Night Feedings

The article below is from Dr Weissbluth's blog.  It deals with how do you know if your baby is hungry at night.  It can be a tricky question.  Your baby is a couple of months old and sometimes seems more interested in a social visit (as an aside, when feeding at night I would just make sure to keep the room dark and dim and make limited eye contact and no talking, no matter how hard it is when they give you a big smile! It is to convey the difference between day and night to them) then eating.  Or they feed well in the middle of the night/early morning but then aren't interested in a full feeding at wakeup time.  These can be signs your baby is getting ready for not needing a feeding.  Dr. Weissbluth has some tips to tell if they are really needed.  He says you can try one of the following methods for a few nights to see if it is habitual waking or truly hunger.  I think that's a good idea.  I hadn't read this with my first but the signs were there that she was getting ready to drop the feeding.  So I tried CIO for a few nights.  The first night was really well but the subsequent nights not as much and didn't seem to improve.  So after a few nights of this I just figured she wasn't quite ready and I fed her.  Lo and behold, about a week later, she just stopped on her own!  (Technically she woke a bit but by the time I got to her she was resettled and I kept waiting for her to wake up and she never did!)  So I don't think it is a bad option at all.  I have read elsewhere that it can take 3-5 nights to be a habit so you can use a reasonable time frame to see what happens.  You may be pleasantly surprised and it will be real easy.  Or if they aren't quite ready it's fine too.  I don't think it hurt mine in any way and she learned self-soothing skills.  Then she did it on her own very easily soon after.  Good luck!

At Night: To Feed or Not to Feed, That is the Question.

December 2, 2009 by weissbluthmethod If your baby is hungry at night, feed your baby.
How do you know if your baby is hungry at night?
If your baby is younger than 2-3 months old, trust your instincts and feed overnight whenever you wish. Usually it is every 1-3 hours for newborns and every 2-4 hours after a few weeks.
If your baby is more than 2-3 months old, most babies are fed no more than twice overnight. Usually once in the middle of the night and once in the early morning.
Sometimes you might not be sure if a feeding is needed. Here are some suggestions to clarify what is going on. If your baby takes a small volume (1-3 ounces) or seems to suck eagerly for only 1-2 minutes and then slows down, your baby is probably not hungry. If the pattern is suck/swallow…suck/swallow…suck/swallow than your baby is hungry but if it is suck/suck/suck/swallow…suck/suck/suck/swallow than your baby is more likely to not be hungry. If you are not sure but suspect that your baby is not hungry, then try one of these suggestions for only 2-3 nights:
1. Extinction: open-ended crying at the time you had been going to feed.
2. Graduated extinction.
3. Check and console with father going and offering a water bottle.
Within 2-3 nights, you will know that either your baby was not hungry and now returns to sleep unassited or persists in fussing/crying because of hunger.
In my experience, when parents suspect that a feeding is not needed, they are usually correct.
Marc

Early Wakeups

There are some children who are early risers.  There are things to look at first to see if the issue can be mitigated.  For example, black-out curtains, white noise machines to cover outside noises, possible illness, overtiredness, temperature (too warm or too cold),etc.  These are all things to be considered.  If however, despite all this, you have an early riser no matter what AND the child is well-rested, you may consider these options below to gradually shift the wakeup time later hopefully.  (These come from the comments section on Dr Weissbluth's blog).  Dr Weissbluth recommends first an earlier bedtime to see if that helps the early waking.  I definitely would do that.  But he does say it could possibly backfire and cause early wakeups.  So a little later bedtime in slow increments may help push the wakeup time later.  Note he does say this may not apply to over-tired children.  With over-tired children, usually making bedtime later is not the answer.   And he also states the strategy rarely works in children who are very young. 
But if you are tired of waking early daily, it may be worth a shot!


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Stephanie Says:
September 9, 2010 at 1:26 pm | Reply
Can anyone comment on how long it took to see a later wake-time with a slightly later bed-time? I know HSHHC suggests instituting a later bedtime (assuming the child is well-rested overall) then waiting four days. However, I am wondering if after four days, if there is no change (and the wake-up remains the same or earlier), do you continue to push with later bedtimes or go back to the earlier one?

• weissbluthmethod Says:
  September 9, 2010 at 1:51 pm | Reply You have to balance the possible problems with a later bedtime (less net night sleep for a while or bedtime battles) with the hoped for benefits, a later wake-up time. Each child is different because of age, number and duration of naps, self-soothing skills, and so forth. So there is no hard and fast rule regarding the number of days you might try a later bedtime or how much later you will make the bedtime. Trial and error is the method. Be patient.
  Marc
  
  • Stephanie Says:
    September 9, 2010 at 3:16 pm What if the later bedtime produces a wake-time that is even earlier than the previous? If this occurs over several days, is that a sign you are going in the wrong direction? Or, simply a hiccup in the process of adjusting the wake-time? Thanks.
    
