Category Archives: Sleep

Keeping sleep on track with grandparent visitors

Sleeping baby in grand mothers arms

Just when you thought you had all of your child’s sleep challenges worked out, here come the grandparents for a visit. While grandparents mean well and are absolutely fulfilling their grandparently duty by spoiling their grandchildren, I believe it was Dr. Marc Weissbluth who called grandparents the “enemy of sleep.” Make no mistake, they, of course, do the things they do out of love, but they often don’t adhere to the same limits that we work so hard to establish for our children. Here are some tips to help everyone get through these visits with minimal disruption.  Although we will mostly be talking about grandparents here, these tips and guidelines can apply to any visitor who disrupts your children’s daily routines.

For the sake of clarity, we will discuss the challenges that grandparents present as two separate categories: those related to grandparents who come in town to visit for brief periods of time and those who live locally and may take on more ongoing caregiving responsibilities. Visiting relatives tend to cause short term (although still stressful) disruptions where as if you have a relative caring for your child on a regular basis, this can have many more long-term consequences for your child’s sleep.

So why do we run into trouble with our children’s sleep when grandparents visit? There are a variety of reasons and ways that they may present challenges. Most commonly, I hear from parents that their children becoming more overtired when grandparents are around. Remember, your parents haven’t had a small child to care for in probably 30 years (give or take a few years). It is highly unlikely that they remember what the actual, day to day, experience of having a small child is really like. We repress those early memories very quickly so that we might someday decide to have another child and therefore the human race can continue. If parents forget the experience of having a small child after just a few months, imagine what 30 years must be like? Just try asking a friend of an 8 year old if they remember what it was like to get their child to sleep when he was a baby, and it is likely that she already doesn’t really remember how that actual experience felt. Although grandparents love their grandchildren, if they visit sporadically, they don’t know how to read your child’s tired signs like you do. While you may read your child’s glassy eyes and louder then usual vocalizations as signs that your baby is ready for a nap, grandparents often read that as boredom and a call for increased activity/stimulation (which you know is exactly the opposite of what your baby needs). You probably have heard a grandparent or two utter the words, “he doesn’t look tired to me.”

Another challenge is that children often become over-stimulated or excited when a new person shows up. Whether this causes a problem for your child is largely based on his or her temperament. Some children adjust fine to having new faces around whereas others have a harder time winding down when there are visitors in the house. For children who are very sensitive to disruptions in their routines, new and unusual family outings related to the visitors may also contribute to some sleep setbacks.

Lastly, it is unlikely that your visiting relatives have had as much recent practice at skills like “door closing, ninja-style,” “silent dishwasher emptying,” and generally not clomping around. They also don’t think about when the optimal time (meaning NOT naptime) might be to do a noisy activity such as taking out the garbage or calling the airlines on speaker phone.

Here are some tips for handling stressful grandparent visits:

  • Communicate, communicate, communicate. Ideally before the visitors come to town so you aren’t discussing these issues in an already escalated circumstance. If there are things that have frustrated you on previous visits, make a point to discuss it prior to the upcoming visit so you don’t have a repeat problem.
  • Point out things that you do that are important. Most often, I hear from families that I have worked with that things were going great with their child’s sleep and then grandma came to visit. Because grandma loves to hold her grandson, she rocked him to sleep for all naps and bedtime. Now, a baby who was going down for all sleeps awake will be again used to rocking and when you go back to your routines, expect protest. Let’s give grandma the benefit of the doubt. Maybe she didn’t know how hard you worked to help your child learn independent sleep skills. Talking about how you have helped your child to fall asleep without rocking can, not only help to clear the air, but also prevent future regressions after visits in the years to come. If your relatives are watching your child and will be putting him/her to bed, have them watch you do it (if possible) before they are responsible.  Tell them what you do if your child protests going down. Help them have the tools to respond to they don’t feel like they have to resort to using a sleep crutch, which will be a quick fix but could cause more long-term troubles.
  • If your baby or toddler becomes over-stimulated before bedtime due to visitors, spend some extra time before bedtime winding down (without the visitors). You can do all your good night kisses with your visitors before going into your routine but then give your child some extra quite time in their less stimulating room. Maybe you read an extra book that night, do a quick puzzle or sing a few songs.

