Paediatric sleep consultant Lucy Wolfe on how to help your baby overcome sleep difficulties
FOR parents with a baby who finds it difficult to get to sleep by themselves and to stay asleep, daily life can very quickly become an uphill battle.
Functioning on just a few hours sleep, night after night, it’s difficult to imagine ever feeling well-rested again.
Paediatric Sleep Consultant Lucy Wolfe says there are two major contributory factors to most sleep difficulties.
“The first is where the baby is dependent – where they need things to happen (i.e. holding, rocking) in order for them to achieve sleep and potentially to maintain their sleep.”
Secondly, “the problem in lots of families, when a child has sleep difficulties, is that everything is too late.
“Most babies under the age of one need to nap twice a day, within two hours of being awake, but lots of families start the process two hours (later) or more. When the body becomes overtired it makes it harder to go to sleep and hard to stay asleep.
“I’d recommend that most families, from four to six weeks old, have some sort of flexible feeding schedule implemented throughout the day. Not allowing the baby to become overtired is the next big thing and you then work on getting them to sleep in a way that works for them.
“Really young babies need lot of help, lots of motion, lots of parental input. As the time goes by you work on weakening that. You allow them the opportunity to do one per cent of the work for themselves (by putting them down to sleep) and then two per cent and three per cent.
“If they are upset that’s not what this is about you take them up again. You try in a few weeks.
“If you get to four to six months plus that approach won’t really work. You’ll have to go through a sleep learning exercise with your child.
“As a practitioner, I don’t advocate controlled crying or cry-it-out. I’d be more inclined to use a modified gradual retreat, where there was lots of parental attention, lots of responsiveness. Then we work on phasing the parent’s presence out of the equation as the child fees a little bit more safe and secure in the overall context of their sleep.”
Susie Horan from Fermoy, Co Cork, who is married to Dave, has plenty of experience of sleepless nights.
From the outset her firstborn Sarah, now aged two, was in a lot of pain and cried incessantly. At seven weeks she was diagnosed with silent reflux.
“We got her on Zantac (a medication) and while it made her more comfortable the sleep just wasn’t coming,” says Susie.
“I was at my wits’ end. I met Lucy when Sarah was four-months-old. She put down on paper what I needed to start doing and Sarah was asleep in her bed at 6.30 that night. I could not believe it. We’d put her into her cot awake and we’d sit with her until she’d fall asleep.
“You could be sitting with her for an our or more at bedtime or at naptime [before she fell asleep]. But we got there. It was only a matter of weeks. She was in her grobag with a dummy and a blanket and it was a matter of giving the dummy back to her if she spat it out and loads of eye contact.
“When you child is happy and sleeping and you are getting sleep, life starts again.”
Senior clinical psychologist at Our Lady’s Children’s Hospital, Crumlin, Vincent McDarby says there is a perception among parents that because a friend’s child sleeps through the night at six, nine or 12 months, that their child should be, whereas in reality it differs from child to child.
“Very few babies will be sleeping through the night at six months,” says the psychologist.
“Children wake during the night. They cry, they are looking for comfor — to be picked up. We need to be aware as well that they can cry because they are hungry, uncomfortable, have a dirty nappy, are upset or are ill.”
He recommends a quiet and dark room to encourage night-time sleep. Also if babies are sleeping during the day, it’s best to let them sleep in well-lit rooms.
The belief that a baby will never learn to self-sooth if you keep picking them up is, “a bit of a myth”, says McDarby.
“When we pick them up we are teaching them to relax. This is not detrimental to babies. It’s something that needs to be addressed if it’s something that is causing the parent or the family significant stress, otherwise it’s good bonding with a baby. As they get older they get less reliant on that.”
There are lots of ways to help children self-sooth better.
“One of the things we should always do is we should put children to bed when they are sleepy rather than asleep. Very often we let babies fall asleep in a pram, then we transfer them to bed. So they are not learning to relax in the environment they go to sleep in.
“We want to be alert to the signs that our baby is getting tired. They will differ from baby to baby; that they are starting to get quieter etc — parents are very good at noticing these things.”
1. Regular sleep times are important. Waking by 7.30am is a good anchor to help get the day off to the right start and most young children benefit from a bedtime in the region of 7-8pm.
2. Ensure appropriate daytime sleep. Young children require daytime naps.
3. Know your baby’s sleepy cues; ie, brief eye rubs, decreased activity and staring into space often, represent sleep readiness and would be the optimal time to begin a sleep time.
4. Get out and about. Filling the ‘fresh air and outdoor activity quota’ is important. Aiming for 30 minutes in the morning and again in the afternoon is a good guide.
5. Have a feeding and sleeping balance to the day. Young children need feeding and sleeping frequently throughout the day.
6. Create a sleep-inducing environment. Adequately dark, without distractions.
7. Have a peaceful bedtime ritual that signals to your baby that it is time for sleep. Do this in the bedroom, with the lights turned down. Your task here is to relax your baby in advance of sleep.