• Andrea Says:
  September 9, 2010 at 3:54 pm | Reply Stephanie,
  I had to wait about two weeks to see a later wake-up time with my son when I finally stuck with a later bedtime (around 6:30) at somewhere between 18-24 months 9I can’t remember exactly what age, but he was definitely only taking one nap a day). I can’t comment on what to do if it leads to earlier wake times — he just continued to wake up at the same time for two weeks until it finally took. Good luck!

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Kari Says:
January 25, 2010 at 9:57 pm | Reply
Yes, Carla, I don’t know about you, but I get tired of trying to explain to people how difficult it is to make the wake-up time later.
I don’t know whether the Drs. Weissbluth follow the comments on this blog, but if they do, I would love to hear their comments on this topic.

• Carla Says:
  January 25, 2010 at 11:42 pm | Reply I would LOVE the Drs. opinion!!!
  
  • weissbluthmethod Says:
    January 26, 2010 at 12:47 am For well rested children (this might not apply to over-tired children) who are not napping, when parents slowly move the bedtime later (10-20 minutes) every several days, after a few weeks, the wake up time often becomes later. The reason to do it slowly is to prevent the development of bed-time battles from a second wind. This strategy rarely works for children who are very young and taking two naps every day. It sometimes works for children who are taking a single nap. Go for it!!
    Marc
    ps
    I read the comments but I am sometimes unable to respond because there are too many variables or because I know that the answers have already been discussed in previous posts.
    MW
    
    There are some children who are early risers.  There are things to look at first to see if the issue can be mitigated.  For example, black-out curtains, white noise machines to cover outside noises, possible illness, overtiredness, temperature (too warm or too cold),etc.  These are all things to be considered.  If however, despite all this, you have an early riser no matter what AND the child is well-rested, you may consider these options to gradually shift the wakeup time later hopefully.  Dr Weissbluth recommends first and earlier bedtime to see if that helps the early waking.  But he does say it could possibly backfire and cause early wakeups.  So a little later bedtime in slow increments may help push the wakeup time later.  Note he does say this may not apply to over-tired children.  With over-tired children, usually making bedtime later is usually not the answer.   And he also states the strategy rarely works in children who are very young. 
    But if you are tired of waking early daily, it may be worth a shot!
    
    

Nap Facts in Younger Children

The following are posts from Dr Weissbluth's blog.  He gives some insight into napping patterns for children up to age 2.  He says many times not to compare children.  From reading his other posts it seems like up to age 2, nap lengths are also influenced by genetics rather than solely parenting practicies.  Now of course parenting practices can impact it, but he believes some children are "biological shortnappers" and that is just something that needs to be outgrown.  In the meantime the goal is to have them well-rested and may be through more short naps,etc.   He also says many times, especially in the older infants and the toddlers, to "Adjust the bedtime to keep your baby’s sleep tank full between 4-5 pm".  So this means to make sure bedtime is early enough so they won't be overtired.  So if they are cranky and irritable between 4-5 PM make sure bedtime is early enough so they won't get a "second wind" and that they can settle to sleep easily at night and not be overtired.  So factor in the day's events and adjust bedtime accordingly.  If there were poor/disrupted naps, earlier bedtime. I have found this to be very helpful advice.  If it was a more active or exciting day, an earlier bedtime might be beneficial also.

 Nap Facts: 24 Months

December 27, 2010 by weissbluthmethod

At 24 months, 95% of children are taking 1 nap/day and 5% are taking 2 naps/day.
The average total duration of naps is 2.3 hours and the range is 1-4 hours. 99% of children nap between 1.5-3.5 hours.
Nap duration is largely under genetic control: some infants will usually take long or very long naps and others will usually take brief or very brief naps. Adjust the bedtime to keep your baby’s sleep tank full between 4-5 pm. Don’t compare babies.
Marc

Nap Facts: 21 Months

December 13, 2010 by weissbluthmethod At 21 months of age, 88% of children are taking 1 nap and 12% are taking 2 naps/day.
The average total duration of naps is 2.4 hours and the range is 1-4 hours. 97% of children nap between 1.5-3.5 hours.
Nap duration is largely under genetic control: some infants will usually take long or very long naps and others will usually take brief or very brief naps. Adjust the bedtime to keep your baby’s sleep tank full between 4-5 pm. Don’t compare babies.
Marc
Healthy Sleep Habits, Happy Child

Nap Facts: 18 Months

By weissbluthmethod At 18 months of age, 77% of children are taking 1 nap/day and 23% are taking 2 naps/day.
The average total duration of naps is 2.5 hours and the range is 1-4 hours/day. 98% of children nap between 1.5-3.5 hours.
Nap duration is largely under genetic control: some infants will usually take long or very long naps and others will usually take brief or very brief naps. Adjust the bedtime to keep your baby’s sleep tank full between 4-5 pm. Don’t compare babies.
Marc

