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Monday, January 17, 2011

Good NIGHT!!!- all about sleeping, at all ages

Oh, the joys of a baby who wakes every hour, a child who won't go to bed or won't sleep once he gets there, and a teenager who has to be prised out of bed with a crowbar every morning.   Your child's sleep patterns can be one of the most soul-destroying parts of parenthood.

I was sleep-deprived for about six years after I had my son.  He came out of the labour ward with his eyes open, and from that moment on he needed less sleep than I did (and complained vigorously and ear-splittingly the moment I tried to put him to bed to snatch a moment's rest myself). So as you prop your eyelids up with matchsticks to read this column, rest assured that I Feel Your Pain.

How did I cope with a child who didn't need to sleep much? (Yes, I'm still here, and some even think I'm still relatively sane.)


When he was a tiny baby, his bassinet was right next to the bed in my room, so I could get him out and feed him without falling over anything or stubbing my toe in a sleep-deprived stupor- I was a zombie. I often fell asleep while feeding him.  The fact that I never accidentally smothered him by rolling on him at these times is largely due to the facts that I didn't drink alcohol in the evenings in the first few months, I wasn't on any other artificial relaxants like Valium and I was a light sleeper anyway. 

Sleeping with your baby in the bed can be fraught with danger, and I wouldn't recommend it to anyone unless they were in a situation- as I was- where it was simply the only way to remain sane, in which case you definitely must cut out the drugs and alcohol (and avoid very soft mattresses). But sleeping with your baby in the room with you is common sense.  Being woken over and over when you're exhausted is a recognised form of torture, and it's really no wonder that some mothers snap- why not make it easier on yourself by having your baby close by? Stubbed toes in a freezing hallway at 2am, falling over your dressing gown cord and dropping the baby- nah, not my idea of fun.

This was also a practical arrangement because I fed on demand, and it seemed that 'on demand' meant 'as often as possible' to him. I can't comprehend the concept of feeding tiny babies on an artificial schedule- newborns don't manipulate people; they're crying to tell us they're uncomfortable- hungry, wet, ill, bored, cold, tired (I wish!)... and if we ignore their first communication with us, that's a terrible way to start a relationship with another human being.  To respond to him promptly every time he cried, I simply had to have him next to me.  So my first piece of advice to you is to forget the concept of a 'nursery' until your baby settles into a sleep routine.

During the day when everything got too much for Zombie-mum, I'd put him in the car (where he ALWAYS went to sleep) and drive to my parents' place. He'd wake up the moment the car stopped and howl- and I'd go have a sleep while my parents looked after him.  You really need those support mechanisms if you have a non-sleeping baby.  No willing friends or relatives? You need to ring Tressillian or Karitane before you do that baby some harm.  Nobody will look down on you; LOTS of mums are in the same boat.  Handing a baby around to some trusted alternative carers is good for baby, too.  They learn that they are safe with people other than mum and dad, and that can help when it comes time to put them in childcare or school. 

When my son graduated to a cot, things became tricky again. He walked at 11 months and was awake till all hours of the night- he didn't NEED much sleep- so a long period of constantly returning him to his room started. 

My sanity was saved on this occasion by Dr Christopher Green's brilliant book, 'Toddler Taming'. It's out of fashion these days, but I would still recommend it in certain circumstances like mine.  I learned his technique of controlled crying at a point where I really was losing the plot, and where my son already had excellent receptive language skills.  Without it, I may have become a danger to my child.

In a nutshell, controlled crying is a system of letting your child cry for longer and longer periods until he realises he's not getting any positive gain and gives up.  It sounds cruel when you put it like that. I know that there's a feeling out there these days that leaving a child to cry is always neglectful. Back then I clutched at it like a drowning woman, simply because I was desperate. 

Before we go any further, research has shown that there ARE some situations where controlled crying won't work and shouldn't be used.  Children who have poor receptive language skills (ie can't understand or process what you say to them), children who you have ANY reason to suspect might be on the autism spectrum, tiny infants- these children can't be comforted by words alone. KNOW YOUR CHILD. If your child can't yet respond to your verbal cues, don't use controlled crying with them. If you can't reassure your child from across the room during the day, you certainly won't be able to do it at night.

