The Baby Sleep Book: How to help your baby to sleep and have a restful night

The Baby Sleep Book: How to help your baby to sleep and have a restful night Martha Sears William Sears Drawing on considerable experience as both parents and professionals in the paediatric profession, the best-selling parenting experts Dr. William and Martha Sears have produced the definitive guide to the frequently fraught and troublesome topic of sleep.The Sleep Book is designed as a practical and contemporary guide to parenting, ensuring you can get your child to sleep and making sure night time isn’t dreaded. Containing the latest medical research, and providing informed and considered advice on all the issues, this book offers guidance and support to keep you and your child rested and refreshed.Includes advice on all aspects of sleep such as:• 8 infant sleep facts every parent should know• 31 ways to get your baby to sleep and stay asleep• Bedwetting• Hidden medical causes of night waking• Sleep trainers• Night weaning – 12 alternatives for the all-night nurser• Night terrors• 5 reasons why high need infants sleep differently• Sleep safety• SIDS: the latest research on how sleeping with your baby is safe• Co-sleeping: Yes, No, SometimesAn invaluable resource for parents of young children, The Baby Sleep Book provides guidance on how to get your baby to sleep, what to do if he wakes up to often, what to do if he sleeps to much. It also helps with moving the place of sleep, sleepwear, managing the sleep time of more than one child, and night time feeding. Dedication (#ulink_e2ae23dc-2e52-5340-bada-2fbe78fc0996) to our children – who now all sleep through the night James Robert Peter Hayden Erin Matthew Stephen Lauren and dr bob’s Andrew Alex Joshua contents Cover (#uddcd2dfd-cebc-5009-a3fe-227a5028c847) Title Page (#u90571a74-0531-5a93-b999-b7ca78392b45) Dedication (#ulink_3892e544-81f1-59e7-981d-9af3e8eda564) A Restful Word from Dr Bill (#ulink_cc0f486c-d933-596c-ac83-5a7219d2a6e9) chapter 1: five steps to get your baby to sleep better (#ulink_dcfda074-9a13-500f-9907-0744e8ca9168) Step 1: Find Out Where You and Your Baby Sleep Best (#ulink_fd657c3d-2b68-5028-b084-92bf2a2f0533) Step 2: Learn Baby’s Tired Times (#ulink_5177f663-268a-5d27-980b-44fc2d6a086e) Step 3: Create a Safe and Comfortable Environment Conducive to Sleep (#ulink_2fbed838-3e2b-5b03-81ea-ee2bbc68f60f) Step 4: Create a Variety of Bedtime Rituals (#ulink_5df6629b-a247-5edd-833e-ff67e52f5126) Step 5: Help Baby Stay Asleep Longer (#ulink_8a877a6d-b8ee-576d-9c2e-1378d2e313e5) Keep a Sleep Log (#ulink_d2af3a9e-0ced-5609-9a0d-2a46619768a3) chapter 2: fifteen tips to help toddlers sleep (#ulink_d5f6bd50-78d1-5a6c-b7e8-50035bfa1487) What Toddlers Learn at Bedtime (#ulink_b38c135a-80b8-56e7-bb70-c9d56f102e24) Easing Your Toddler Off to Dreamland – Fifteen Tips (#ulink_64050997-9530-530e-b1c8-626109eca523) Teaching Your Young Child to Fall Asleep Alone and Happy (#ulink_97f140c0-e66e-5989-85ee-4604a9f63fc5) FAQs About Toddler Sleep (#ulink_a194dac1-d841-58b0-9b56-c2484f55f0f2) Why Nighttime Parenting Matters (#ulink_9ed698a8-b386-5252-a6e2-53b90cf7272d) chapter 3: the facts about infant sleep and what they mean for parents (#ulink_7b38860e-0623-502b-bb30-af46c2d78af9) Learn the Facts of Infant Sleep (#ulink_488364f5-587f-5528-96f5-f04376904a21) How Babies Sleep at Various Ages (#ulink_5f4dae7b-dcb7-57d1-869e-abb30aeed535) Why Babies Wake Up (#ulink_3cc235c4-85b4-5a83-9768-bba34bd1dbb6) Normal Night Noises Sleeping Babies Make (#litres_trial_promo) Adopt a Nighttime Parenting Attitude (#litres_trial_promo) Unclutter the Daytime Life of a Nighttime Parent (#litres_trial_promo) Get Connected (#litres_trial_promo) Get to Know Your Baby’s Sleep Personality (#litres_trial_promo) Matching You, Your Baby, and Your Sleep Plan (#litres_trial_promo) Sleep Safety (#litres_trial_promo) chapter 4: meet different families with different sleep plans (#litres_trial_promo) Newly-Born or Soon to Be (#litres_trial_promo) Doing it Differently with the Next Baby! (#litres_trial_promo) Baby Training (#litres_trial_promo) Baby Fights Sleep (#litres_trial_promo) High-need Sleepless Baby (#litres_trial_promo) Painful Night Waking (#litres_trial_promo) Won’t Sleep Well in Cot (#litres_trial_promo) Feeding All Night (#litres_trial_promo) Family Burned Out from Frequent Night Feeding (#litres_trial_promo) chapter 5: the joys of sleeping with your baby (#litres_trial_promo) Our Co-sleeping Experiences (#litres_trial_promo) The Truth About Co-sleeping (#litres_trial_promo) Our Co-sleeping Experiments (#litres_trial_promo) Science Says: Co-sleeping is Healthy (#litres_trial_promo) Nine Benefits of Co-Sleeping (#litres_trial_promo) Nine Ways to Make Co-Sleeping Easier (#litres_trial_promo) Common Co-Sleeping Questions (#litres_trial_promo) chapter 6: night feedings and nightweaning – when and how? (#litres_trial_promo) Ages and Stages of Feeding at Night (#litres_trial_promo) Fifteen Ways to Make Night Feeding Easier (#litres_trial_promo) Thinking About Cutting Back on Night Feeding? (#litres_trial_promo) Twelve Tips for Getting Baby to Feed Less at Night (#litres_trial_promo) chapter 7: moving out! tips for transitioning to a big kid’s bed (#litres_trial_promo) Five Steps to Easing Your Kids Out of Your Bed, Out of Your Room, and into their Own Room (#litres_trial_promo) Getting Your Child to Sleep Independently: A Case Study (#litres_trial_promo) chapter 8: twenty-three nighttime fathering tips (#litres_trial_promo) Part One – for Dads (#litres_trial_promo) Part Two – for Mums (#litres_trial_promo) chapter 9: naptime strategies that work (#litres_trial_promo) Creating Healthy Nap Habits (#litres_trial_promo) Getting Baby to Nap at Predictable Times (#litres_trial_promo) Winding Down the Reluctant Napper (#litres_trial_promo) FAQs About Naps (#litres_trial_promo) chapter 10: should baby cry it out? (#litres_trial_promo) What Crying It Out Really Means (#litres_trial_promo) How Crying It Out Sabotages the Parent-Child Relationship (#litres_trial_promo) Sensitive Sleep-Training That Does Work (#litres_trial_promo) chapter 11: hidden medical and physical causes of night waking (#litres_trial_promo) When to Suspect a Medical Cause for Night Waking (#litres_trial_promo) Gastroesophageal Reflux (GER) (#litres_trial_promo) Food Allergies/Sensitivities (#litres_trial_promo) Formula Intolerance (#litres_trial_promo) Stuffy Noses (#litres_trial_promo) Ear Infections (#litres_trial_promo) Environmental Allergies (#litres_trial_promo) Anaemia (#litres_trial_promo) Pinworms (#litres_trial_promo) Sleep Apnoea (#litres_trial_promo) Irritating Sleepwear (#litres_trial_promo) Teething (#litres_trial_promo) Growing Pains (#litres_trial_promo) Nappy Irritation (#litres_trial_promo) Baby too Hot or too Cold (#litres_trial_promo) Bedroom Noise (#litres_trial_promo) Separation Anxiety (#litres_trial_promo) chapter 12: nighttime parenting in special situations (#litres_trial_promo) Night Waking after Mother Returns to Work (#litres_trial_promo) Night Waking in a Premature Baby (#litres_trial_promo) Twins and Multiples (#litres_trial_promo) When Child Is Sick (#litres_trial_promo) When Travelling (#litres_trial_promo) Moving (#litres_trial_promo) When Dad Travels (#litres_trial_promo) “Feeding” Baby to Sleep during Childcare (#litres_trial_promo) Single Parents – Two Different Beds (#litres_trial_promo) Nightmares (#litres_trial_promo) Sleep Terrors (#litres_trial_promo) chapter 13: eleven tips to help parents sleep better (#litres_trial_promo) 1. Make Sleep a Priority (#litres_trial_promo) 2. Eat to Sleep (#litres_trial_promo) 3. Dress for Sleep (#litres_trial_promo) 4. Exercise for Sleep (#litres_trial_promo) 5. Enjoy a Before-Bed Bath (#litres_trial_promo) 6. Turn off the Tube (#litres_trial_promo) 7. Don’t Worry, Be Happy! (#litres_trial_promo) 8. Sleep More the First Month (#litres_trial_promo) 9. Enjoy a Before-Bed Ritual (#litres_trial_promo) 10. Nap When Baby Does (#litres_trial_promo) 11. Make Nighttime Mothering More Restful (#litres_trial_promo) Keep Reading (#litres_trial_promo) appendix a: music to sleep by (#litres_trial_promo) appendix b: bedtime books to sleep by – for toddlers and pre-schoolers (#litres_trial_promo) appendix c: references (#litres_trial_promo) Index (#litres_trial_promo) Copyright (#litres_trial_promo) About the Publisher (#litres_trial_promo) a restful word from dr bill (#ulink_4978dd97-b108-5785-b04e-fbefb6a2334f) Each day in our pediatric practice we hear tired parents sigh, “If only our baby would sleep more.” In all our years of writing books and of practising pediatrics, our goal has been to do good things for babies and make life easier for parents. We believe that helping babies sleep better is not only good for them, but good for parents. Parents who get enough sleep at night will be happier during the day. Over the years, we have devoted a lot of time and energy to the sleep problems parents in our practice share with us. We have offered these tired parents many suggestions for helping their baby sleep longer, and we have asked them to report back to us about which worked and what didn’t. We have also asked parents who have visited our website (www.askdrsears.com) to share their sleep problems and solutions with us. As a result, much of the advice in this book comes from parents like yourselves who have struggled to help their babies sleep, found solutions, and willingly shared them with us. You will find quotes (the ones in italics) from these parents sprinkled throughout the book. We’ve also taken the advice of these parents on how to write a book about sleep. They told us, “Cut right to the plan.” This is why the first two chapters of this book contain our step-by-step approach to help your infant and toddler sleep healthier and happier. As authors we lose sleep reading many of the baby sleep books currently on bookstore shelves, since most of them are yet another variation on the tired old theme: “Just let your baby cry it out.” This tough love for babies is like training a pet, and taking this approach to parenting babies at night puts families in a lose-lose situation. Babies may eventually give up crying and go to sleep, but they lose their trust in their parents to meet their nighttime needs. This can’t be good for a baby. Parents lose because this quick ticket to the promised land of sleep keeps them from learning about their baby’s individual sleep needs along the way. Most baby sleep books preach the extremes: either cry it out (forcing baby to sleep) or tough it out (just hang in there). Neither of these approaches is fair to tiny babies or tired parents. Instead, ours is a sleep tools approach. If babies could talk, they would say: “Please don’t force me to sleep; instead, teach me to sleep. After all, I’m just a baby!” Sleep is not a state you should try to force a baby into. It’s better to set conditions that allow sleep to overtake baby and that make self-settling and sleeping longer, easier and more attractive to baby. Yes, you read it correctly – self-settling, which does not imply selfish parenting. While newborns and young babies need help from parents to relax and fall asleep, older babies will eventually learn to settle themselves. Depending on their temperaments and need levels, different babies will master self-settling skills at different ages, but parents can do a lot to help them along. It requires commitment, time, and sensitivity to teach your baby how to sleep and how to go back to sleep. In this book, we’ll show you how. how to read this book In response to our “advisers” (sleepless parents) we begin this book by giving you steps and tools to help your baby sleep so you can begin our sleep plan right away. But, nighttime parenting is not just a list of sleep tools, it’s a relationship with your baby. So, if you’re not too tired, you may want to read chapter 3 first. It will help you understand how babies sleep – or don’t! After you’ve read the first three chapters then you are ready to put all these sleep tools together into your baby’s individual sleep plan (ISP), which we show you how to do in chapter 4 (#litres_trial_promo). The rest of the book takes you to a deeper understanding of all the sleep tools listed in the first four chapters. Promise you’ll read the whole book! We could have just written a booklet in cookbook fashion with a catchy title such as Two Weeks to Sleeping through the Night – Twenty Tips. This has never been our way of writing. Parenting is too precious to be cheapened by such gimmicks. Instead, in this book we have taken our usual approach: giving you the tools to become your own expert in your baby and to help you work out your own style of nighttime parenting. This is a book of options, not “should do’s”. There is no one-bed-fits-all approach to helping babies sleep. We will give you tools and help you select the ones which fit the sleep temperament of your child so that you can create an individual sleep plan. Helping your baby learn to sleep better is not like following a diet or exercise regimen. There’s a lot of give and take, and the options you choose to try will depend on your baby’s personality. Just as there are quiet and more active babies in the daytime, there are sound sleepers and frequent wakers during the night. Some high-strung babies are not fans of sleep in general and will need an extra set of tools to help them want to sleep longer. This is also a book about options for different family lifestyles and different philosophies of nighttime parenting. Realistically, many parents juggle many different sleeping arrangements during the years their children are small. There are co-sleepers, cot sleepers, and families who play musical beds. One baby may start out as a cot sleeper and then upgrade to being a co-sleeper, and then back to a cot sleeper. There is no right arrangement for every family. The one that gets all family members the best night’s sleep is the right arrangement for your family. Yet, the key is to be open to trying various sleeping arrangements at various stages of your child’s development until you arrive at one that works for your family. The important thing is to keep working at it. Sleep is important. Higher quality sleep is associated with happier and healthier babies – and parents. Nighttime parenting is a season of child rearing. Yes, your baby will eventually sleep through the night. Now, you may wonder how to get your infants down to sleep at night. In a few years, you’ll be wondering how to get them up in the morning. Remember, the nights of baby in your arms, at your breasts and in your bed is a very short while in the total life of your child. Yet the memories of your love and availability last a lifetime. We wish you and your child years of restful sleep. William, Robert and Martha Sears San Clemente, California February 2005 chapter 1 (#ulink_d6223142-0d39-5f0b-9aa6-be341bfbe9de) five steps to get your baby to sleep better (#ulink_d6223142-0d39-5f0b-9aa6-be341bfbe9de) You are probably thinking, “Wow, it’s only the first chapter and we’re getting right to the point!” That’s because we assume you’re too tired to wade through a lot of the sleep facts and theories which we’ve placed in chapter 3 (#u40d788b3-9557-5179-9904-2c617c25b004). You just need to get your baby to sleep longer stretches. But, here’s the bargain. In order to make these five steps work best, you still need to learn a lot about how and why infants sleep differently than adults, and how to develop a realistic attitude about nighttime parenting. So, promise to read the rest of the book as soon as your whole family is more rested. Do we have a deal? This chapter is designed to help a baby of any age sleep longer, and more importantly, to get you a better night’s sleep. After you read this first chapter we hope you and your baby will be ready to sleep soundly the whole night through. Maybe you’ll be ready, but unfortunately your baby won’t just yet. But trust us. We’ll help you all get there soon. Here’s a preview of the five steps you will now learn: Find out where you and baby sleep best. Learn baby’s tired times. Create a safe and comfortable environment conducive to sleep. Enjoy a variety of bedtime rituals. Help baby stay asleep longer. We also call this plan: First we offer some precautions: If your baby is a newborn, do not jump into this plan (or any other plan) in the early weeks. Get to know your baby first, before you introduce a sleep plan into your parenting life. Be aware that not everything we suggest will be right for your baby. We don’t like parenting books that tell parents “this is how you have to do it. This is the only right way. Tough luck if it doesn’t fit your own ideas or your baby’s personality.” We believe that parents who know and love their baby are the best judges of how to care for that baby. This is why it’s so important to first get attached to your baby – so that you have the wisdom to know what’s best for your baby. In this book we will give you lots of strategies to help your baby learn healthy sleep habits. Which ones you choose depends on your baby’s unique sleep temperament. So let’s get started, and here’s to a good night’s sleep … finally! step 1: find out where you and your baby sleep best (#ulink_7a1ead75-b782-5d64-b606-d5062ec0d065) Where will your baby sleep best? With you in your bed? In a co-sleeper, Moses basket cradle, or cot next to your bed? In a cot in your room, or in his own room? Where do you sleep best? Where do you want your baby to sleep? Realistically, be prepared to play musical beds with all of these sleeping arrangements as you try to work out where all of you get the best night’s sleep. Expect these sleeping arrangements to change at various stages of your baby’s development. The only people who can answer the question “Where should baby sleep?” are Mum and Dad. Listen to what your baby and your inner voice are trying to tell you! Perhaps you have a new baby (or you will soon) and you are trying to decide where baby will sleep. Or, if your current sleeping arrangement is one of the reasons why you or your baby are not getting a restful night’s sleep, let’s explore your three options: 1. Sleeping alone in baby’s own room. This is the traditional picture that many first-time parents envision for their babies. As you flip through baby magazines and furniture catalogues you see pictures of smiling parents (who look like they’ve had plenty of sleep) placing their baby into a cot or cradle in the corner of a beautifully decorated nursery with the evening sunset filtering through the curtains. Parents gaze happily at their baby, who smiles up at them. You dream that this is how your baby will go to sleep, too. You’ll pat her little tummy, kiss her on the cheek and say “night-night”. She closes her eyes, you tiptoe out of the room, and you and your partner enjoy a nice quiet evening together. Your baby sleeps peacefully the whole night through. Sounds like a fairy tale, doesn’t it? Will it all come true? Eventually, but not in the early months. Most, if not all, younger babies need more out of their parents at bedtime than this magazine picture. This is “quality time” for babies. They often do not willingly succumb to quick-to-sleep methods. Will this sleeping arrangement work? It may work for easy-going babies. Mellow babies tend to fall asleep more easily and awaken less often at night regardless of where they sleep. Some of you parents-to-be are nodding your head, “Yeah, that’s the kind of baby we are going to have, right sweetheart?” Yet many of you have discovered that you have been blessed with a baby who is already letting you know that she’s going to need more nighttime closeness than this distant arrangement offers. Those of you with cot sleepers are probably in one of two situations right now: either your baby had been sleeping well in a cot for months, and is now waking up too often, or you have been trying to get your baby to sleep in a cot for months, but he has never really slept well in the other room and you (and he) are tired. You have two choices. You can either continue to try to get baby to learn to sleep well in the cot using the rest of the steps in our plan, or you can explore some other options of where baby can sleep. Why won’t your baby sleep well in a cot in his own room? It may be that teething or a temporary medical cause of night waking is suddenly rousing your baby at night. We discuss many such causes of night waking in chapters 3 (#u40d788b3-9557-5179-9904-2c617c25b004) and 11 (#litres_trial_promo). But there may be much more to this picture. If your baby has never really slept well alone, and nights of stumbling down the hallway to rescue your crying baby every two hours have taken their toll, it may be that your baby is trying to tell you that he needs more nighttime comfort and closeness. “But our neighbour’s baby sleeps just fine through the night in her own room”, you may hear. Every baby has a different personality. Some needier babies simply need more of you day and night. On page we discuss infant personalities and temperaments and how these relate to nighttime needs. It’s time to lose the magazine fantasy