What's The Protocol That Leads To An...
ChatterBank9 mins ago
sleeping
Posted a question last week reference my 2 yr old not sleeping through! Went out on thursday before she went bed so babysitter stuck to my routine! AND SHE SLEPT THROUGH! It must be just me what else can i try. The sticker chart is not too good as they don't interest her and the doctor suggests a child sleeping pill which i don't really like the idea of that any more suggestions???? Thanks 4 your help!
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hello. I'm a health visitor. I'm going to copy and paste the information sheet that I give to parents who have a child with a sleeping difficulty. Theres a lot ...so read on..!
SLEEPING DIFFICULTIES IN BABIES/CHILDREN
� Babies and children who don�t sleep well can be the cause of great unhappiness to their parents. Sleep deprivation, as any well practiced torturer will tell you, is a sure method of breaking your spirit, determination and ability to think clearly.
� In order to understand your childs sleep problem, you have to have a degree of understanding about sleep
� Sleep is not one consistent state of unconsciousness, it is a cycle of deep, light and dream sleep, broken up with regular brief periods of partial wakening. Sleep studies back this up, showing a different electrical brainwave pattern for each stage. First we drift off to sleep, then hit the deepest part of sleep, we dream for a while, the come to a lighter state of sleep, before coming back to being briefly awake, when we stretch, pick our pillow up off the floor where it has fallen, turn over, and drift back off to sleep, for a re-run of the cycle. We hardly remember that we have even been awake at all, but when we are experiencing these periods of being partially awake, our brains are actually assessing our environment, and checking that we are safe, and that things are as they should be. This is a physical remnant of our caveman ancestors, who even during sleep would have to regularly check that they were safe from the saber toothed tiger that lurked around for its dinner.
� The electrical tracings of sleep indicate that the average new-born has a sleep cycle of just under 1 hour, a toddler about an hour, whilst we adults go about 1 and a half hours, between partial awakenings.
� One study recorded children with a video camera as they slept in their homes. The parents of the children studied believed that their little ones were sleeping soundly right through the night, but the recordings showed otherwise. It appeared that even apparently good sleepers may wake a number of times to sit up, look around, play with heir toys, kick off their covers, then perhaps have a quiet grizzle before slipping back off to sleep. We have to accept that all humans will wake regularly each night, but we do not have to accept that human children should disturb their parents when they do wake.
� As adults, we surface regularly to hear the window rattle, notice that it is still dark, or that the clock says one minute past three. Our brains register this, and then we turn over and zzzzzzzzzzzzzz. We don�t wake our partner and say, �Hey, its one minute past three, How about getting me a drink?� The same must apply to children. They can kick, grumble, and make some noise, but they cannot expect you to share in their nocturnal activities. Waking should be discouraged, not encouraged, but we often get this back to front by what we do when our children wake up in the night.
� Think for a moment from the toddlers� point of view. You are 16 months of age, you dream, then go into a light sleep, and as you start to become partially awake, you stretch and grunt. A minute later as you open your eyes, there out of the darkness a breast or a bottle approaches. That�s great, thanks Mum, then zzzzzzzzzzz, down once more to the deep sleep. An hour later, once again, you come to the surface, make a bit of fuss, and, hey presto, here�s mum again with that feed. What the child learns is that if they grunt or make any kind of fuss in the night, they get a nice comforting feed. Yummy! It is like �genie of the lamp�! If Mum can do this, and still feel rested, that�s fine. If not, you have a problem.
� As adults, we surface regularly to hear the window rattle, notice that it is still dark, or that the clock says one minute past three. Our brains register this, and then we turn over and zzzzzzzzzzzzzz. We don�t wake our partner and say, �Hey, its one minute past three, How about getting me a drink?� The same must apply to children. They can kick, grumble, and make some noise, but they cannot expect you to share in their nocturnal activities. Waking should be discouraged, not encouraged, but we often get this back to front by what we do when our children wake up in the night.
� Think for a moment from the toddlers� point of view. You are 16 months of age, you dream, then go into a light sleep, and as you start to become partially awake, you stretch and grunt. A minute later as you open your eyes, there out of the darkness a breast or a bottle approaches. That�s great, thanks Mum, then zzzzzzzzzzz, down once more to the deep sleep. An hour later, once again, you come to the surface, make a bit of fuss, and, hey presto, here�s mum again with that feed. What the child learns is that if they grunt or make any kind of fuss in the night, they get a nice comforting feed. Yummy! It is like �genie of the lamp�! If Mum can do this, and still feel rested, that�s fine. If not, you have a problem.
There is no reason why a baby of over 16 weeks would need to wake during the night for a feed. A child who is fit and well, and eating normally and gaining weight as anticipated, does not need nutritional supplements during the night.
