Children and Sleep: What Every Parent Should Know

islad

May 9, 2012

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These questions and answers about helping your child sleep were taken from a Live Q&A with Lucy Wolfe from Sleepmatters.

Don’t miss the chance to have your say! We’re looking for parents to get involved and give their feedback on all aspects of family life. Find out more here.

Q. If baby is waking several times in the night and then going back to sleep after a cuddle – how do we stop this?

A. When your baby is waking several times and settles immediately once certain conditions are it place in may signal that he is relying on the cuddle to help him transition through his sleep phases. As little as a 30 second pat can become a re-enforcer for night time awakenings.

Firstly, you need to make sure that you baby is able to put himself to sleep at bedtime. This means that he can lie in his place of sleep and drift off without you doing something to him.

When he has mastered that skill, you can attempt to phase out the cuddle association; initially you could just change what you do when you respond to him, so rub and shush him back to sleep and then gradually touch and shush less over the course of many nights until he becomes more efficient at cycling through his sleep…good luck

Q. Hi I have a ten year old who goes bed around nine reads for fifteen mins but it’s awful hard to get her up in morning at quarter to eight. How much sleep does she need?

A. Your 10 year old needs about 10.5 hours at night, but they should be able to wake naturally. You could try moving bedtime slightly forward to try to find the perfect time.

Q. My daughter wakes up every night. She is gone 3. I would love to break this habit but don’t know how to start.

In order for her to go asleep at night I have to lie beside her until she falls asleep. She rubs my hand as her security thing as she doesn’t have a favourite teddy. when she wakes up in the night which could be between 12-3 I would go to her room & lie beside her till she falls asleep which she does very quickly but I end falling asleep there as well. Her bedtime is 9pm which we are happy with & she doesn’t take naps during the day. I would love to break this habit but don’t know how to start.

A. Your daughter associates going to sleep with you and holding your hand. If you don’t want to have to re-create this in the middle of the night you will have to deal with changing her sleep association at bedtime.

I would encourage you to make sure that she is getting enough sleep in the over-night period. She needs 11 hours uninterrupted, and you may need to consider bringing bedtime forward. At this age, you can discuss your plans to help her sleep in her own bed, without mummy or daddy lying down with her.

You could also make a booklet with her of the behaviour that you would like to encourage. You could replace lying down in bed with her with a bedtime routine of stories, songs and one to one time, outside of the bed, and then when lights out into bed to go to sleep.

You could sit beside her without holding hands as she develops this skill. Talk calmly and soothe her if she is upset. Do the same thing during the night also. It can be difficult to correct this issue and will take time and patience on your part. Good luck!

Q: She is still waking at night up to 3 times, asking for bottle.

Hello, I have a 2 year old daughter who never slept through the night since she was born. Maybe 5 times max. She wasn’t breast fed (only 8 days). She is still waking at night up to 3 times, asking for bottle. She always gets it, diluted milk, 2 -3 ounces. Otherwise she won’t go back to sleep.

Terrible habit that we can’t get out of. No time, energy and heart to do the controlled crying. But open to professional help and will try the controlled crying method if a good one is suggested. All books describe it differently.

We tried the controlled crying method once, lasted 3 nights. She bangs her head off the cot side and was left with bruised forehead for a week afterwards. (She is a very sweet girl by the way :-) I am not able to go through that again. Any suggestions would be greatly appreciated!

A. I think that controlled crying or cry it out is very difficult on all involved. The work that I do does not endorse those sleep learning methods, although it is fair to say that when we try to make changes, crying may be part of the picture as this is their primary form of communication for quite some time.

We have to consider sleep in a 24 hour context and we also have to acknowledge the behavioural component; If you want your child to sleep in the overnight period without drinking milk, changes have to be made, but it is how you approach the changes, dictate whether it is successful or not. You will have to ensure that she is first able to go to sleep herself at bedtime, if you want her to do that during the night as she transitions through her phases of sleep.

Just like in my previous post of a similar age, she requires adequate daytime sleep as this helps to complement the night time sleep. I think that if we are teaching a brand new skill set (falling asleep unassisted) and making changes in relation to what our children associate with going to sleep, we should stay with them as they learn the process and then phase ourselves out of the bedtime ritual.

Evidence supports that children who are verbally, physically and emotionally responded to in this process can learn more easily self regulation, with limited stress. You will then have to handle the overnight period-sometimes gradually reducing the amount that you give over a number of nights is a good option; it may not mean that she will just stop waking, but it will initially get her less used to the calories and for you to develop soothing techniques to help her through the change.

Solving sleeping problems takes 100% patience, consistency and commitment and done gradually and gently, can take many weeks.