What if the grandparents live locally and either care for your child while you work or you make frequent trips to their home where sleep may be required? This may necessitate a firmer set of limits.

  • As with grandparent visitors, communication is key. Regardless of who cares for your child when you are away, there is always a degree of control that we have to give up when someone else is caring for our children. No one is going to do things exactly the same way you do. If your parents or in laws are responsible for caring for your child, try to prioritize what is important about how they care for your child and handle sleep. This may mean that you have to pick your battles. Maybe it is most important to you that they adhere to your rules about your baby going down awake but getting them to wind down early for bedtime may be asking too much. If your parents watch your child frequently, they may learn the hard way what happens when your baby becomes overtired and then have more incentive to adhere to your limits.
  • If they can stick to your same routines, more or less, this can be helpful with creating consistency. Try to create as much of the same environment for sleep as possible. This is true if you spend every weekend in the suburbs or if your child goes to grandma’s house every day while you are at work. Here is where having a bedtime/naptime routine and a security object can be particularly helpful. If your child understands the association between the routine, having his blankie and going to sleep, it can make that experience much easier, no matter where he is.
  • If you want your baby to be able to sleep at grandma’s house on the weekends (especially without you), practice. The more you are able to make the experience of sleeping someplace different, a familiar experience, the easier it will be.

In our world where families often live far apart, grandparent visits are a reality for many families.  When they relationships are good and the communication is open, growing up knowing and having a relationship with one’s grandparents is a gift to your child.  Working together with your family to help your child sleep will lead to a much more relaxed visit and enjoyable time for everyone!

 

Common sleep regressions and how to handle them

sleep regressionsSleep regressions are every tired parents big fear.  Especially if you have completed sleep coaching your child and now things have gone off the rails, you are bound to be frustrated and discouraged if your baby begins waking again.  Parents ask me all the time, “Once my child has learned how to sleep, what regressions may happen?  What do we do when there is a sleep regression?  How do I help my child without falling back into bad habits.”

What is a sleep regression?  A sleep regression is when your baby was previously sleeping well (possibly through the night) for a long period of time and then, all of a sudden, without a known cause (such as the big sleep stealers:  illness, teething, travel), their sleep suddenly goes downhill.  Sleep regressions can last anywhere from 2 to 6 weeks and often coincide with cognitive or developmental milestones.  Commonly sleep regressions tend to happen at 6 weeks, 3-4 months, 6 months, 8-10 months, 12 months, 18 months and 2 years old.  Fear not, most children do not experience a full regression at each of these milestones.

Here’s what is likely to be going on at each regression

6 weeks:  Newborns frequently go through a series of growth spurts leading to increase hunger and fussiness.  Think about how rapidly your newborn is growing at this age!  So much happens in a relatively short span of time and this all takes lots of work on your baby’s part.

3-4 months (referred to as the 4 month sleep regression):  I often think of this as one of the hardest time periods.  In addition to a growth spurt, your baby is going through bursts of brain development increased awareness of her surroundings leading her to being more distractible in months past.  At the same time, many of the tricks (like Harvey Karp’s infamous 5 Ss) you may have used in the first several months to get your baby to sleep may stop working.  Whereas previously you may have been able to put your baby to sleep while holding her and transfer her to her sleeping spot, now the minute you put her down she wakes.  This is challenging because some babies are still really too young to soothe themselves from a wakeful state to a sleeping state so it may take several tries to get your baby into bed.  Some babies will also begin rolling at this point, which means if you are still swaddling, you will need to stop so that your baby doesn’t roll themselves in the swaddle.  Also, there are often a few days to weeks when your baby will roll from their back to front and get stuck (or vice versa) and not be happy in whatever position she is stuck in.  Lots of tummy time is essential to help your baby become proficient at rolling during the day so less practice at night is necessary.

6 months:  If your baby wasn’t an early roller, he may begin rolling more frequently by 6 months.  With rolling and increased core strength comes crawling.  Some babies will crawl as early as 5 or 6 months.  Others wait until a bit later.  Whenever it happens, it can become a big sleep stealer where you may see your baby up on all fours in his crib rocking back and forth, just practicing and getting ready for his upcoming mobility.  Some babies also go through a growth spurt at 6 months so increased hunger can occur.

