The most common problem with this second nap is that the interval of wakefulness following the first nap is too long. This causes your baby to become overtired, and he has difficulty either falling asleep or staying asleep. If you are using Method A, please leave your baby completely alone for one hour after soothing to see if he will fall asleep. If the duration of crying and sleeping associated with the early afternoon nap puts you way past 2:00 or 3:00 P.M., forget this nap and try to get your child to sleep in the late afternoon or early evening. If it is early, say around 4:00 P.M., limit this nap to about one and a half hours to protect a reasonably early bedtime. If it is later, say around 5:00 P.M., let your child sleep, because this “nap” may simply continue into the night and it's important to maintain an early bedtime hour.
IMPORTANT POINT
This afternoon nap commonly continues until the third birthday, but after age three, it begins to drop out.
Nap #3: Late Afternoon: 16 Percent of Babies Have Three Naps
The third nap may or may not occur. If it does occur, the time when it starts may vary between 3:00 and 5:00 P.M. Also, the duration of this nap may vary, but it is usually very brief. This nap disappears by about nine months of age. A problem with allowing this third nap to continue much past this age is that the child is unable to fall asleep in the early evening, and bedtime battles may emerge around nine to twelve months of age because the bedtime is too late. In order to go to an earlier bedtime, eliminate the third nap. The earlier bedtime then abolishes the tiredness that had made the third nap necessary. Early bedtimes are especially difficult in families where both parents work outside the home, but, as will be discussed later, the entire family benefits.
PRACTICAL
POINT
Never wake a sleeping baby except when you are trying to protect a sleep schedule.
Afternoon Wakeful Time
If there is no third nap, this is the time to go on longer excursions, errands, or shopping trips. Exercise classes and outings to the park may be fun during this wakeful period. Many parents will give their baby solid foods in the late afternoon.
Nap Duration
Q: How long should my child nap?
A: Ask yourself this question: Does your child appear tired?
If your baby is tired in the late afternoon or early in the evening, this might indicate insufficient naps. A possible solution is simply to put your child to bed earlier at night. Keeping a baby up too late produces fatigue and sleep deprivation, and will ultimately lead the child to resist falling asleep or to wake at night. This may be a problem, especially when a working parent or parents arrive home late, feeling guilty about being away from the family so long. As I mentioned above, after about six to nine months of age it is not a good idea to encourage a third, brief nap in the early evening just so the child can stay up later. This leads to an abnormal sleep schedule, and the result is the equivalent of sleep deprivation.
Bedtime
Remember, you are establishing an orderly home routine and enforcing a bedtime hour. You are not forcing your child to sleep. When your child seems tired and needs to sleep, you will establish his bedtime routine, whether he likes it or not. The bedtime routine should be regular in terms of what you do: bathing, massage, story, lullaby, rocking, or other soothing efforts. Approximately the same sequence each night helps signal to the child that it is the time for night sleep at approximately the same time. But don't be rigidly regular in terms of when you do it; there is enough normal irregularity in napping to produce some variability in bedtime. In much older children, extreme variability in bedtimes has been shown to be unhealthy.
PRACTICAL POINT
A parent who keeps a baby up past his natural time to sleep may be using this play time with the child to avoid unpleasant private time with the other parent.
Some parents make the mistake of always putting their baby down to sleep at exactly 7:00 P.M. For a few months this may work well, but when naps are irregular or the child stops taking the third nap, parents should learn to be more flexible in the timing of soothing to sleep at night, especially in the direction of an earlier bedtime!
Method A and Method B apply only to naps. At night, adopt whatever style seems comfortable to you. For example, at nap time, you may wish to put your baby down awake after soothing, and at night you may prefer to sleep with your baby. No problem. It appears that different parts of the brain are responsible for day and night sleep, so simply be consistent both in how you soothe to sleep for daytime naps and how you soothe to sleep at night, even if the two routines are different. You are “training” different parts of the brain at different times.
If it is your desire to put your baby down for the night after soothing and he is overtired, then there will be some crying. During the day, limiting the amount of crying to one hour in the hope of getting a nap at a time that will not mess up the rest of the schedule is reasonable, but at night, the crying that occurs as you put your child down should not be time-limited. Otherwise you train him to cry to your predetermined time limit. If you do not check on your baby, he will eventually fall asleep. He may cry more the second night, but each subsequent night he will cry less. This assumes that the bedtime is early, naps are in place, and night sleep is not fragmented.
This may be the first time you will ignore your child's protests, but it certainly will not be the last time. At some future point you will teach other health habits such as hand washing or tooth brushing. As he becomes mobile you will protect his physical safety by not allowing unreasonable risks involving playground equipment. Later still, you're not going to risk brain damage by letting him ride his bike without a helmet. In each of these cases, you won't let protest crying discourage you from implementing healthy practices and safety rules. Starting early and being consistent are the keys to establishing good habits.