Nap Facts: 15 Months

November 8, 2010 by weissbluthmethod At 15 months of age, 44% of infants take 2 naps/day and 56% of infants take 1 nap/day.
The average total duration of naps is 2.7 hours and the range is 1-5.5 hours/day. 91% of infants nap 1.3-3.5 hours/day.
Nap duration is largely under genetic control: some infants will usually take long or very long naps and others will usually take brief or very brief naps. Adjust the bedtime to keep your baby’s sleep tank full between 4-5 pm. Don’t compare babies.
Marc

Nap Facts: 12 Months

October 25, 2010 by weissbluthmethod At 12 months of age, 82% of infants take 2 naps/day, 17% take 1 nap/day and 1% take 3 naps/day.
The average total duration of naps is 3 hours/day and the range is 1.5-5.5 hours/day. 94% of infants nap between 2-4 hours.
Nap duration is largely under genetic control: some infants will usually take long or very long naps and others will usually take brief or very brief naps. Adjust the bedtime to keep your baby’s sleep tank full between 4-5 pm. Don’t compare babies.
Marc

Nap Facts: 9 Months

October 11, 2010 by weissbluthmethod At 9 months of age, about 90% of infants take 2 naps /day and 5% take 3 naps /day and 5% take 1 nap/day.
The average total duration of naps is 3 hours but the range is 1-5.5 hours. 93% of infants nap between 2-4 hours.
Nap duration is largely under genetic control: some infants will usually take long or very long naps and others will usually take brief or very brief naps. Adjust the bedtime to keep your baby’s sleep tank full between 4-5 pm. Don’t compare babies.
Marc

Nap Facts: 6 months

September 27, 2010 by weissbluthmethod At 6 months of age, about 80% of infants take 2 naps/day and 20% of infants take 3 naps/day.
The average total duration of naps is 3.5 hours but the range is 1-6 hours. 80% of infants sleep 2.5-4 hours/day. 5% sleep less than 2.5 hours/day and 15% sleep more than 4 hours/day. Don’t compare naps between babies.
Attempts to extend brief naps by swaddling, replacing the pacifier, or a quick feeding are likely to fail because they are more socially stimulating than soothing.
Marc

Nap Facts 4-6 Months

September 13, 2010 by weissbluthmethod Some babies have predictable mid-morning and mid-day naps. Each nap is 1-2 hours. Other babies still have brief naps or a mixture of long and brief naps. Post-colic babies and others who have not yet learned self-soothing skills are more likely to have brief naps. Don’t compare napping patterns in babies and be patient.
Some babies have a brief late afternoon 3rd nap and two major naps (mid-morning and mid-day). Perhaps these babies are able to have a later bedtime than those who sleep less during the day. Don’t compare bedtimes.
The variability between babies is often frustrating when parents compare their baby to other babies. Accept the fact that babies are different and stay on course to ensure good quality night sleep (especially a bedtime at night that is in synch with emerging drowsy signs). In general, practice soothing your baby when drowsy signs are first emerging but sometimes (especially if the wake-up time is very early) also try to stretch your baby towards mid-morning and mid-day to have the naps occur in synch with nap rhythms.
Marc

Nap Facts: 3-4 Months

August 30, 2010 by weissbluthmethod The morning nap emerges before the mid-day nap. Naps become regular before they become long. Brief naps are common. Naps may be very brief or very irregular if self-soothing skills have not been developed, the intervals between naps are too long, the bedtime is too late, night sleep is fragmented, the child is post-colic, or there is too much environmental stimulation. Some infants nap best in pitch black and very quiet rooms. White noise machines might help.
This transition from no regular naps to more regular but brief naps is often frustrating to parents who want their baby to nap longer. If your baby is well rested during the day, be patient and the naps will get longer. If your child is short on sleep during the day, experiment with nap schedules, earlier bedtime, let cry at night for consolidated night sleep, make the room darker, practice more putting her down drowsy but awake.
Some brief naps might be extended by re-swaddling, a quick feeding, or replacing a pacifier.
Marc Healthy Sleep Habits, Happy Child

Nap Facts: Birth to 3 months

August 16, 2010 by weissbluthmethod Naps are irregular and brief. Help your baby learn self-soothing skills as soon as you come home from the hospital: put your baby down drowsy but awake, keep the intervals of wakefulness short to avoid a second wind, and get dad (or anyone else) on board to do nap duty when available. Swaddling and pacifiers might help and will not harm your baby. For those with colic, do whatever works to maximize sleep and minimize crying: swings, strollers, cars, sleep at mom’s breast or on dad’s chest.
Focus on night sleep and after 6 weeks of age, counting from the due date, move the bedtime earlier. Watch for drowsy signs at night and catch the wave.
Some brief naps might be extended by re-swaddling, a quick feeding, or replacing a pacifier.
Marc Healthy Sleep Habits, Happy Child