8-10 months (referred to as the 9 month sleep regression):  This most often coincides with your baby’s new found ability to pull herself up to stand.  When this happens, your first job is to make sure she knows how to sit back down.  This can be practiced during play time when your baby is standing at a couch, coffee table, or ottoman height surface.  Place something on the ground that is sufficient incentive for your baby to reach down for it.  Maybe it is a favorite toy or something that is often off limits like your TV remote control or cell phone.  Guide your baby down to reach for the object, at first helping to bend her legs and then letting her do it on her own.  You can also practice this in the crib and can work on teaching your baby to walk her hands down the crib rails to a sitting position.  It is essential that you ensure that your baby can sit herself once she can stand, otherwise she will have no way of laying down to return to sleep if she wakes and stands.  You can end up in an endless game of “I lay you down, you stand up.”

12 months:  Walking!  Some babies will walk sooner then 12 months, some later.  I see 1 year olds having less regressions than younger babies but whenever your child begins walking, it can easily throw your child’s sleep for a loop.  This regression can crop up about 2 weeks before you see any significant skills emerge.  As with the earlier milestones, be sure to give your baby lots of practice time during the day so his is a bit more tuckered out when it comes time for sleep and is feeling less of a need to practice in bed.

18 months:  While many babies have been babbling away for months by now, words and direction following can really begin to emerge at this point.  Your toddler will still have difficulty communicating exactly what he wants, which can produce much frustration for both parent and child.  Remember, your child’s receptive language (what he understands) is likely to be move advanced then his expressive language (what he can articulate) so be sure to talk to him about what you are doing and when you are doing things that involve him.  Toddlerhood often brings the obsessive need for predictability to help your child have some semblance of control of their environment.  Being very consistent with your bedtime routine and in your response to any night wakings is essential to keeping any regressions short lived.

2 years old:  Some children’s verbal skills may not increase until closer to 2 leading to a later regression.  Some 2 year olds may also be potty training.  When children potty train at a young age, it can sometimes throw sleep for a loop.  Most children do not night potty train when they learn to stay dry during the day.  This typically follows later (by months to years for some).  Still, if your child potty trains early, it can lead to a few sleep troubles as she begins to master a new skill.

What to do during a regression

It may be that you don’t even realize that the regression is happening until your child masters his new skill and then you look back and think “So that is what was happening!”  If you find yourself in the midst of a sleep regression, do your best to soothe your child by being responsive but not creating any new sleep crutches or falling back into old ones.  Try to remind yourself that this is temporary, but if previously you didn’t need to step foot in your baby’s room at night, you may now need to make an appearance, even if it is just for a “parenting check.”  When you establish that your child isn’t sick and that there is nothing that you need to “do,” you can go back to a spot of increased support if you have gone through a behavioral fading method and your child was once comforted by having you close by.  Or you may need to do a few timed checks to reassure your child that you are nearby but that it is still time for sleeping.  Recognizing that your child also is tired and frustrated with whatever developmental milestone is happening is also helpful to keep in perspective.  Hopefully it will be short-lived and everyone will be back to sleeping great very soon.  If not, feel free to contact me for a free 15 minute consultation and get to the bottom of whatever is going on.

 

 

The importance of a bedtime routine

bedtime routineI can’t emphasize enough the importance of a bedtime routine.  Children as young as 8 weeks old can appreciate a bedtime routine.  Why is bedtime routine important?  From a biological standpoint, opioids are created in the brain when entering a welcoming, cozy, or familiar space.  This helps calm the brain and get ready it ready for sleep.   The bedtime routine is designed to help your child go from an alert state to a calm and drowsy state.  When you go through a bedtime routine, you are showing your child that their room is a safe and nurturing space and creating a foundation for comfort, thereby activating oxytocin and the sleep hormone melatonin.

From a cognitive standpoint, the bedtime routine is important because your child doesn’t know how to tell time.  As parents, we do things throughout the day that help our children to understand what is happening next and to help their day start to have some order and predictability.    Your child will begin to associate the things you do in your bedtime routine with going to sleep.   Bedtime routines help children calm down and relax in order to be ready for sleep.  Especially for alert children, making the transition between interacting and playing and quieting and down to go to sleep can be very challenging.   The process you go through before bed will help your child be ready to go to sleep rather then continuing to play.