Now is the time to let him learn to fall asleep at night by himself, to return to sleep at night by himself, and to learn that being alone at night in slumber is not scary, dangerous, or something to avoid. Keep everything calm and not too complicated as you go through a bedtime ritual. Fathers should be involved, especially if the child is breast-fed, because babies know dads cannot nurse them and so any protest crying is likely to be less intense or shorter.
Once your child is in bed, he is there to stay, no matter how long he cries, if you are using the Extinction method. Please do not return until your baby falls asleep. Little peaks or replacing pacifiers may be harmless when he is four months old, but they will eventually sabotage your efforts to help your child sleep well because intermittent positive reinforcement has enormous teaching power. Remember:
When the duration of protest crying at night is open-ended, not limited, learning to fall asleep unassisted takes place.
When you put a time limit on how much protest crying at night you can tolerate or accept before going to the baby, you teach the baby to cry to that time limit.
HELPFUL SUGGESTION
When your child is crying and she is not hungry, say to yourself: “My baby is crying because she loves me so much she wants my company, but she needs to sleep. I know the value of good sleep, and I love my baby so much that I am going to let her sleep.”
Night Wakings for Feeding
Your child may wake to be fed four to six hours after his last feeding. Some children do not get up then. Others are actually hungry at this time, and you should promptly respond by feeding.
You may say, “But when my baby was younger, he slept through the night.” Remember, in a child under four months, the bedtime was much later and the last feeding at night was much later. Now your baby is going to bed earlier, is fed earlier in the evening, and may need a night feeding; this is normal. This night feeding, and a second night feeding, may be needed until the baby is about nine months of age.
As you may recall, partial awakenings or light sleep stages, called arousals, occur every one to two hours when your child is asleep. Sometimes your child will call out or cr
y during these arousals. If your child is not sleeping with you in your bed, going in to him at the time of these partial awakenings will eventually lead to a night-waking or night-feeding habit. This is because picking up, holding, and feeding your baby will eventually cause him to force himself to a more alert state during these arousals for the pleasure of your company. He will learn to expect to be fed or played with at every arousal.
However, if you are sleeping with your baby and breastfeeding, you might promptly nurse at all of these arousals while you and the baby are still in a somewhat deeper sleep state, and then there is no real sleep fragmentation. No night-waking habit might develop.
Parents should not project their own emotions or misinterpret these naturally occurring arousals as signifying loneliness, fear of the dark, or fear of abandonment.
If your baby wakes at night and behaves as if she is hungry, feed her. If your baby appears to want to play at night, stop going to her. At night, the question is “Does my baby need me or want me?”
A second waking for feeding may occur around 4:00 or 5:00 A.M. Some children do not get up at this time, but those children who do awaken are wet, soiled, or hungry, and a prompt response is appropriate. While you attend to your baby's needs, maintain silence and darkness so your child will return to sleep. A common mistake is to quietly play with your child, preventing the return to sleep. The return to sleep is important so your child will be able to comfortably stay up in the morning until the time of the first nap. Although many children do not need to be fed twice at night, others simply get up at 2:00 or 3:00 A.M. or not at all. A common mistake is to feed around midnight, 2:00 A.M., and again around 4:00 or 5:00 A.M. Please do not respond at the 2:00 A.M. time; the baby is not hungry then.
Summary: Your Baby at Five to Eight Months
In this age range, many babies accept naps without protest and fall asleep at night without difficulty. These easy babies may still awaken once or twice in the middle of the night. I consider this behavior normal, natural, and not changeworthy—if it's for a brief feeding and not prolonged playtime.
Choose the one or two times when you'll go to feed your baby and change diapers, and don't go at any other time. Please review the earlier discussion on arousals (Chapter 2) if you are puzzled as to why babies sometimes get up or call out frequently throughout the night. If you have an intercom or baby monitor that allows you to hear all the quiet cries or sounds that occur during the arousals, turn it off. All you are accomplishing by listening to your child's awakenings is messing up your own sleep. A mother's sleeping brain is so sensitive to her baby's crying that any loud, urgent call will awaken her. You do not need an amplification system to ruin your sleep over every little quiet sound your baby makes!
Most mothers will partially synchronize feedings to sleep patterns so that the child is fed around the time he gets up in the morning, around the time of (before or after) the two naps, around bedtime, and one or twice at night. In other words, bottle-feedings or breast-feedings now occur four to five times per twenty-four hours. Frequent sips, snacks, or little feedings throughout the day are not necessary.
Gradually your child will begin to associate certain behaviors on your part, certain times of the day, his crib, and his sensation of tiredness with the process of falling asleep. This learning process, when started at about three or four months of age, usually takes only about three days in a fairly well-rested baby, or a little longer in an older or overtired baby.