Bedtimes

Repost: BEDTIMES

September 6, 2010 by weissbluthmethod Q: My job does not allow me to come early in the evening. I think that my child is already tired when I get home. What’s wrong with keeping her up a while to enjoy time with me? Isn’t this important for bonding?
A: This is not an all or none issue. It depends on how often the child is kept up, how late the child is kept up, how the child naps, how the child behaves and looks in the late afternoon. The loving bond between child and parent is not simply measured in the number of minutes you spend with your child; it also has to do with how focused, relaxed, and engaging both you and your child are when together. If your child is a little short on sleep occasionally, it’s probably not a big deal but chronic sleep deficiency is a problem for kids.
Consider the similarities between food and sleep. Let’s first think about food and food quality. Food is a biological need. Food is energy for the body. Poor quality food –junk food – damages the body by causing all manner of medical issues including malnutrition, anemia, diabetes, heart disease, and obesity. A little junk food is O.K., a lot is not.
Now let’s think about sleep and sleep quality. Quality sleep means consolidated sleep occurring in phase with circadian rhythms. Sleep is also a biological need. Sleep is energy for the brain; poor quality sleep harms the brain. Think of poor quality sleep as junk sleep. Junk sleep is just as bad for our children as junk food. Just as you read labels on food to determine quality, think of sleep quality for your child. You would not starve your child by withholding food; try to not let your child get short on sleep.
Sleep is the power source that keeps your mind alert and calm. Every night and at every nap, sleep recharges the brain’s battery. Unlike a light bulb that shuts down completely when it is turned off, your child’s sleeping brain is active and purposeful. Providing your child’s growing brain with quality sleep is necessary for its development. Sleeping well increases brainpower just as weightlifting strengthens muscles. Sleeping well makes your child physically relaxed and mentally alert; he is at his personal best. Sleep is not a luxury, sleep is a biological necessity.
HEALTHY SLEEP IS LIKE HEALTHY FOOD
Many questions have been received regarding nap problems, bedtime battles, night awakenings, and difficulties with extinction or graduated extinction. It is not possible to answer all of these individual questions but it is obvious that many of the parents have not read the earlier posts that provide explicit answers to these questions. I understand and am sympathetic to the sleep deprivation and frustration that you feel. However, if you do not have the energy to read the earlier posts, the solution to most sleep problems will usually include a much earlier bedtime. Super early bedtimes are not the only answer to sleep problems but they are usually a necessary part of the sleep solution. if you are unable to do any reading, your default should be a temporary super early bedtime to get some improvement.
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The above is a post from Dr Weissbluth's blog.  It seems like the majority of sleep issues (nap issues, bedtime battles, night wakings,etc) stem from overtired.  And the best solution to this is an early beddtime.  This can be as early as 5:30 PM or so.  As crazy as that sounds! But let me assure you that these early bedtimes CAN work.  It is possible that the super early bedtimes may only be temporary until the sleep deficit is caught up and then it will slowly move backward.  But there are children who will thrive on an earlier bedtime and will continue to have this for a while and that is perfectly fine too.  So if you are having some sleep disturbances give this a shot.  It is really worth a try.  Now if your children's bedtime is normally 8 PM you may not move it up so early and it may involve some trial and error to see what works but you may find your sleep issues gone after trying this simple solution!
Good luck!

Child Psychology and Sleep (and Early Bedtimes!)

This is an EXCELLENT post from Dr Weissbluth's blog.  It talks about how many behavioural issues can be simply symptoms of an overtired child.  I think about my children and when they get tired.  They can get hyper/giddy on one extreme or emotional/having a meltdown on the other extreme.  They also test more and are not generally obedient or compliant.  But when they are well-rested, we don't have these issues hardly.  So clearly sleep has a BIG impact on children and their behaviours.  I have also seen how children get "hyperalert" from lack of sleep and how others say "They just don't need much sleep" when in fact the opposite is true.  This article highlights the benefits are an early bedtime for preschooler.  It really is a great read and has some great thoughts. Enjoy!