In large part, bedtime routine is a very personal process and individual to your family’s traditions (or the traditions you are creating).  You can customize it in whatever way you choose so that your child has their special time before bed with you.  Bedtime routines often involve taking a bath (although baths are not typically relaxing for children-it tends to be play time but children do make an association between playing in the bath and going to sleep soon after), infant massage, diaper changing, turning down the lights, turning on white noise. putting on pajamas, feeding (nursing or a bottle) for babies, a special bedtime song or short story.  For many young babies, it can be a challenge to even get through the shortest of books before bed when a baby is already very tired.  I often recommend saving books for other times of the day when you expect your child is more alert and interactive.  As children get older and are no longer eating before bedtime, adding in a story can be a good way to substitute one comfort (feeding) for another (concentrated attention from parents during story time).  Make sure to include your child’s special lovey or security object in the bedtime routine because your child also associates having his or her lovey as part of the process of going to bed.

When babies are little, bedtime routine may not take much longer then 20 minutes and much of that may involve feeding.  I often encourage parents to keep bedtime routine on the short end when their children are younger because as they turn into toddlers, they love to add to the bedtime routine.  Toddler shenanigans can often make a bedtime routine rather lengthy because they are famous for their stall tactics.  It is important, however, that you keep the routine consistent, especially with regard to the order of events because the consistency is very comforting.  Changing around a bedtime routine can throw a toddler into a tailspin.

Sweet dreams!

Nightmares vs. Night terrors: How to know the difference

nightmaresNo one likes nightmares.  Even as an adult, nightmares are scary and can leave me awake for extended periods in the middle of the night while I try to remind my brain that it is safe to go back to sleep.  In children, it is no different only they don’t have the ability to understand that the vivid images they just experienced were not real.  Sometimes, however, children experience what looks like a nightmare but it is, in fact, a night terror.  It is important to understand the difference, to know how to spot a night terror, and how to handle each of these circumstances.

Nightmares

Nightmares occur during REM sleep, typically during the end of our sleep period.  When your child has a nightmare, she will seek comfort from you and may not want you to leave for a bit until she has recovered.  She may be able to describe the dream in detail both at when she wakes and hours later the next day.  It may take a while to go back to sleep.  Nightmares can begin as early as age 2 when your child’s imagination starts to develop.  They are very common after difficult events or when your child is reliving a trauma.

When your child wakes from a nightmare, it is important to go to her, offer comfort, help her understand that it was just a dream and she is safe.  Use creative visualization to help her come up with happy thoughts to put into her head to replace the scary thoughts that remain after a bad dream.  Avoid television shows or movies, even ones that, as adults, we think of as fairly benign and not scary at all.  It is particularly important to screen the media your child is being exposed to, especially if your child is sensitive to these things and often gets “the scaries.”  Even television or radio news can spark a bad dream.

Night terrors

Night terrors are very different from nightmares.  Night terrors usually occur within the first two hours of the onset of sleep, during nonREM sleep.  Your child is not actually awake even though his eyes may be open.  He may be screaming, sweating, his heart is racing, and he is inconsolable.  Typically, they last between 5-15 minutes unless you interfere with it and try to wake him.  Night terrors are more common in boys and can start as early as 15 months old.  They are often caused by sleep deprivation or sleep disturbances resulting from illness, travel, stress or sleep apnea.  Your child will not remember the incident in the morning.

When your child has a night terror, less is more, when it comes to what to do.  Make sure he is safe and can’t hurt himself but other then that, do as little as possible.  Doing too much to interfere can prolong the episode.  Research has recently come out that shows a link between screen time and night terrors.  Limiting screen time sometimes altogether or at least in the later half of the day can reduce the incidences of night terrors.  Also, helping your child get more sleep by moving bedtime earlier (even briefly) and regulating his sleep schedule so he is going to bed at the same time and waking at the same time is important.  If your child is frequently experiencing night terrors, start keeping a detailed log for 7-10 nights.  If they are always occurring at the same time each night, you can wake him briefly 15 minutes prior to the terror.  Wait until he mumbles, moves, and rolls over before letting him go back to sleep.  Do this for 7-10 days to 2 weeks to interrupt the sleep cycle.