and work out on your own what is best for you and your baby. If we had to pick the single most important message of this book, it would be: trust your own instincts and make your own decisions about what is best for your individual baby and you. 2. Sleeping in your room, but not in your bed. This is a common sleep set up for two types of families: those who are living in a one-bedroom apartment (like medical resident Dr Bob was when his second son was born – four people sleeping in one room!), and those who want their baby close by (but not so close that baby’s tiny feet are kicking them in the ribs). Maybe you want baby close by simply for convenient breastfeeding, because baby wakes up several times each night. Or, perhaps your baby is a great sleeper, yet you prefer having baby sleep near you for your own peace of mind. Having baby in your room has these advantages: When baby wakes he is within arm’s reach or just a step away from you. You can get to baby quickly and rock or feed him back to sleep before he fully wakens. If you wake up, you can easily check on baby to reassure yourself all is well. You feel close to baby, yet you and your partner have the bed to yourselves. Baby enjoys a sense of security. You can easily bring baby into your bed to feed back to sleep so your comfort is less interrupted. Of course, there are possible disadvantages as well: If you are a light sleeper, you may find yourself disturbed by every sound that baby makes. Baby may grow accustomed to your proximity and may wake up more often because there is something to wake up for (feeding) and someone to wake up to. Here are some common options for finding a safe place for baby to sleep in your room: The Arm’s Reach Co-sleeper. This is about as close as you can get to having baby nearby but not technically in your bed. With the co-sleeper, you can truthfully tell your in-laws, “No, our baby is not sleeping in our bed with us.” Since baby is on a separate mattress, he won’t feel your every movement, and you won’t feel his. You and your partner can enjoy your intimate space. It also gives you instant access to baby when he wakes (he’s within arm’s reach) so you can move close to him and feed or pat him back to sleep before he fully wakes up and cries. (See page for illustration of the Co-sleeper (#litres_trial_promo)). Cradle or Moses basket. These baby beds have the advantage of being right next to your bed, but don’t offer the convenience of easy-access feeding like the co-sleeper. Cradles and Moses baskets are portable, however, so you have the flexibility of seeing if baby would sleep well in his own room, too. Swinging hammock bed. This baby bed is like a soft-bottomed cradle, and it hangs from a spring inside a steel frame, so every time baby moves, the spring gently moves and often lulls baby back to sleep. It too has the advantage of being portable, so baby can sleep in any room of the house. It can sit right next to your bed for easy access to baby at night. Some of you reading this book may be finding that your baby thinks being in the same room with you just isn’t close enough. Baby needs to feel you right next to him, and if he doesn’t, he wakes up. So, what do you do? Co-sleep! 3. Sleeping with baby in your bed. Perhaps your baby isn’t even born yet, but you’ve decided that you want to sleep with your baby right from the start. You may feel: “after all, she’s a baby. She’s been close to me for nine months.” Or maybe you are just getting to know your newborn, and you aren’t yet sure what you want to do. Or, you may encounter this situation. “When I put our baby in the cot he wakes up a lot, but as soon as I bring him into our bed he sleeps better – and so do we.” Baby is trying to tell you something: “For my well-being I need to sleep closer to you.” Listen to your baby! Sleeping with your baby has some unique advantages: You can feed baby back to sleep while you fall easily back to sleep. Baby can fall back to sleep more quickly because you can comfort him before he fully wakes up, and you fully wake up. Baby may sleep longer and better because you are nearby. Baby benefits from eight extra hours of closeness each night. Working parents get extra “touch” time with baby. Studies have shown that even though sleep-sharing babies wake up more to feed, co-sleeping mothers actually get more restful sleep compared to mums who don’t sleep with their babies. These very advantages can also turn out to be disadvantages (depending on how you look at it): Baby may actually wake more frequently because he feels you nearby. Some parents don’t sleep well with a baby in their bed. They want their baby close, but not that close. If Mum sleeps well with the baby, but Dad is a light sleeper and can’t get used to the extra presence in his bed, Dad may not sleep well. This may prompt Dad to find another room to sleep in, such as the pastel-coloured nursery that he painted for the baby. Once baby gets used to sleeping with you, he may not want to give it up. For some of you, this is an advantage because you welcome this long-term bonding arrangement. For others, co-sleeping may go on longer than you would have liked. You may have enjoyed sharing sleep with your baby, but now one or all of these disadvantages are interfering with your sleep. If your co-sleeping baby is waking up too much, you can choose either to keep baby in your bed and work through the other steps in our plan, or you can look at the other options for where baby may sleep. Deciding about co-sleeping isn’t as simple as weighing a short list of pros and cons. Co-sleeping is part of an Attachment Parenting style that can be rewarding for families in many ways. (See the “Baby B’s (#litres_trial_promo) of Attachment Parenting”,) Because most parents sleep with their baby at some time in the first couple of years, in chapter 5 (#litres_trial_promo) we will go into detail about sharing sleep with your baby and how to decide if it is the right arrangement for you. 4. All of the above. Most families play musical beds during their child’s early years and juggle bits and pieces of all of these sleeping arrangements. For example, baby may start off in a separate bed or room, then move closer to Mum sometime during the night. Remember, it’s about what’s best for you and your baby, and adapting to everyone’s changing nighttime needs. Now let’s move on to step two. step 2: learn baby’s tired times (#ulink_9f700a8a-6117-5df8-9523-1c8c406ed509) When opportunity comes yawning, don’t miss it! Watch for drowsy signs. Try to catch her by the third yawn. Observe your baby’s need-to-go-to-sleep signs as you do her hunger cues. When babies begin to show signs of being tired, there is a 10–15 minute window of opportunity in which they will fall asleep fairly easily. If you miss this window of opportunity, the tired baby may get progressively more cranky and revved up (the proverbial “second wind”). Even though baby is growing more tired by the minute, this cranky mood makes it harder for him to relax and fall asleep. sleepy signs Get to know your baby’s “I need to go to sleep – NOW!” signals. Here are the usual ones: Change in mood. Baby starts to fuss. Some babies become quieter when they are tired or they get less coordinated and their limbs get more “floppy”. A great deal of fussing may mean baby is overtired and you missed the earlier signals. Drooping eyelids Nodding head Glazed look, “zoning out” Yawning Whimpering Toddler signs: Rubbing eyes Lies on floor Grabs favourite sleep prop or “cuddly” The reason for figuring out when your baby is most likely to be tired is so that you can work out when to begin your baby’s bedtime ritual (more about bedtime rituals below). If you wait until baby is actually showing signs of being tired and then you give him a bath, put on his pyjamas, feed him, and rock him to sleep, the tired time will be over and baby will be revved up and ready to rock and roll for another hour. A better strategy is to begin the bedtime routine twenty or thirty minutes before the expected tired time. That way, baby will be feeling sleepy just as you get to the part of the bedtime routine when he is supposed to fall asleep. What’s more, since sleepy feelings begin to creep over baby as you go through the bedtime ritual, he will eventually learn to associate these drowsy feelings with his usual bedtime ritual. A prompt response at tired times is especially important in energetic, alert babies and toddlers who fight sleep. The baby or child who is tired but who is resisting going to sleep is trying to tell you, “I don’t know how to relax. Please help me!” The longer he fights it, the harder it gets. If you can jump in and ease baby off to sleep before he starts to put up a fight, he will go to sleep more easily and stay asleep longer. He will also learn to associate these first signs of being tired with going to sleep immediately – both at naptime and at nighttime. As soon as he seems tired, I pick up on his cues. I talk very softly, hold him, feed him, rub him (but not in a stimulating way), and gradually lower my voice and slow down my lullaby. This is his cue that sleep is expected to follow. Charting your baby’s tired times. On the chart below, write down baby’s tired time every evening for one or two weeks. Do you see a pattern? Does your baby get sleepy around the same time every night, give or take 15–30 minutes? In our experience, most babies have their natural sleepy time between 6:30 and 7:30pm if they routinely take a nap in the early afternoon, or around 8:30 or 9 if a late afternoon nap is the norm. Or does your baby get sleepy at times that vary by more than an hour? Your baby’s internal clock may not yet have developed a routine sleepy time, especially if he’s still quite young. Or, this may be because baby’s naptimes are not yet consistent. It may also be because your family’s day-to-day schedule is not predictable. tired time chart Write down your baby’s natural tired times over one week. Tired times are not the times when baby actually falls asleep. They are the times of day when you observe tired behaviour, regardless of whether or not you get baby to sleep at that time. If five out of seven of these times are all within 30 minutes of each other at naptimes and bedtime, then you have likely found a predictable sleepy time. Your baby’s predictable Tired Times at this age are: _____________________ for naps and _____________________ for bedtime. If your chart is not showing you a predictable evening sleepy time after one week of observation, continue charting for another week. Be sure baby’s naps are on a fairly routine schedule. If you still don’t find a routine evening sleepy time, you may need to focus more on nap scheduling. In that case, read “Naptime Parenting”, chapter 9 (#litres_trial_promo), now. It takes effort to get baby on a nap schedule. It may be easier to let baby nap whenever he happens to, but in order to get a predictable sleepy time in the evening baby needs to take naps at predictable times as well, most of the time. Changing your baby’s tired time. If you have determined your baby’s tired time is around 7:30pm, and you want baby to have an early bedtime, then you’re all set. But what if your baby is happily wide awake at 7:30pm, at 8:30pm, even at 9pm? What if your baby doesn’t act tired until 10pm? You can either accept this and help baby fall asleep at his natural time, or you can try to change it. If you want your baby to be in bed earlier in the evening (for whatever reasons), put baby down for a nap earlier in the afternoon. You may enjoy having baby’s company at night, especially if you are away from your baby during the day. In this case, don’t worry about working on an earlier bedtime. What if you would rather have your baby stay up late with you, but baby is always tired by 7:30pm? Again, you can adjust baby’s afternoon naps. We’ll show you how in chapter 9 (#litres_trial_promo). To summarize: find your baby’s predictable tired time, schedule your baby’s naps if needed to get a more predictable bedtime, start your bedtime ritual about 30 minutes before tired time, and baby will eventually learn to fall asleep easily and predictably. to schedule or not to schedule? A week or two of charting baby’s tired times may show you that your baby’s tired times are more predictable than you thought. Or it may show you that your baby’s naptimes and bedtimes depend a great deal on what else is going on in your household. At this point you may have to make some choices: put yourself on a predictable schedule, so that baby can take predictable naps and go to bed at the same time every night, or continue to “go with the flow” during the day and give up the idea of baby having a set, early bedtime. You may not be able to have it both ways. step 3: create a safe and comfortable environment conducive to sleep (#ulink_cff6af4f-d355-50d1-b5a1-246116a67d60) If baby’s bedroom (or your bedroom) is too light, too dark, too noisy, too quiet, too scary, or too stimulating, your baby may have difficulty going to sleep or staying asleep. Some babies are more sensitive to their sleeping environment than others. What kind of environment is best for your sleeping baby depends on her sleep temperament. For example, some are “subway sleepers”, meaning they can sleep through loud noises as long as the noise is always there. Others need a relatively noiseless environment. Here are some ideas to help you set the stage for your baby to sleep. Quiet the bedroom. Most babies can block out disturbing noise, so you don’t have to create a noiseless sleeping environment for your baby. Yet, some babies do startle and awaken easily with sudden noises. For noise-sensitive babies, oil the joints and springs of a squeaky cot or the door hinges, put the dog outside before he barks, and shut the windows. Quiet the house. Quieting the house down at tired time will give your baby the message that it’s time to transition into sleep and also programme her to associate this quiet routine with sleepy time. Lower your voice, close the doors, turn off the phone ringer, slow down your movements, and minimize any other distractions. Turn off the TV and put on some calming music. Let your baby sense that the general mood is changing from one of activity to one of quiet. Don’t bounce or jiggle baby. Remember, he’s already over stimulated. I made sure he knew the difference between day and night. During the day I did not try to keep a very quiet house. The phone rang, the dog barked. I kept it dark and quiet at night. I would feed him by nightlight, change him by nightlight, and everything would be calm. During the day we would sing at the changing table, at night we wouldn’t sing. Now he understands that when the lights go out it’s time for bed and not playtime. Darken the bedroom. Help your baby learn to associate darkness with sleep. Don’t turn on any bright lights during the night, as this can trick baby’s internal sleep clock into thinking it’s daytime (and wake time!). You can use a nightlight, or install a dimmer switch on the bedroom lights, so that you can keep the light level low during nighttime nappy changes. If necessary, close the curtains to keep out the morning (or evening) light. Use opaque shades to block out the light. This may get you an extra hour of sleep if you have one of those little early birds who wakes with the first ray of sunlight entering the bedroom. We used a room-darkening temporary shade, a heavy black-pleated fibre paper shade which quickly sticks to the top of the window as a temporary solution. Warm the bed. Always make sure baby’s bed (or yours) is warm. Laying baby down onto cold sheets is a sure way to shock baby awake. One creative dad told us he used to lie in bed with baby snuggled on his chest for five minutes before scooting over and laying baby down in the warm spot. Before laying baby into a cold cot or cradle, warm the sheets with a warm towel from the tumble dryer, a hot water bottle, a heating pad, or an electric blanket (any of which you remove before laying baby down, of course, for safety reasons). Use flannel sheets in cold weather. Lessen physical discomforts. A baby who itches, hurts, or has difficulty breathing is going to wake up. Here are some tonsil-to-toe tips on helping your baby sleep more comfortably: Clear the nose. Babies need clear nasal passages to breathe. Bedroom inhalant allergies are a common cause of stuffy noses and consequent night waking. Remove airborne irritants. Environmental irritants can cause congested breathing passages and awaken baby. Common household examples are cigarette smoke, baby powder, paint fumes, hair spray, animal dander (keep animals out of an allergic child’s bedroom), plants, clothing (especially wool), stuffed animals, dust from a bed canopy, feather pillows, blankets, and fuzzy toys that collect lint and dust. If your baby consistently awakens with a stuffy nose, suspect irritants or allergens in the bedroom. Make your baby’s bedroom as dust-free as possible. Besides dusting regularly, remove fuzzy blankets, down comforters, dust-collecting fuzzy toys, etc. If your baby is particularly allergy-prone, a HEPA-type air filter will help. As an added nighttime perk, the “white noise” from the hum of the air filter may help baby stay asleep longer. Relieve teething pain. Teething discomfort may start as early as three months and continue off and on all the way through the two-year molars. A wet bed sheet under baby’s head, a drool rash on the cheeks and chin, swollen and tender gums, and a slight fever are telltale clues that teething is what’s disturbing your baby’s slumber. If the teething pain seems really bad, with your doctor’s advice, give appropriate doses of paracetemol just before parenting your baby to sleep and again in four hours if baby awakens. (See “Teething” (#litres_trial_promo)). Change wet or soiled nappies. Wet nappies bother some babies at night. Most are not. If your baby sleeps through wet nappies, there is no need to awaken her for a change – unless you’re trying to get rid of a persistent nappy rash. Nighttime bowel movements necessitate a change. Here’s a nighttime changing tip: if possible, change the nappy just before a feed, as baby is likely to fall asleep during or after feeding. Some breastfed babies, however, have a bowel movement during or immediately after a feeding and will need changing again. If you are using cloth nappies, putting two or three nappies on your baby before bedtime will decrease the sensation of wetness. Also, if baby is prone to nappy rash, slather on a hefty layer of barrier cream to protect baby’s sensitive skin from the sensation and irritation of wetness. Cold nappy wipes are sure to startle baby awake. Run wipes under warm water (a great job for Dad!). Remove irritating sleepwear. Many infants cannot settle in synthetic sleepwear (some adults, too!). A mother in our practice went through our whole checklist of night waking causes until she discovered her baby was sensitive to polyester sleep suits. Once she changed to 100 per cent cotton clothing, her baby slept better. Besides being restless, some babies show skin allergies to new clothing, detergents and fabric softeners by breaking out in a rash. (See “Sleepwear – How to Dress Your Baby Safely and Comfortably for Sleep (#litres_trial_promo)”.) Create a comfortable bedroom temperature. Try these temperature tips. A consistent bedroom temperature of around 21°C is preferable. Also, a relative humidity of around 50 per cent is most conducive to sleep. Dry air may leave baby with a stuffy nose that awakens him. Yet humidity that’s too high fosters allergy-producing moulds. A warm-mist vaporizer can act as a heater in your baby’s sleeping area, and it helps maintain an adequate level of humidity in homes with central heating (and the “white noise” of the consistent hum can help baby sleep longer.) Fill tiny tummies. The tinier the tummy, the more frequently babies need to be fed – both day and night. Babies have tiny tummies – about the size of their fist – which is why babies under six months of age need one or two night feedings. Some babies (especially breastfed) continue to need night feedings even in the second six months of life. You can maximize the amount of time baby will sleep after a feeding by being sure that baby fills his tummy as he feeds off to sleep and again when you feed him in the middle of the night. (See “Night Feedings (#litres_trial_promo)”, pages for how to comfortably fill tiny tummies for longer sleep.) Swaddle your baby. Swaddling recreates the womb environment. In the early months, many babies like to “sleep tight”, securely swaddled in a cotton baby blanket. Older infants like to sleep “loose”, and may sleep longer stretches with loose coverings that allow them more freedom of movement. Often, dressing a baby loosely during the day, but swaddling him at night, conditions the baby to associate sleep with swaddling. Make sure baby doesn’t get too warm. Once I started swaddling her, she slept through the night. At about three months she got too strong to swaddle in the traditional way. She would get her arms out and rub her face and startle herself