Become Your Child's Timekeeper:
The Morning Nap Develops at 9:00 to 10:00 A.M.
Watch the clock during the day and expect the baby to need to sleep within two hours of wakefulness. Use whatever soothing method or wind-down routine works best to comfort and calm your baby. This may include a scheduled feeding, non-nutritive (“recreational”) nursing, a session in a swing or a rocking chair, or a pacifier.
After a while you may notice a partial routine or a rough pattern of when your child's day sleep is best. Based on your child's behavior, the time of day, and how long she has been awake, you may reasonably conclude that she needs to sleep at any given time. However, she may want to play with you instead. Please try to distinguish between your child's needs and her wants. Have the confidence to be sensitive to her need to sleep and lie down with her or leave her alone a little to let her sleep. How long should you leave her alone? Maybe five, ten, or twenty minutes; there's no need for a rigid schedule. Simply test her once in a while to see whether she goes to sleep after five to twenty minutes of protest crying. If this approach fails, pick her up, soothe her, comfort her, and then either try once more to get her to go to sleep, or play with her for a while and try again later.
This lack of rigid scheduling is appropriate for children a few months old who are biologically immature. However, as the child gets older, extreme inconsistency will produce unhealthy sleep habits. Be flexible, but also become sensitive to your child's need to sleep.
When put down to sleep drowsy but awake, you are giving her the opportunity to develop self-soothing skills, to learn how to fall asleep unassisted. Some children learn this faster than others, so don't worry if your child seems always to cry up to your designated time. Perhaps she was too young; try the technique again another time.
Always going to your child when he needs to sleep robs him of sleep. Never letting your child cry might reflect confusion in your mind between the healthy notion of allowing him to be alone sometimes and your own fear that he will feel abandoned.
Here's an account from the mother of a three-month-old infant.
IT GOES AGAINST HUMAN NATURE
To leave a baby crying and not pick him up goes against human nature. However, after three days of teaching Katie to sleep and having to listen to her crying and being helpless, her hysteria was almost completely solved!
It started at just twelve weeks. Katie was so fatigued she would cry for hours, screaming completely out of control, scratching her head, pulling her ears. Holding her didn't help, so it wasn't hard not to pick her up—she screamed anyway.
Instituting a new day schedule was easy. As soon as she started getting cranky, I rushed her to her crib to sleep. She would watch her mobile, and then sleep for hours at a time. The first week, she was so tired that she only stayed up thirty to fifty minutes at a time and slept three to four hours in between. The key for me was to get her down before she got really upset.
The afternoon was when she was awake the longest, and then it was hard getting her to sleep at night. The first few nights under our new regime were the worst. Positive reinforcement from my doctor was important then. I had to hear several times that this “cure” was the best thing to do.
The first night under our new strategy, my husband lay on the floor in her room (I guess to make sure she didn't choke) while I sat crying in our living room. Finally after forty-five minutes Katie was quien Hurray! Each night she cried less and less, and I handled it better and better. After a week, her hysteria was gone! Sure, she cried a little sometimes, but now she was on a schedule. She napped two or three times a day, two to four hours at a time, and slept twelve to fifteen hours a night. Sleeping promotes more sleep, and makes it easier to fall asleep. It's a catch-22.
Writing down the sleep patterns helped, too. For one week I kept track of every time I put her down and every time I picked her up from her nap. At the end of the week I noticed a distinct pattern. She fell into it herself!
MAJOR POINTS
Letting your baby “cry it out” is not the only way your baby will learn to sleep.
Babies and children learn to sleep when parents focus on timing, motionless sleep, and consistency in soothing style.
As Katie's mother noticed, sleep begets sleep. This is a true statement. Even though it is not logical, it is biological!
Q: My three-month-old used to take very long morning naps, but now at four months, they are shorter. What happened”?
A: Between three and four months, your child went to sleep later at night, he now goes to sleep earlier, wakes up better rested in the morning, and no longer needs a very long morning nap.
Preventing and Solving Sleep Problems
Sleep periods develop as the brain matures. This means that there are times during the day and night when your baby's brain will become drowsy and less alert. These time “windows,” when the sleep process begins to overcome your baby, are the best times for him to be soothed to sleep, because it is easier to fall asleep at these times and because the restorative power of sleep is greatest when your baby's brain is in a drowsy state. Your child is able to sleep at other times, but going to sleep is more difficult and its restorative power is then much less. Unfortunately, your baby's brain may not be drowsy when you want him to sleep. You cannot control when he will become drowsy any more than you can control when he will become thirsty. As your infant's brain matures, these biologically determined periods of drowsiness will become more predictable and longer.
After your baby is born, there is a quiet and calm honeymoon during which he is very sleepy. This ends when he is a few days old, or a few days after his due date if he was born early. You may not have a honeymoon if your baby was born late! After a few days of life, the sleepy brain wakes up, and during the first six weeks of life infants display increasing amounts of fussiness, crying, or agitated wakefulness, during which they swallow air and become gassy. The duration of these periods peak and become more common in the evening hours at six weeks or six weeks after the due date. During these first six weeks, the longest single sleep period is not very long and can occur at any time; this is day/night confusion. At about six weeks of age, something dramatic occurs naturally. Your baby begins to produce social smiles, and the evening fussiness begins to decrease. One mother asked me if she could “fast-forward to six weeks” and skip the hard part. Sorry.