 

Baby sleep myths

sleeping-babyThere are many myths around about various things you can do to help your baby sleep better.  In truth, sleep is a learned skill for many children so nothing you do “to” them is going to improve their sleep until they learn how to sleep better.  Here are some of those myths, debunked.

Rice cereal:  Many well-meaning relatives, friends and random strangers with opinions in the grocery store will often suggesting giving babies rice cereal (either in the bottle or spoon feeding it) in order to get babies to sleep longer.  Breastmilk and/or formula provide babies with all the nutrition they need in the early months.  Solid food is just adding carbs to their diet and doesn’t do anything to improve their sleep.  A family I once worked with was adding rice cereal to their 11 month old’s bottles.  When I asked her about it, she said her mom had told her that her daughter would sleep longer from the rice cereal.  My next question (given the fact that they had hired me to help them with their daughter’s sleep at that point) was “So how is that working out for you?”  Didn’t seem like it was J

Formula (for breastfed babies):  Many breastfeeding moms hear from their formula feeding mom friends that their babies sleep longer.  This may be true briefly but it tends not to be true in the long term.  While some say that formula metabolizes in the body more slowly then breastmilk, there are plenty of breastfed babies out there who sleep great.  In addition, giving formula to a breastfed babies right before bed can actually lead to tummy troubles in the middle of the night due to the fact that their system isn’t used to it.

Stretching out feeds:  Some sleep experts and books claim that if you stretch out your baby’s feedings during the day, then he will be able to go for longer stretches at night.  In fact, the opposite is true.  While it may be easier for your baby to go for longer stretches during the day because he is distracted and entertained by all the excitement that happens in his day, it is likely that he will want to play “catch up” at night and actually need to eat more.  I encourage families to feed more during the day so that your baby is more full at night and can sleep a longer stretch.

Breastfed babies don’t sleep well:  A recent study actually shows that breastfed babies and moms sleep better due to the fact that they are often able to nurse quickly laying down and go right back to sleep with minimal disruptions in the middle of the night.

Skipping naps will help your baby sleep longer at night:  Nothing could be farther from the truth!  Babies (and children up to age 5 in some cases) need day sleep.  Newborns need to sleep every 90 minutes.  That number only increases to about every two hours as they get closer to 4 and 4½ months (and sometimes there may be points in the day that your baby still can only make it an hour and a half).  Skipping naps will lead your baby to be overtired, have a harder time falling asleep at bedtime, more night awakenings and early rising the next day.

So since now you know all the things that won’t help your baby sleep and you understand that this is something your child has to learn, if you need help teaching your little one this MOST valuable skill, contact me.  I can help!

Crying, what’s all the fuss about?

bigstock_crying_baby_12401891Making the decision to change your child’s sleep habits can be a hard and stressful decision to make.  Not to mention that if you need to make this decision, you are sleep deprived yourself, and it is hard be consistent and follow through when you are exhausted as an adult.  There is much controversy over crying these days and the harm may cause your child.  The vast majority of parents who contact me report concerns about letting their child “Cry It Out” (CIO).  I hear from parents, “I just can’t let my child cry all alone in a dark room.”  However, this is not the only way for your child to learn improved sleep habits.  Yes, there is nearly always crying involved but giving your child space to learn the skill of putting him/herself to sleep can be done while still providing comfort and support.  Ultimately you will be giving a gift that your child will use for a lifetime.  Regardless, parents are often asking me about what methods I recommend and how much crying will be involved.

Most parents who contact me have reached out because what they have been doing until this point to help their child fall asleep is no longer working.  As crying is a preverbal child’s way of expressing frustration, I cannot promise families that their child will not cry.  When you are making changes to your child’s sleep, you are teaching him or her to do your child has never had to do before:  to learn how to put him/herself to sleep at the beginning of the night and back to sleep throughout the night.  Sleep is a learned skill and it is something that takes time for your child to learn.  As part of the process of learning something new (remember, change is hard for EVERYONE) there is no way to protect your child from experiencing frustration.  In fact, by continually trying to minimize the amount of frustration your child experiences, you can prolong the period of time it takes for your child to learn this skill.  How long your child has been sleeping with the help of sleep crutches (anything that you do to your child to help him/her fall asleep such as rocking, bouncing, nursing, holding) and to what extent their current sleep behavior is engrained will determine how hard it is for your child to learn how to put him/herself to sleep and how much crying there will be.