awake. I took a larger thin blanket and wrapped the sides individually over each arm and under her back so she couldn’t get loose. It may sound cruel, but she smiles as I do it and nods off peacefully all night long. Babies usually start squirming out of the swaddling wraps by six months. Another possible problem with swaddling is that once babies get used to it, they have a hard time sleeping without being swaddled. The movement of their arms and legs wakes them up. caution about over swaddling Dr Robert Salter, Professor of Orthopedics at the largest children’s hospital in the world, the Hospital for Sick Children in Toronto, Canada, literally wrote the book on infant hip development. He wrote me a long letter after the publication of the first edition of The Baby Book, in which we extolled the merits of swaddling and showed parents how to swaddle a baby. He believes leaving babies swaddled too long, especially in the early months, can interfere with the development of the ball-and-socket hip joint. For this reason, we recommend parents only swaddle babies during sleep time. Give baby plenty of time to “let loose” when awake. step 4: create a variety of bedtime rituals (#ulink_06cfd802-05b5-5572-bc02-0c5787981dae) You are learning where baby sleeps, when baby sleeps, and how to create a comfortable sleepy environment, and now we come to the next step in our plan: helping you work out what bedtime rituals work best for your baby. As you use these same routines night after night (or alternate through several routines consistently) baby will learn to fall asleep easily and stay asleep longer. Creating healthy and relaxing sleep associations A sleep “association” is not a naptime playgroup or a group of sleepy parents who gather to yawn and complain about their baby’s sleep habits. A sleep association refers to a connection in baby’s mind between falling asleep and the various activities, places, experiences, and feelings that precede his nodding off into slumber. The wiring in baby’s brain is full of patterns of association. For example, if you usually feed and sing your baby to sleep in a rocking chair, this setting will become programmed into your baby’s mind as a sleep-inducing routine. He will remember the calm and drowsy feelings he gets from rocking and feeding, and this will help him fall asleep. What kind of sleep associations do you want to teach your baby? Do you want to create attachment-based sleep associations or independence-based sleep associations? Attachment-based sleep associations. Many parents like to “parent” their babies to sleep; rocking, feeding, or snuggling while baby drifts off to sleep. Baby learns to associate falling asleep with a parent’s presence. The advantage? Closer bond between parent and baby. The disadvantage? Mum or Dad must be involved with baby falling asleep for months or years. Depending on your own instinctive parenting style, you may actually view this as an advantage; certainly your baby would. Independence-based sleep associations. Other parents strive to help baby learn a more independent way of falling asleep, without the need for parent involvement. The most popular method for learning to fall asleep independently is the cry it out method. The disadvantage? You don’t teach baby to fall asleep, you force him to. Medical research has shown that excessive crying creates stress for a baby. So a baby learns to associate falling asleep with fear, stress, and worry. This is not healthy in the long run. (We will discuss sleep anxiety more on page (#litres_trial_promo) and the harmful effects of crying it out on page (#litres_trial_promo).) We all want our babies to eventually learn to fall asleep independently by their own self-soothing strategies at an appropriate age. Our sleep plan teaches them how, rather than forcing them to sleep independently. As parents ourselves, we chose to create attachment-based sleep associations in our kids. But we know that not all parents will make the same choice. Is there a middle ground? Is there a way to help a baby learn to fall asleep independently but without excessive crying or stress? Is there a way to create attachment-based sleep associations that meet baby’s need and at the same time aren’t overly demanding on parents? We believe the answer to these questions is YES! Why is it necessary for you to help your baby develop healthy sleep associations? Why not just put baby down in her cot, walk out of the room, and let her fall asleep on her own? Won’t she learn that being in the cot means there’s nothing to do now but sleep? Well, yes, she will begin to associate being left alone in the cot with sleep. Her developing brain is busy building patterns of association all the time. That’s what brains do. But in the early months, babies do not have the developmental capacity to transition themselves from the state of being awake to being asleep without help. A tiny baby left alone in her cot to fall asleep on her own is likely to cry fearfully and then sleep anxiously. Going to sleep anxiously defeats one of the goals of your sleep plan: to teach baby a healthy attitude about sleep; that sleep is a pleasant state to enter and a happy state to remain in. Babies need to be parented to sleep so that they can form pleasant sleep associations. So what kind of activities, experiences, and feelings do you want your baby to associate with going to sleep? Babies who fall asleep while breast- or bottle-feeding will learn to associate warm milk, rhythmic sucking, and being cuddled close to Mum with sleep. Babies who are carried around or rocked to sleep will learn that motion and comfort, as well as contact with Mum or Dad, are what send them into dreamland. Babies who are put in a cot to cry themselves to sleep learn that sleep is a lonely time when they need to comfort themselves. Remember, you not only want your baby to sleep longer, but to sleep happier. So, in considering any advice about sleep, including the advice in this book, ask yourself: “If I were my baby, how would I want to go to sleep?” Getting behind the eyes of your baby and imagining how you would want your parents to act in a certain situation is one of the most important parenting tools we have learned over our years as parents and pediatricians. You will nearly always make wise decisions about how to parent your children if you begin your decision process by trying to understand the situation from your child’s point of view. If you were a baby, would you rather be parented to sleep at the breast of mother or in the arms of father, or just put down in a lonely cot and left to cry off to sleep? We are now going to show you ways to create sleep associations that have one goal in mind – to help baby learn that sleep is a pleasant state to enter and a happy state to remain in. Primary and secondary sleep associations Another concept we want you to understand is primary and secondary sleep associations. Think of your baby’s primary sleep association as whatever usually turns on the sleep switch. and the sleep association winners are: Primary Feeding to sleep (breast or bottle) Rocking Wearing down in a sling Falling asleep independently Secondary Soft music Singing lullabies Dimmed light White noise Dummy or “cuddly” Patting Being walked Stroking (massage) Swinging Dancing in arms Scent of mother Verbal sleep cues (i.e. “nighty, night” …) Stories A combination of several Secondary associations are things such as soft music, dim lights, or stories that may help to calm a child and prepare her for sleep. Some parents will choose one primary sleep association as the foundation, and use several secondary associations to help. Others like to get baby used to several different primary associations for sleep so that they have more options for bedtime. Choosing sleep associations that fit your baby best Which primary sleep association is going to work best for your baby? You won’t know until you’ve tried them all. We suggest you go through a trial period of a few weeks to see what primary method of putting baby to sleep works the best. Try feeding baby to sleep a few nights, then try rocking or walking. Try snuggling with baby but not feeding to sleep. Involve Dad in the routine as well. Try a variety of methods until you learn what works best. Here are the main primary associations to consider as you decide what will work best in your family: feeding baby to sleep, feeding baby almost to sleep, lulling baby to sleep without feeding, and laying baby down to fall asleep independently. 1. Breastfeeding or bottle-feeding your baby to sleep. Breastfeeding mums often find the easiest way to get their baby to sleep is by breastfeeding. In fact, in the first few weeks it is almost impossible to keep a baby awake at the breast for more than ten minutes. Baby is inevitably going to fall asleep feeding. Young babies also fall asleep very easily while bottle-feeding. Breastfeeding seems to be nature’s plan for comforting babies and helping them fall asleep. In fact, breast milk contains a sleep-inducing protein that helps lull baby into dreamland. As baby relaxes, so does mother, thanks to the hormones released when baby sucks at the breast. We recommend that you not place any limitations on your baby feeding to sleep during the early weeks of breastfeeding. In the first four to six weeks after birth, you are learning to read your baby’s hunger cues, your baby is learning to tell you when he is hungry, and your milk supply is adjusting to baby’s needs. Relax and enjoy the breastfeeding experience. A smart baby will get to love this feeding-to-sleep association and come to enjoy and expect it for as long as you breastfeed or use bottles. On the one hand, this means that you will be able to count on feeding as an easy way to get baby off to sleep. Even a baby who is fighting sleep will eventually succumb to the relaxing feelings that come from feeding. On the other hand, Mum’s breasts have to be there at bedtime, and again, when baby awakens in the middle of the night. Even if breastfeeding is your baby’s number one primary sleep association, you may want to help him learn other associations so you have other ways to put him to bed. In developing our sleep plan, we asked mothers of frequent night wakers, “For your next baby, what will you do differently?” The following answer, from our daughter Hayden (formerly the star of our Fussy Baby book and now a new mother), is representative of what many mums told us: I cherish those precious times of feeding Ashton to sleep, as I realize they will pass all too soon. Yet, for our next baby, I will not use just one way of putting her to sleep. I’ll do a variety of things so she’s not so set in only one way of falling asleep. This will include my husband, Jason, putting her to sleep now and then, so that when she’s older he can put her to sleep in his own way. Many parents tell us that feeding baby at bedtime and a couple more times during the night works very well for them. Baby is content, and mother manages to get enough sleep, because baby is sleeping close by and she can feed baby back to sleep without waking up completely herself. Maybe Mum wakes a little more often, but she feels that the benefits outweigh any inconvenience for her. Some mums, however, have told us that at age six months, twelve months, even eighteen months, their babies continue to wake up several times (or more!) each night to feed, and that they can no longer cope with this much night-feeding. They wish that their babies would learn that there is more than one way to fall asleep. Well, babies can learn other ways to sleep, and we will share ways to teach a baby new sleep associations later in this book. For now, we want you to know that many mothers breastfeed their babies to sleep for many months, feed them during the night, and still manage to get enough rest. If you currently enjoy breastfeeding your baby to sleep, we don’t want to get in the way of a good thing. One of the lessons we want you to learn about parenting is to enjoy the moment. We want you to get attached to your baby without worrying about a lot of what-ifs. (If frequent night feeding is a top concern, you will welcome the tips offered in chapter 6 (#litres_trial_promo).) 2. Feeding baby ALMOST to sleep. Breastfeeding parents who want Dad to be able to put baby to sleep, as well as Mum, often teach their baby sleep associations beyond breastfeeding. Baby breastfeeds at bedtime, settles down, and starts to feel drowsy. Then Dad takes over while baby drifts off to sleep, using walking or rocking while patting baby’s back, and other methods, for easing the transition into sleep. (See “Try Our Favourite Nighttime Fathering Strategies”). Bottle-feeding parents can use this approach, too, if they don’t want their baby falling asleep with a bottle in her mouth. This approach helps baby learn that there are other ways to fall asleep besides relying on the comfort of sucking. When you use this approach with an older infant who no longer needs two or three nighttime feedings, baby may be less likely to wake up at night and she may be more willing to go back to sleep with just some gentle patting or snuggling from either Mum or Dad. The main reason for getting baby used to other sleep associations is to avoid mother burnout from frequent night feeding of the older infant (the most frequent sleep concern we encounter in our pediatric practice). In the wonderful world of night feeding, babies absolutely love going fully to sleep at mother’s breast and having instant access to this warm and cosy prop when they awake, and if it’s working for you please don’t change. Yet, it often helps to add the finishing touch of another prop after feeding to help baby go from being awake, but drowsy, through light sleep into a state of deep sleep. Try these finishing touches: Feed, then pat, sing, or rock to sleep. Instead of feeding baby completely to sleep, breastfeed until she starts to slow down her sucking and closes her eyelids, but she’s not yet asleep. Ease your nipple out of her mouth (see Martha’s de-latching trick (#litres_trial_promo)), and then rock, pat, or sing her down until she is completely asleep. Mother nurse, plus father nurse. Near the end of the feeding, ease baby gently into father’s arms to add the finishing touch (see a complete discussion of how fathers can do this, page (#litres_trial_promo)). Then, hopefully, when baby wakes up, she is more likely to accept Dad or another caregiver putting her back to sleep using the same finishing touch. Add a variety of secondary sleep associations. You can use any of the tools listed on page (#ulink_88d97f46-f6da-58c9-ae7d-9fe9441bf385) to lull your baby to sleep. If these techniques are not working and baby insists on feeding to sleep, consider that a baby who is not willing is not yet ready. Give your baby a few weeks for her sleep patterns to mature and then try again. 3. Putting baby to sleep without feeding. Easier said than done. Because of the sleep association principle discussed above, if baby always falls fully asleep the same way, especially at the breast, she will expect, demand, or even scream for the same prop – usually the breast – to put her back to sleep. Occasionally try putting your baby down when he is sleepy, but not totally asleep (or feeding almost to sleep as mentioned in tip number two). Learning to fall asleep without feeding teaches him that it’s okay to go to sleep in other ways. Expect that your baby might fuss when you try to use some of these sleep-inducing tools listed on page (#ulink_88d97f46-f6da-58c9-ae7d-9fe9441bf385). If he does fuss more than just a little, remember the parenting principle: don’t persist with a bad experiment. Yet, even if just once or twice a week you try to put your baby down partially asleep, at least you’ve planted a bit of the “I can do it” association. 4. Putting baby down to sleep independently. Some parents like to set up a more independent sleep arrangement early on, in which, hopefully, baby learns to settle himself down to sleep without much parental interaction. They reason that a baby who learns to fall asleep on his own will also be able to settle himself back to sleep on his own when he wakes during the night. This type of sleep training has become popular with some parents because it results in a “low maintenance” baby at night. It has also received a great deal of criticism because of the amount of crying that baby experiences during the training phase. Babies are born with an innate need for comfort and security while falling asleep, upon waking, while going back to sleep, and in some cases even while sleeping. Ideally, a human caregiver supplies this comfort. Babies who sleep independently usually need to have some sort of secondary sleep association handy to calm them when they are falling asleep and when they awaken. They may need motion, such as rocking, swinging or bouncing movements of a cradle, swing, or baby hammock. They may depend on a dummy. Perhaps they learn to associate soft music or other sounds with sleep. Parents develop a routine around this sleep association that lulls baby into dreamland. varying baby’s sleep associations Get baby used to a variety of sleep associations at bedtime. The way your baby goes to sleep is the way she expects to go back to sleep when she awakens. When baby is older, you and your partner may want to take turns putting baby to sleep. Baby will learn Mum’s way of getting her to sleep (probably feeding) and Dad’s way of getting her to sleep (walking, “wearing down” in the baby sling, rocking and humming, and so on). For example, you may decide that you want to have your baby sleep in bed with you, but you are going to vary what you do to help her fall asleep. Some nights Mum will feed baby to sleep. Other nights Dad will soothe baby to sleep. You both can vary your soothing techniques. Some nights wear baby down to sleep by walking her around in a baby sling carrier. Other nights lull her to sleep in a baby swing. Mum has the option of not feeding baby to sleep and instead using Dad’s “wearing down” technique. You can even vary where baby sleeps. Some nights put baby in her cradle. On other nights put her in a cot and bring her into bed with you when she wakes. Or, share the whole night in your big bed together. To train babies to fall asleep lying in a cot by themselves without any comforting sleep associations would be very tough on them. In chapter 10 (#litres_trial_promo) you will learn why we discourage this “tough-love” approach to sleep training when it involves crying it out. Research shows that a sleep-training method that involves extended crying alone (without parent comforting) is not emotionally or physically healthy for babies – or for parents. Very easy-going babies may be able to learn to fall asleep independently with only minimal fuss, and we will offer suggestions on how this can be done in an appropriately sensitive way later in the book. Remember, our goal is for you to create stress-free sleep associations that result in a happy, healthy sleeper. We’ll now go through a list of favourite sleep associations to help your baby fall asleep happier. Laying baby down to sleep – transitioning tips Babies don’t come equipped with the type of sleep switch that you can suddenly turn off at naptime and bedtime. Yet, a transitioning-to-sleep ritual can be like a dimmer switch that gradually tunes out and turns down stimulation in baby’s environment. In sleep psychology, this is known as “fading” (like what happens when you are listening to a dull talk). You can’t expect a baby to go from his exciting waking life right into sleep. (You don’t fall asleep this way, do you?) There has to be a transition time. Here are some favourites that have worked in our families: Feeding down. If babies could vote, going off to sleep the warm way would win the Best Transition Award. A high-touch continuum from warm bath, to warm arms, to warm breast, to warm bed is a winning recipe for sleep. Nestle up next to your baby on your bed and feed her off to sleep. If you feed baby to sleep in your arms, be sure to wait until she is fully asleep before you try to transfer into her own bed. Once baby is asleep, try Martha’s de-latch technique (page (#litres_trial_promo)) to learn how to ease away. (For related strategies, see “Night Feeding” (#litres_trial_promo), to learn why night feeding is such a special and effective sleep-inducer. See also “Try Our Favourite Nighttime Fathering Strategies” where Dad adds the finishing touch to mother nursing, page). Fathering down. “Nursing” implies comforting, not only breastfeeding. Fathers can and should “nurse” their babies down to sleep. Place baby in the neck nestle position (see illustration, page (#litres_trial_promo)) and “dance” or rock your baby to sleep. One day after explaining the concept of sleep associations to a tired mother, she replied, “My baby has only one sleep association – ME!” If this is you, read – with your partner – chapter 8 (#litres_trial_promo), “Twenty-three Nighttime Fathering Tips”. Nestling down. Transferring the sleeping baby from your arms to his bed may prove to be tricky. An abrupt