PRACTICAL POINT
To help your child sleep better during natural room changes such as vacations, moves, or bringing her to your workplace, try to build an environment of familiarity by using certain cues only for sleeping:
The same bumper pads
The same music box
The same stuffed animal or blanket
A spray of perfume, used only at sleep times
The child will then learn to associate these sensations with falling asleep, and this will help reduce the disruptive effect of the novelty of any new surroundings. None of these items, however, will work in the absence of regularity and consistency of parent care.
Please don't let your guilt about being away so much during the day cause you to keep the child up too late, to reinforce night wakings for sweet nocturnal private time with your baby, or to induce nap deprivation on weekends when you cram in too many activities. And don't let household errands, chores, or nonessential social events rob you and your child of unstructured, low-intensity playtime. The most common mistake is to keep your child up past the time of tiredness; your child needs sleep just like she needs food. Don't withhold sleep any more than you would withhold food.
Home Office
Parents who work at home are closer to their children throughout the day, and some parents have a similar situation when they are able to bring their baby to their workplace. The general problem is that some parents try to schedule their child's sleep around their work. In the beginning, with a newborn baby who naturally sleeps a lot, parents sometimes have the illusion that it will be smooth going. This is especially true if you have an easy-temperament baby. Unfortunately, the ebb and flow of the baby's developing sleep rhythms cannot be molded to fit a work schedule. An exception might be made if both parents are working together and there is always one available to attend to the baby.
Let's say that you have a home office and have hired someone to assist you with the care of your baby. Please do not expect to work, care for your baby, and breast-feed on any regular schedule. Your baby can smell you; she will know you are there! When she is hungry and wants to be fed, even though she might not see you, she senses your presence and expects you to feed her—now, not later. If you decided to feed formula instead of breast milk, then others will be able to help out more with the feedings. Expect to make lots of compromises between your needs, the baby's needs, and the expectations of the person helping you care for your child.
One thing you can do to make it easier is to start early to respect your child's need to sleep, and be very careful to avoid the overtired state. Starting as soon as you come home from the hospital is the best. The reason for starting early is that a well-rested baby is more adaptable to schedule changes that might occur when you try to coordinate baby care and working in your home office. Second, if you are breast-feeding, introduce a single bottle per day of expressed breast milk or formula at about two weeks of age. It does not have to be at the same time each day. If you do this, your baby will be able to take a bottle. If you wait a longer time to introduce a bottle, your baby may decide that he will take only the breast, and you lose some flexibility. The single bottle will not confuse your baby or cause weaning to occur.
Here is one mother's account of how starting a bottle early and establishing a schedule really helps.
“MOMMY WORKS AT HOME”
In some ways, working from home proved to be much more challenging that I had expected. The hardest part of being at home was hearing my new baby cry and realizing that my caregiver was unable to quiet her as quickly as I could. The urge to go to Katherine was incredibly strong, and many times I had to force myself to stay at my desk and allow the caregiver to find her own way of comforting the baby. While I knew intellectually that she needed to bond with Katherine, it was very hard to fight the maternal instinct.
I also found that the noise a two-year-old makes carries quite easily up two flights of stairs and through two closed doors! My oldest child, Caroline, became an unexpected participant this way on many phone calls with my clients and coworkers. I quickly learned to plan important phone calls around nap times, or go into the office on busy days to avoid the distraction.
It's not easy being a parent; it's harder when you have to work outside the home. The home office option is not available to everyone, but with planning and an attitude of flexibility and willingness to compromise, many mothers and fathers find the rewards are more than worth the effort.
Even when children outgrow naps, the home office is a possibility. Charlie's mother describes the lifestyle of a parent who works out of her home.
NEW ARRANGEMENT
I've had a home office for five years, ever since my son Charlie was born. Before Charlie entered our lives, I had a fast-paced job at a public relations agency, which I thoroughly enjoyed. But as my maternity leave progressed, I lost my appetite for going back to the grueling hours that were expected at the office. What kind of time or energy would be left for my son? Not surprisingly, the agency didn't have much sympathy for my point of view. I was lucky, however, because my biggest client suggested I work for them from home, and they were willing to accept a part-time arrangement. I know full well how fortunate I am; in fact, I wish I had a nickel for every person who has told me that I have the best of both worlds.
From my perspective as a home-office veteran, there are many, many benefits. For example, working from home allowed me to nurse my son for thirteen months. A home office setup also makes it much easier to establish good sleeping habits for your child. First, you have more opportunity to get tuned in to your baby's need for sleep, especially during that first year. When he gets tired, you're able to pick up signals—which can be subtle—and you can put him down before he gets overtired. It used to amaze me how much sleep my son needed once he got past that newborn, semi-colicky period; a couple of hours awake, and then it was back to bed. He took three naps a day until he was nine months old.