So, assuming that you KNOW your child can respond to you appropriately when you speak without touching him or her, how would you implement controlled crying? Before you start, you make sure that your child is comfortable and has everything he needs.  The story is read, the room is the right temperature, the night light is on, the PJs aren't twisted, the nappy is dry, he doesn't look ill, he's had big cuddles and kisses and a glass of milk or water... all those positives are present when you start.  You are his loving mum or dad. You're about to help him learn that he CAN self-settle, and that's a very important self-help skill- he NEEDS to learn this.

If your baby is anything like my son, he'll start to cry the moment you say good night and let go of his hand- forget even getting yourself out of the room! The trick is NOT TO REWARD CRYING when he doesn't actually need anything else from you.  Begging for another kiss or cuddle is just playing for time, and it won't be the last request for the same thing- you KNOW that.  So even if he cries, you remove yourself from his vice-like grip and say something reassuring like 'I know you're sad, but it's night time now and it's time to go to sleep.  I love you, good night.' And leave without further cuddles.

If- like my son- he's already very mobile and can open the door, you need a snib on the door so he can't get out of bed and follow you to the living room (where you are probably pouring a stiff drink to help you handle the rest of the evening's shenanigans). Look around his room. It's probably like Paradise. It's okay to keep him in there. You'd put a snib on his door to keep a cat from sleeping on his face, wouldn't you? It is NOT a prison cell in there.  It's a safe, comfy, familiar environment.  (I would also not advocate starting a controlled crying regime away from home- it's likely your child is feeling unsettled by the change, so is genuinely upset and will become more so by being left alone in a strange room.)

CONTROLLED CRYING WILL MAKE YOU FEEL LIKE HITLER THE FIRST TIME. You are NOT Hitler.  You are a good mother or father who's in danger of becoming a bad mother or father due to sleep-deprivation-based zombie-insanity.  You will feel WONDERFUL the first time your child settles himself, believe me, so put the champagne on ice now as an incentive. Your child is okay (you made sure of that before, remember?), you've acknowledged that he feels sad, you've drawn the boundary of 'today is over' and now he needs to accept that and go to sleep. 

What on earth is anyone going to gain if he stays up?  Is it good for him?  Is it good for you?  You are teaching him to settle himself.  Do you want him to still be in your bed when he's five?

Seriously, I had the mother of a 5-yr-old (who was about to start school) proudly tell me that her son had slept in his own bed last night... I shudder to think what her relationship with her husband had become, and it explained a lot about a child who constantly tested every boundary, sulked when he didn't get his own way and cried like a 3-year-old when anything went wrong at preschool.  At some stage your child has to learn self-settling.

The first time you leave, set the kitchen timer for one minute.  It will be the longest minute of your life, and you're already fragile from lack of sleep- you will probably cry. But don't go back to your child until that timer goes off.

(EXCEPTION ALERT- know your child!!- if the pitch of your child's crying suddenly changes dramatically, go check on him or her in case there's a physical problem. Sudden silence or sudden extreme escalation is not a good sign. Please use common sense. Children's crying has different urgency levels and you need to be able to recognise a switch of level.)

When you go back, wipe your eyes first! Then use the reassuring words again FROM THE DOORWAY but DON'T give another kiss or cuddle- you already did that- it will make the whole process longer, and do you want to have a tearful curtain call of the whole routine every night??  Just put him back in bed if he's got out- remember, no extra kisses and cuddles!- and remind him that he's safe, you love him and it's sleep time now. Leave again, and set the timer for two minutes.