change from being nestled next to a parent’s body to lying alone on a mattress will awaken some babies. To ease your baby through this transition, try the intermediate step of lying down on your bed with your sleeping baby still in your arms. We call this the “teddy bear snuggle”. Once he’s sound asleep (see limp-limb sign opposite), you can ease yourself away and maybe even move him to his own bed. Sucking down. Sucking is soothing, yet the human pacifier can wear out. Besides the breast or bottle, try your finger or teach baby to find his own hand to suck on. Patting down. As you are easing baby into her bed, pat her chest or tummy gently and rhythmically, around 60 pats per minute (like your heartbeat). Gradually lighten and slow the patting as she succumbs to sleep. Add some verbal sleep cues (listed on page (#ulink_20cb511f-7b45-5fe3-b371-09194a2e8694)). As she was just about to sleep, I’d run my fingers across her face, over her eyes, and down her nose so that her eyes would close. Touching down. Oh, how babies love to be touched as they fall asleep. Here are some ideas for soothing, loving touches: Patting – gentle, rhythmic patting on baby’s back or bottom while she is being held in your arms. Gentle patting on her tummy can also be used to soothe a baby who is lying in bed, especially when picking her up might be too stimulating. Massage – light stroking of baby’s head and back is a favourite. Skin-to-skin – young babies especially love the familiar feel of your skin on theirs. sears’ sleep tip for dads: Avoid the quick release in getting your baby to sleep. Have patience. Sometimes a too-quick release of the feeling of being securely attached to a parent can bother babies and cause them to jerk back awake. If baby continues to wake up when you try to transition him from your arms into his bed or is not falling completely asleep in your arms while rocking or walking, try putting him down on your chest in the neck nestle position or next to you. Once he is fully asleep (you can tell by observing the limp-limb sign – hands unclenched, arms dangling loosely at his side, facial muscles still), then ease yourself away. If baby’s hands are fisted and limbs flexed, chances are he is still in the state of light sleep and will awaken if you try to put him down too quickly. Wearing down. Place your baby in a baby sling and wear her around the house for a half-hour or so before the designated bedtime. When she is fully asleep in the sling, ease her out of the sling onto your bed. Or, if she’s not fully asleep, lie down with her in the neck nestle or snuggle hold position on your chest. When baby is fully asleep, roll over on your side, slip yourself out of the sling, and let baby lie on the bed on her back using the sling as a cover. Wearing down (or what we also dub “slinging down”) is particularly useful for the reluctant napper. When baby falls asleep in the sling you can both lie down and enjoy a much-needed mutual nap. Wearing down in a sling. Rocking or walking down. Try rocking baby to sleep in a bedside rocking chair, or walk with baby, patting her back and singing. To keep the motion going (and keep baby asleep), ease her into a cradle and continue the rocking motion at a rate of about sixty rocks per minute. This is the heartbeat rhythm your baby was used to in the womb. Swinging down. Try a bedside baby hammock. For most babies, motion, not stillness, signals sleep. Remember how your baby used to sleep during the day when you were pregnant but kept you awake at night when you lay down to sleep. When you were up and around, the motion of your body soothed her into sleep. When you were still, she woke up. Wind-up swings for winding down babies are a boon to parents when their arms are wearing out. Some infants find the mechanical swing less interesting, if not downright boring, compared to being in the arms of a human being. So, off to sleep they go. Yet some babies are notoriously resistant to mechanical mother substitutes and will protest anything less than the real Mum. Before you actually spend money on a swing, you might want to borrow one for a week or two to see if the spell of the swing will work for your baby. You may discover that you are uncomfortable with mechanical mothering and decide that your baby is better off in your arms. Driving down. If you’ve tried all the above transitioning techniques and baby still resists falling asleep, place baby in a car seat and drive around until he falls asleep. When you return home and baby is in a deep sleep, carry the infant car seat (with the sleeping baby) into your bedroom and let baby remain in the car seat until the first night waking. If he is in a deep sleep, you may be able to ease him out of the car seat into his own bed. Using props. Called transitional objects or “cuddlies”, these are favourite toys that help children more easily transition from the familiar and interesting waking world to the world of sleep. Transitional objects should be cuddly, but safe. (See “Sleep Safety” (#litres_trial_promo)). Rolling over on plastic toys may awaken baby. Transitional touch. If baby starts to stir as you try to slip her out of your arms or ease away from her in bed, offer the laying on of hands. Place your hand on baby’s chest or tummy and leave it there until she drifts back to sleep. This extra touch is especially important in babies who have a hard time transitioning from your arms into the Moses basket or cot. They need this transitional touch to stay fully asleep. It can save you a trip back to the rocking chair, to soothe an awakened baby back to sleep. The scent of mother. Leaving in the cot a breast pad or t-shirt mother wore all day may help baby transition from the whole mother at night. Music to sleep by. A parent softly singing a lullaby is the classic sound cue for babies to go to sleep. Quiet instrumental music is another traditional favourite. Here are some creative ways you can use sound to soothe baby to sleep: Mum’s musical voice. The soft sounds of Mum’s voice, either in song or in quiet words will mesmerize baby. That’s why they’re called lullabies. I saved one song, our sleep song, for when it was time to go to sleep. She learned to associate that song with falling asleep. need more sound advice? Put together a medley of easy-listening lullabies on a CD or tape, and then set the player for continuous play. You won’t have to worry about running out of music and breaking the sleepy mood. Tape a medley of you singing baby’s favourite lullabies. Your familiar voice may help baby settle when put to sleep by someone else. For babies in a cradle or cot, turn on a musical mobile to help baby associate the gentle movement and the sound with going to sleep. If the mobile helps to get him to sleep, restart it when he wakes to get him back to sleep. Besides choosing music that is easy listening to your ears, select tunes that your baby enjoys. Infants usually settle better with classical music that has slowly rising and falling tempos with lots of repetitive themes. Simple music with repetitive rhythms tends to work best. Turbulent rap or rock music is likely to be a night waker. A music box with classics, such as Brahms’ Lullaby, is a proven settler. For some suggestions from the Sears’ family library of music to fall asleep by, see Appendix A (#litres_trial_promo). Dad’s deep tones. Some babies really take to Dad’s full, rumbly tones. Besides hearing his voice, they can feel the vibrations from the voice box when held on Dad’s chest. (See the neck nestle, page (#litres_trial_promo)). Rhythmic music. Music with simple repeating words and rhythms is soothing to babies. Nursery rhymes and lullabies are the classic examples. Even quiet pop music with a steady beat can get baby into the rhythm of sleep. Peaceful classical music is another favourite. Complex classical music, on the other hand, can be over stimulating. More sounds to sleep by. Use white noise – monotonous sounds that block out other noises and bore a baby to sleep. Besides the continuous monotone humming or “Shhhh” of a parent, here are some white-noise sounds that work: Sound of a fan, air conditioner, or even tape recordings of womb sounds or vacuum cleaner sounds. (Don’t wear out your vacuum – record the sound.) Running water from a nearby tap or shower. (Record it to conserve water.) A bubbling fish tank. A loudly ticking clock or a metronome set at sixty beats a minute. (These can be tape-recorded too.) Recordings of waterfalls or ocean sounds. Rocking in a rocker to the hum of a small fan. I wore my baby in a sling while vacuuming. The sounds lulled him to sleep and I got some cleaning done. Our son loves to feed to sleep and sometimes will prolong the feed as much as 30–40 minutes. My partner realized one evening that our son had fallen asleep after only ten minutes while feeding and listening to a quiet Mummy and Daddy conversation. I decided to tape our conversation one evening. Now when our son needs to go to sleep a little faster and my partner isn’t around to talk to, I just play our Mummy and Daddy tape. If baby is restless and won’t feed off to sleep, my partner turns on the dishwasher for white noise and then walks baby for a while. Motion for sleep. What baby doesn’t like motion? This is why babies fall asleep in swings, rockers, cars, and while being held and walked. Here are suggestions for slings, swings, and other things you can use to lull baby to sleep: Rocking. Mum or Dad’s arms and the steady motion of a rocking chair have been putting babies to sleep for ages. Cradle. Gently rock baby’s cradle to lull baby to sleep or back to sleep. Baby swing. Many babies will drift off to sleep in a baby swing at nap time or bedtime. Baby slings. “Wearing baby” in a sling or other infant carrier while you move about simulates the womb environment and will soothe baby to sleep. (See wearing down (#litres_trial_promo)). Dancing for all the senses. You can combine all kinds of sensory input in a dance that will envelop baby in a soothing environment. This works well for fussy babies or those that fight sleep. Snuggle baby in your arms, either in the cradle hold, up on your shoulder, or draped tummy down over your forearm. Move around gently in all directions – up, down, and back and forth, and pat baby’s bottom as you hum, sing, or make other gentle sounds. All this gentle stimulation blocks out the anxious, fretful feelings coming from inside of baby and really takes baby back to the womb. science says: crying it out could be harmful to babies Is it possible that excessive crying can harm a baby’s intellectual, emotional, and social development? Here is how science answers this alarming question: Infants who are routinely separated from parents in a stressful way have abnormally high levels of the stress hormone cortisol and lower growth hormone levels. These imbalances inhibit the growth of nerve tissue in the brain.1 (#litres_trial_promo), 2 (#litres_trial_promo), 3 (#litres_trial_promo), 4 (#litres_trial_promo) Researchers at Yale University and Harvard Medical School found that intense stress early in life can alter the brain’s neurotransmitters and structure in a similar way to that found in adults with depression.5 (#litres_trial_promo), 6 (#litres_trial_promo) A study from the University of Hertfordshire, U.K., showed infants with persistent crying episodes were 10 times more likely to grow up to have ADHD, concluding this may be due to unresponsive parenting.7 (#litres_trial_promo) Research at Baylor University found when chronic stress over-stimulates an infant’s brain, the child will grow up with an overactive adrenaline system, causing aggression, impulsivity, and violence later in life.8 (#litres_trial_promo) Studies at the UCLA School of Medicine found the stress hormone cortisol actually destroys nerve connections in critical portions of an infant’s developing brain, and when babies are neglected, they can grow up to be violent, impulsive, and emotionally unattached children.9 (#litres_trial_promo), 10 (#litres_trial_promo) Doctors at Case Western and Duke Universities showed prolonged crying in infants caused increased pressure in the brain, elevated stress hormones and decreased oxygenation to the brain.11 (#litres_trial_promo), 12 (#litres_trial_promo) Researchers found babies whose cries are usually ignored will not develop healthy intellectual and social skills.13 (#litres_trial_promo) Doctors at the National Institute of Health found that infants with prolonged crying (not due to colic) in the first 3 months of life had an average IQ 9 points lower at five years of age and had poor fine motor development.14 (#litres_trial_promo) Infants with excessive crying during the early months show difficulty controlling their emotions and become even fussier when parents try to console them at 10 months.15 (#litres_trial_promo) All babies cry, and most babies grow up to be emotionally and neurologically healthy children. However, this research is clear on one point: intense, extended periods of crying alone can permanently harm a baby’s developing brain. What does this mean for the CIO method? A baby who only cries briefly for a few nights is probably fine. What about crying for many minutes, night after night? We can’t say how many minutes and how many nights are safe, because no one has ever researched this. We urge parents to be very cautious if they decide to try this method. A box full of tricks. While most babies need a predictable routine to get to sleep, some enjoy novelty. And even your best transitioning tips may not work when baby enters a new stage of development. You need a box full of sleep strategies to see you through the first year or two of your baby’s life. Keep trying new things. Your attitude. Consider winding-down routines as an opportunity to spend quality time with your child. Enjoy this peaceful time together. Don’t look at your watch. Don’t think about everything else you have to do. Your baby will pick up on your relaxed attitude and probably go to sleep more easily. Trial Period During this first week or two you will be trying to work out what primary sleep associations work for your baby. For newborns and younger babies, you will be trying to find one (or maybe two) things that you can depend on to get your baby off to sleep. This may turn out to be feeding, rocking or walking. For older infants and those who already have a strong primary sleep association (in other words, something you can count on to nearly always turn on the sleep switch), you will be trying to find one or two new primary sleep associations either because the old ones are no longer working for you or because you want your baby to be able to fall asleep in other ways. Your baby will probably protest or fight this change and want you to go back to the tried-and-true. Keep trying different ideas, as long as you are comfortable. Use secondary sleep associations, such as music or motion, along with whatever primary sleep association you are trying to establish. Write down your observations, to help you remember what works. What is your baby’s favourite sleep-association combo? _______________________________ Now that you have figured out a variety of ways to happily parent your baby to sleep, let’s learn ways of helping baby to enjoy sleeping longer. step 5: help baby stay asleep longer (#ulink_1e23c580-aeda-582b-8352-33fdff38efd4) Babies – and parents – enjoy a more restful night if their sleep is not cut short. As you will learn in chapter 3 (#u40d788b3-9557-5179-9904-2c617c25b004), babies are wired to wake up during the night, and they usually need a parent’s help to settle back into sleep. As babies mature, so do their sleep patterns, so that they are able to sleep longer stretches and resettle themselves. When this blissful time happens varies greatly from baby to baby. While you can’t force your baby to sleep through the night, you can provide conditions that will help your child attain sleep maturity to sleep longer stretches. Why do babies wake up so much? Answer: they’re babies! In chapter 3 (#u40d788b3-9557-5179-9904-2c617c25b004) and chapter 11 (#litres_trial_promo) we’ll discuss the many developmental, medical, and physical reasons babies wake up. Keeping in mind that breastfeeding babies under one year typically need to feed twice a night, and over a year sometimes at least once, here are some ideas for teaching babies how to go back to sleep. Change where baby sleeps. In step one you chose where you want baby to sleep. Hopefully it is working for both of you. However, the bed that baby starts the night in may not necessarily be the same bed she wakes up in each morning. Consider this: is your baby waking during the night because she is alone in another room and wants to be closer to you? If you think this may be the case, try moving baby closer to you (see “Sleeping in your room, but not in your bed” (#ulink_d2dd2488-2050-5246-92a1-e2505d112367), or “Sleeping with baby in your bed” (#ulink_86be590a-7d75-5f55-ba96-3adeab6b9218)) at the first night waking. Or is baby already in your bed, and waking up because you are right there? If so, try moving baby further away from you when you come to bed or at the first night waking. “Coach” baby to sleep. Repeating cue words, sounds that baby associates with going to sleep, will often help baby get back to sleep. Offer these cues as the last sound baby hears before drifting off to sleep and use these same words again when she awakens in the middle of the night: “night-night”, “sleepy-sleepy”, “happy nappy”, or “Shhhh”. Using the sleep associations principle, baby learns to associate these sounds with both going to sleep and going back to sleep. The time-tested sound “shhhh”, which mothers naturally do, has a biological basis. It is similar to the sound of uterine blood flow that baby was used to while in the womb. When he made his first peep, we quickly issued reminders, such as: “Shhhh … sleepy-sleepy.” We let him know that it wasn’t time to get up yet. Lay on hands. When baby stirs, gently lay hands on her without picking her up. Stay with her and continue laying on a comforting hand as you say or sing your favourite sleep cues, such as “night-night”, “sleepy-sleepy” … Stay by her bedside until she falls asleep. If she starts to wake up right away or awakens during the night, again lay on hands and give her your “sleepy-sleepy” sleep cue. Hopefully this will be enough to soothe her back to sleep. If she just can’t fall asleep, pick her up and walk around the bedroom a while holding her in a sleep-inducing position, such as the neck nestle (see this technique, page (#litres_trial_promo)), or sit in a rocking chair or recliner and try to get her back to sleep. Leave a little bit of mother behind. To help a baby stay asleep when you are not there, have something nearby that smells like you. This might be a breast pad, which has the odour of your milk, or an item of your clothing. Your bed will naturally have your scent. You can also sleep with baby’s cot or cradle sheets for a night (use them for a pillow case), and then place them on baby’s mattress. Your scent should last for a few days. I feed and wear my baby a lot during the day. He actually sleeps better if I take off the shirt that I have worn all day and cover him with it before I put the blanket on him at night. Offer a thumb or a dummy. Pacifier, the American name for dummy, literally means “peacemaker”. Giving baby something to suck on will often bring peace to both baby and parents. You can actually help your baby learn to suck his thumb. Thumbs are handier than dummies. They are warm, soft, and easily available. They don’t fall on the floor; they are just the right size for baby’s mouth. They don’t obstruct the nose or need to be clipped on with a cord. Babies feel more in control of a thumb. As you’re putting baby down to sleep, ease her thumb into her mouth, and do this again each time she wakes up. This way she learns to associate sucking her thumb with going to sleep – and back to sleep. If baby continues to suck but wakes up anyway, she’s probably hungry and needs you, and not just a milk-less thumb. During a check-up when I need tiny babies to be quiet so that I can listen to their hearts, I sometimes insert their thumb in their mouth. Sometimes I notice mothers raise their eyebrows as if they didn’t realize they could do this. Babies in the womb suck their thumbs. In the early months, babies who can’t quite find their thumbs will suck on their wrists, or even forearms. They are born with their own natural pacifier. Take advantage of it. And don’t overuse artificial pacifiers. If when baby cries you find yourself by reflex reaching for the dummy instead of baby, remember our advice: “use it, don’t abuse it, and quickly try to lose it”. Some parents worry that purposely teaching baby to suck his thumb will lead to a long-term habit which will be hard to break (you can’t just throw the thumb away like you can the dummy). While this can happen, if it gets you a better night’s sleep for now it’s probably worth it. Try both the quick and the delayed response. Should you come running as soon as you hear your baby awaken in the night? Or