Child Psychology and Sleep

December 8, 2010 by weissbluthmethod

Robert Daniels, PH.D., has helped many families in Chicago and we welcome his views on the importance of sleep for our children.
Marc
Disruptive Behavior and Bedtime Battles
By Robert E. Daniels, Ph.D., Licensed Clinical Psychologist
Executive Director,
Chicago Children’s Clinic
It’s 4:30 PM and your 4 year-old child is hungry, so you feed him a light snack to tide him over until his dad gets home and you can have a family dinner at 6. By 5:15, he’s really getting disruptive—screaming, throwing things. Around 6, your husband comes home. Instead of being greeted by the warm embrace of his family, everyone, instead, faces the prospect of another evening of dodging kicks and flailing arms. After a ridiculous dinner at which you struggle to get your child to sit down to the table, you take a deep breath to weather the storm of another bedtime battle. You battle to get him to bed over the next 2-2.5 hours. When you’ve completely had it, and you think you cannot weather any more kicking, pinching, and screaming, he or she finally falls asleep between 8:30 and 9 PM. You can sometimes get him to sleep by 8, if you let him sleep in your bed, but you know that is not a good idea, so you only try that under desperate circumstances. Lately, you have noticed your child waking up between 1 and 5 AM. You are way too tired to fight to get him to go back to his own bed, so you let him sleep fitfully in your bed until 5:30, but you don’t get any sleep.
During the day, your child is having difficulties in preschool. He cannot sit still on the rug. He is easily upset. His teacher and school call you for a meeting to discuss his behavior. You call your pediatrician. He refers you to a psychologist, psychiatrist, or social worker. Or, perhaps, people conjecture; it’s a “sensory issue.” You look up on the Internet all sorts of disorders: ADHD, Sensory Integration Disorder, Reactive Attachment Disorder, Depression, Anxiety. You feel guilty, scared, overwhelmed.
This scenario is a textbook example of an overtired child, and overtired family. Families facing these challenges are referred to me often. The importance of taking a detailed sleep history cannot be underestimated when assessing the cause of daytime disruptive behavior. Preschool-aged children require 12-14 hours a day of sleep. Overtired children may need even more. In children and families who have nightly bedtime battles, their children are going to sleep after 8 PM, sometimes not until 9 or 10. Their sleep becomes shallow, easily disturbed, and fragmented. They awaken again between 1 and 4 AM. Many times, they are then taken to their parents’ bed, where they may “rest” for 1-2 more hours. Little restorative sleep is occurring.
Professionally, in these cases, I say to parents, “You have an over-tired child. While it is possible that there is another condition, as well, until you have a well-rested child, it will be difficult to determine what, if any, other condition exists.” When parents institute a very early bedtime: dinner at 4-4:15, bath at 4:30, bedtime routine by 5; the child usually falls asleep by 5:15-5:30. Routinely, the parents call me 1-2 days later saying that their child is sleeping from 5:30 PM until 7 AM the next morning. After 2 weeks of an early bedtime, 8 out of 10 times, the child’s behavior has improved so significantly, no further treatment is necessary. In the remaining cases, treatment is still necessary, but the psychological issues are significantly easier to treat because we are now treating a well-rested child; one who is better able to tolerate frustration. In addition, we now have well-rested parents! Finally, the institution of an early bedtime provides additional predictability, structure, and routine into their family’s life together.

Nap Facts in Older Children

Nap Facts: 5-6 Years

February 14, 2011 by weissbluthmethod At age 5, 27% of children are napping one nap/day about 4 days/week. Among those who are napping, 80% nap between 1.5-2.5 hours.
At age 6, 12% of children are napping one nap/day about 3 days/week. Among those who are napping, 90% nap between 1-2 hours.
Napping is less influenced by genetics than parenting practices.
Marc
Healthy Sleep Habits, Happy Child

Nap Facts: 4 Years

January 24, 2011 by weissbluthmethod At age 4 years, 57% of children are napping one nap/day about 5 naps/week. 80% of children who nap are napping between 1.5-2.5 hours.
Napping is less influenced by genetics than parenting practices.
Marc

Nap Facts: 36 Months

January 10, 2011 by weissbluthmethod At 36 months of age, 92% of children are napping one nap/day. 80% of children who nap are napping between 1.5-2.5 hours.
Napping is less influenced by genetics than parenting practices.
Marc
Healthy Sleep Habits, Happy Child


The above are posts from Dr Weissbluth's blog.  Note that in these ages he states "Napping is less influenced by genetics than parenting practics".  So that is an important distinction.  In younger ages, despite best parental efforts, he believes genetics play a role.  BUT at these ages it is more parental efforts.  I agree that parenting practices plays a large part in napping at these ages.  So many times you hear "My child gave up napping at age 2...."or whatever figure you want to put in here.  I am not sure that is entirely accurate.  The child may have had some napping issues at that time but it was the parent who chose to stop giving the nap instead of really troubleshooting (timing of nap, physical and mental stimulation, adequate winddown before nap, etc)or just pushing through the phase and consistently giving a nap.  I don't think that can be underestimated.  A consistent day and sleep routine sends clear messages to children and signals the body it is time to rest.  That is where the parental role plays a big factor.  I think it can be easy to "schedule out" a children's nap as they get older and involved in extra activities (such as classes, preschool programs, sports, daycamps,etc).  But I think many children can benefit from daytime naps (or a minimum resttime), especially as they do tend to be involved in more activities and are exposed to more which make them tired.  So it is kind of backwards to schedule out their naps before they are really ready.  I think a good option is to schedule alternating nap and no-nap days when they are clearly dropping their nap (or some variation of that).  So their bodies can get used to no-nap and not having a "cold-turkey" approach.  I think that would be a drastic change for their bodies and could lead to overtired creeping in.

Also a crucial key when dropping nap (or weaning,etc) is to have an ultraearly bedtime.  As Dr. Weissbluth has said many times early to bed can mean LATE to rise.  It may not be convenient and it may not be "fashionable" but a bedtime of 5:30 PM on no-nap days can have children sleeping til 6:30 AM the next day and being well rested.  (Or 6 PM, etc).  It is funny how it works.  I know a friend who put her daughter down no later than 6 PM on skipped nap days and she'd sleep 12.5 hrs.  But if she put her down late at 7 PM, she woke up the same time on her own at 6:30 AM, having only 11.5 hrs sleep.  So early bedtimes can really work wonders many times.  It may take a bit of trial and error to see which times work best for your little one.