I sympathize with parents who don't get home from work until 6:00 P.M. and then, quite naturally, want to spend time with their children. Early bedtimes have to be tough. But if you're already home, you can give your child dinner at a reasonable hour and get him to bed when he's ready to sleep, not when it's convenient for you. When our son was going through the transition period from two naps to one, he needed to go to sleep by 6:30 P.M. at the latest. Instead of all of us gobbling down our food, I gave Charlie an early dinner, and when my husband got home, he would give him a bath. My husband and I would eat later in peace and quiet. This was only a temporary period, and in a few months, we were back to eating dinner as a family again, which we felt was important.
For most of the time that I've had a home office, I've had a baby-sitter come in two or three days a week. On the days that she's off, I'm on my own. I used to relish nap time because I could get so much accomplished. When Charlie was taking two naps, I would have uninterrupted blocks of one to two hours, both in the morning and in the afternoon. A friend of mine used to warn me darkly that this two-naps-a-day stuff wouldn't last, and, of course, it didn't. But I've also discovered a side benefit to working at home, which is that you tend to become very productive. No meetings, no interruptions from colleagues, no hanging out in the break room. When I am in my office, I work.
I routinely work at night, after Charlie goes to bed. He is asleep by 7:30 P.M., which pretty much leaves the whole evening. That's another benefit of early bedtimes! Sometimes I have to work very late to make a deadline, and then I'm tired the next day, but I'm willing to pay this price.
Home offices are not a perfect arrangement. You miss out on the office gossip, so you have to make an effort to stay connected. Another problem is that things come up unexpectedly, and I have to scramble if my baby-sitter isn't here. Yet the best thing about a home office is the flexibility. I used to think that I'd probably go back to work when Charlie got a little older, but now I'm not so sure. I like being able to participate in his school activities, and I like being here when he gets
home. My home office represents freedom, and I can't imagine trading that in, even for a regular paycheck.
Some parents try to set up a mini-nursery or nest in their offices or stores for their babies to sleep. The truth is that it is difficult to answer phones or do business with clients at the same time your baby needs your attention. Perhaps for a few months, your child might seem to fit in, but it will become increasingly more difficult as he becomes more social, more alert, and more needy for your attention. Again, an exception might be when both parents are working together, so that one is always available for the baby.
Dual-Career Families
When both parents are working outside the home, the major problem is that the child tends to be put to sleep too late. Sometimes this occurs because, by the time the child is picked up from day care and brought home, it is already past the child's biological time for night sleep to start. Occasionally this is further complicated by the day-care facility not being able to maintain a routine and environment conducive to good-quality day sleep. At other times, both parents return home late from work and they naturally want to play with their child before feeding, bathing, and bedtime.
If the child goes to sleep past the time of biological sleep onset, then the child gradually becomes overtired. If the child is young, naps might be extra long in order to partially compensate for going to bed too late. Later, the older child begins to outgrow naps, and then the problems associated with the too-late bedtime begin to develop. But research has clearly shown that even with a fixed amount of sleep deficit, the child's irritability, fussiness, and short temper do not stay fixed; rather, they increase. Everything gets worse, but this process may develop very slowly. Eventually bedtime battles and night waking emerge, perhaps for the first time. Many parents assume that there is some other problem, such as teething pain, separation anxiety, insecurity from the mother returning to work, the “terrible twos,” nightmares, or the stress of a move or new sibling. Parents often do not see that the child has simply, slowly become overtired because several months before, the bedtime was allowed to become later.
MAJOR POINT
Constant sleep deficits cause increasing amounts of impaired functioning during wakefulness.
Q: When should my child go to sleep at night?
A: Before she becomes overtired.
If you think your child might be overtired in the late afternoon or early in the evening, try putting her to sleep twenty minutes earlier than is your current custom. If she falls asleep at this earlier time, then you will know that you have been putting her to bed too late. After several days, consider moving her bedtime another twenty minutes earlier if she still looks overtired. Remember, the way your child behaves or appears to you is more important than any recommended sleep duration or bedtime for “average children.”
The most common inhibiting fear in putting your child to bed early are that he will start the day too early and he will love you less because you are spending less time with him. Not true! Because sleep begets sleep, if your child becomes better rested, he will be better able to fall asleep and stay asleep. He will not get up earlier and earlier because of an earlier bedtime. You will prevent or correct bedtime battles and night waking for attention. Naps will tend to become longer and more regular if your child goes to bed earlier. One common scenario is that because of a too-late bedtime, the child takes a too-long morning nap, which causes him to be extremely tired by 4:00 or 5:00 P.M. A temporarily very early bedtime will often shorten the morning nap so that the child is able to take a restorative afternoon nap between noon and 2:00 P.M. and subsequently be able to stay up a little later.
REMEMBER
Sleep begets sleep. It's not logical that earlier bedtimes allow children to sleep in later in the morning, it's biological.
Q: I miss my baby so much during the day, why can't I spend more time with her at night? The only time I have to love my baby is late at night. Won't she miss me?
A: If she becomes overtired, her company will not be much fun. She will not enjoy or benefit as much from your social interaction because both of you will become increasingly fatigued. Her evolving bedtime battles and night waking will eventually produce an overtired family. At the price of seeing her less at night, she will stay better rested, more charming, more sweet, and you will mutually enjoy each other's company more in the morning and on the weekends.