should you hold off and see if baby goes back to sleep? Again, it’s your decision. Some parents find it easier if they quickly get to baby and help baby back to sleep before the cries escalate and baby gets revved up. If you wait too long, it can be much harder for both mother and baby to get back to sleep. With co-sleeping babies, a half-awake mother can simply roll over and feed her half-awake baby, and the pair drift back to sleep without either one getting worked up. Other parents find that if they just let their baby squirm and fuss a bit, baby is able to resettle without intervention. This is a waking-by-waking decision. It helps to remember that not all noises that sleeping babies make are cries for help. (See “Normal Night Noises Sleeping Babies Make” (#litres_trial_promo)). If you think your baby can settle himself back to sleep, delay rushing in and picking him up. Give him a chance to work things out on his own. He will let you know if he needs help. Sometimes in the middle of the night I would quickly offer her a breast or a “soothie” dummy and she would not fully wake up. The trick is to never let him fully wake up and never let him cry. If he cries, he’s wide awake. learn when to let sleeping babies lie One of the most difficult lessons for new co-sleeping/breastfeeding mothers is to develop a balance between “I feed my baby at the first whimper” and “Oh, that’s just a normal sleep noise – she’ll go back to sleep by herself.” If you feed your baby right away, you will probably both get back to sleep sooner. Yet if you feed every time she awakens, you may end up with a baby who wants to feed all night long and doesn’t know any other way of falling back to sleep. You have to try to find the balance that works best for you and your baby. We’ll discuss this dilemma in detail in chapter 6 (#litres_trial_promo). Keep it simple and quick. No middle-of-the-night entertainment, please. You’re there as a comforter, not a playmate. Nighttime is for sleeping, not for playing. If baby needs your help to resettle, try to do it quickly, calmly, and comfortably. Even though you’re tired – and perhaps angry – try what we dub the Caribbean approach – “no problem, baby”. If baby senses your anxiety and irritation, she is less likely to resettle. Try to resettle baby with a simple song or patting with your hands. If you need to pick up baby for a bit of swaying or rocking, don’t make the routine too interesting. Your goal is to lull her back to sleep. Someday your child will find the promised land of sleeping through the night. Babies will wean! This high maintenance stage of nighttime parenting will pass. The time in your arms, at your breast, and in your bed is a relatively short while in the life of a baby, yet the memories of love and availability last forever. your checklist of sleep tools In helping your baby sleep happier, healthier, and longer, here’s a checklist of all the topics we covered in this chapter, or will cover in subsequent chapters: Review sleep safety (page (#litres_trial_promo)) Juggle different sleeping arrangements to see where baby sleeps best (page (#litres_trial_promo)) Chart baby’s tired times (page (#ulink_c4e1a527-d30c-59d4-af92-f1ed472923b2)) Try a variety of sleep associations (pages (#u1cfff497-fc3b-4e67-b28d-355aca653f93)) Turn on sounds to sleep by (page (#ulink_4ecabf81-c098-5eb9-a20a-c95e62b9378d)) Try a loving touch (page (#ulink_9483aa34-a80b-52a6-bca6-d106b2ec6d51)) Offer a familiar scent (page (#ulink_e6ecd06d-dc36-5e5f-ad77-3f0af695f590)) Offer a dummy (page (#ulink_e6ecd06d-dc36-5e5f-ad77-3f0af695f590)) Try motion for sleep (page (#litres_trial_promo)) Try feeding baby partially to sleep (page (#ulink_855bb20b-90ba-547c-869a-4ff0dfd70589)) Teach baby back-to-sleep cues (page (#ulink_34550018-f111-57eb-96e4-74fc770367e3)) Enjoy bedtime rituals (page (#u1cfff497-fc3b-4e67-b28d-355aca653f93)) Enjoy feeding down (page (#ulink_ddf519c3-cea9-57ff-96b1-44a1c92967f0)) Try wearing down (page (#ulink_9483aa34-a80b-52a6-bca6-d106b2ec6d51)) Try fathering down (pages (#ulink_201e6ec7-3baf-528d-9dbf-22aef5540a18)) Try nestling down (page (#ulink_9483aa34-a80b-52a6-bca6-d106b2ec6d51)) Try patting down (page (#ulink_9483aa34-a80b-52a6-bca6-d106b2ec6d51)) Try walking/rocking down (page (#ulink_c3025b05-b06b-5b27-8bc3-b9ceed725e32)) Try swinging down (page (#ulink_c3025b05-b06b-5b27-8bc3-b9ceed725e32)) Offer a “cuddly”(page (#ulink_c3025b05-b06b-5b27-8bc3-b9ceed725e32)) Quiet the bedroom (page (#ulink_6c701ce5-c355-506c-9a6f-3cdbe5064b9b)) Quiet the house (page (#ulink_6c701ce5-c355-506c-9a6f-3cdbe5064b9b)) Darken the room (page (#ulink_6c701ce5-c355-506c-9a6f-3cdbe5064b9b)) Warm the bed (page (#ulink_6c701ce5-c355-506c-9a6f-3cdbe5064b9b)) Clear stuffy noses (page (#ulink_d83fd679-4cd7-5a6a-9010-dfea88d2bef9)) Fill tiny tummies (page (#ulink_b8beb694-3a06-556f-befa-3217933b08ca)) Swaddle baby (page (#ulink_b8beb694-3a06-556f-befa-3217933b08ca)) Create a comfortable bedroom temperature (page (#ulink_b8beb694-3a06-556f-befa-3217933b08ca)) Dress baby comfortably for sleep (page (#litres_trial_promo)) keep a sleep log (#ulink_1f7a32e2-3a50-5d67-92f2-8c8f2eaac490) While most mothers would rather spend their free time resting than filling in charts, sleep logs can help in many ways. Charts give you a visual picture of your child’s individual 24-hour sleep patterns. You may be surprised that he sleeps more – or less – than you thought. Sleep logs help you spot problem times and track progress to see if your sleep strategies are working. When discussing your baby’s sleep concerns with your health visitor or GP, show him or her the sleep log and point out the problem areas that you’ve identified. In this way you can see at a glance your baby’s sleep patterns and where certain sleep strategies may be applied. Photocopy the sample sleep log on the next page. As you try all the sleep-inducing strategies described in chapters 1 (#uc7da03ba-d02b-5ef6-bacd-f1f9100a2dd4) and 2 (#u4dbb0c0c-8a13-5e57-87d8-604c0d6c0a77), fill in the sleep log as you chart your baby’s progress. 10 day sleep log Directions: Colour black each hour of sleep including daytime naps. Mark ‡ for each time your baby wakes up. Mark F for each time you feed baby. Comments: ______________________________________________ chapter 2 (#ulink_8367dd47-0449-553b-8470-565f0d399b23) fifteen tips to help toddlers sleep (#ulink_8367dd47-0449-553b-8470-565f0d399b23) The five steps to happy sleeping that we described in the previous chapter apply to toddlers as well as babies. Yet, as babies turn into toddlers, their nighttime needs change and parents need to learn more sleep strategies. Toddlers still need your presence at bedtime, and their bedtime rituals will reflect their need for closeness. Sometime between two and three years of age, children begin to form conscious memories that will stay with them for the rest of their lives. What bedtime memories do you want your child to file away? Sears’ Parenting Tip: As children learn to sleep, they learn to live. what toddlers learn at bedtime (#ulink_782b990f-feae-5b87-bed7-fcbc537b6c00) It’s good to have goals as a parent. When you know what you want for your children in the long term, it’s easier to do the things you have to do right now to reach that goal. So what are your sleep goals for your child? Two important sleep goals are: Children should learn that sleep is a pleasant state to enter and a peaceful state to stay in, and therefore develop healthy sleep habits. Children should have pleasant memories of how they were parented to sleep. Children need to develop a pleasant attitude toward falling asleep and staying asleep. We believe that your child’s ability to sleep well in the future depends on his having happy, stress-free, positive experiences at bedtime when he is young. Eventually, these positive experiences will translate into sleep independence – the ability to fall asleep and back to sleep on his own. And all these good sleep experiences will help your child grow up to be a happier, less stressed, and healthier person. Many well-meaning parents push their kids into sleep independence too soon. After a long day at work and caring for the kids, parents need a break and want the evening for themselves. Between the ages of one and four their whole goal at bedtime is for a child to fall asleep on his own, and do so quickly and quietly. When this is achieved, parents feel they have finally succeeded in creating a “good sleeper”. But what if a child isn’t quite ready for this? What happens when a child grows up feeling that bedtime is a time when she is forced to stay in a darkened room alone and told to be quiet and go to sleep? This is a child who will procrastinate because she fears or resents the isolation at bedtime. She will make up all kinds of reasons why she wants Mum or Dad’s attention at bedtime. She will get up to come and find you because she’s thirsty or there’s a monster under the bed. She will ask you to leave the light on or the door open. She will use every stalling tactic she can think of when what she really means is she just wants you. This is a child who is more likely to grow up with a fear of bedtime, of the dark, and of being alone. She may feel anxious and insecure, because her parents have pushed her into nighttime independence before she was truly ready. Imagine how you, as an adult, would feel if you went to bed every night feeling stressed, scared, and unfulfilled. There is one more ingredient that parents often add to this bedtime picture without realizing it – anger or hostility. We use phrases like “Get back to bed”, “If you get out of bed one more time …” “Stop your whining and go to sleep.” Even if there is no anger in your voice, these negative phrases night after night over the years add up to a child who resents and fears bedtime. Ask yourself: are you willing to put in some time now to help your kids achieve the long-term goal of a healthy attitude about sleep and a trusting, secure attitude toward life? Remember what we said about keeping the long-term goal in mind when you are making short-term decisions about parenting? While most of what is in this chapter assumes that you are going to be close by while your toddler drifts off to sleep, one of your long-term goals is a child who goes to sleep happily on his own. So, keep in mind that while you are parenting, not just putting your toddler to sleep, you are also teaching him skills and attitudes that he will someday use to help himself fall asleep without you there. As he is ready, you are encouraging him to use these skills. No, you are not a victim of childish manipulation. When you rub a child’s back at bedtime to help her relax or soothe a tearful toddler with quiet talking in the middle of the night, you are modelling self-help skills. When your child is ready to cope with these challenges on his own, he will call up images of the good feelings he had while falling asleep in your presence. And bingo, he’ll fall asleep. easing your toddler off to dreamland – fifteen tips (#ulink_8094ccbc-3442-5b52-8e57-d8aa64515d36) We’ll begin with fifteen tips that apply to nearly all toddlers. These are practical strategies aimed at 1) getting little ones off to dreamland and 2) teaching them a healthy attitude toward sleep. The second half of this chapter turns the spotlight (or a very dim nightlight – don’t want to wake the kids) on common toddler sleep concerns – and solutions – that tired parents have shared with us. One night my daughter called out “Mummy, I need you!” I went straight away to her room, fed her, and she sleepily said, “Thank you, Mummy” and drifted off to sleep. I thank God that she knows we are here for her and that she uses us when she needs us. I hope that this will be a lifelong pattern, not just in sleep, but with her everyday life. 1. Tire out your toddler Encourage your child to be active during the day. The more physical activity that children – and adults – get during the day, the better they sleep at night. Babies who are not yet walking can be encouraged to play on the floor, cruise and crawl. Take your toddler to the park and run, jump, and bounce on the playground equipment. Toddlers get their exercise in bursts of activity. They don’t take long walks or set out to jog three miles as adults do. They take frequent rest stops during active play, but they don’t mind being active much of the day. Toddlers should not be plugged in for more than a half-hour a day playing video games or watching television. Sears’ Sleep Tip: Kids who are couch potatoes by day tend to sleep less at night. 2. Set consistent bedtimes Infants and toddlers generally go to bed “too late”. Or they go to bed at different times every night. Modern families’ busy daytime lifestyles encourage this “whenever” approach to bedtime. Unless your family’s lifestyle allows for your toddler to sleep later in the morning, try to set an early and consistent bedtime for your little one. Even if a later bedtime is what works best in your family, try to be consistent about when your child goes to bed. By putting kids to bed at the same time night after night you are programming their internal sleep clock to fall asleep easily at this set time. 3. Set the stage Toddlers and preschoolers are not going to go to bed willingly if there is a lot of activity going on in your household. They don’t like to miss out. When it’s time for your toddler to go to bed, turn down the lights all over the house, turn off the television (you can record what you’re missing), and channel older children’s energy into quiet activities. As you turn down the household activity level, let your child know that bedtime is coming. Set the kitchen timer for 10 or 15 minutes and tell your child that when the timer goes off, it’s bedtime. Or use an egg timer and say, “When all the sand hits the bottom, it’s time to start getting ready for bed”. Kids are less likely to argue with a timer than with a parent. nighttime props for tots While a mother’s breast, a father’s arms, and a familiar voice singing a lullaby will always be your child’s favourite sleep inducers, there are times when parents need some reinforcement. Try these: An aquarium. The bubbles, the graceful fish, the hum of the heater, the lights and shadows – the slowly changing patterns all built into this cute container are mesmerizing. They will calm toddlers and eventually bore them to sleep. White noise machines. A favourite of adults, these bedside sound machines allow you to choose various monotonous sounds, such as a bubbling brook, ocean waves, rainfall, and melodious chants, that soothe young and old into sleep. (See “More Sounds to Sleep By”, page). An air filter. A HEPA air filter not only rids the bedroom air of dust, allergens, and other nose stuffing and night waking irritants, but also produces white noise that blocks out other sounds that may awaken a light sleeper. A dimmer switch. Gradually dimming the lights will help ease your toddler into sleep. See if you can find a dimmer that can be operated with a remote control. Or put a dimmer on the reading lamp next to the bed. 4. Enjoy a variety of bedtime rituals Bedtime rituals are all the things you do consistently, every night, starting a half hour to an hour before tired time. Bedtime rituals help the busy toddler wind down and make the transition from an exciting and active evening to the quietness and relative boredom of sleep. You can’t force a child to sleep, but you can create a quiet, soothing environment that allows sleep to overcome the child. Avoid stimulating activities, such as wrestling or running around the house for a while before bedtime. Save exciting activities that rev up a child’s mind and body for late afternoon. Children need a buffer zone between a busy day and bedtime. Quiet activities and a regular bedtime routine can help kids make the transition from awake time to sleepy time. Bedtime routines don’t have to be exactly the same from night to night. Toddlers enjoy novelty. Bedtime with Mum may be different from bedtime with Dad, but that’s good. Even children who are very tired may not be willing to give up and go to bed. They don’t want to be separated from you or miss anything interesting. This is why bedtime rituals need to be creative and include quality time with parents. Bedtime routines should be interesting and special, even as they wind children down from an active day. Ritual tips. Different babies enjoy different rituals at different ages. Be flexible. What works one month may not necessarily work the next. Here are some tried and true favourites: The Bedtime B’s: bath, bottle or breastfeeding, backrub, book, and clean bottom (if bath time revs up your child, bathe her during the day). Strolling through the house with baby in a sling (see “wearing down”, page). Reading a poem or singing “Twinkle, Twinkle Little Star”. Saying goodnight to everyone: toddlers love long goodnight lists: “Good night, toys, good night, pets, good night, Mummy, good night, Granddaddy”, etc. The bath and favourite, calming book combination. Back rubs. Give your child a massage and gradually lighten your touch as your child drifts off to sleep. Or “plant a garden” on your child’s back using different touches for the different kinds of seeds your child asks to plant. Gradually lighten your strokes as you smooth out the soil. Listen to music and hum or sing along. Choose quiet, gentle songs, not get-up-and-dance-along music. You may find that playing or singing one special song becomes part of your settling-down-to-sleep routine. Your child may fall asleep more easily if there is quiet background activity in the household instead of complete quiet. A little bit of noise reassures her that you are close by. Feeding to sleep – a perennial favourite. I’d save all my phone calls and return them when I knew my toddler was ready for sleep. Toddlers always want to feed when you’re on the phone, so take advantage of that and let the quiet ebb and flow of your voice lull baby right to sleep. Signing off. The bedtime ritual that worked best for us with our toddler, Matthew, who had a hard time winding down and leaving the excitement of daytime activities, was one we called “signing off”. When it was near his bedtime, we made the rounds: “Say night-night to the toys, night-night to Mummy, night-night to Princess (the cat), night-night to Honey Bee (the dog).” As we walked upstairs, we said night-night to the relatives in the photos on the wall, and night-night to whatever else we encountered between the family room and the bedroom. When we finally arrived in the bedroom, we completed the wind-down ritual by saying night-night to the toys and pictures on the wall. This slow signing off seems to help children who are so engrossed in their play that they have a hard time transitioning into bedtime. The fish story. When Matthew was three, an evening of exciting activity often meant that he would have a hard time falling asleep. So after he had climbed in bed, I would tell him a “fish story”. It was not an exciting tale about the one that got away. Instead, it went like this: “When I was a young boy, I used to go fishing … and I would catch one fish, two fish, three fish …” With each fish my voice got lower and slower. Some nights it was a ten-fish story, other nights I caught twenty fish before Matthew was peacefully asleep. Basically, I was boring him to sleep. Before bed prayers. Nighttime prayers are a way to share your faith with your child. We have always felt that the words children hear as they drift off to sleep are imprinted more deeply in their minds than words spoken during the day. You can say the same prayer every night, either a traditional child’s prayer or one you make up in your family, or use a basic prayer with variations based on the child’s day (“Thank you, God, for …”) This prayer is likely to stay in your child’s memory for the rest of his life. 5. Respond to sleepy signs Throughout this book, we have urged you to respond to signs that your baby is tired. Toddlers, like babies, go to sleep more easily when they are feeling sleepy. Watch for signs that your child is tired and ready to wind down and go to sleep: Activity slows, lies on floor, rubs eyes, yawns (younger toddler) Activity picks up – to fend off the send off (older, wiser toddler) Picks up cuddly and ambles toward bedroom (fairy tale toddler) If you wait to start your ritual until after tired signs begin, you’ll miss this window of opportunity. For some toddlers, preparations for going to sleep can wind them up. If you wait until he’s tired to start getting ready for bed, he may be all charged up again by the time he’s clean, dry, and in pyjamas. Bathe him, brush his teeth, put his pyjamas on and get him all ready for bed before the usual time the drowsy signs occur. Let your child become drowsy while you do the quiet part of your ritual like stories, massages, and snuggling. Rather than do the whole ritual thing, we simply did quiet things until our toddler gave off tired signals. If she wasn’t in pyjamas, no big deal. I’d feed her to sleep and that was it. As long as clothes are clean and comfortable anything can be “pyjamas”. Tooth brushing can be whenever, too. And if you get caught by tired time and the clothes are dirty, change them once baby is out. Do the main thing, feed off to sleep when the window opens or it will close while you’re fiddling around with toothbrushes and outfits. 