Q: My 5 month old was sleeping the night he started to wake and then had chicken pox and now his sleep pattern is gone to pot. How do I teach him to self settle again so he doesn’t wake?

He doesn’t sleep for more than 40 mins naps unless he’s in car/buggy and also is night waking and rarely settles himself without being picked up and also fed. In the latter part of the night /early morning (post feed) he does chatter away and then drop back or at worst shushing will settle him. How do I teach him to self settle again so he doesn’t wake?

A. Hi there, your poor little fellow, getting chicken pox so young, at least now it’s out of the way. At five months, there is a lot of variability it terms of night time waking and required feeds. It is a good indication of his sleep skills that he was sleeping through for you.

Establish a calm bedtime routine and encourage him to go to sleep as independently as possible. This doesn’t mean necessarily alone, but without you having to “put” him to sleep by walking, feeding, rocking etc, help him to do the last bit of falling asleep himself, ideally in his cot. This is a skill he needs to develop.

Again at five months day sleep is just getting organised and he needs to start to consolidate his naps beyond 45 minutes. Make sure that you are reading him properly and allowing him to sleep when naturally tired and note that now is a good time to phase out motion sleep and promote day sleep in the cot.

He needs 3-4 hours days during the day broken into 3 naps, with bedtime getting earlier around 7/8pm. If you hang in there and create the right environment, you will be able to unearth his previous good sleep skill set.

Q. What age is a good age to put a toddler/baby in with an older sibling?

A. I think that this totally depends on the family unit. It can also be temperament based too. I advise that if both the children have good sleeping habits and that you create the necessary boundaries to avoid high jinks at bedtime and in the morning, the sooner the better if you intend them to share. I often recommend using a timer light at bedtime to enforce that when the light goes out-no more talking.

Q. My 9 year old son cannot get to sleep easily at night and then starts to worry about things and makes the situation worse. Please can you suggest any tips to help him? Thank you

A. Although I don’t normally work with 9 year olds, there are a few things that you can try to help him. Avoid any stressful or worrying scenes prior to bedtime and ensure that his bedtime is not too late. Typically a reasonable bedtime for this age range is no later that 8.30. Encourage him to talk about what his worries might be earlier on in the day-time, as things often seem more difficult to process at night time.

Make sure that he has a nice wind down prior to getting into bed and don’t underestimate the power of a bedtime routine-keep it to his bedroom with the lights dimmed to enhance the sleep hormone and engage in quiet one to one time to enhance the relaxing hormone. Consider using a “waste” basket approach to any distracting thoughts that he can mentally screw up and throw away.

There are some relaxing exercises that you could try that involve tensing various muscles and releasing. I often recommend Maureen Garths visualisations for kids, a series of books of visualisation and meditations to help “quiet” and relax the body and mind. Often changing everything that you do close to bedtime can help so that you change the dynamic of going to bed.

Of course, ensure any electronic distractions are kept out of the bedroom and that DS games etc are not in use too close to sleep time as well.

Q. My little boy Alex is 25 weeks old and has a problem sleeping.

It’s generally no problem to get him to sleep however at varying stages throughout the night he cries out in pain, sometimes harshly others just whimpering in his sleep. He will sleep then till maybe 8am-8.30 (last night he went to bed at 8.30pm, woke at 3.10am, and then every forty mins approx after that. At 6 am we gave him some gripe water and he slept till 7.30am. (We also give him Infacol before a feed and lately he won’t take his bottle unless he has a little taste of gripe water beforehand…it seems to calm his tummy).

This morning he had his bottle and his porridge and winded very well. He had a disturbed sleep after this and when I picked him he gave two loud burps. Also after taking approx 10mls of his next bottle he gave 3 really deep burps. Generally he is very hard to wind even at this stage. There seems to be no connection between the food I give him and how he settles either.

I think the problem is mainly wind. He was a very colicky baby…he would scream for approx 12 hours a day until he was 14 weeks old. He also has silent reflux and is on 10mg of losec administered in the morning. Because of his reflux the paediatrician advised we put him on baby rice from 13 weeks and wean as normal from 17 weeks onwards. At present he has three meals a day. He then has a final bottle in the evening. So all in all he takes between 700-900mls of Nutramigen milk per day. I give him cooled boiled water at times too. So I know it’s not hunger waking him up. I have also had him at an osteopath (Pamela Synge) and she identified tightness in his neck and ribs and said it would be giving him headaches but we have finished our sessions with her and although he has much freer movement in his body than before we still have the sleeping problem. At around 16 weeks we had two blissful weeks where he slept from 9.30-7.30am uninterrupted.