Keep repeating this, gradually increasing the time by one minute between each visit.  Remember, DON'T kiss, cuddle or do anything but return him to bed and reassure him with words from the doorway- you have to cut out all the positive effects of him crying. Try to control your own tears as well- it will be hard!- you need to be enough in control to be able to reassure him calmly that all's well, but it's simply time for sleep. Your partner can take turns going to the door and delivering the message if he or she understands the method and wants to give you a break. Your child IS safe- you're telling the truth here! He's just crying because he doesn't understand the need to let go of today's fun and rest his body, because he wants to go on playing (even though he's probably got to the stage of throwing toys in frustration), because he wants your complete attention all the time (he still thinks he's the centre of the universe- he isn't!) or because he's simply overtired, and he thinks being with you will fix all those problems (IT WON'T). 

If you let him up again he might be cute and cuddly for short time, but he will become an outrageous little over-tired monster again within minutes; you're only delaying facing that monster, and it will be a much worse monster who's learnt that if he cries enough, you'll give in. DON'T GIVE IN.

You might have to keep this up for well over an hour the first night. BE STRONG.  Remember, if you weaken you'll teach him that you WILL give in if he keeps crying.  Do you want him to learn that lesson??

Controlled crying WORKS with children who have adequate receptive language skills, and your child will NOT end up with an insecurity complex- he's perfectly safe in there and at some level he knows it.  You've been positive and loving at all times, but you've also set an important boundary. 

Eventually he WILL stop crying, and you should notice that this happens through a gradual decrease in intensity rather than suddenly.  Don't rush in... listen first, then peek slyly, or you may set the whole thing off again! The first time I did this routine, the deathly silence indicated that my son had fallen asleep from sheer exhaustion.  The second night (yes, you will need to do it each night till he self-settles) he eventually started talking to himself instead of crying and played with one of his toys for a while, then went to sleep on the rug.  The third night.... oh my goodness... he didn't cry when I left, he just started playing quietly by himself in his room... and took himself to bed when he was ready. Miracle!  It might take you longer than that- or not.

As children get older, things should settle down for a while- unless you're lucky (!) enough to score one of those very bright children who don't need much sleep.  Give them a good bed lamp and a great library of books, and go to bed yourself.  No point trying to keep up with kids like that!  Their brains are going way too fast to settle at 7 or 8pm, so don't expect it.  All the hot milks and warm baths in the world won't make a damn of difference, so relax.

My poor mother took my very bright brother to the doctor when he was young, because she was concerned at how little he was sleeping- midnight was his usual bedtime. The doctor gave her a sedative for him, and after taking it he stayed awake literally all night.  My mother would have done better to take the sedative herself and leave my brother to his books.  If you have a bright, wakeful child, the most constructive thing you can do is to snib that door so he can't start wandering around the house and playing with the kitchen knives if you fall asleep first. Your safety precautions become even more important than usual.

Teenagers are a completely different kettle of fish.  After all those years of  being woken by someone jumping on your stomach at 5am, suddenly you can't get them out of bed to go to school! Recent research has shown that this isn't actually bloody-mindedness- it's part of their normal development.  Don't expect a cheerful, wide-awake teenager in the morning, and you won't set yourself up for failure, because if you're lucky enough to get one of those it's sheer blind luck.  Let the poor kid sleep in whenever it's practical.  IT'S NOT THEIR FAULT, it's their circadian rhythms doing their adolescent thing.  Bring them a cup of coffee (or whatever they drink in the morning) in bed if you do have to get them up, and you stand much more chance of a civilised beginning to the day.

So I guess my message is one of keeping your sanity by any method possible in the early years, and tolerance in the later ones.  Children will usually sleep when they need to, unless they're sick or upset about something specific; the exception is those terrible toddler years, and then you've got controlled crying to help you if you're desperate.  Please don't be scared to try it- it does work.

9 comments:

  1. http://www.drmomma.org/2009/12/dangers-of-leaving-baby-to-cry-it-out.html

    Children will learn to "self-settle" in their own time. Co-sleeping/bed-sharing is not dangerous and does not mean a child will be clingy/sooky. Children will leave the family bed in their own time. Leaving a child to cry is disrespectful of their needs. They give up because they have learnt that no one is coming, not because they have magically learned to go to sleep. Very dangerous for growing brains.