6. Enjoy bedtime stories A story tops off the day, like dessert at the end of a meal. Reading to your child is an important part of nighttime parenting, one that most parents enjoy most of the time. (There may be one or two stories that your child absolutely loves that you might get a little tired of.) If you treasure the time you spend reading bedtime stories, you will radiate patience and relaxation as you read them. If your child senses you are tense and just trying to get to the last page (or trying to actually skip pages), she won’t fall asleep as quickly. Here’s how to get the most out of books for babies: Love your books. Since you’re going to spend a lot of time reading, pick stories that you enjoy too, so that when your little one pleads, “Read it again”, you won’t mind. Martha and I have been reading bedtime stories for 38 years now. Our last child, Lauren, was no longer breastfeeding as a toddler (she’s ours by adoption), so it took a large stack of books, and she loved every one. It was a great way to get our biggest night owl to lie still long enough to get relaxed and drift off. Some of our favourites that are appropriate for children ranging from two to five years are listed in Appendix B (#litres_trial_promo), page (#litres_trial_promo). Use your sleepy-soothing voice. Speak gently, quietly, and in a monotonous voice. Avoid exaggerated facial expressions or sudden change in volume, which can startle a child awake. Gradually pause longer between sentences and read more slowly and softly toward the end of the story. Keep it simple. Read age-appropriate stories with simple pictures. Try to keep to one book. Otherwise, your child may awaken during the pause while you search for another book. Position for sleep. Have your child lie in her most common sleeping position while you read to her. Don’t stop too soon. Even though their eyes are closing, children’s ears are very keen to follow a story. We once heard a child instruct his mother to “Keep reading – I can still hear you even when I’m sleeping.” I read to my three-year-old daughter at bedtime, and then she tells me “good night, love you, sweet dreams” and then rolls over and goes to sleep on her own. 7. Put a “cuddly” to bed, too As you tuck in your toddler, put a favourite stuffed toy, doll, or other “cuddly” to bed next to her. Help her tuck her little friend under the covers and give her cuddly a hug or a kiss goodnight. Watch her parent her doll or toy off to sleep the same way you help her sleep – this will help her wind down. On nights when your child is reluctant to go to bed, tell her, “Let’s go put dolly to bed”. As she shares in dolly’s bedtime ritual, she will get ready for sleep herself. I stumbled upon a way to get Ashton to fall asleep once when she was just resisting. I went cheek to cheek with her as if I was giving her a hug and I nibbled her earlobe with my lips. I immediately felt her body relax and her eyelids start to droop. The rhythmic nibbling combined with the warmth of my breath and our closeness to each other sent her quickly into dreamland. It was also very soothing for me and a good tool for my partner to try. 8. Offer sleep cues Find a few favourite phrases that relax your child. Say these over and over in a singsong voice as your child is falling asleep or when he needs assistance in getting back to sleep. The child hears your soothing voice, but doesn’t have to think about what you are saying. Dr Bob used to repeat, “Rest your eyes” to his son over and over again. Try: “Nighty-night” “Go night-night” “Sleepy-sleepy” “Time for sleep” “Sleep now” Find a phrase that is reassuring to your child during the day and use it consistently to help him recover from a meltdown, something like, “It’s okay!” Soon your child will learn to associate “It’s okay” with settling. When he awakens from a scary dream or some other reason, hearing the familiar “It’s okay” may quickly resettle him back to sleep. Our two-year-old loves trains. Sometimes he wakes up during the night fussy and upset and we say, “Can you hear the train?” and we make train noises. He listens, nods, and stops crying. He knows we can’t hear the real train, but at least he will stop crying to listen carefully. 9. Enlist help from a sibling At age six, our daughter Hayden could easily “mother” her two-year-old sister, Erin, to sleep (because she had plenty of it when she was little). We would occasionally encourage Hayden to lie down with Erin and sing to her or look at a picture book and get her to sleep “just like Mummy and Daddy did with you”. Erin fell asleep, and sometimes Hayden did too. We got a lot of mileage from sibling co-sleeping. When we had two close-in-age children that we wanted to go to bed at the same time, we would announce, “Whoever is in bed first, picks the story.” Sears’ Parenting Tip: Your future grandchildren will value the parenting-to-bed skills you taught their mother or father. 10. Make peace before bedtime Children, like adults, have difficulty sleeping when they are angry or upset. If children have been arguing or fighting during the day, help them make up before bedtime and go to bed friends. If you and your child have been at odds all day, or if it has been an upsetting day for other reasons, take time to talk it out briefly, then do something pleasant with your child before bedtime. Maybe this is a night for an extra bedtime story, or for a tale from your adventures as a child. Cuddle your child off to sleep and help him clear his mind of upsetting thoughts. This can even be a part of your sign-off prayer to help it happen in a neutral way. 11. Try a reward chart If bedtime is not going well at your house, try a reward chart. Set the timer to announce bedtime, and tell your child that if he goes to bed without complaining, he will get a gold star on his chart. After three good nights in a row, take him out for a fun reward (fun as in play, not as in a junky treat). When you’ve had a success or two, change the reward schedule to once every 7 days. Soon he’ll forget all about the chart. 12. Water your child “I need a drink of water” is a classic stall tactic. Head this off by giving your child a drink of water in the bathroom before bed. Call it the “last drink” so she knows she can’t keep asking for water. Or, put a trainer cup or water bottle next to the child’s bed to quench the thirst that invariably hits as soon as the child is under the covers. He’ll enjoy the independent feel of having it on hand for himself, especially if he feels he’s had a good dose of hands-on nighttime parenting. 13. Use a nightlight Sleep researchers have shown that the brain is able to sleep better at night with no light on, but some children are afraid of complete darkness. Try using a dim night light in your child’s room. An older child may feel more secure with his own flashlight or a reading light next to his bed that he can turn on if he wakes up. With our daughter Lauren we found that when she was older and in her own room she was happier when we let her keep the light on. We then turned it off when we went to bed. 14. Try the “fade away” strategies Getting your baby to sleep independently implies helping your baby get used to needing less of you and comfortably relying on his own self-settling abilities. “Fading away”, means gradually weaning your child from breast, bottle, arms, voice, and eventually your presence at his bedside as he falls asleep. (See pages (#litres_trial_promo) for examples of this getting-baby-to-sleep-alone strategy.) 15. Just go to bed! You know your child is tired, you’ve been through the whole wind-down ritual, but he will not go to sleep. In this case, tell your child to go to his bedroom, lie in his bed, and either look at books or play quietly. If he still needs you close by, read your own book or magazine in his room. If he has to entertain himself, he will probably soon be ready to sleep. The rule is he doesn’t have to go to sleep. He just needs to stay in bed. He is allowed to read as long as he wants. He seems to get to sleep earlier and easier when he feels he has some control of his sleep time. teaching your young child to fall asleep alone and happy (#ulink_5f372a03-30eb-5466-8990-cb912fd1c08a) Putting your child to bed while you are there snuggling with her is easy. The challenge that most parents face is getting a child to learn to fall asleep without Mum or Dad there. All the steps so far in this chapter are designed to help your child feel comfortable and happy at bedtime, but how do you move towards sleep independence in a way your child will accept? A better question is this: is it realistic for parents to expect all young kids to fall asleep alone? In our experience the answer is no. Around age two or three a child’s imagination kicks in and they develop a fear of being alone in the dark at night. They can imagine monsters in the closet or under the bed. Or they may simply want you there for no particular reason. This is normal behaviour for a child. But because these fears are irrational, most parents don’t take them seriously and simply expect their child to get over them. Even kids who slept alone as babies can begin to fear sleeping alone later on. So how can parents get their kids to be happy going to bed alone? Slowly, gradually, and as peacefully as possible. Getting your child to sleep independently implies helping her get used to needing less of you and comfortably relying on her own self-settling abilities. It means gradually weaning your child from your arms, voice, and eventually your presence at her bedside as she falls asleep. If you have been staying with your child while she falls asleep up to this point, then there is probably very little stress to overcome. If your child used to fall asleep alone but has stopped, and you now realize that there may have been some months of stress while you’ve tried to accomplish sleep independence again, then you will probably need to take a step backwards in the weaning process, reconnect with your child, spend a few weeks or months letting your child fall asleep worry-free with you right there next to her, then begin what we call the “fading away” process. On pages (#litres_trial_promo) we go into detail on how to slowly fade out of your child’s bedroom. Skip ahead now and read those pages if you are currently trying to achieve this goal. We would like to summarize the fading away idea here for the purposes of this chapter: Snuggle to sleep. Lie in bed with your child while he falls asleep. Camp out next to bed. Sit on the floor next to your child while she goes to sleep. Move in and out. Leave the room for brief intervals, but come back frequently. Check on your child. Hang around in the hallway or next room, but peek your head in to let your child know you’re there. Infrequent checks. Come back to your child’s room every 5 or 10 minutes until he’s asleep. Realistically, this is not a welcome idea for parents who used to enjoy the evenings alone when their baby was a good sleeper. No parent wants to go backward in this weaning process. But if you don’t re-create a stress-free bedtime, your child will likely continue to have nighttime fears, anxiety, and stress for many years. Put in a little time now. View this as a short season in your parenting career. In the long run, your child will be better for it. In chapter 7 (#litres_trial_promo) we will go into more detail about how to transition a toddler from needing your presence to fall asleep. We will also discuss how to move a child out of your room and into his own. food for sleep Toddlers have tiny tummies. They usually need a snack before going to bed. Just remember that what children eat affects how they sleep. Some foods contribute to restful sleep – we call them “sleepers”. Other foods – “wakers” – get in the way of a good night’s sleep. “Wakers” are caffeine- and sugar-containing foods that stimulate neurochemicals that perk up the brain. “Sleepers” are foods that contain tryptophan. Tryptophan is an amino acid that the body uses to make serotonin and melatonin, neurochemicals that slow down nerve traffic and relax the busy brain. It’s a good idea to eat tryptophan-containing foods with complex carbohydrates. The carbohydrates help usher more tryptophan into the brain so it can manufacture more sleep-inducing neurotransmitters. Without carbohydrates to help, other amino acids that ride along with tryptophan, such as tyrosine, can perk up the brain and keep the child awake. High-protein, low-carbohydrate menus are best saved for breakfast, when it’s time for the sleeping brain to wake up and be busy. Carbohydrates all by themselves are not good sleeper foods. There’s no tryptophan in these foods, and sugary, junk-food carbohydrates eaten all by themselves can set you up for a blood-sugar roller coaster ride. First, you get a jolt of energy from the sugar. A couple hours later, when your blood sugar falls, causing your body to release stress hormones, you feel restless. If you’re sleeping, you may wake up. Calcium is another “sleeper” nutrient. It helps the brain use tryptophan to manufacture melatonin. Magnesium, another sleep-inducing mineral, is found especially in whole-grain cereal, sunflower seeds, spinach, tofu, and nuts. So what makes a good bedtime snack? The best sleepy snacks contain protein, healthy carbohydrates, and some calcium and magnesium. So how about grandma’s classic bedtime snack of homemade biscuits and milk? The glass of milk contains tryptophan, healthy carbohydrates (lactose), and calcium. Homemade oatmeal biscuits contain healthy carbohydrates to partner with the proteins in the milk. Best snooze foods Here are foods that contain significant amounts of the sleep-inducing amino acid tryptophan. Try these for dinner and bedtime snacks. dairy products: cottage cheese, cheese, milk soy products: soy milk, tofu seafood meats poultry whole grains beans hummus lentils hazelnuts, peanuts (Nuts and seeds are not safe for children under three; try nut butters, or grind up nuts into a fine meal and sprinkle them on other foods) eggs Don’t worry, be sleepy! Stress stimulates the body to release cortisol, which can deplete the brain of tryptophan. This is one of many biochemical ways in which stress keeps you awake. So enjoy those bedtime snacks in a stress-free, peaceful environment, to get the maximum benefit from tryptophan. Best sleepy snacks For good snacks to sleep by, try these protein-carbohydrate-calcium combinations: milk and whole-grain biscuit (e.g. raisin-oatmeal) milk and whole-grain cereal a hard-boiled egg and a slice of whole-grain toast a half peanut butter sandwich on whole-grain bread (see age advice above) homemade apple pie and ice cream (our favourite) tofu and fruit The above snacks contain just enough carbohydrates, calcium, and protein to relax rather than perk up the brain. It takes about an hour for all these sleep-inducers to reach the brain. Best dinners for sleep The foods you serve your child at dinner can help him get to sleep, too. Here are some dinners to help wind down your family. (These foods, in small portions, make great bedtime snacks too, even if they’re a bit unconventional.) chilli with beans, not spicy sesame seeds (rich in tryptophan) ground and sprinkled on salad with tuna chunks, and whole-wheat crackers tuna salad on whole wheat sandwich tofu stir-fry with hazelnuts scrambled eggs and cheese meats or poultry with veggies hummus with whole-wheat pita bread seafood, pasta, and cottage cheese whole grain pasta with parmesan cheese faqs about toddler sleep (#ulink_2eca6c27-c047-5c5c-a916-ce6d2f791078) You’ll run into many detours on the road to getting your toddler to sleep. Some of them can exhaust your patience. If you can manage to hang on to your sense of humour, some are actually pretty funny. Here are the most common questions we get asked in our medical practice and on our website: Bedtime procrastinator We begin putting our 2?-year-old to bed at 8pm, but he has a load of excuses that prolong the routine: he needs a drink of water, he has to go to the toilet, he asks us to ‘read again (and again)’ … Sometimes it takes me an hour to an hour and a half to get him to sleep. We’re tired after a day’s work, and we often could fall asleep before he does. Where should we draw the line? The main reason kids procrastinate at bedtime is stress. They aren’t worried about the actual getting-ready-for-bed routine. They are anxious about the very end of the routine – when you leave them alone to fall asleep. Fear of going to bed alone will make the whole routine stressful and your child is much more likely to act out in any way he can to delay the impending alone-in-bed time. This makes the whole bedtime hour less enjoyable for you too. Get behind the eyes of your child and understand bedtime procrastination from his viewpoint. Ask yourself, “If I were my child, what would I need from my parents at bedtime?” Answer: my parents! Instead of regarding bedtime as a chore, think of this prolonged going-to-bed ritual as quality time you spend with your child. This may be the only time during the whole day when he has your focused attention, so of course, he wants to make the most of it and reconnect with you. If you can relax and enjoy this time, you will both be happier. Parents in this situation will usually need to take a step backwards and spend a few weeks or months sitting by their child’s bedside using the fade away technique introduced above. This can be difficult, since you are tired and your tired child is being very demanding. You may be wanting some time with your partner or time just for yourself. Take it as a compliment that your child enjoys this special time with you. We worry more about babies who are not so “demanding” of their parents at night. And keep it in perspective – those early years fly by quickly. Sears’ Sleep Tip: It’s all about attitude. Instead of dreading prolonged bedtime rituals, view them as treasure times that you are storing up so that you can all sleep better later on. Develop a consistent bedtime ritual using the tips from earlier in this chapter. On nights when you know you don’t have enough patience for the whole routine, call in a crutch. Listen to an audiotape of your child’s favourite story, or watch a calm video together. You can snuggle up on the couch with your child, enjoying bedtime closeness without expending a lot of energy. Many nights when Matthew was three to four years old he and I snuggled together in a beanbag and he dozed off to Lady and the Tramp. Meanwhile, Martha was free to be with baby Stephen. tuck me in, dad Little minds are in a receptive state at bedtime. Bedtime stories can help a child reflect on her life, and you can tuck a little teaching into the stories you tell. Events from your growing-up years are a great source of bedtime tales. You can also use bedtimes as teachable moments to implant into your child pleasant thoughts and admirable values as she drifts off to sleep. Do this night after night and these bits of wisdom will be filed away in her library of experiences. Years later these bedtime lessons will be an important influence in her life. Bedtime prayers are a time-honoured tradition for smoothing out the wrinkles of life and for passing on parental values and beliefs. Teach your child a familiar prayer, or make up your own prayers of gratitude and concern for others. Dr Bob remembers toddler Andrew used to ask while snuggling to sleep, “Tell me good things, Daddy.” Bob would create peaceful scenes for Andrew to imagine. “We are sitting next to a quiet river in the warm sunshine with little fish swimming by.” Four or five little images would help Andrew settle into sleep peacefully. After one or two stories, if she wanted more I said something like, “Mummy needs to go put on her pyjamas now, and I’ll be back to check on you in a few minutes.” I encouraged her to look at the books we had just read together. She was okay with that and would often be asleep by the time I got back. Wants to stay up late Our two-year-old figts going to bed until 10 or 11pm. I know he’s tired, certainly we are. How can I get him to sleep earlier? The most important aspect of helping a toddler go to bed early, especially when you know he is tired and is just fighting it, is to learn what his tired time is (review page (#ulink_10ca544b-4e62-567d-b623-f53ff090699b)), anticipate it, get into the bedtime routine early, set the stage for sleep (review page (#ulink_6c701ce5-c355-506c-9a6f-3cdbe5064b9b)), and do this consistently night after night. You may also need to eliminate any afternoon naps (see “Getting Baby to Nap at Predictable Times (#litres_trial_promo)”, page). (See related situations, “Establish a Set Nap Schedule”, page.) Also, take inventory of what else is going on in your family. Does your child miss you during the day and want to make up for it at night? Are changes in your routine, such as a move, a