He is gumming down on his fists and fingers but I don’t think he’s really teething. Sometimes I give him Calpol in case he still has headaches as he seems to thrash (gently ish as if he ahs a pain) in the cot. Really I want to eliminate whatever pain he has if he has some and ensure a better quality of sleep for all of us. Can you help?!!

A. I’m not really able to do anything about suspected wind and/or pain etc. There are lots of reasons for disturbed sleep and as parents it is our job to ensure that they are as comfortable as they can be during this time; sickness, teething travel, developmental milestones will all cause broken, interrupted sleep.

You can concentrate on making sure that he is well fed and winded during the day and possibly inclining the cot to help with the reflux. You can make sure that he is getting the right amount of sleep and at the right times during the day.

Also at this age, there is a lot going on and in the most part, if you are sure that you are not giving him sleep associations that do not help to consolidate sleep, and then as soon as he is able he should piece his sleep together for you. If you have any real medical concerns you should speak with your GP or health nurse. HTH

Q. Is there any research suggesting that an early bedtime is preferable?

My DS goes to bed late (10/11 ish) and sleeps in until he wakes, usually around 9:30-10:30 – he’s 3years old and gets about 11 hrs of sleep in total. No naps any more -but he will take a nap every so often when he seems to need it. He’s usually in good form. Extended family seem concerned that he’s up too late – but I don’t think it really matters which hours he sleeps as long as he gets enough sleep and is in good form. This sleeping pattern suits us as a family. Is there any research suggesting that an early bedtime is preferable?

A. That’s a great point, as long as he is getting the right amount of sleep: and that it is uninterrupted and un-fragmented and there is no problem, then it would appear fine. It would seem that his internal body clock has adapted to your way of life as most young children are pre-programmed for an earlier bedtime and earlier wake-time and lots of kids don’t do well to operate outside of their natural body clock. If he gets the required amount and is not unreasonably fussy, cranky etc I would enjoy it until you will have to make changes for school.

Q. Is it true that sleep induces sleep for babies, i.e. when babies/ toddlers sleep during the day, they sleep better at night?

A. Yes absolutely, sleep breeds sleep. The biology of sleep dictates that the more rested your child is from the day the better they present in the overnight period. So it’s important not to under-estimate the amount of sleep your child needs and resist the urge to wake them or cut short their naps in an effort to encourage better sleep at night.

Q. I have two sons one 34 months and one 9 months when is there a suitable time to put them in one room?

We have the 9 month old in a cot in our room at the moment :) I’m happy with that but don’t want to leave it too late :)

A. I think if they have good sleep skills; no time like the present!

Q. My son who’s dyslexic finds it incredibly hard to fall asleep

He could be lying in the bed for over an hour prior to dropping off. I mention the dyslexia because I have been told he could be over anxious but even when he’s had ‘good’ days he can’t fall asleep off … Any suggestions??

A. I mention in a previous post some relaxing exercises for bedtime that involve tensing various muscles that can help promote a more relaxed body at bedtime, I use a series of them for this purpose. I often use Maureen Garths visualisations and meditations to quiet the mind. You could buy the book and read them with him and/or record some of the stories with your voice and let him listen. HTH

Q. My 11 month old slept 8-10 hours from 8 weeks old until 6 months. Now she is up every 3-4 hours and we’ve resorted to co sleeping so we all can get sleep (other wise she is up every 1/2-1 hour).

I’ve been having her fall asleep in her crib for the last 2 months but that hasn’t made a difference. She won’t fall asleep in her crib unless she’s holding my hand either. She usually sleeps 11-12 hours at night with 3-4 hour nap during the day. Any way I can get her to sleep longer in her crib without having to make her cry it out?

A. Your daughter needs to perfect the skill of going to sleep at bedtime without you holding her hand. If she associates holding our hand to go asleep she will wake as she transitions through her sleep cycles.

You have made progress by starting her sleep off in the cot, but she also has a learned expectation that her sleeping location will change when she calls out in the night. You need to help her fall asleep without your hand at bedtime and then have the same consistent response when she wakes in the night.

You don’t have to let her cry it out, stay with her and soothe her gently as she masters the skill set.

Q. Our 8 year old has not slept for 3 weeks – up every hour. She is deaf and lip reads and was traumatised by 20 seconds of a music video showing talking lips. Any suggestions on how to get this image out of her head and get past the nightmares?

She also has a specific speech and language impairment which complicates explaining things to her.

A. Hi, I m sorry to hear that, you may have to do some exercises with her close to bedtime that involve looking through pleasant pictures that she would like or that she can relate to. I have some dream cards that I could show you and also sometimes making a photo album specifically for bedtime can help.

Q: How can I help my 18 month old to learn at this late stage how to fall asleep by himself?

