If your child is substantially past his third birthday, trying to reestablish the nap may not make sense, and trying to establish an earlier bedtime will help your child sleep better. Here is a report of how a temporarily super-early bedtime and the use of the “nap hints” on page 123 helped create long and regular naps.
A 5:30 P.M. BEDTIME UNTIL HENRIK'S NAPPING GOT BETTER
When our pastor asked us if our eight-month-old son, Henrik, was a “serious, sullen” boy, I knew we had a problem. Just one month before, my friend had sent us a note saying how Henrik was the happiest baby she'd ever seen. She could elicit a belly laugh from him with just a sideways glance. Now, our pastor, an experienced grandfather, was pulling out all the stops—goofy faces and exaggerated sneezing—and Henrik wouldn't crack a smile. But it wasn't because he was suddenly sullen or serious; he was exhausted.
What I had hoped was just a napless phase that he'd outgrow was catching up to him and choking his vibrant personality. We needed help.
I called our pediatrician's office and explained our predicament: While Henrik was sleeping better at night, his daytime naps were becoming history. Over the past two months, his decent, if erratic, nap schedule had faded into two brief naps and then disappeared altogether.
Getting my son to fall asleep was never a problem; nursing or rocking soothed him easily. It was getting him to stay asleep once I set him down where the trouble began. As soon as I'd set him in his crib, his back would arch and he'd be choked up before he touched the mattress. “Nap time” had come to mean Henrik crying in his crib until my nerves couldn't take it anymore, or him sleeping soundly on me.
I knew he needed to learn to soothe himself to sleep, but crying it out just didn't seem to work. The longer I'd let him cry, the more he would work himself up. I knew sleeping on me wasn't a good solution, but when I'd see the dark circles under his eyes and hear his voice husky from crying—and especially when he got his first cold—I just couldn't let him cry anymore. He needed sleep. So I'd get comfortable with him on the sofa and hope a good movie was on cable.
When the nurse at our pediatrician's office suggested Dr. Weissbluth's Healthy Sleep Habits, Happy Child (a book I had already devoured and loved), I decided to take it a step further and make an appointment to see Dr. Weissbluth himself, since his office was near our home.
Eight days later, with a copy of his book and a sleep journal in tow, we set off for our consultation with Dr. Weissbluth. As soon as he walked into the room, I knew we'd find help. Dr. Weissbluth listened to, empathized with, instructed, and encouraged us in a manner that assured us we would get back on track.
After studying our son's erratic sleep patterns, he recommended an earlier bedtime and regular wake-up times for my son. Dr. Weissbluth explained that Henrik was going to bed too late and wasn't getting enough sleep at night. (Henrik usually fell asleep between 8:00 and 9:00 P.M. and woke up around 7:00 A.M.) This lack of sleep and a consistent schedule—as odd as it may seem—is what was keeping him from being able to cry himself to sleep during the day. He was too overtired to sleep! Dr. Weissbluth suggested a 7:00 P.M. bedtime and a 7:00 A.M. wake-up for the long-term goal, but said that we'd probably be looking at a 5:30 P.M. bedtime until Henrik's napping got better.
Once Henrik was up in the morning, we were to stimulate him through walks, outings, and vigorous play. After that, a soothing period would precede his attempt at a 9:00 A.M. nap. I was to continue putting Henrik to sleep in my normal way (nursing and rocking) and then set him down in his crib. I was then to leave him alone for one hour either to sleep, cry, or a combination of the two.
Then, after his morning nap, we were to repeat the process for his attempt at a 1:00 P.M. nap (or earlier if no morning nap was taken). And then we'd go about our afternoon until it was time for the evening soothe. He asked us to chart our sleep data so we could clearly see Henrik's progress.
After a round of handshakes and encouraging words, we left the office equipped to help our son become the sleeper he needed to—and could—become. We were to report back to Dr. Weissbluth in a week. His confidence that we'd see improvement by then rubbed off on us. We couldn't wait to get going.
When we got home, we played and played, and then I soothed Henrik to sleep. When I set him down for his afternoon nap, he cried. I said a quick prayer, told him I loved him, walked out, and closed the door on my wailing son.
As I walked down the stairs, I breathed in slowly, reminded myself that I was doing this for my son's well-being, and hit the pause button on my emotions. I spent fifty-nine minutes e-mailing friends with one ear to the monitor to see if and when he'd stop crying. “Didn't work today,” I was telling myself on the way back up the stairs. But by the time I got to his door I realized he was quiet. He fell asleep after fifty-nine and a half minutes of crying. If I had gone up one minute sooner, I would've cheated him out of this accomplishment. We were on our way.