change in childcare providers, or the arrival of a new baby, upsetting your child? Some children don’t want to go to bed because they are afraid of going to sleep. Others resist bedtime because they don’t want to be separated from their parents or because they want more “quality time” with their parents. In our family we noticed that the busier and more preoccupied we were during the day, the more our children lobbied for quality time at night. You know that your son needs to get to bed earlier so that he can get enough sleep. And you and your partner may need some couple time in the evening. So how do you take what you have figured out about why your child is resisting bedtime and use this insight to get him to sleep earlier? If there are stressful situations that make it hard for your child to sleep, try to remedy them. Make an effort to spend quality time with your child at times other than bedtime. Encourage lots of active play, so your child really is tired at night. Turn off the television. Plan ahead for an earlier bedtime. Start your winding-down-for-bed routine earlier. Have your child take a bath and get his pyjamas on earlier in the evening. Then at least he is ready for bed, and you don’t have to hurry through the whole routine when you are both tired and cranky. Then use the time between bath and bed for quiet games and other activities that you do together. It may be that your child is just not ready to go to sleep before 10pm. Throughout this book we have stressed the importance of earlier bedtimes, especially for infants and children. Yet, an early bedtime may not work well in your family. With today’s busy schedules, parents may not have much time with their children during the day. As a result, children demand more attention from their parents in the evening and balk at bedtime. If your child is, on the whole, well rested (maybe he’s taking a long afternoon nap that helps him stay awake at night), a later bedtime may be more realistic. When your child goes to bed is not as important as going to bed at the same time from one night to the next. Wakes up too early Our almost three-year-old wakes up at 5am to play. He’s bright-eyed and bushy-tailed and ready to go, but I’m not. Some children are like roosters. They wake up and are ready to go with the first ray of sunlight on their little faces. This doesn’t necessarily mean you have to get up at the crack of dawn. Put blackout curtains on the windows in your child’s room. This should keep the little rooster asleep for an extra hour or two. But you will probably have to let him stay up an hour later at night. To do that he may need a slightly later nap. In other words, everything gets pushed forward clockwise – later rising, later nap, and later bedtime. You have to decide if you want more time for yourself in the morning or in the evening. You won’t get both. If Dad gets up early, your toddler can tag along with him while he does all the guy things – shower, shave, dress, fix breakfast – while you get longer to sleep. It’s a good father/son “alone together” time. If that’s not going to happen, you can get up and lie with your toddler on the couch – while he plays quietly, you can snooze or at least be horizontal long enough to feel more rested once the clock says it’s a more reasonable hour. By modelling that it’s still sleepy time for you, your toddler will get the message that it’s a good idea to play quietly. Of course this assumes that your house is thoroughly childproofed, the doors to outside are locked, and any off-limit areas are gated off. Even though most youngsters won’t wander all over the house when they could be by you, you’ll rest easier knowing he won’t get in trouble if you really doze off. Dr Bob’s partner positioned her toddler on the couch in a way that he’d have to crawl over her to get down, which meant she’d know if he was on the move. Place a child safety gate in your child’s doorway. Set up a water bottle and small snack (something non-chokable) on your child’s nightstand before you go to bed. Teach your child to play and eat quietly and safely in his room when he wakes. You can even set an alarm clock and tell him he can call for you when the alarm goes ding. Even better is a music player with a timer that you can set to come on with your child’s favourite music (a regular alarm buzzer may be too scary). Wakes up to play Our eighteen-month-old baby sleeps in a cot next to us and sometimes she wakes up in the middle of the night eager to play. It’s cute, but we’re not in the mood to play at 3am. How can we stop this habit? First, you can be encouraged that this is usually just a phase as baby discovers new milestones. It often passes within a few weeks. Despite this, your toddler needs to learn that nighttime is for sleeping, not for playing. Here’s how we discouraged middle-of-the-night playmates. When our toddler was sleeping close to us and woke us up, we acknowledged her presence but then told her “time to sleep”. Then we pretended to go back to sleep. If we “played dead” long enough, she would decide that it wasn’t very interesting to be awake in the dark, and she would go back to sleep. If baby protests this silent treatment, you can cuddle her close to you (use a firm hand) and repeat the sleep cue: “time to sleep” or “sleepy-sleepy”. Or roll over and lie with your back to baby. Most babies eventually give up and after a few nights, go back to sleep easily. If this phase lasts too long, and is obviously not going away, in the interest of letting one of you actually get to stay asleep, the one who is feeling generous can get up and walk or rock baby back to sleep. Don’t turn on any lights (there will be enough “night light” coming in to find your way around). After she gets bored she’ll be ready to go back to sleep. Then you can both make your way back to her cot, or your bed. Discouraging the midnight visitor Our two-year-old comes into our room, where he used to sleep, at all hours of the night. How can I get him to stay in his room short of locking him in, which I obviously don’t want to do? Like salmon returning to their birthplace to spawn, children often naturally gravitate back to their preferred sleeping place. Those middle-of-the-night visits, though disrupting, are a usual developmental stage, especially if your child is making the transition from sleeping in your room to sleeping solo in his own. Here’s how to give your child extra nighttime security without disrupting your sleep: Have an open-door policy, but with rules. Put a futon, mattress, or a cute sleeping bag at the foot of your bed and market this as his “special bed”. Then show and tell him this rule: “You can come into Mummy and Daddy’s room at night if you need to and sleep in your special bed, but you must tip-toe in as quietly as a mouse and not wake up Mummy and Daddy. Mummy and Daddy need their sleep, otherwise we will be cranky the next day. And a cranky Mummy and Daddy are no fun to be with …” Try not to view this nighttime visit as bad behaviour. It is natural and normal. It will diminish in time without you even needing to discourage it. To reinforce both your availability and the message that nighttime is when everyone sleeps, go on to tell him, “If you wake Mummy and Daddy up, you have to go back into your room.” Try another show and tell game. During the day walk with him from his room into yours and show him how to slip quietly into his special bed without waking you up. Here’s how some parents in our practice negotiated with their midnight visitor: After we moved, our four-year-old, Josh, wanted to sleep with us all the time. Even after he fell asleep in his own bed, he’d creep in with us at about three o’clock in the morning. Even though we enjoy cuddling with him, especially as we all fall asleep, he’s an after-midnight kicker, and we’d spend most of the nights he was with us crossing our arms over our sensitive body parts. So we made a deal. We told Josh that we loved sleeping with him, but now that he was bigger, we didn’t sleep well when he was in our bed all the time, and this made us tired and grumpy parents. We further explained that we could probably handle feeling that way once a week. So we made up a chart and told Josh that if he stayed in his own bed all night Monday through Saturday, he could sleep with us all night on Sunday. Now Josh is eager to sleep “well” on his own so that we can all enjoy our Sunday night snuggles. Weaning off nighttime bottles Our two-year-old still insists on a bottle at bedtime and if he wakes during the night. I know this isn’t good for his teeth, but he really seems to need the comfort. I also wish he’d stop needing the bottle during the night. What can I do? This is a common dilemma. A toddler who is used to the comfort of sucking on a bottle to get to sleep won’t give this up easily, but it’s true that milk or juice sugar that stay on the teeth at night can cause cavities. In chapter 6 (#litres_trial_promo) we’ll discuss this situation in detail, but here’s the basic approach we recommend: Go sugar free. Slowly dilute the milk or juice with water over a couple weeks until it is all water. If your child clues in to this trick, back off for a few days then continue again. This at least eliminates the risk of cavities. Have a bye-bye bottle party. Have a ceremony where you toss the bottles into the outside dustbin, watch the rubbish trucks take it away if possible, celebrate with songs, dancing, cake and presents. Encourage your child that he is all grown up now and tonight will “go night-night as a big boy”. Have a hidden spare bottle handy in case your child decides he doesn’t like this idea come bedtime and his hysterics are beyond what you feel is ok. Some of his presents can be other bedtime props, like a musical stuffed toy, new pillow, or blanket. Substitute yourself. You may find that once you’ve taken the bottle away you need to find something to take its place. Your child may declare that that something is you. You may need to spend a few weeks helping your child go to sleep if you feel he needs you. If you’re using other substitute props, make sure your child knows how to find them during the night when he wakes up and asks for the bottle. If you feel your child really needs the comfort of a bottle with water, that’s okay. You know best when to be rid of the bottle once and for all. Becoming a bed hog Our thirteen-month-old has been sharing our bed, and up until now it has been great. Lately he has started moving around while he sleeps. It’s like he thinks he owns the bed. My partner and I are starting to feel the effects of a third person in our bed. Help! Funny – and not so funny – things happen when baby shares your bed. Three familiar, though sometimes annoying, sleep positions that family-bed babies seem to enjoy are the heat-seeking missile, the starfish, and the H-sleeper. The “heat-seeking missile” snuggles comfortably into a parental armpit or a breast and refuses to back off. Like a mother hen, you instinctively put your wing (your arm) over the top of your baby’s head. He may want to stay in touch with, or actually attached to, your warm body all night long. Baby sleeps great, but you may not. No worries, though, about this baby falling out of bed. With the “starfish”, baby sprawls his arms and legs out as far as they can go, sometimes stretching out so much they seem to force you right off the bed. Starfish sometimes become thrashers. The H-sleeper enjoys physical contact with both parents. He falls asleep between the parents, parallel with their bodies, and then strategically rotates himself until he is perpendicular to the parents, resting his head on one parent and his feet on the other. Isn’t that nice? He loves you both! Again, baby sleeps comfortably that way all night – but you may not, especially if you’re the one getting kicked in the ribs. Baby’s head in mother’s armpit. Usually when an infant or toddler starts taking over the bed in these positions, dads announce, “It’s time for a big boy bed!” Is Dad right? Here are your options. If everybody is sleeping reasonably well, you may be able to laugh this off and hope it’s passing phase. Yet if baby’s nighttime frolicking means baby is the only one who is sleeping well, you need to take some action: “Draw the line.” Put a line of pillows between you and your toddler. He gets one-third of the bed space; Mum and Dad get the rest. Try Dr Jim Sears’ trick he calls “staying in your own lane”: Jonathon sprawled across the bed with arms stretched out forming the letter H with the three of us. When he was around two years old, I was watching a swimming competition and I was paying attention to the lane dividers that kept the swimmers from swimming on top of each other and it gave me an idea. What if I could keep Jonathon in his own lane in the bed? We had tried pillows but they just took up a lot of room and it was hard to have an entire pillow between him and us. Even though we had a king-size bed they just didn’t seem to do the trick. When I saw these lane dividers in the swimming pool I thought, “hmm, something like that might work” so I went downstairs into our garage and noticed that we had some of those water woggles, long thin cylinders made of firm foam. Using ones that had hollow centres, I slid broom handles in to add some rigidity. After Jonathon fell asleep I placed one on each side of him, each one running the length of the bed, and this worked beautifully. If he started to roll over or rotate sideways the foam was firm enough to keep him from going over it. These were perfectly safe because they were rigid enough so that he didn’t become entangled and light enough that he wouldn’t be hurt if he somehow slipped under. They were also easy to store under the bed when not in use. One point: I don’t suggest using old woggles that have been sitting in the pool in the sun for months because the foam tends to break down and be quite flaky and makes a mess. Go out and get some new ones. To give everyone more space, put a twin bed next to your queen- or king-size bed. Take bed sprawling as a sign that it’s time to start transitioning baby to his own bed. Dad may be right! (See chapter 7 (#litres_trial_promo), “Moving Out (#litres_trial_promo)!”) Fear of monsters Our three-year-old wakes up yelling about the “monsters” in his room. I try to tell him there really aren’t any monsters and that Daddy has chased the monsters away. Is this the best way to deal with this? I don’t want him to believe that there really are monsters in his room. Children’s dreams distort reality, and young children have difficulty knowing what’s real and what’s pretend. Therefore, if they see a monster in their dream, they may believe that the monster is real. There are two schools of thought on monsters and other imaginary creatures. The usual suggestion is to play along and just get rid of the monsters. Or, try to teach your child that monsters are fun and friendly. When your child wakes up frightened about them, you search the bedroom and say things like “no monsters anymore”, “monsters went bye-bye”, “Daddy scared the monsters away”. If he worries at bedtime, you can make a show of ordering the monsters out of the bedroom and reassure your child that they’re not coming back. While we are sceptical of this approach, for some children it does work. The problem is, it’s not true. When you chase monsters away, you’re reinforcing the child’s concern about monsters, and since you say those monsters are indeed real, they can come back. Here’s a better alternative: tell your child the truth. Monsters don’t exist. They are pretend. If your child is going through a “seeing-monsters-in-his-sleep” stage, avoid scary TV or cartoons that could be distorted into monsters in his dreams. Your child trusts you. If you say there are no monsters, he will believe you. You might also talk about other things besides monsters that are only pretend, to help your child learn to tell the difference between what’s real (a family pet, elephants at the zoo) and what’s not (characters in cartoons, such as Monsters Inc., animals in story books who talk). Nighttime anxiety Our three-year-old had been sleeping well on his own for a few months, but now he’s waking up and coming into our room at night. He seems really upset. How can I help him get back to sleeping through the night in his own room? Realize your child has a need. He is growing and developing, and new fears and worries are going to come along. Sometimes they will disturb his sleep, and you are right in thinking that he needs your help to cope with his nighttime anxiety. Why is your child suddenly feeling insecure about nighttime? There are many possible reasons. Here are just a few: Imagination. As kids get older they develop the mental ability to imagine that there is a monster in the closet, a giant hand under the bed (that was Dr Bob’s fear as a child), or something looming in the darkness outside. They don’t necessarily have to see these things first on TV or hear about them in stories. Kids can create these fears all on their own. Separation anxiety. This occurs not only around nine months of age, it can also show up again between age 2 and 3. Your happy sleeper becomes anxious because you are not there. Your child needs your physical presence as reassurance that he is safe because you aren’t going anywhere. Life changes. Changes in a child’s life, such as starting preschool nursery or childcare, moving, or having a younger sibling can trigger some temporary nighttime anxiety. Changes in the family’s life, such as in a parent’s work schedule, can also affect how well a child sleeps. Here are some ideas you can try to help your child learn to sleep through the night again: what’s on your child’s mind? Do you think that your awake-at-night child is purposefully trying to manipulate you? Do you think he is lying in bed thinking, “Hmmm. I know Mum and Dad are having a relaxing evening. How can I disrupt them? I know, I’ll get up and go ask for a drink of water. I know they hate that!” If your child is really thinking like that at the age of three, then good luck. But we really don’t think kids are that devious (well, not until they are older). When your child gets out of bed at night to come find you, you may be tempted to send him back to his own bed with firm orders to stay there. Instead, put yourself into the mind of your child as he crawls back into his own bed, wide awake, and lies there, staring at the wall. “I’m afraid, and my Mummy won’t help me”, he thinks. Or, “I wish my Daddy was here with me.” Remember that a child’s needs are not always rational from an adult’s point of view. I don’t want her nighttime memories filled with her screaming from her cot. I don’t want my memories filled with hearing her scream from her cot. Talk it out during the day. Sit your child down in the afternoon and tell him that you want to help him with his nighttime worries. Decide on a plan together. Perhaps you will go back to his bed with him when he wakes up, and lie down with him until he falls asleep again. Maybe you will decide to put a mattress or a comforter on the floor in your room, where he can sleep if he gets scared during the night. Maybe you and your child will come up with another idea. Act quickly at night. When your child wakes up in the night and comes into your room, don’t get into a debate with him about going back to his own bed. Just do what you planned to do. Take him back to his room and fall asleep together in his bed. Or, get him settled in his little bed in your room. Or let him climb in bed with you. The object here is to get everyone back to sleep without feeding your child’s nighttime fears. Enjoy a peaceful day with active play. As we have said before, minimizing the stress in your child’s daytime life will minimize nighttime problems. If the daytime stress is unavoidable, be prepared to live with a few sleep problems until things settle down. Encourage your child to run, jump, and be active during the day. This tires him out, and it also alleviates tension and anxiety. Wean him back to sleeping alone. As your child starts to feel more secure at night, you can begin to work on getting him back to sleeping alone. He may decide that if he wakes up he will join you in his special bed in your room without waking you. Or you can take him back to his bed, staying with him just until he’s nearly asleep. Tell him “I’ll be back in a minute to check on you”, and then be sure to come back. Dim the lighting. Too much light may keep your child awake, but a nightlight may keep him from being afraid when he wakes up alone in the dark. Keeping the hall light on with the door open is another good option. why nighttime parenting matters (#ulink_b6d2f9df-2e82-5a0f-b5b1-f5f9bb6f5b9b) Long-term nighttime stress can lead to long-term sleep insecurities that can create daytime insecurities and problems with self-confidence. That’s a mouthful, but we want you to understand it. Picture the following two scenarios: Alex is four years old and had been sleeping well in his own room. Bedtime was a relaxing routine of stories, hugs and kisses, and sweet dreams. Until tonight. When his Dad tries