REMEMBER
Long night sleep periods will develop first, so you will notice longer sleeping periods at night before you will notice longer naps.
The onset of social smiles followed by a decrease in fussiness reflects maturational changes within your baby's brain. In addition, the brain becomes more able to inhibit the stimulating effects of the sights, smells, sounds, and other sensations around her. Your baby is more able to console herself—she is becoming more self-soothing. As a result of these biological changes, at six weeks of age your baby develops night sleep organization. This means that her longest single sleep period now occurs at night. This is the end of day/night confusion. This longest night-sleep period may be only four to six hours long, but it regularly occurs at night. You cannot control the exact time when this long sleep period will occur, but at least you now know that you will get a little more rest at night.
Night sleep usually develops without problems at six weeks of age because:
Darkness serves as a time cue
We slow down our activities and become quieter at night
We behave as if we expect the baby to sleep
These three factors may be absent during the day, and so the major way to prevent sleep problems from developing is to focus your efforts on helping your baby nap during the day.
There are three factors that will help your baby sleep well during the day: timing, motionless sleep, and consistency in soothing style. If you have experience because you have more than one child, start early; if you have a colicky baby, start later.
Timing
Keep the intervals of wakef
ulness short. Look at the clock when your baby wakes up in the morning or after a nap. After about one hour, begin a soothing process before your child appears grumpy, crabby, or drowsy. Usually the total duration of wakefulness plus the time of soothing should be less than two hours. This does not mean that you keep your baby awake for about two hours before trying to soothe him to sleep. The point is that young infants cannot comfortably tolerate long periods of wakefulness. In fact, some babies go to sleep after being awake for only one hour.
MAJOR POINT
Perfect timing produces no crying.
Think of surfboarding. You want to catch the wave of drowsiness as it is rising to enable your baby to have a long smooth ride to deep slumber. If your timing is off and your wave crashes into an overtired state, then the ride is bumpy and brief. If your timing is off, you have accidentally allowed your child to become overtired, then there will be some crying, which you may ignore. Crying is the consequence of becoming overtired. Think of how your baby behaves when she becomes overly hungry. She twists, turns, and may dive-bomb at the breast for a few minutes before she settles down to suck well. Similarly, the overtired baby takes a few minutes to settle down to sleep. Crying is the consequence of becoming overtired. At this particular time your efforts to soothe—hugging, rocking, talking—may be stimulating and interfere with the natural surfacing of the sleep process. After all, your baby does not fall asleep immediately in the same way a light switch is turned off. Rather, the sleep process takes time. Remember, it is easier for her to fall asleep before she becomes grumpy, because when she becomes overtired—from nap deprivation or any other reason—her body produces stimulating hormones to fight the fatigue. This chemical stimulation interferes with sleeping well. This is why sleeping well during the day will improve night sleeping and why, conversely, nap deprivation causes night waking.
One mother told me that her child had been extremely fussy/colicky, but that at twelve weeks of age, he began to slip into a better sleeping routine at night and began taking longer naps during the day between twelve and sixteen weeks of age. She was breast-feeding and used the family bed; her child went to sleep at about 10:00 P.M. around twelve weeks of age. Her two-year-old son was not sleeping well at night either and he distracted her, and this allowed the baby to become overtired, and now the naps were a mess. The baby was “napping” between 5:00 and 6:00 P.M. By sixteen weeks of age, the baby was asleep for the night between 7:00 and 8:00 P.M. She recognized that the baby should be falling asleep for the night around 6:00 P.M., not napping then. Here was the solution that eventually corrected the overtired state.
Temporarily, her baby was put to sleep at a very early time, between 5:30 and 6:00 P.M. The plan was to help the child get more rested at night. The mother was to soothe her baby at night and then either lie down with him or put him in his crib. She wanted to use the crib because the hour was so early and she had a two-year-old to deal with. Because of his age, because he had been extremely fussy/colicky, and because he had become accustomed to sleeping with his mother in her bed at the breast, we knew he would protest our plan. We decided that we would ignore his protest crying at the onset of sleep and we would use the father to soothe him at night when he might cry but was not hungry. During the day, the mother would do whatever worked to maximize sleep and minimize crying to keep him as well rested as possible. The two-year-old made this part of the plan a little difficult. Within eight days, there was substantially less crying at night, and longer and fewer naps were occurring during the day. Now that he was better rested, he was able to stay up a little later at night. However, he still needed to go to sleep between 6:00 and 6:30 P.M.
EARLY BEDTIMES
A common complaint is “We don't get to eat dinner as a family.” Or, “How can we play outside as a family after dinner?” My answer is that what is most important is a well-rested family.