A. The older they get the harder it obviously is. That said, my work is with children from birth to 6 years of age, so I believe it is never too late, but also important to recognise that learning to fall asleep is a key emotional skill, a form of self-regulation and one of our tasks as parents.

Again, at the risk of repeating myself, it is how you approach it. Treating bedtime or night time in isolation will not yield success. The easiest time to make the changes is at bedtime, provided that it is during their natural time to sleep (when you see yawning, rubbing eyes), and typically around 7pm.

Create a calm bedtime routine, keep it exclusively to the child’s place of sleep and make sure that you allocate enough time 20-30 minutes is a good number. I normally advise that parents remain with their child as they learn the skill in an effort to minimise tears, and then work on weaning yourself out of the process. Day sleep is hugely important, noting that a well-rested child can learn to fall asleep more easily and stay asleep for longer too.

Q: I would love some more sleep before the new baby arrives. So would my husband. Can you help?

I am writing to ask for help in regard to our 21 month old. We have a 5 year old a three year old a 21 month old and I am pregnant with our fourth. Our third child is a dote and any problem with sleep has been our own making. It just seemed easier to take her into our own bed when she woke. But now she is not easy to sleep beside she is thrashing around vocal and keeps us up.

We would like to get her sleeping through the night before the new baby arrives. We have to hold her to get her to sleep and then lift her into the cot at bedtime. I did try putting her into the cot to go to sleep by rubbing her back but she cried so much and vomited within 1 min. She is quite determined. We probably lift her quickly when she wakes because she stands up immediately and cries as we probably don’t her walking her siblings.

I would love some more sleep before the new baby arrives. So would my husband. Can you help?

A. I would encourage you to practise the cot acclimation exercises detailed during times that have nothing to do with sleep in an effort to take the initial fear and anxiety out of the cot and sleep time. By putting her to sleep in your arms, you are almost making her feel more distrustful of the cot as she keeps waking up in an environment that she did not initially go to sleep in, and then when she wakes you immediately take her out, sending her the message that she is right, she is not safe in the cot, because you keep changing the sleeping location.

The only way that you can help her to consolidate her night time sleep as you request, is to concentrate first on what happens to her at the onset of sleep and then having a consistent response during the night. At this age, she requires uninterrupted, unbroken sleep, but it is how you approach this is what will make the transition as smooth as it can be.

It is important that you ensure that she is getting adequate daytime sleep (around 2 hours) and that her bedtime is when she is naturally tired – I suspect this would typically be around 7pm. This would be the easiest time to try making the changes and naturally she will protest and not understand why things are changing.

Stay with her, respond with touch and verbally but mainly do your best to get her to fall asleep in the cot and then follow through in the overnight period. You could try using white noise in an effort to prevent waking the other children.

Tips for Cot Acclimatisation

  • Bring him to cot during non-nap times, every 1-2 hrs all day.
  • I have parents start by flying baby, then “bopping” them in cot – hold out, have feet touch mattress while parent makes a funny sound (like boop). Do this for maybe 3-5 mins, gradually increasing time feet stay on mattress.
  • If he is open to it, let go and play peek-a-boo – with hands over eyes, or through the crib rails.
  • Then pick him up & leave room.
  • Over the day, I increase time towards 5-10 minutes, see if you can hand him a toy to play with or sit next to the crib and sing an interactive song like itsy bitsy spider, or read a favourite book, then go.
  • It teaches him to be calm in cot & you’re not leaving, teaches you he won’t necessarily scream.
  • The goal is to interact with your child in cot without any threat of leaving, no tears, then leave the room and do normal activities. Takes the fear /anxiety out of naps /bedtime.

Related articles: Baby and Sleep: How the Clocks Changing Affects Them and Mastering the transition from cot to bed

Lucy Wolfe, CGSC, MIAPSC, Paediatric Sleep Consultant and mum of four young children, specialises in infant and child sleep problems that parent’s experience and need assistance in solving.  She can help you identify areas affecting your child’s sleep and gently unlock your child’s natural ability to sleep through the night and nap during the day, without leaving them to cry alone.

She is a trained and certified Gentle Sleep Coach, undergoing continuing professional development and weekly clinical supervision with Sleep Expert Kim West.  Additionally she holds a Certificate in Child Sleep Consultancy, accredited by the OCN and University of Reading. Furthermore, she is Certified Happiest Baby, New Parent Educator, specialising in teaching techniques to calm crying and help newborn babies to sleep longer.  She is a member of the International Association of Professional Sleep Consultants

Tel: 087 2683584, Web: www.sleepmatters.ie, facebook: www.facebook.com/sleepmatters

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