to put him to bed, he protests that he wants his Dad to stay with him. When Dad says no, Alex asks for an extra hug and kiss, a longer story, tucking in the covers better, or whatever else he can think of to keep Dad around for an extra minute or two. Dad leaves his room, and Alex starts getting out of bed every five minutes to ask for a drink of water, to find out what his parents are watching on TV, to ask what he’s doing tomorrow, or to complain that he’s hungry. His parents send him directly back to bed, alone. On subsequent nights, Alex’s tactics escalate into complaints of tummy aches and headaches. He takes a long time to fall asleep and doesn’t seem quite as happy and secure in the daytime anymore. He even starts wetting the bed (something he’d never done before). This goes on for years, and as he grows through childhood he feels that bedtime is a time of loss and separation. Now let’s meet the same child, but with different parental responses. Alex is four years old and had been sleeping well in his own room. Bedtime was a fun routine of stories, hugs and kisses, and sweet dreams. Until tonight. When his Dad tries to put him to bed, he protests that he wants his Dad to stay with him. His Dad gives him an extra long hug, stays in the room for a few minutes pretending like he’s putting some clothes away, lingers in the hallway busily, then tells Alex goodnight (kiss, hug, and tuck again), and leaves. Alex is asleep in two minutes. He just needed a little extra something that particular night, and his Dad gave it to him. Dad discusses this situation with Mum. While they want to keep their early bedtime routine with Alex (they like their evenings uninterrupted, and don’t want to have to waste an extra hour every night trying to cater to their child’s bedtime fears), they also have been sensitive to his changing needs over the years. They didn’t push it when he needed some time getting used to starting preschool. They didn’t leave him crying with a babysitter, but took the time to help him feel comfortable and playful. They’ve yet to go on a holiday without him. Now they realize that their child is trying to tell them he is feeling anxious about being away from them at night. They understand that if they fulfil his needs now for the short term, they won’t turn into long-term unfulfilled needs that will leave him feeling insecure over the years. They also know that if they meet those needs without Alex continuously having to ask (or protest), his needs should diminish faster. Plus, everyone will be happier. So the next night when Alex protests when Dad turns to leave the room, Dad sits on Alex’s bed and says “I don’t mind staying with you for a little while. You rest your eyes, and I’ll sit by the bed here for a few minutes.” Dad winds up spending the next three weeks lingering in Alex’s room or the nearby hallway at bedtime. Sometimes he folds laundry while waiting for Alex to fall asleep. He sits in the chair and uses a tiny clamp-on book light to read without turning on the overhead light. He doesn’t interact much with Alex, he’s just there. Sometimes he tells Alex that he needs to go in the other room, but he will be back to check on him in a few minutes. He putters around, making just enough noise for Alex to know he is close by. It is a very slow weaning process that, while time-consuming, really pays off in the long run. Eventually Alex returns to his former easy-to-sleep routine, and his parents get their evenings back. Bedtime was always a drawn-out affair in our family. The routine took forty-five minutes to an hour, especially with my oldest son, who has always been very tuned in to what’s going on around him. Now, many years later, everybody goes to bed on their own. My three children are expert sleepers who rarely have trouble falling asleep at night. I’m the one who needs to stop at my kids’ bedroom doors to chat for a few minutes and connect with them before I can fall asleep. chapter 3 (#ulink_a31f3066-091e-55e0-93ed-51ae54c7c104) the facts about infant sleep and what they mean for parents (#ulink_a31f3066-091e-55e0-93ed-51ae54c7c104) The steps and tips on how to get your infant and toddler to sleep that we shared with you in the first two chapters of this book are based on general principles about how babies and toddlers sleep. When you know why babies do the things they do, it is easier to work out how to respond. Learning more about how babies sleep and why they wake up during the night will help you understand the nighttime parenting strategies we suggest in this book. It will also help you bring a helpful attitude to caring for your baby’s nighttime needs. learn the facts of infant sleep (#ulink_e977da6d-e186-5112-a480-a5d03cbce1c9) Read all about it! We want you to understand why babies sleep the way they do – or don’t. First, here are some general facts about sleep. How adults sleep. There are two main states of sleep – REM (rapid-eye-movement sleep) and non-REM. The term “falling” asleep is biologically correct. As you drift off to sleep, you enter non-REM sleep, and over the next hour and a half you descend through the levels of this sleep state until you are at level four, the deepest level of sleep. You may even sleep through a phone ringing, or here in California, through earthquakes. If you are awakened from this deepest level of non-REM sleep – say, by a persistently crying baby, you are more likely to be disoriented and grouchy than when you are awakened from lighter levels of sleep. After the first 90 minutes of gradually descending into non-REM sleep, your brain begins to arouse and move into a lighter and more active kind of sleep, the state of REM sleep. During REM sleep the brain is quite active (it’s when you dream), although the rest of your body is usually relaxed and relatively quiet. You experience rapid eye movement even though your eyes are closed (hence the term REM sleep), and men can get erections. During REM sleep, facial muscles may twitch, producing “sleep grins”. It’s fun to watch for this in babies. Since this is the lightest stage of sleep, it is easiest to waken out of REM sleep. Adults cycle through REM and non-REM sleep approximately every 90 minutes. Early in the night the periods of non-REM sleep may last as long as 60 minutes, and REM periods may last from 10 to 30 minutes. Toward morning the proportions of non-REM and REM reverse, so that much of early-morning sleep is REM. The length and pattern of these sleep cycles varies greatly between individuals and at different ages. However, during an average eight-hour sleep adults may spend two hours in REM, or active (light) sleep, and six hours in non-REM, or quiet (deep) sleep. Both of these states of sleep are important for a person’s overall well-being. Non-REM, or deep sleep, is necessary to help the body rest and recuperate. It is known as the restorative state of sleep. REM sleep is necessary for brain development. Understanding these sleep cycles explains why human babies awaken so easily and why it may not be wise to fiddle around too much with babies’ natural sleep cycles. How babies sleep. Why do babies wake up so much? This is probably the question new parents ask most. The simple answer: because they’re babies. Babies sleep differently from adults. Babies go to sleep differently. Infants take longer (at least 20 minutes) to drift off and enter deep sleep. On the other hand, adults and older children “crash” into deep sleep, drifting into non-REM sleep in just a few minutes. The younger the infant, the longer it takes him to drift into deep sleep. What does this sleep fact mean to parents? Babies awaken easily during this drifting off period. Parents don’t have to be sleep scientists to figure this out. Many parents describe their baby as “difficult-to-settle”, or they say “she has to be fully asleep before I can put her down”. Many parents have had the experience where they think their baby is asleep, so they gently carry her to her cot and lay her down – but she wakes up as soon as Mum or Dad turns to tiptoe out of the room. Baby is not truly asleep until he arrives in the state of deep sleep, 20 to 30 minutes after closing his eyes. Trying to hasten the bedtime routine can leave parents very frustrated. You can see why the advice from sleep trainers to “put babies down in their cots awake” doesn’t work, especially for babies less than three months old. Babies need to be gentled through this first period of REM sleep, so that they can stay asleep until deeper sleep overtakes them. Between three and six months babies begin to drift more quickly into non-REM sleep. They can be put down awake, or partially awake, and they will enter deep sleep fairly quickly. Bottom line: babies need to be patiently parented to sleep, not just put to sleep. Babies stay asleep differently. While adults cycle from deep to light sleep approximately every hour and a half, infants move through these states every hour. The younger the infant, the shorter the sleep cycle. What does this mean for parents? When passing from one state of sleep to another, the brain is more likely to awaken than at other times. We call this the “vulnerable period”. If by chance an arousal stimulus (teething pain, loud noise, hunger, separation anxiety, and so on) bothers baby during this vulnerable period, baby is likely to awaken. Because babies have shorter sleep cycles, they have more vulnerable periods – more times during the night when they are likely to wake up. In addition, babies spend more time in REM (light) sleep in the second half of the night. This explains why babies often wake up more during that time. Bottom line: minimize arousal stimuli during vulnerable periods for night waking. As babies grow, their sleep cycles lengthen and the percentage of deep sleep increases. There are fewer vulnerable periods during the night when they can awaken easily. They also sleep more deeply and they stay asleep longer – a sleep maturity milestone called settling. The age at which babies settle varies greatly according to the sleep temperament of the baby. The good news is that all babies eventually settle. Babies’ developing sleep patterns are much like their changing feeding patterns. In the early months babies take small, frequent feedings and short, frequent naps. About fifty per cent of the total sleep of a newborn is REM sleep. This percentage is even higher in premature infants. As you can see from the graph below, as babies grow, they learn to sleep and feed more like adults. These five things happen: REM (active) sleep decreases Non-REM (deep) sleep increases Sleep cycles lengthen Vulnerable periods for night waking occur less frequently The total number of hours of daily sleep lessens. This is called sleep maturity. Babies are designed this way. Why are babies’ sleep patterns so different from adults’? Answer: because babies need to sleep this way. How babies sleep is one of many things throughout infancy and childhood that parents can’t control, and it may even be unsafe and unwise to try to change. Keep in mind that babies sleep the way they do – or don’t – because they are designed that way for both developmental and survival benefits. Babies sleep smarter. REM sleep is more than an annoying nuisance that keeps parents as well as babies from sleeping more deeply. The fact that babies’ developing brains don’t turn themselves off as well during sleep as adult brains has developmental benefits. Sleep researchers believe that REM sleep stimulates the infant brain at a time when it is growing very rapidly. Blood flow to the brain increases during REM sleep. The lower brain centres fire off electrical stimuli toward higher brain centres. This stimulation works like mental exercise to help the brain centres develop. The mental activity of dreaming helps the brain grow more neurons. This theory that REM sleep stimulates brain growth is supported by the fact that the young of highly intelligent animal species spend more time in REM sleep than the young of less intelligent species. One day as I was explaining the light sleep/better brain correlation to a tired mother of a wakeful infant, she chuckled, “In that case, my baby is going to be very clever.” Babies sleep healthier and safer. Not only do these immature sleep patterns help babies grow smarter, they help them grow healthier and sleep safer. Suppose your baby slept like an adult. Suppose baby slept so deeply that he couldn’t signal when he was hungry, cold, had a stuffy nose and was having difficulty breathing, or was just plain scared? Baby’s well-being would be threatened. Babies come wired to awaken so that they can let nearby caregivers know what they need to thrive and survive. What does this mean to parents? These arousals are thought to be protective arousals, and they are beneficial. Training babies to sleep too deeply, for too long, too young is not in the best interest of the baby’s development and well-being. Sears’ Sleep Tip: Now that you understand infant sleep, when people ask, “How does your baby sleep?” you can answer, “Like a baby”. There are sleep trainers who ignore these basic biological facts and insist that babies should be able to put themselves to sleep and sleep through the night. As you can see from the information in the previous pages, putting a baby down to sleep alone in a cot and leaving the baby to cry himself to sleep, and back to sleep when he awakens, is biologically and developmentally wrong. We are passionate about helping parents understand their babies’ basic sleep needs and giving them tools to cope until their babies reach sleep maturity, so we hope you’ll keep these biological facts in mind when making all decisions about your baby’s sleep. how babies sleep at various ages (#ulink_0d3eb7f8-ef01-57bb-a679-eb181717438f) As with all developmental milestones, the age at which babies wake up less and start “sleeping through the night” varies from baby to baby. Here are the general sleep patterns that most babies follow at various stages along the way to sleep maturity: Newborn period. In the first month, babies tend to sleep a total of sixteen to seventeen hours a day. They sleep in three to four hour stretches with an equal amount of sleep during the daytime and nighttime hours. At this age babies wake up mainly from hunger (which they don’t experience until they’re born, so it’s very scary for them at first). One to three months. Between six and eight weeks of age, babies begin to “consolidate” their sleep into shorter periods during the day and slightly longer periods at night. They sleep from 15 to 16 hours a day. At this age, most babies wake up at least once a night and need a feeding and help to resettle (many will wake up two or three times). Babies start waking up not only from hunger, but also from a need for closeness (being alone is also very scary). Three to six months. Babies sleep a total of around fifteen hours a day, taking two or three two-hour naps during the day and doing the rest of their sleeping at night. By six months, most babies will begin to sleep four- to five-hour stretches at night. At this age babies also begin having shorter REM periods of sleep and longer non-REM. babies sleep differently Notice how babies sleep differently than do adults and imagine what could go wrong if they didn’t. Infant Sleep Designed to easily awaken Designed to sleep less deeply Need night feedings Short sleep cycles, 60 minutes Mostly REM (active) sleep Adult Sleep Designed to stay asleep Designed to sleep more deeply Don’t need night feedings Long sleep cycles, 90 minutes Most non-REM (quiet) sleep Six to nine months. Babies sleep around 14 hours a day and may drop one of their naps. Most babies between six and nine months take one morning and one afternoon nap. They may start sleeping seven-hour stretches at night. Most continue to wake up several times a night, and some can self-soothe back to sleep. Developmental changes start triggering night waking at this stage. They practise their motor development, such as sitting up, while still half-asleep. Add teething pain to this list and you have a recipe for night waking even in babies who were previously “good” sleepers. Nine to twelve months. Babies sleep between thirteen and fourteen hours a day, still with two naps. Some babies may sleep ten hours at night, occasionally maybe even twelve hours (often interspersed with one or two feedings). While babies still need a morning and afternoon nap, the morning nap will usually be shorter. One to two years. Babies sleep from twelve to thirteen hours a day, with ten to twelve hours at night, and two shorter naps. Around (or even before) eighteen months of age, some infants will begin to relinquish the morning nap, but need the afternoon nap. Some need two naps one day and one nap the next. Between 12 and 18 months babies often start waking up because of separation anxiety. From 18 months to two years, the concept of person permanence clicks in, enabling babies to fall asleep on their own more easily because they can understand that their parents are nearby in another room even though they can’t see them. Two to three years. Toddlers sleep between eleven and thirteen hours in 24 hours, and often give up the morning nap. Nightmares and sleep terrors may begin, as well as sleep fears and fear of the dark. Previously “good sleepers” may become fretful sleepers at this age. Most toddlers graduate from cot to bed between ages two and three. sleep needs Three to four years. Finally by this stage most children’s sleep patterns become like those of adults. By four years, many children no longer nap during the day, yet still need eleven to twelve hours of sleep at night. why babies wake up (#ulink_faf3ca5f-6a6e-5056-a1d5-73fd8be818e4) Understanding all the things that can go on in that little body and mind when you put her down to sleep at night may help you understand why babies wake up so often, develop some creative tips to help her sleep, and above all sympathize with your baby. Here are the main reasons why babies awaken frequently. 1. They’re babies! As discussed in detail on page (#u9bc1a270-5e45-4c8f-896c-a7fbe59c5403) babies have shorter sleep cycles. Every hour or so as they pass from the state of deep sleep into light sleep, they go through a vulnerable period for night waking. If they sense any upset or discomfort during this vulnerable period, they cry for assistance. For safety’s sake, babies’ sleep patterns have easy arousability, which means that if anything threatens their well-being (such as SIDS) they wake up more easily than do adults. Exhausting as it may be to their caregivers, these are survival and developmental reasons why babies are prone to night waking. 2. They’re hungry. Tiny babies have tiny tummies and fast metabolisms. They can’t go as long without food as adults can. And breastmilk moves through baby’s stomach faster than formula. Many infants don’t start clustering their day feedings and dropping night feedings for at least six months, and most breastfeeding babies continue to need a night feeding for sometime thereafter. While some books may say infants don’t need night feedings after a certain age, try telling that to a baby with an empty tummy. 3. They’re thirsty. If your baby was used to feeding several times at night, or getting a bottle or two, but has now learned to sleep without this (thankfully!), he may start to feel the lack of fluids at night. This becomes truer during the toddler and preschool years. If you find your child is waking up and feeling thirsty, have a handy trainer cup or water bottle nearby that your child can drink from before he fully wakes up. Also be sure to provide a good size drink of water before bedtime (unless, of course, you are potty training at night). Doctor Bob’s third child used to wake up between 18 months and 2 years asking for water (even though he was still breastfeeding). He wouldn’t even open his eyes. He’d just lie there asking for water, and when we gave him a drink, he’d fall right back to sleep. 4. They’re growing. Growth hormone levels are much higher during sleep. Thus, the saying, “he seemed to outgrow his baby clothes overnight”. Growth hormone also stimulates hunger. Waking to feed frequently is the baby’s way of making sure he has enough fuel to do the growing. Babies typically will experience growth spurts around three weeks, six weeks, three months, and six months. During these stretches your baby will go on feeding marathons day and night. Don’t worry. If your baby is generally a good sleeper, things should go back to normal within a few days. If your baby has been a night waker all along, then you probably won’t even notice the difference. Growth spurts are just another way that Mother Nature robs us of sleep (when we say “us”, what we really mean is you mums out there, and you dads who are noble enough to share the nighttime duty.) Конец ознакомительного фрагмента. Текст предоставлен ООО «ЛитРес». Прочитайте эту книгу целиком, купив полную легальную версию (https://www.litres.ru/martha-sears/the-baby-sleep-book-how-to-help-your-baby-to-sleep-and-have-a/?lfrom=688855901) на ЛитРес. 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