Motionless Sleep
How well do you nap in a car or on a plane compared to in your bed? I think babies have better-quality, more-restorative sleep when they are sleeping in a stationary crib, bed, or bassinet. Vibrations or motion during sleep appear to force the brain to a lighter sleep state and reduce the restorative power of the nap. I explained to the mother of one child that her baby would not sleep well while she was shopping, walking in the park, or doing something active with her friends. The mother discovered that this was true, that her baby napped best at home, but she also found it very difficult to spend more time at home during the day, as she and most of her friends were outdoorsy people. On the positive side, her child no longer cried before going down for a nap.
You may wish to use a moving swing or a calm ride in the stroller or car for a few minutes as part of the soothing process, but after your baby falls asleep, drive home, turn off the swing, or stop walking with the stroller. Although your baby may appear to be in an awkward position, don't disturb him if you notice that he always wakes as you try to move him to a crib. It doesn't hurt children to sleep in their swings or car seats. Your baby might also sleep well outdoors in a stationary stroller, especially if it's a quiet neighborhood. In general, however, as the brain matures, the child's increasing curiosity and social awareness make it more difficult to have good naps outside, so be careful.
Consistency in Soothing/Sleeping-Style Naps
Parents often assume that there is a right and wrong way to soothe a baby to sleep. This is not the case. Falling asleep is simply learned behavior, a habit. Your child will learn best if you are consistent in how you soothe him to sleep for naps. Below are two popular ways to soothe a baby to sleep. Either will work as long as you are consistent.
IMPORTANT POINT
One method is not better than another; both Method A and Method B can help your child sleep well. There is no reason to be judgmental about soothing styles or brand other parents as “bad” simply because they do not agree with you. Different methods will seem more natural or more acceptable to different parents, and different methods work better for different children.
Method A: At nap time your baby sometimes soothes himself to sleep unassisted. After soothing your baby for several minutes, you always put him down to sleep whether or not he is asleep. The soothing is a winding down, a transition from active to quiet, from alert to drowsy. Soothing may include breast-or bottle-feeding. Contrary to popular belief, your child will not develop night-sleeping problems if you include breast-feeding as part of the soothing process. Also, contrary to popular belief, it is not necessary that you always put him down fully awake. The key is that you consistently spend a relatively brief period of time soothing your baby to sleep for naps. Because he is not necessarily always asleep when you put him down, he eventually learns how to soothe himself to sleep without being held. Method A may be viewed positively (creating independence, learning self-soothing skills, acquiring the capacity to be alone) or negatively (creating insecurity, neglecting or abandoning your baby, selfishness in the mother).
Method B: Your baby always begins naps with your help. You always hold and soothe your baby until she is in a deep sleep state, no matter how long it takes. You may then lie down or sit down with your baby, nap with her, or perhaps put her down only after she is in a very deep sleep state. Your child learns to associate the process of falling asleep with the feel of your breast, your breathing and heart rhythm, and your body's scent. Method B may be viewed positively (providing more security, is more natural) or negatively (creating dependence, spoiling). Contrary to popular belief, this association, in and of itself, does not automatically lead to a night-waking problem. A night-waking problem sometimes occurs when the mother indiscriminately responds to normal arousals, misinterprets them to reflect hunger, and inadvertently fragments the child's sleep. Perhaps this situation occurs more often in those mothers who choose Method B for naps.
Be decisive; choose a soothing style and be consistent. Consistency helps your baby sleep better, because the process of falling asleep is a learned behavior. Review the “Resour
ces for Soothing” on page 177. Grandparents and baby-sitters should handle your baby as you do. Sometimes grandparents are a major problem, interfering with the baby's sleep schedule. They want to come over to play with their grandchild when it is convenient for them. This is a difficult problem without a simple answer because, in addition to wanting your child to be well rested, you want to maintain family harmony. If the grandparents are the primary caregivers during the day, it may be difficult. Try to teach them how important sleep is for their grandchild.
Q: When should I start to try to establish regular naps’? When should I start to become consistent in how I soothe my baby before naps?
A: Day-sleep organization develops at twelve to sixteen weeks of age. A regularly occurring midmorning nap appears first, followed several weeks later by a regularly occurring early afternoon nap. The age when you start nap training depends on your experience and your baby's temperament.
Regardless of when you begin to start nap training, the sooner you develop a consistent approach, the easier it will be for the family. Please begin to be consistent around six weeks of age, when your child is clearly becoming more social and everyone is getting more rest at night. For babies born before their due date, these changes occur about six weeks after the due date, and that is when you start.
I encourage fathers to become as involved as possible—for example, on weekends—so that sometimes the mother breastfeeds the baby and then passes the baby to the father to be soothed to sleep. As I said, either soothing method works well, but my observation is that for well-rested babies whose parents have consistently used Method B and sometime later decide to switch to Method A, the transition is made with very little or no crying. However, the children of parents who use Method B inconsistently may never develop regular naps; they then become overtired, and when the parents switch to Method A, the overtired child cries a lot. For some parents, then, it is simply easier to be consistent using Method A.
Healthy Sleep Habits, Happy Child Page 25