The afternoon nap was the first to get back on track. It took about a week for him to be able to go down at all without crying, and he was still only sleeping for a half hour at a time. But he was sleeping—and on a schedule! I used to think that because Henrik was an erratic sleeper, a sleep schedule wouldn't work for him. Now I know that Henrik was an erratic sleeper because he lacked that schedule. (While the idea of a schedule sounds limiting, establishing a schedule was the most freeing thing for our family. We are now able to make accurate plans instead of having to wait around and guess when our son would be ready to go.)
The morning nap was more of a challenge. For two weeks he cried through his entire morning nap. It was difficult to put him down each day knowing he would cry, but his success in the afternoons, along with the giant hug I'd receive when I came to get my teary son, gave me the strength to keep going. Then one day he cried himself to sleep after twenty minutes, and from then on he would stay sleeping after we put him down. It took two weeks for Henrik to get back to two naps a day, but he did it.
Despite sleeping for only thirty to forty-five minutes at a time, Dr. Weissbluth told us we should get him as soon as he woke up. He suggested we keep the 5:30 bedtime, which would naturally help lengthen his naps. Our days are now virtually tear-free.
My son is thriving on his new schedule. He's back to his giggly, healthy, and well-rested self. Instead of being the sullen boy in church, he's now the chipper angel who sings out loud with joy—with or without the rest of the congregation.
Bedtime Is Too Late:
Sometimes or Always a Battle
Past six weeks of age, biologically driven bedtimes tend to become earlier. If you are unable or unwilling to allow these early bedtimes, your child will become overtired. Common problems occur (1) in the postcolic child who is dependent on the family bed and breast-feeding to sleep but now wants to sleep much earlier than the parents do, (2) parents who have to use day care so extra time at night is required to bring the child home, or (3) dual-career families with long commute times from work. Solutions involve using others to help prepare the baby or child for bed (bathing, dressing for sleep, and feeding) and, as early as possible, the parents begin a brief bedtime routine. Although you will see your child less at night, you will have lovely morning time. To really enjoy the mornings, some parents will have to go to sleep earlier themselves! Other parents may be able to alter their work schedule to come home early on some days or do some of their work at home in the evenings after their child has gone to sleep. Obviously, not all parents can come up with a solution. Review the list of resources for soothing on page 74.
If circumstances cause your baby to go to bed too late, do the best you can but try for the earliest bedtime possible.
Night Waking, Difficulty Staying Asleep
Night waking occurs normally in all children, and the real problem is not developing the ability to return to sleep unassisted after the awakening. Night waking is the most common postcolic sleeping problem and is discussed in Chapter 4. All sleep problems eventually lead to night waking. The sp
ecific treatments depend on the child's age and are discussed in the appropriate chapter.
More Than One Child
Creates Bedtime Problems
An older child, about age three years, might not nap and need to go to sleep around 6:00 or 6:30 P.M., especially if he has a very active day. His younger sister, about age six months, might be taking three naps and be able to stay up later. A parent cannot ignore the baby and attend to the three-year-old's bedtime routine. A solution is to eliminate the third nap for the baby so she goes down earlier, around 6:00 or 6:15 P.M., while the three-year-old is playing by himself. Twins who have different sleeping schedules, causing different bedtimes, are challenging to parents and sometimes there is no solution except putting them down at about the same time and if there is any crying associated with falling asleep, then temporarily separate them.
Unable to Fall Asleep
Young babies or children may have difficulty falling asleep except when they are in bed with their parents or in their arms. Most of these are children who had colic (see Chapter 4) or whose parents had used the family bed from the beginning. Read the sections on the Family Bed in Chapter 6, and “Transition from Family Bed to Crib” on page 177. Older children and adolescents may have difficulty falling asleep and these are discussed in Chapter 9.
Afraid of the Dark or Being Alone
Fears are very common between the ages of two and four years. Thunder, lightning, barking dogs, shadows, and many other scary items over which we have no control can frighten children. A light on in the closet or even a conventional seven-watt night-light might keep a sensitive baby from sleeping well. A quarter-watt guide light that produces a faint yellow glow will usually be sufficient illumination. Extra long and soothing bedtimes will help. A new protecting teddy bear might help fight off fears and protect your child. A father might walk around the room and capture the “monsters” and put them into a bag or box to remove them from the room. Guardian angels, charms, or dream catchers may help make your child feel more secure. An older child might be given a bell to summon his mother or father with the understanding that he can use it only once. The parent will then come to soothe him, once, for a predetermined period of time, using a kitchen timer placed under a pillow or cushion to control the duration of the soothing time. Knowing that he can have some attention at night gives the child confidence and he will sleep better. The goal is to provide extra attention at night without it becoming open-ended and a ploy to fight sleep.
Will Not Stay in His Crib or Bed
One-or two-year-olds who climb out of their bed may receive too much social interaction from parents and therefore may continue the behavior because they are curious and social. To protect their sleep and prevent the development of sleep problems, buy a crib tent. You may have to use duct tape to keep the child from getting to the zipper. Parents are often reluctant to use a crib tent because they imagine their child will feel like a caged zoo animal, restricted, or abandoned. Of course, there might be some protest crying for a few days. However, many children quickly seem to enjoy the comfort zone like a teepee or fort; they do not appear sad or angry. Some parents do not want to use a crib tent but feel more comfortable putting a latch lock on the door. If you stand at the door preventing your child from leaving the room, your child will fight sleep all the more because he is getting attention from you.
