Proceed

Infant Carl sleeps between his parents.  His room will be used primarily for play and keeping his things until he is older and chooses to move to his own bed.  Carl’s parents decide to respond to criticism with a smile and the comment, “This is what works for us – Carl’s needs are being met and we’re all getting the sleep we need.”

Elizabeth is welcome in her parents’ bed when she feels she needs them – when she is frightened or ill.  She always begins the night in her own room, and the expectation is that she stay there most of the time.  As she grows older she will come less often to her parents’ room.

Cry It Out Approach

Parents do not respond to the child while he learns to put himself to, or back to, sleep.  This usually involves crying for as long as necessary each time – most often taking about three days or up to one week.

Philosophy

Attention from a parent reinforces behavior.  In this cases, the behavior is crying for a parent’s presence and help to get back to sleep.  A parent’s attempt to help or check on the child will hinder his learning independent sleep habits.  A child will learn to go to sleep by himself when he wakes; staying awake is not rewarded by his parents’ attention or presence.

Procedure

Select a time to begin the plan when the child and parents won’t need to be especially well-rested.  Weekends are often good times to start.  Prepare for the discomfort crying brings.  Parents need to plan ahead to cope with the setting and their own feelings.  Blankets around doorways and rugs or floor covering in the child’s room helps to muffle sound.  Parents also plan on how to nurture and support each other during the crying.  “Explain” the plan to the child in a positive, reassuring manner.  Prepare other family members or neighbours, if need be.

One Family Proceeds

At bedtime:  After a simple, calming bedtime routing mom puts Andrew to bed and leaves the room. Andrew cries (if he needs to) until he falls asleep.

During the night: Two Options

  • Go to Andrew immediately. Check on his safety and health.  Offer brief, calm words of goodnight and leave the room.  He cries until he falls asleep.
  • Do not go to him or respond in any way. He cries until he falls asleep.  When you are certain he is asleep, check on him if you like.

While working on a problem, try to limit excess crying to sleep learning times.  The child is reassured that his cries are heard and responded to as appropriate.  In the morning, parents respond quickly.

Try to schedule some quiet, nurturing time for parents to interact with the child during daytime hours.

Teaching in Small Steps Approach

Parents decide on a goal and work backward breaking down the necessary learning into small steps, and ask the child to make changes gradually.

Philosophy

When a child is accustomed to, and attached to, her sleep habits, asking her to change them all at once is difficult.  New learning done in stages allows time for adjustment to the new expectation.  Parents can provide emotional support during the process.

If crying is necessary, it is broken down into a time frame that the parent feels comfortable with and the child learns from.  The parent responds less frequently and is less involved, and the child is given more time to learn to settle herself. The child is not left totally alone, nor is the parent left out.

Procedure

A child can be taught to get herself to sleep when given an opportunity to settle independently of her parents.  She finds and relies on her own resources to get to sleep.  While she is learning, she knows parents are nearby but visits are short and they are not part of the process of going to sleep.

One Family Proceeds

Parents decide how much crying they can reasonably tolerate before checking on the child – 15 minutes is a typical maximum for the first night.

Night One                                                    Night Two                                                   Night Three

Put child to bed.                                      Put child to bed.                                      Put child to bed.

Cries 5 minutes                                       Cries 10 minutes.                                     Cries 15 minutes.

Parent checks                                           Parent checks                                           Parent checks

Cries 10 minutes                                     Cries 15 minutes                                       Cries 20 minutes

Parent checks                                           Parent checks                                           Parent checks

Cries 15 minutes                                     Cries 20 minutes                                      Cries 25 minutes

Parent checks                                           Parent checks                                           Parent checks

Continue at 15 minute                        Continue at 20 minute                        Continue at 25 minute

intervals until child falls                    intervals until child falls                    intervals until child falls

asleep.                                                         asleep.                                                         asleep.

 

At Bedtime:  After a calm, quiet routing, Emily is put into bed with some words of goodnigh.  Dad leaves the room.  Emily cries for 5 minutes, dad goes to her.  Without picking her up, dad offers a few words of reassurance and good night (taking only a minute or so) and leaves the room while she is still awake (she may not even be calmed).  Dad continues waiting and checking as long as Emily cries vigorously.  If the crying subsides, he need not check on her because she is starting to learn to settle herself.

During the Night:  For each waking they follow the same approach, beginning at 5 minutes and continuing with 15 minute intervals as needed.

Subsequent Bedtimes and waking:  Parents use the same approach – increasing the beginning and maximum interval each night.  Increases continue for as many nights as is necessary until Emily is no longer crying vigorously.  She may complain or whimper, but is no longer frantic.  She will learn to find her blanket, suck her thumb, or “nest” in whatever way works to get herself to sleep.  During the normal nighttime arousals she may cry out as she re-settle herself, but this does not require intervention.

 

Living With It Approach

Parents decide to live with the situation as it is and to develop ways to cope.

Philosophy

For personal reasons, parents feel it would not be appropriate or beneficial to make changes at this time.  These reasons may include:

  • A change in life circumstances, such as a move, has occurred or is expected.
  • Due to the child’s temperament or individual circumstances, parents feel it would be better for them to make changes than the child.
  • Parents’ values or temperaments indicate that there is no need for change, or that there would be no practical commitment to it.
  • Parents are simply not ready yet.

Parents view not making a major charge as a viable choice.  They consciously accept it without feeling guilty or fighting it.  They assess the situation and implement ways to cope.  They schedule a time in the future to reevaluate.

One Family Proceeds

Michael’s parents decide that he has less need for sleep than is typical.  At one year old he sleeps only six hours a night and doesn’t go down for a nap. He shows no ill effects during the day.  Michael’s paediatrician agrees that he seems to simply need less sleep than most people.

Chart current sleep patterns:  Michael is ready for bed at 23h00 and is awake again by 06h00.

Find a support system:  Mom arranges for a babysitter to come in for a portion of the day to give her a break.

Develop a plan:  Parents alternated staying up nights with Michael.  On weekends, Dad sleeps in and Mom takes a nap.  Parents plan a “date” once a week to be by themselves and talk.

Reevaluate Plan:  Parents plan to re-assess the situation at the end of each month.

Tips for Coping

  • Parents alternate being “on duty” each night of the week
  • Parents split and/or share responding the to the child each night
  • Divide up household chores and childcare duties between partners
  • Find help during the day to have time away from children and to rejuvenate
  • Couples plan special time together away from the children
  • Plan fun times with child to balance time spent in nighttime caretaking.
  • Stop seeking / listening to “solutions” offered by others.