� It is normal for children to wake briefly in the night, but they should be encouraged by your behaviour, to learn to settle themselves back off to sleep.
� If you are an exhausted reader, with a sleepless child, relief is now in sight. The method of sleep training that follows offers a 90% chance of cure within one week.
� Consider and think about this......
Everybody has a bedtime routine. They make take a bath, read a book, have a warm drink. Things that �settle you down�. Things that make you feel comfortable and secure. Things that you associate with getting ready to go to sleep, preparing the brain for rest.
Imagine that following your regular bedtime routine, you go to bed one night, and you fall asleep. An hour or so later, when you are �partially awake�, you open your eyes and notice that you are actually on the sofa in the living room! Weird! Your brain would register this change in environment, and make you become even more awake to investigate how and why you�re on the sofa. You would probably feel puzzled and slightly anxious about this. Your brain has recognised that something is wrong, and has made you wake up to deal with it. So translate this experience to what might happen to a child. A child is put in the cot already asleep, (as they have been rocked to sleep in their mothers arms, or fall to sleep during their last feed). When they experience a �partial wakening� during the night, their brain expects that they will still be in exactly the same circumstances as when they fell to sleep in the first place, i.e., their mothers arms, or on the sofa.
� It is normal for children to wake briefly in the night, but they should be encouraged by your behaviour, to learn to settle themselves back off to sleep.
� If you are an exhausted reader, with a sleepless child, relief is now in sight. The method of sleep training that follows offers a 90% chance of cure within one week.
� Consider and think about this......
Everybody has a bedtime routine. They make take a bath, read a book, have a warm drink. Things that �settle you down�. Things that make you feel comfortable and secure. Things that you associate with getting ready to go to sleep, preparing the brain for rest.
Imagine that following your regular bedtime routine, you go to bed one night, and you fall asleep. An hour or so later, when you are �partially awake�, you open your eyes and notice that you are actually on the sofa in the living room! Weird! Your brain would register this change in environment, and make you become even more awake to investigate how and why you�re on the sofa. You would probably feel puzzled and slightly anxious about this. Your brain has recognised that something is wrong, and has made you wake up to deal with it. So translate this experience to what might happen to a child. A child is put in the cot already asleep, (as they have been rocked to sleep in their mothers arms, or fall to sleep during their last feed). When they experience a �partial wakening� during the night, their brain expects that they will still be in exactly the same circumstances as when they fell to sleep in the first place, i.e., their mothers arms, or on the sofa.
They become fully awake and agitated as they realise that something has changed, and then demand the same circumstances, the same bedtime routine of being held or fed, or cuddled or comforted, be repeated in order to get back to sleep! This is why it is important that a baby/child is allowed to go to bed awake, in order to fall asleep in exactly the same circumstances they will find themselves in when they become partially awake some time later, i.e., on their own, in a dark, warm and quiet room.
� No two studies have ever shown the same incidence of sleep problems, but a few figures are shown below that give some insight into how other peoples children behave at night.
The Chamberlin study in New York found that...
70% of 2-year-olds, 46 % of 3-year-olds, and 56% of 4-year-olds regularly resist going to bed at night.
52% of 2-year-olds, 52% of 3-year-olds, and 56% of 4-year-olds regularly wake up during the night.
17% of 2-year-olds, 18% of 3-year-olds, and 36% of 4-year-olds regularly have nightmares.
A study in the UK found that....
37% of 2-year-olds living with their parents were waking up at night.
3% of 2-year-olds who lived in a residential nursery were waking at night.
� No two studies have ever shown the same incidence of sleep problems, but a few figures are shown below that give some insight into how other peoples children behave at night.
The Chamberlin study in New York found that...
70% of 2-year-olds, 46 % of 3-year-olds, and 56% of 4-year-olds regularly resist going to bed at night.
52% of 2-year-olds, 52% of 3-year-olds, and 56% of 4-year-olds regularly wake up during the night.
17% of 2-year-olds, 18% of 3-year-olds, and 36% of 4-year-olds regularly have nightmares.
A study in the UK found that....
37% of 2-year-olds living with their parents were waking up at night.
3% of 2-year-olds who lived in a residential nursery were waking at night.
� This lends weight to the belief that the more readily available the comfort is at night, the worse the sleep pattern of the child. Certainly, when a child enters a period of semi-wakefulness, he is more likely to roll over and go back to sleep if he realises, from past experience, that crying and fussing does not bring rapid Grade A attention.
When is waking at night a sleep problem?
What appears to one family to be a massive sleep problem may not concern the next. The problem is, therefore, only really a problem if parental well-being and happiness are affected..