Sometimes parents have to allow the sitter or the parent who comes home early to bathe, feed, and dress the child for bed; immediately after the arrival of the parent who comes home late, the child is quietly soothed to sleep. With our busy lifestyles, it may be difficult to coordinate a work schedule with a child's biological needs. If this is the case for you, your baby's needs must come first. You would not withhold food when the body needs it because it is inconvenient to feed your child, and you try to anticipate when your child will become hungry in order to feed her before she becomes overly hungry. Similarly, try not to withhold sleep when the brain needs it, and try to anticipate when your child will become tired before she becomes overtired.
Occasionally it happens that, during the week, a sitter or day-care center is protecting and maintaining naps, but on weekends everything falls apart. Dual-career families might try to do too much playing with their children on weekends to compensate for being with them less during the week, or they may simply not respect the child's need to nap because there are so many errands that have to be done. Either way, these children are often so overtired that they appear to be in pain. Every pediatrician gets some of these calls Sunday night or Monday morning because the parents often believe there is a painful ear infection. Severe sleep inertia can cause a child to awaken from a nap, which might be extra long, and scream as if in severe pain. Also, night terrors are often more common when children become severely overtired. On busy weekends, you should not feed your baby on the run; you need to find a quiet time to feed. Same thing for naps; don't nap on the run.
Adoption
Infants’ sleep patterns are influenced by powerful biological or genetic forces when they are very young, but as they become older, their sleep patterns begin to reflect more of the social circumstances of their family and their culture. The child's biological sleep needs may or may not be met by their experiences. The following story illustrates how experienced parents were able to help their new child learn to sleep better, even though she hadn't slept well for nine months.
“WITHIN ABOUT A WEEK OR SO, SHE
WAS ON A REASONABLE SCHEDULE”
With our son, we had followed Dr. Weissbluth's method since the get-go, and Charlie developed excellent sleep habits. As a kindergartner, he's no longer napping, but per Dr. Weissbluth, it's lights off by 7:30 P.M., and he's happy as a clam. As an infant and a toddler, Charlie very much needed consistent nap times and an early bedtime. Without that structure, he tended to fall apart. There was absolutely no question that Carina, our adopted daughter, would follow the “Weissbluth method,” too. She just didn't know it yet. As it turned out, there was plenty we didn't know yet either.
The big moment finally arrived, and we met Carina. (No, I didn't fall in love immediately.) At the time, she was nine and a half months—old enough to be wary of strangers, which is what Bill and I were. She clearly preferred her foster family, as we had anticipated and understood. They got to the hotel about an hour and a half later than originally planned, and I naively asked if they were late because she was napping. Well, no, that wasn't the reason; in fact, she hadn't had a nap that day.
We arrived back home late that night, and for the first time in her short life, Carina slept in a crib. She cried for a little while, but she managed to sleep pretty well, probably out of sheer exhaustion. The next day was a blur. We called Dr. Weissbluth, who arranged for Carina to have a battery of tests performed right away at Children's Hospital. Blood and stool tests are typically recommended for international adoptions, and we were concerned about the parasite issue. The good news is that she turned out
to be perfectly healthy, and the lab could find no signs of parasites.
The next day we paid a visit to Dr. Weissbluth's office, and he advised us how to get Carina on schedule. Put her down at 9:00 A.M. for a morning nap, he said. Ideally, she should sleep an hour and a half. If she cries, pick her up after an hour. After lunch, try again. Put her down at 1:00 P.M., and if all goes well, she'll sleep until 2:30 P.M. If not, don't let her cry more than an hour. Bedtime should be between 6:00 and 7:00 P.M.
That sounds pretty simple. It wasn't. Carina didn't like her crib, she didn't like her room; she just didn't want to be alone. And she let us know it—vociferously. The trick was keeping her awake until bedtime. I'd learned from Charlie that those little catnaps can wreak havoc with sleep schedules.
Then, once Carina went to bed, there was no guarantee she would stay asleep. Bill and I were so tired and so tense, and we kept asking each other if one of us should go back into her room. But we honestly didn't think it would help, and besides, Dr. Weissbluth had said to leave her alone. She finally stopped crying at about 2:45 A.M.
The next night was much better, and believe it or not, within about a week or so, she was on a reasonable schedule. It wasn't perfect. Sometimes she would take a good morning nap, and then her afternoon nap would be restless. Sometimes she would wake up in the middle of the night. But as time went on, her sleep rhythms seemed to consolidate, and she became much more predictable.
We thought all our problems were solved until we went through a period where she was waking up in the middle of the night. I was convinced that she was missing her foster father and that she was grieving for everything she had left behind in Guatemala. I felt so tormented by this that I went into her room and snuggled with her. This did not help at all. In fact, one night after I had supposedly soothed her, she cried for two more hours. I gave up on sleep and went downstairs to cut out coupons from the Sunday paper.
Healthy Sleep Habits, Happy Child Page 44