Stranger wariness or stranger anxiety may be present in some babies by about six to nine months of age, and with this new behavior, some mothers note some separation anxiety—that is, the child shows distress when the mother leaves. I do not think this type of separation anxiety directly makes it more difficult for a child to fall asleep unassisted. I have observed that babies with separation anxiety learn to sleep well as rapidly as any other babies when their mothers leave them alone at sleep times. The problem is that some mothers also suffer from the thought of separation and will not leave their children alone enough at sleep times to allow healthy sleep habits to develop. (This will be discussed further in Chapter 12.)
REMEMBER
Watch your baby more than your watch.
A major problem in implementing an age-appropriate sleep schedule is that it is inconvenient. Many parents resent the fact that their babies are now less portable. It is inconvenient to change their lifestyle to be at home twice a day so that the baby can nap. But when parents initially suffer through the process of establishing a good sleep schedule and their child is well rested, occasional irregularities and special occasions that disrupt sleep usually produce only minor and transient disturbed sleep. The recovery time is brief and the child responds to a prompt reestablishment of the routine.
Bluntly put, when parents are unwilling to alter their lifestyle so that regular naps are never well maintained or the bedtime is a little too late, then the child always pays a price. The child's mood and learning suffer, and recovery time following outings or illness takes much longer. These parents often try many “helpful hints” to help their child sleep better. I'm not sure any or all of these hints can ever substitute for maintaining regular sleep schedules. Parents in my practice who have utilized regular sleep schedules have rarely, if ever, found these hints to be useful.
BUREAU OF “HELPFUL” HINTS OF DUBIOUS
VALUE TO SOOTHE BABY TO SLEEP
Lambskins
Heartbeat sounds
Womb sounds
Continuous background noises
Elevating head of crib
Maintaining motion sleep in swings
Changing formulas or eliminating iron supplement
Changing diet of nursing mother
Feeding solids only at bedtime
PRACTICAL POINT
You are harming your child when you allow unhealthy sleep patterns to evolve or persist—sleep deprivation is as unhealthy as feeding a nutritionally deficient diet.
Babies seem to respond quickly at this age to a somewhat scheduled, structured approach to sleep. If you can learn to detach yourself from your baby's protests and not respond reflexively by rushing in to her at the slightest whimper, she will learn to fall asleep by herself. As one mother said of her child, “She now goes down like warm butter on toast!”
Month Nine:
Late Afternoon Nap Disappears.
No More Bottle-feeding at Night
Strong-willed, willful, independent-minded, stubborn, headstrong, uncooperative. Sound familiar? These are the words parents often use to describe their toddlers. You may observe that your child is simply less cooperative. A psychologist might use the term noncompliance to describe this lack of cooperation, but the psychologist would also point out that these behaviors go hand in hand with the normal, healthy evolution of the child's autonomy or sense of independence. All infants can now express what they do and do not want with greater energy than previously. It is harder for you to distract your child. This increased ability to express intentional behavior may be described as persistence, drive, or determination. A child's expressing her own likes and dislikes may be called “self-agency,” which becomes stronger over time.
Usually, the experts tell us, the times when you should expect the most difficulties, or “oppositional behaviors,” are at dressing, during mealtimes, in public places, and at bedtime. Since this is the beginning of the “stage” of autonomy (and noncompliance), some experts claim that it is natural for this independence/stubbornness to cause either resistance in going to sleep or night waking. I will explain later why I think this “stage” theory is an incorrect interpretation.
Children in this age range also often develop behaviors described as social hesitation, shyness, or fear of strangers. A child also might cry or appear distressed when his mother leaves him alone in one room while she goes to another room or when she leaves the child with a baby-sitter. Psychologists call this behavior stranger wariness, stranger anxiety, or separation anxiety. So if
a child developed increased resistance in going to sleep at night at this stage, some experts might say that separation anxiety, or fear of being apart or away from the mother, was the cause. I think this is an incorrect interpretation also.
The major sleep change that occurs around nine months is the disappearance of the third nap. If the late-afternoon nap persists, it often causes the bedtime to become too late. Also, children who are bottle-fed after nine months of age are likely to develop a night-waking or night-feeding habit. If your baby goes right back to sleep after a feeding, then do not stop the feedings. But if he decides to play with you and does not easily and quickly return to sleep after the feeding, then stop going to him at night. Again, if you are breast-feeding in the family bed, no night-waking habit might develop.
Months Ten to Twelve: Morning Nap Starts
to Disappear but Mostly Two Naps
A small percent (17 percent) of babies are now taking only one afternoon nap. Often the bedtime now has to be twenty or thirty minutes earlier because they tend to get more tired near the end of the day. Sometimes it is the afternoon nap that starts to disappear because the morning nap is too long. In this case, move the bedtime much earlier and/or wake your child after an hour or an hour and a half into the morning nap in order to protect the afternoon nap.
Healthy Sleep Habits, Happy Child Page 28