A child who wakes up 4 or more times a night may not necessarily have the worst sleep problems. He may merely wake, cry briefly, and go straight back to sleep after some reassuring words from his mum or dad, and the parents may return to sleep within seconds with no real problem occurring.
Another child may only wake once or twice in the night, but each wakening may be followed by considerable difficulties before returning to sleep. By the time the parents have paced the floor, and bounced the child up and down, the child may be fast asleep again, but the parents are wide awake, wound up and incapable of further sleep.
Its not the number of times that a child wakes at night that constitutes a problem, but the effect this disturbance has on the parents.
When is waking at night a sleep problem?
What appears to one family to be a massive sleep problem may not concern the next. The problem is, therefore, only really a problem if parental well-being and happiness are affected..
A child who wakes up 4 or more times a night may not necessarily have the worst sleep problems. He may merely wake, cry briefly, and go straight back to sleep after some reassuring words from his mum or dad, and the parents may return to sleep within seconds with no real problem occurring.
Another child may only wake once or twice in the night, but each wakening may be followed by considerable difficulties before returning to sleep. By the time the parents have paced the floor, and bounced the child up and down, the child may be fast asleep again, but the parents are wide awake, wound up and incapable of further sleep.
Its not the number of times that a child wakes at night that constitutes a problem, but the effect this disturbance has on the parents.
Exactly who suffers?
It is not just parents who suffer the effect of sleepless nights. The shockwaves are felt by all around. They influence the mother, father, brothers and sisters, the neighbours, and most of all, the child with the problem.
Parents
Mothers who have not had enough sleep tend to be tired, irritable, and less patient. As a result, their ability to look after their children both by day and by night, may be affected. Many get so tired that life with a child is viewed as a form of penance to be endured, with child care giving little joy. Wonderful mothers end in tears, because they genuinely fear that they will harm their children unless they get some sleep. Others slip past coping, and sink into depression.
The Marriage
A tired mother makes a tired wife, who needs the help and support of an understanding husband. Where this is not forthcoming, a great strain is placed on the marriage.
It is not just parents who suffer the effect of sleepless nights. The shockwaves are felt by all around. They influence the mother, father, brothers and sisters, the neighbours, and most of all, the child with the problem.
Parents
Mothers who have not had enough sleep tend to be tired, irritable, and less patient. As a result, their ability to look after their children both by day and by night, may be affected. Many get so tired that life with a child is viewed as a form of penance to be endured, with child care giving little joy. Wonderful mothers end in tears, because they genuinely fear that they will harm their children unless they get some sleep. Others slip past coping, and sink into depression.
The Marriage
A tired mother makes a tired wife, who needs the help and support of an understanding husband. Where this is not forthcoming, a great strain is placed on the marriage.
SLEEP TRAINING PROGRAMME � Controlled Crying
The Controlled Crying exercise is an incredibly effective way of encouraging a healthy sleep pattern in a child, and discouraging their need for parental attention when they do wake.
� Bedtime routine Dinner - Bath - Story and cuddles - Quiet-time - BED
� Settle into cot. Create exactly the same situation that your child will encounter when they wake in the night. i.e., dark, quiet, alone. Do not overly prolong the settling down time. Lay them down, tuck them in, kiss them night-night, close the door on your way out, and ��..
� Leave the room
� Controlled crying.
Initially wait for 1 minute, and enter the bedroom. Be matter-of-fact in your manner, NOT overly comforting and sympathetic. DO NOT PICK UP YOUR CHILD. Soothe them as best you can, laying them back down, telling them quietly and firmly that it is sleep time, minimum of talking. Leave the room after 45 seconds, even if they are still fussing.
This time, allow them to cry for 2 minutes, before entering the room, and repeating your actions. Again, DO NOT PICK YOUR CHILD UP. That would be interpreted by your child as a reward for crying, exactly what you should avoid.
Make the periods of time when you are outside the room listening to your child crying gradually longer. Parents who significantly increase the periods of time (2mins, 4mins, 6mins) often achieve better results than those who leave them to cry for slightly longer (2mins, 3mins, 4 mins) periods of time. I do not recommend that you leave your child to cry for longer than 10 minutes at a time. Just stick at 10 minute intervals. Your child will eventually go to sleep. If your child wakes in the night and makes a fuss, repeat the whole process.
The Controlled Crying exercise is an incredibly effective way of encouraging a healthy sleep pattern in a child, and discouraging their need for parental attention when they do wake.
� Bedtime routine Dinner - Bath - Story and cuddles - Quiet-time - BED
� Settle into cot. Create exactly the same situation that your child will encounter when they wake in the night. i.e., dark, quiet, alone. Do not overly prolong the settling down time. Lay them down, tuck them in, kiss them night-night, close the door on your way out, and ��..