    ReplyDelete
    Replies
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  2. I heard a story once of a child actually dying because the mother was told not to go into her baby's room until a certain time was up. VERY dangerous!!

    ReplyDelete
  3. http://www.aaimhi.org/policies.php

    Read the controlled crying one.

    ReplyDelete
  4. Hi Natalie- thanks for your comments. I do realise that this is a contentious issue!! -and I also realise that there are parents (and carers) out there who misuse the controlled crying technique and use it without due attention to the personality, age and needs of their child. Knowing your child is SO important. No parenting advice in the world can replace a mother's knowledge of her child's level of understanding and development.

    I did read the information in the link you provided. I agree that infants, ie children under a year old, should definitely not be subjected to controlled crying. I've worked in several babies' rooms at childcare centres, and putting babies in a cot room and letting them cry themselves to sleep does NOT sit well with me- I won't do it. This needs clarifying in my post.

    I have also become aware since writing this post that there are some children, especially those on the autism spectrum, who will not respond to controlled crying; because of limitations in their receptive language development, they are unable to process what is said to them and are not reassured, so naturally it doesn't work for them. Any parent who has noticed that their child doesn't respond age-appropriately to verbal and visual cues should not use controlled crying, and I will edit the post to include that information.

    Not sure about that story of the child dying 'due to' controlled crying- I would need more information before commenting at length, but certainly any sudden change in the child's style of crying should be investigated.

    On the flip side, I have absolutely no doubt that some cases of child abuse happen (and that also can be fatal) because exhausted parents simply can't settle their child to sleep and can't sleep themselves with a restless child in the marital bed. I know from experience how severe sleep deprivation can cause an adult to make bad choices, whether in the way they respond to their child or even just driving a car- you simply are NOT yourself. You only have to look at the amazing viral popularity of the online book 'Go the F*** to Sleep' to see that this is a huge, huge problem.

    Controlled crying saved me from becoming a bad parent. My son suffered no ill effects from it, it didn't affect his connection to me and it did teach him that he could settle himself; he discovered how to use his own resources to get to sleep at bedtime. I will be forever grateful to Christopher Green.

    Like all parenting advice, it's a tool to use if you think it fits your situation. It fitted my situation like a glove.

    ReplyDelete
  5. Okay, I've done a bit of editing to reflect Natalie's concerns and my own more recent learning. Feedback is good! Thank you, Natalie, for your care and concern for children.

    ReplyDelete
  6. The controlled crying method worked for my 2 children(nearly 3&5) back in the early 1990s. Single mum. It was very hard for me as I'd never let them cry to sleep. Ever!
    It was a matter of preparing myself to see it through and it only took 2 nights of chaos! I did what Dr. Chris suggested and was a very similar story to Aunt Annies. My darlings didn't like it one bit as we battled wills but they remained safe the whole time and were able to see me from the small opening in my bedroom, from the rope on the handle,that kept them from being able to get into my room. It would only open wide enough for them to see me. They'd cry and carry on trying to get in and I'd calmly reassure them that they were ok and needed to sleep. Go back to bed. I'd take them back to their owns beds. Say goodnight and quickly go back to my room, leaving the hall light on for them the whole night. It was a long night....
    By night 2 we were all exhausted from very little sleep on night one. I started the bed routine , bath, book and kiss and cuddle ect. Then, goodnight! Walk out and into my room with door rope again. Again it started, the crying ect, waiting times and put them back to their beds. After a couple of hours of this carry on, back and forth they both fell asleep on the hall floor.(carpeted, it was warm in the house) I got their pillows and doonas and covered them and made them snug. They woke up there in the morning. Very surprised I must say.
    I had won. The next night and onwards they stayed in their own beds all night. I'd do their bedtime routine and lie in their beds with them, giving a back rub until asleep. They knew I meant business. The foot was down!
    We were all much happier for it but it wasn't easy to follow through with. I felt mean but they knew they were safe, as they knew I was right there and could see me but not get in my bed.
    It's the battle of the wills and I won.
    Goodluck.

    ReplyDelete
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