When families ask about how much crying there will be, I am up front about the fact that I can’t answer that question exactly.  I do know that if parents are consistent with their plans and follow through, the crying can be minimized in the long run.  Specifically, there are three factors that impact how much your child will cry:

  1. Temperament:  Temperament refers to your child’s behavioral style or the manner with which he or she interacts with the environment.  If your child has a typically easy-going temperament, handles change well, and is generally adaptable, then making changes in his or her sleeping behaviors is not usually accompanied by much crying.  If, however, you have a very alert, high needs or fussy baby, he or she is going to let you know, and probably forcefully so, that they are not pleased about your plans to change their sleeping behavior.  Assessing your child’s temperament can help you set realistic expectations for the best method to use to change your child’s sleep behaviors.
  2. Age:  As babies get older, move closer and closer to toddlerhood, become more and more aware of their environment and surroundings and have had longer for various behaviors and patterns to become engrained, it becomes more challenging to change their sleep behaviors.  Making changes to your child’s sleep is typically the easiest between 6 and 9 months old.  4-6 month olds also learn very quickly but special attention must be paid to their more demanding nutritional needs at this age and not all children are ready to learn this skill at less then 6 months.  At 9-12 months, most children are still fairly adaptable as well although some will go through a sleep regression at around 9 months (often tied to developmental changes such as the ability to stand up and a burst of separation anxiety).  Children over 18 months old fall into the category of much more challenging with regard to sleep changes as they are beginning to want to control much of their environment and they have the ability to outlast their parents in many battles of will.  This is not to say that it is impossible to improve your child’s sleep over 18 months old.  It certainly is possible.  It will just require much more consistency and commitment.
  3. How much you have tried and been unsuccessful at changing your child’s sleep in the past:  Every time you attempt to change your child’s sleep and are inconsistent by giving in and go back to old patterns, you are training your child to cry longer and harder to get what they want.  This means that every time you start over again, it is going to be harder and there will likely be more crying.

Make no mistake, it can be hard to go through the process of making changes to your child’s sleep.  With a good plan, support and consistency, you will be amazed at what your child can do.

 

Transitioning from the bassinet to the crib

bassinetParenthood can easily be characterized by a series of many transitions that both we and our children make on an ongoing basis.  Many of these transitions occur in relation to your child’s sleep, the first of which is often transitioning from a bassinet to a crib.   While some babies have always slept in their cribs since they came home from the hospital, many babies sleep in a bassinet when they share the room with their parents.  The SIDS recommendation for where a child should sleep states that babies should share a room with their parents for at least the first 6 months of their life.   Some families choose to do this and some do not.  Every family does what they are comfortable with.  Babies often stay in their bassinet until they either outgrow the weight limit (most have a maximum of 15 pounds) or they are too long for it.  Sometimes, however, babies start to become very mobile and are ready to be able to move around more in their sleep.  I remember when my daughter turned herself 180 degrees in the middle of the night in her tiny bassinet.  I still don’t know how she did it, but that was when we decided she was too big and too mobile for it.

crib photoMaking this transition can be daunting for some parents.  I often find there is a bit of sadness that accompanies this change as it is one of the first moments when parents begin to realize how quickly their babies are growing and changing.

Here are some tips to help make this transition a bit easier for everyone.

  • Depending on your baby’s age, you may still be swaddling her when you make the move.  If you are, continue to swaddle until your child doesn’t need it anymore.  This can help your baby to continue to feel the comforting confinement they had in the bassinet even though there is now more space in the crib.
  • If your bassinet has a separate base and “basket,” you take the basket off and spend a few nights with it placed in the actual crib.  Although your baby won’t actually be sleeping in the crib, they will at least be in their crib environment.
  • So that your baby doesn’t have quite so much space all around, put your baby in the crib the short way.
  • Spend a few days prior to the move giving your baby some time to “play” in her crib with you nearby and interacting with her.  This is not at a time when you are wanting your child to be sleeping.  This is just playtime.  This will help your baby become acclimated to the crib and start to think of it as a familiar place.  Even if your baby starts to fuss, try not show distress yourself and pull her out of the crib immediately otherwise it can send the message that the crib is not a good place to be.  Even small babies can pick up on their parents’ anxiety.