One thing that his studies do not state is  the average length of night sleep for these children.  I suspect as they get older (especially the 5-6 range), if they are napping long during the day it will mean a shorter night.  Or it could be that the nap days are a catch-up from a  busy week.  For example possbily children in kindergarten,etc who can't nap/rest during the school week and nap on the weekends.  But I think it gets to a point where if they get older and they nap they may have trouble falling asleep at night at a reasonable hour and that is when you would go to no nap and an early bedtime instead....but it's a long process to get there! And don't rush it:)

As excerpted from Dr Weissbluth's blog

Total Sleep Duration may be Misleading

March 9, 2011 by weissbluthmethod Some parents focus on total sleep duration such as saying, “He sleeps 12 hours total so I thought everything was fine.” The problem with this is that if the bedtime is too late and the naps are long (for example: 9pm to 7am and a 2 hour nap), than they may not see that a long latency to sleep or bedtime battles or night awakenings are caused by a bedtime that is too late. Also, if the nap is late (for example, 2-4pm) the parents coming home from work and getting ready for dinner, evening activities, and getting ready for bed might mask a second wind and the ill effects of running low of sleep (for example, “Between 8-9pm he’s fine as long as we are playing with him or he is watching his DVD).
Marc
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This is an interesting post from Dr Weissbluth and I agree with the theory behind it.  I see on boards about my child only sleeps "X" hours in a day and is just on the "low sleep end".   BUT that is not necessarily an accurate picture.  For example, a 2 yr old that only sleeps 10 hours at night BUT used to sleep longer, that could indicate problems.  That 10 hours could be a classic sign of overtired (for example if you had closer to a 11-12 hr sleeper).  It could be things such as teething pain (especially molars as these can cause discomfort in the morning hours when in lighter sleep mode and cause to wake), sickness,etc.  In some cases, like older toddlers, it could mean daytime nap needs to be shortened a bit (BUT this is usually only when the naps are really long.  For example, those kids that were doing 3 hr naps.  I would hesitate to shorten naps too much when they are young, especially less than 2 hrs as that can easily backfire and cause more issues.  Remember Dr Weissbluth treats day and night sleep differently).  It does not necessarily mean "My child is getting older and just needed less sleep" as so many parent erroneously believe. So then the parent just puts the child to bed later thinking they only need 10 hrs of sleep and they end up with less and less sleep over time. 

And like the article points out, if the bedtime is too late the child is not truly rested and may take long daytime naps to compensate......BUT it'd be better if the night sleep was timed earlier and much longer and then the child would be more rested and not overcompensate on nap.  Also the late nap can cause issues as pointed out, as that might interfere with bedtime.  I have found from personal experience that earlier naps help preserve the earlier bedtime and keep the sleep times in sync with the body's circadian rhythm.  Dr Weissbluth has mentioned many times how sleeping outside of the circadian rhythm is not good quality sleep.  So a child sleeping from 10 PM-10 AM even is not the same quality as 7 PM-7 AM.  So that is why just looking at the total can be inaccurate.

Another example of  this being misleading is a child who skips nap.  A young preschooler, and definitely toddlers, NEED daytime rest and sleep for optimal development.  So a preschooler who sleeps a 2 hr nap and 11 hrs at night is more rested than one who skips nap and sleeps the same overall at night (even 13 hrs).  I truly believe putting them down ultraearly on no-nap days is crucial so they don't get in an overtired cycle and allows them to get caught up on the missed sleep (and that may be ok to do once in a while) but to sustain this every day would build up a sleep defiiciency.  It would not be good on a daily basis or for their optimal development.  As they get older, maybe around 4ish, that may change and you may do consider some things like having resttime some days and naps other days,etc.  But also many parents do not put their children to bed early enough when naps are skipped and this just builds up a sleep debt (and from expereince, as counterintuitive as it sounds, the later they go to bed the less sleep they'll sleep.  Versus going to bed extraearly, they'll sleep a longer night). 

 Bottom line: I find that the most useful sleep tool for mine is to look at how much sleep they are getting within 24 hrs and to make sure it is adequate and consistent.  Anytime there is a big sudden drop, it is a red flag.  Then I troubleshoot and make sure there isn't anything else going on (like illness, teething, or overtired creeping in).  But this article points out that it is the overall picture to still consider, so that is both day and night sleep and other factors.

Achieving "Personal Best" with good sleep

This is an excellent article from Dr. Weissbluth's blog.  Often you hear from parents that their kids don't need as much sleep but are "fine".  I think it really varies and depends on each child's temperament.  There can be overtired children who seem fine and have nice dispositions still BUT the point is how much better they could be if they are well-rested.  A lot of children who are overtired have behavioural issues and are have mood swings, irritability, hyperactivity,etc.  It is easier to see in these children how they would benefit from better sleep.  So some parents may have easier children but that does not mean that good quality sleep is not beneficial for them (and note that he emphasizes quality which means not on the go naps and to have sleep at the optimal times, ie more in synch with the body's natural times, usually earlier in general).  Think about how when you are really well rested how you feel.  The same applies to our children!