� Leave the room
� Controlled crying.
Initially wait for 1 minute, and enter the bedroom. Be matter-of-fact in your manner, NOT overly comforting and sympathetic. DO NOT PICK UP YOUR CHILD. Soothe them as best you can, laying them back down, telling them quietly and firmly that it is sleep time, minimum of talking. Leave the room after 45 seconds, even if they are still fussing.
This time, allow them to cry for 2 minutes, before entering the room, and repeating your actions. Again, DO NOT PICK YOUR CHILD UP. That would be interpreted by your child as a reward for crying, exactly what you should avoid.
Make the periods of time when you are outside the room listening to your child crying gradually longer. Parents who significantly increase the periods of time (2mins, 4mins, 6mins) often achieve better results than those who leave them to cry for slightly longer (2mins, 3mins, 4 mins) periods of time. I do not recommend that you leave your child to cry for longer than 10 minutes at a time. Just stick at 10 minute intervals. Your child will eventually go to sleep. If your child wakes in the night and makes a fuss, repeat the whole process.
Start from the beginning with the bedtime routine, but when it comes to leaving their room for the first time, begin with allowing them to cry this time for 2 minutes. Repeat the process, making the periods of time longer. Your child will eventually go to sleep. If they wake in the night, repeat the whole process.
� Vomiting
If your child vomits while they are crying (this is common, do not worry about it, children often vomit if they are crying), DO NOT PANIC. Do not wait for their 2 minutes or 4 minutes to be up, but go in immediately. Try not to change your attitude, or all your good work will be undone. Get some help if you. Sit your child on the floor, and coolly change the bedding and clean up your child. Do not be overly sympathetic. When you have done, put them back to bed with a kiss, and leave the room again.
� Continue...! (sorry)
What your childs brain starts to realise, is that, if they cry and make a fuss at bedtime, Mummy or Daddy will always come (this will promote your childs security, and they will learn that you will always be there for them when its really needed) but they will not take any nonsense, and do not even pick them up! They realise that each time, they have to cry for longer and longer periods of time, and still get the same result, of Mum or Dad checking on them, but basically saying, �there�s nothing wrong, go to sleep�. In the end, the brain realises that it is quite hard work doing all that crying, for a completely minimal result, and decides that it is easier to just go to sleep and get some rest!
� Vomiting
If your child vomits while they are crying (this is common, do not worry about it, children often vomit if they are crying), DO NOT PANIC. Do not wait for their 2 minutes or 4 minutes to be up, but go in immediately. Try not to change your attitude, or all your good work will be undone. Get some help if you. Sit your child on the floor, and coolly change the bedding and clean up your child. Do not be overly sympathetic. When you have done, put them back to bed with a kiss, and leave the room again.
� Continue...! (sorry)
What your childs brain starts to realise, is that, if they cry and make a fuss at bedtime, Mummy or Daddy will always come (this will promote your childs security, and they will learn that you will always be there for them when its really needed) but they will not take any nonsense, and do not even pick them up! They realise that each time, they have to cry for longer and longer periods of time, and still get the same result, of Mum or Dad checking on them, but basically saying, �there�s nothing wrong, go to sleep�. In the end, the brain realises that it is quite hard work doing all that crying, for a completely minimal result, and decides that it is easier to just go to sleep and get some rest!
� This process can take some nights to work, and it is often when you are thinking that you cannot take another night of this, that you will put your child to bed, and expect to listen to an hour of crying again, when amazingly, after 20 seconds of fussing, your child will just ���.. go to sleep! They are learning a new bedtime routine. They are learning how to go to sleep on their own without your assistance. Therefore, when they wake in the night, they now have the skill to get themselves back off to sleep, and do not need to wake you.
� Bear in mind�Childrens routines are easily disrupted, by illness, visiting relatives, a new baby, etc. If they slip out of their good bedtime routine, then start back at the beginning of the sleep training programme. It will probably only take them 1 or 2 nights to get them back to sleeping well again.
� Be strong! I recommend that as parents, you psychologically prepare yourselves over a few days, and discuss how you might practically deal with the controlled crying, and how you might help and support each other during the sleep training programme. It can be difficult. It will be tiring. You may feel like giving up. It might be worth considering doing the programme when you�re both on a week off, which would allow you to get some sleep in the day if you�ve had a particularly bad night.
� One word of reassurance. Sleep training works! It WILL work for you. But it will not work just by thinking about it. You have to DO IT. You may have a couple of nightmarish nights, but this surely has to be worth it if following this, your child starts to sleep through the night. Imagine��� 8 hours, unbroken sleep. NICE!
Really hope this helps. Its cracked EVERY single child its been used upon in my experience. Let me know how you get on.... and best wishes.
Jo
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