Congratulations on the first of many transitions!  Don’t worry, before you know it, you’ll be helping your baby make her twin bed at college.

Answers to your questions: 11 month old not sleeping well

fussy babyQuestion from a tired mom: My 11-month old will not sleep for more than 2 hours at a time. I feel like we have tried every trick in the book aside from cry it out. Co-sleeping was saving my life but now my daughter won’t even nurse to sleep! Realizing it has been over a year since I have had more than 4 hours of consecutive sleep just made me even more tired and I know my little one can’t be feeling the best either.

Linda: After 11 months, I can completely understand why you are so exhausted! Sleep is so important to our children. When we sleep our body produces and secretes growth hormones, builds its immune system system, and the brains retains, stores and organizes memories which are the foundation of learning—something all parents want for their children. Without sleep, all of these processes become very difficult.

Before making any decisions about changing your child’s sleep habits, it is always important to decide what your goals are. If your child is co-sleeping because this is a decision that your whole family is in agreement on, and it is something your child will cooperate with, then it is possible to continue this. If, however, co-sleeping is your last resort at 2am or 5am (or whatever time) in the morning for how to get your child to sleep, then that is an important factor to take into account. No matter what method you choose to change your child’s sleep, the most important component is your ability to remain consistent throughout the process. If you always put your baby to sleep at bedtime by nursing or bottle feeding her, when she goes through a partial awakening or arousal during the night (these can happen every 10, 20 or 30 minutes in some children), then she will need the same sort of intervention in order to put herself back to sleep.

Bedtime is the easiest time for your baby to learn how to fall asleep. Make no mistake, learning how to go to sleep and stay asleep is a learned process. As much as children learn how to sleep, they also learn how to not sleep. Many parents spend the whole night using every trick in the book to try to get their child to sleep. If at bedtime, you feed your baby to sleep, at 10pm, you put in the pacifier, at midnight, you feed her, at 2am dad goes and rocks her, at 4am you feed her again and then when nothing else is working at 5am,you finally throw up your hands and bring her into bed, she has never learned what to expect at each waking. Each night is going to be another act in the dance of trying all your tricks to get her to sleep. For a baby who has spent 11 months of her life doing this dance, it is going to take a very consistent response to teach her what to expect when she wakes. If you have taught your child a habit, and you go to change it, your child will have something to say about it and for a preverbal child at 11 months, she is going to express that frustration and confusion in crying.

At 11 months old, I typically recommend a method that is going to be comforting to your child in that you will be remaining with her as she is going to sleep. An 11 month old is often experiencing heightened separation anxiety and will become very upset when you put her in her bed and leave the room. I would encourage a family with an 11 month old to check out Kim West’s Sleep Lady Shuffle, also known as fading or camping out. This method enables you to be a reassuring secure base for your child while she is learning how to go to sleep without doing it for her. It communicates to her that you are there for her and you will be able to provide comfort and reassurance as she is learning how to put herself to sleep.

I would strongly suggest discussing your plans with your partner during the waking hours (2am is never a good time to be making important decisions), choosing a plan that both of you are in agreement about, deciding who is going to do what and make a commitment to stick with it. Know that the first few nights of any plan to change your child’s sleep behavior are going to be hard. Behaviors that have been inconsistently or intermittently reinforced are the hardest to change and produce the most frustration from your child. However, after only a few nights of being consistent, you should start to see significant changes in your child’s sleep.

For more sleep advice or to contact Linda directly for an individual sleep consultation for your family, please contact me!

5 sleep tips for traveling with children

Traveling, whether it is on a 2 hour car trip to the grandparent’s house or a 10 hour plane ride to another country, often throws small children’s sleep for a loop. Traveling brings unfamiliar spaces and new people to play with. This combination can often make it hard for a child to quiet their mind for sleep. Here are a few tips to help your child sleep better while traveling:

sleeping kids in car1. Be sure to bring along your child’s beloved lovey or sleep security object when you travel. I even go so far as to say it is a good idea to make sure it is in carry-on luggage in case your luggage is lost.