Repost: “Personal Best” & “Hidden Problems”

March 31, 2011 by weissbluthmethod

1. Children who miss naps and stay up too late might appear “fine” to their parents but they would appear better with better quality sleep.
All children are born with different temperaments, skills, and endowments; ask any mother of fraternal twins! These individual differences are part of the joy and challenges of parenting. For a discussion of individual differences in temperament, see the Posts dated 8/5/09, 8/7/09, 10/4/09, and 10/9/09.
There are also individual differences in nap duration so that at six months of age, some children take long naps and others take short naps and these patterns are stable over time until about two years of age. Adult research has shown there are individual differences in how resilient we are to performing on not enough sleep. Sleep, 2008-9: “Sleep deprivation-induced performance deterioration is more marked in some individuals than in others. These inter-individual differences in response to sleep deprivation have trait-like characteristics consistent with a genetic basis.” We should assume that some children pay a higher price than others when they are short on sleep.
So in families or cultures where babies and children are allowed to sleep out of synch with biologic circadian sleep rhythms (unhealthy sleep), I’m sure that this harms some children more than others. But I cannot imagine that if this unhealthy sleep is chronic and severe that it causes no harm in some children. You can’t fight circadian rhythms! But hold on, what about entire cultures (See Posts Children’s Sleep Around the World, 7/29/10 and Our “Tropical” Heritage, 8/2/10) where the children’s bedtime is very late?
Think of swimmers performance when the best time is achieved by the swimmer in a particular event. We call this her “personal best.” Child development is not a swimming contest but think of how are babies and children learn skills and express their emotions, talents and personalities. Parenting is not a competition but you can try to raise her to achieve her “personal best.”
I think healthy sleep has a permissive effect so that the resources of parents, family, and culture allow every baby and every child to be at her own “personal best.” I think that sweet, bright, and caring children who are receiving unhealthy sleep will become sweeter, brighter, and more caring when they get healthier sleep. My research shows that sleep modulates temperament so that sleeping better makes children more adaptable, cooperative, and calmer.
2. “Hidden Problems” are like post-menopausal thin bones from inadequate calcium intake during adolescence or cavities from too much sugar in the diet. It takes time for the problem to show itself. I suspect that sleep short babies and children are more at risk for educational/school/behavioral problems when older. I also suspect that when we and our children are more rested, we have more resilience to adverse events in our life so being well rested acts like a protective buffer.
Please send in your Comments on how sleeping better helped your child.
Marc
Marc

The Necessity of Sleep

As excerpted from Dr Weissbluths' blog

A Good Night’s Sleep Isn’t a Luxury: It’s a Necessity

June 3, 2011 by weissbluthmethod

This is the title of Jane Brody’s piece in The New York Times  on Tuesday, May 31 on page D7. It is informative and well written. Unfortunately, there is nothing in the article about infants, toddlers, children, or teens. Additionally, there is no suggestion that adult sleep problems may have their roots in not learning to sleep well when much younger. The general adult population does not appreciate sleeping well as a health habit like exercise and seat belts. Therefore, many adults have a blind eye to their children not sleeping well. But for those of you who are reading this blog, even when there are struggles over sleep issues, know that you are giving your children a gift of healthy sleep that will last their lifetime. Read the article to imagine how better your children will be for your efforts now. This is no small thing. Coincidently, the title of her article has appeared in my handout, Sleep Smarts written years ago and has appeared in this blog on more than one occasion.


http://www.nytimes.com/2011/05/31/health/31brody.html?_r=1
This is the link to the article if you can't access above

Shoot the Monitor!:)

Shoot the Monitor!