“Sleep Rules” (page 325) and “silent return to sleep” (page 320) are used for the older child who will not stay in bed. Here, too, some parents know that they cannot be consistent at night, so they want to put a latch lock on the door. Whenever parents want to put a lock on the door, I ask that they have the child watch them put the lock on. One parent felt that the additional step of bringing her three-year-old child to the store where she purchased the lock for the door helped convince him that she was serious. The child is told that if he leaves the room, he will be put back in and the door will be locked. Almost all the time, the child picks up on her parents’ serious demeanor and does not even attempt to leave the room in the first place. If, however, the child tests the rules and leaves the room, and the parents place her back into the room and lock the door, although there may be loud and long protest crying, it is usually only for one night, because the child is now highly motivated to prevent the door being locked.
Will Not Sleep Anywhere Else
Maybe your baby sleeps well in your home but does not sleep well at grandma's. Try to play the same music only at sleep times at both homes. Buy something soft and safe for your baby to feel or clutch and use it only at sleep times at both homes. Spray some fragrance or perfume around the crib or bed only at sleep times at both homes. Use the same sleep schedules and nap time and bedtime routines at both homes.
Only One Bedroom
When your baby becomes more curious and aware of the sounds and movements of people around him and you are using a crib, it might be time to move your baby to his own room. What do you do if you do not have an additional bedroom? Some families have their baby sleep at night in their bedroom and they use a sofa bed and convert their living room into their bedroom at night. In this way, the baby can go to bed early in a dark and quiet room and the parents know that their nighttime sounds will not wake awaken him.
Transition from Family Bed to Crib
Moving your baby from a family bed to a crib will be easy or difficult depending on whether the family bed was unwanted but occurred in reaction to extreme fussiness/colic or was wanted from the beginning. This will be discussed in detail on page 177.
Action Plan for Exhausted Parents
Young children and infants cannot tell us how they feel, so parents need to watch their behaviors. Does your child behave as though he were active, alert, vital, and wide awake, or is he fighting sleep, woozy?
MAJOR POINT
Junk food is bad for the body. Junk sleep is bad for the brain.
This chapter and the two previous chapters describe the terms healthy sleep and disturbed sleep. Obviously, sleeping is not an automatically regulated process such as the control of body temperature. Sleeping is more like feeding. We do not expect children to grow well if all they eat is junk food. Children need a well-balanced diet in order to grow. If the food that is provided is insufficient or unbalanced, this unhealthy diet will interfere with the child's growth and development. The same is true for unhealthy sleep patterns.
REAL LIFE
If your child has a sleep problem that requires multiple changes but you are only able to make some of the changes, go ahead and do the best you can.
Be consistent. Anytime you make a change, allow at least four to five days before making another change to see whether you have helped your child. Be patient.
Keep a sleep log as described on page 118
Identify the main sleep problem as described in this chapter
Read the brief solution outline and the age-appropriate section in later chapters or the action plan for that chapter
Identify the elements of sleep that need improvement or correction for your child's sleep problem
Sleep duration: night and day sleep
Naps
There are good naps and bad naps. Occasional nap strikes may not be harmful, but nap-stubborn kids are usually overtired.
Sleep consolidation
Sleep schedule
Sleep regularity
Determine what you can and cannot do
Ignore morning crying that is too early versus bringing your baby to your bed
Control the wake-up time
Change the schedule for nap times
Eliminate the third nap
Change the schedule for bedtimes
Change the nap time or bedtime routine
Provide more soothing at sleep times
Give less attention at night when your child is not hungry
Use a crib tent or lock the door
IMPORTANT POINTS
Sleeping well is a 24/7 process. It's not just about how we get them to go to
bed at night without crying.
Solving sleep problems may be a very tough prescription and demands a consistent approach.
There may be increased crying in the beginning, but the upside is that crying around sleep should be eliminated altogether.
Sleep,
Extreme Fussiness/Colic,
and Temperament
How to Use This Chapter
I believe about 5 to 10 percent of babies are at risk for developing 90 to 95 percent of the severe sleeping problems that drive parents crazy. If your baby already has sleeping problems and you think you may have come down this path, this chapter will tell you the necessary corrections you need to make to solve the sleeping problem. However, you may be too exhausted to make it through the whole chapter, so you might benefit more by reading the summary and action plan at the end of the chapter. If you have not yet had your child, this chapter will help you later identify whether your baby is just starting on this path. Reading the entire chapter will enable you to prevent future sleeping problems.
Healthy Sleep Habits, Happy Child Page 15