2. For young babies especially (under 1 year old), if your child will be sleeping in a crib while traveling, bring your crib sheet from home so that there will be familiar smells for your baby where you are staying.

3. Try to give your child plenty of time to become familiar with the new space before attempting to put him down for a nap or to bed at night. In a strange environment, your child is likely to need extra comforting and snuggles in order to be able to relax and fall asleep. Also, keep in mind that seeing fun and entertaining friends and family will be be extra stimulating, so be sure to give your child lots of wind down time before sleep.

4. As much as possible, try to keep to somewhat of a similar schedule while traveling. If your child still needs a nap, make sure that time is set aside for a nap. Being overtired and sleep deprived from not enough day sleep can interfere with night time sleep while traveling.

5. If you have healthy sleep habits established at home, even if things get off track while traveling, returning to your normal routines once you are back home will help your child return to their good patterns.

5 things that kept your child awake last night

SleepingBabyBoy5Is your family exhausted?  Is your child waking multiple times a night, each time relying on your to help put him or her back to sleep?  Is bedtime a battle?  Do you find yourself dreaming about the day when your child will sleep well at night and wake up feeling refreshed in the morning?  If any of this sounds familiar, check out these 5 things that could be contributing to your child’s night wakings or early rising.

Too Late Bedtime:  Going to bed too late means that your child is overtired when he or she is going to sleep.  When your child is overtired, it becomes harder to stay asleep, contributing to more night wakings.  Bedtime can be dependant on how well your child naps but typically anytime between 6:30 and 8pm is an appropriate bedtime for most children.  As many parents learn the hard way, going to bed too late often leads children to wake earlier in the morning.

Nap Deprived:  Most children under age 3 nap regularly.  The number of naps a child takes and the amount of day sleep required varies by age.  By about 4 months, most children need 3-4 hours of day sleep, spread among 3 (sometimes 4) naps.  Between 6 and 9 months, the third nap disappears and two naps remain—a morning and an afternoon nap with a total amount of day sleep from 2-4 hours.  Between 12 and 18 months, most children drop the morning nap and take one longer afternoon nap, usually between an hour and a half and three hours.  How long your child will continue to nap is very individual.  Some children will try to drop their nap as early as 2 years old (not that they don’t still need it but some will try), others will start to nap sporadically as they approach 3, while others will continue on full steam ahead as napping rock stars until the kindergarten day forces them out of it.  When children whose bodies require daytime sleep are not getting it, it will often lead to night waking due to being overtired.  If your child still needs a nap and isn’t taking one, it is a good idea to move bedtime earlier to help your child get more night time sleep.

Already asleep when put in crib:  When you put your child in bed already asleep by rocking or feeding, when he goes through a partial awakening, whether it is an hour or 5 hours later, he will require the same external action to return to sleep.  In addition, without the skill to put himself to sleep at bedtime, he will not know how to do this at other awakenings throughout the night.  The skills your child uses to put himself to sleep at bedtime are the same ones he will use to return to sleep throughout the night and early in the morning.

Parents’ inconsistent response:  It is very confusing and unpredictable for a child when your baby wakes and is responded to differently at each waking.  Every time you address night wakings, address it in the same way.  By responding inconsistently, this leads to increased anxiety and more waking.  It is always best to decide how you are going to respond to wakings before they happen.  3am is never a good time to be making decisions.

Medical conditions:  Asthma, allergies (particularly uncomfortable eczema), reflux, and obstructive sleep apnea are the most common medical conditions that interfere with sleep.  As one would expect, when children are uncomfortable, they are going to find it hard to sleep.  Before working on making changes to your child’s sleep behaviors, medical problems must be addressed by your child’s health care professional and resolved in order for you to be successful with any sleep behavior changes.

If you want to make changes to your child’s sleep, I strongly encourage you to have a well thought through plan for how you are going to address it.  Creating a plan that provides your child with a consistent response at bedtime and the middle of the night will give you the greatest chance of being successful.  For help understanding what is expected of your child based on their developmental stage and putting together a plan to make changes to your child’s sleep, contact Sleep Tight Consultants today.

Copyright 2010 Kim West, LCSW-C, LLC   The Sleep Lady®    www.sleeplady.com