July 11, 2011 by weissbluthmethod Audio and visual monitors for your baby might be useful in very few situations. For example, you are in your yard and you want to hear when your baby awakens from a nap. Or your home is multilevel and you think that you really will not be able to hear your baby awaken or cry. But the truth is that monitors are rarely needed. The sleeping brain of the mother is acutely sensitive and discriminating to her baby’s cry. Even a quiet cry is like an alarm bell going off in her head. A louder but distant siren will usually not awaken the mother because the brain recognizes that there is no close danger.
Audio monitors robs mother of deep long sleep because it amplifies very quiet sounds that do not need to be attended to. The visual monitor can make a parent compulsively watch their baby when there is no real need for watching. Monitor companies prey on the natural fears of new parents.
Shoot the monitor!
Marc
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The above is an interesting post from Dr Weissbluth's blog.  I think it has valid points and I agree with a lot of it, but not all.  I do know that when my babies started sleeping through the night, I turned off the monitor at night and it was BLISS!:)  It was so wonderful to finally have an uniterrupted night of sleep and not hear every little snuffle, whimper, sneeze,etc.  I do think a mother's ear is fine-tuned to her children and even though I had the monitor on as soft as possible, I would hear their minor noises during sleep (and babies aren't quiet sleepers, at least not at first) and it would disturb my sleep.  So it was a huge relief to turn off that monitor once we dropped the middle of night feedings.  All of our bedrooms were upstairs so I was confident I would hear them cry if they needed me.  But it was wonderful not monitor at night anymore.  We had an audio monitor (actually through our phone system, so that was really neat and dual purpose) and of course we monitored when we woke up in the morning (and husband is an early riser) and naps. 
We did not get a video monitor until our 2nd child was about 10 months old or so.  She was getting her legs stuck in the crib slats and going through a funny phase so I wanted to see what was going on.  Also our older daughter was taking off her socks at night (and waking early in the morning from cold feet!) so I thought a video monitor would be good to see what was going on with her:)  And I thought it would be useful when we would transition to the toddler bed and to make sure she was staying in bed.  So we get a monitor that had 2 cameras, one for each room.  It was really great! BUT I made a conscious effort not to get too wrapped up in them as I have heard how some moms get a bit "obsessive" over them and stare at them too much.  So my rule was when I got up in the morning I just turned on the phone monitor and never the video monitor  before 6:15 AM the earliest, sometimes closer to 6:30 AM.  I think you know when a lot of children are awake just because you hear them.  With my 2nd, when she wakes she starts to babble.  Or sometimes I'll hear a song like "Itsy Bitsy Spider" come over the monitor and know she woke up:)  So a lot of children do that.  Now my other daughter is a bit different and is quiet when wakes.  So it does help with her.  And also for settling at night, as it may be quiet but they aren't asleep.  So it's useful to determine overall sleep lengths and use that as a measurement tool.  BUT again, I will say to not become a slave to the monitor! It causes undue anxiety in some parents.  It CAN be a useful tool.  Especially in things like sleep training, and when they are going through funny developmental things (like learning how to roll over-for example you wouldn't want to go in all the time if you're not sure they are "stuck"),etc.  And it can really help in troubleshooting.  For example my 1st daughter was seeming tired a lot around age 2 and I think she was quietly awake earlier than I thought (2 yr molars or other issues) and it helped make sure she was well-rested overall by making sure she slept enough for naps and night (so that maybe meant adjusting naptime, bedtime,etc).  And it was very important for her as she got older and was weaning off her nap.  With the video monitor I could determine if she didn't fall asleep for nap til late (or skipped it!) and would do an ultraearly bedtime.  Without the video monitor I wouldn't really have known.  So there are definite advantages to a video monitor and I do recommend them . I personally don't think there is any need to monitor at night though.  Mom and Dad need the best rest they can get (although I actually think only Mom's would be bothered at night:)

How much sleep do we need and the Regulation of Sleep

 I am a huge fan of Dr Weissbluth and highly recommend the book "Healthy Sleep Habits, Happy Child".  It is a great book and goes into a lot of the science behind sleep.  (Although I also read Babywise and the Babywhisperer and think all 3 go together well.  He explains more the importance of sleep and how it works and is a huge advocate of the early bedtimes which work WONDERS! Babywise talks a lot of "optimal wakefulness" to help good sleep....so if you time the naps and nights right, you should have good naps,etc.  And The Babywhisperer has good info on sleep cues,etc) This is a post from Dr Weissbluth's blog and it is real helpful.  And I think it also helps remind parents to not compare children as each can be so different in sleep needs and also to be patient. 

Enjoy!

How Much Sleep Do We Need and the Regulation of Sleep

July 25, 2011 by weissbluthmethod

(Adapted from Science: 325:825, 2009)
Sleep and Wakefulness are controlled by two interacting processes which are each independently regulated and under genetic control. It’s messy and complex but I will try to give you an overview so that you better understand why you should never compare children. The bottom line is that sleep, like height and weight, is highly inherited.
1. Circadian Process
This sets the timing of sleep onset and offset. The biologic times of drowsiness and awakening are controlled by this internal clock.
There are individual differences among adults and children.
2. Homeostatic Process
This tracks sleep need and forms the genetic basis for how long we sleep (sleep need). If we get shorter and shorter on sleep, we feel more pressure (drowsiness, sleepiness) to get sleep. It’s like feeling more and more thirsty as we become more dehydrated. But there is a catch. Sleep loss is primarily recovered by increasing sleep intensity (deep or slow wave sleep) and not necessarily by sleep duration. Maybe shorter periods of intense sleep can be more restorative than longer periods of light sleep or fragmented sleep. That’s why sleep quality (intensity, consolidation, and in phase with circadian rhythms) is more important than just sleep duration.
There are individual differences among adults and children.
The developmental pace of these two processes is not the same in all children as any parent of fraternal twins knows! So don’t compare children and be PATIENT. Some children will sleep longer and easier than others at any given age.
Our goal is to have well rested families. But, always remember, the amount of sleep we need and the amount of sleep our children need is measured by mood, behavior, and performance…not hours by a clock.
Marc