Sleep & Nap Issues: Nighttime Crying & Proof That Crying It Out Is OK

Don't flame the messenger, but here's more proof that SOME nighttime crying won't harm your baby -- and actually may help the whole family by boosting mom's mental health. A big shout-out to mom's health advocate Katherine Stone for being on-record about this hot-button issue. She risks the backlash that I've experienced here, but she does it for the health and well-being of families and babies. Kudos to you, Katherine!

The bottom line is this: Neglect, hostility, and abuse DO hurt babies. Blowing off some steam to settle down for a better night's sleep DOESN'T. Of course, individual personalities and circumstances make a difference: Pick up and comfort your baby if she's sick, super-scared, or if she has an unusually sensitive temperament (or, if you have a crying/barfer, like one of my kiddos. Who wants to be up all night AND clean a barfy crib?) If you want to argue, argue with the respected journal that published the research today, Pediatrics.

Judging parents for their reasonable decisions about their own children is NOT good for families and babies. So hurray for more proof that this controversial parenting decision doesn't deserve the attacks it often gets. Parents and children who get more sleep are happier AND healthier. That's nothing to cry about.

Aloha,

Dr. Heather

The BabyShrink Mom of Four, Parenting Expert

Sleep & Nap Issues: When Your Toddler Looks Tired -- But Won't Nap

It was 2 pm, and my toddler STILL hadn't gone down for her nap. Routines were followed, milk was drunk, and the house was quiet (no small feat around here, I assure you). She was rubbing her eyes, complaining -- but plowing ahead. Throwing her little arms in the air, she was chanting, "Up! Up!"

Some of you are pretty mellow about your toddler's nap schedule. But I'm the type who has to have "mellow" beaten into me with the stick of experience. "Toddlers are supposed to nap. Go to sleep, toddler of mine."

Not always that easy, is it? Turns out, none of my 4 babies ever read the Weissbluth or Ferber books, and they totally failed the "How Many Hours Per Day Babies Need To Sleep" test. They didn't follow those rules, and I was left fretting that something was wrong (and trying to soothe an overtired baby).

But guess what? I'm up at 3 am writing this post. Why? I can't sleep. I did my nighty-night routine, but my BabyShrink work beckoned me from bed. Your baby has important work to do, too. Sometimes, it's more important than sleep.

But what does a poor parent do with an obviously sleepy (but not napping) toddler?

Here on my 4th baby, I've discovered some important truths about nap schedules:

* The best-followed routine doesn't always work. Sometimes a nap simply isn't in the cards.

* Yes, an over-tired toddler sometimes means a cranky and difficult afternoon. But often, your toddler can rally and make the most out of the day.

* Toddlers are notoriously wacky about following nap schedules -- some more than others. Focus on nighttime sleep, and an earlier bedtime when there's no nap.

* Some parents attempt to hang on to that second nap for too long. If she used to be a good napper and now isn't, experiment with dropping the nap.

* Yes, I know: Sleep is important to a baby's brain. But as with food, parents need to focus on the overall amount, over time. A bad day ( or week) of sleep isn't going to do any lasting damage (except to us).

Now it's off to bed for me. If you're still awake, go and read more about your toddler's sleep challenges here.

Aloha,

Dr. Heather The BabyShrink Mom of Four, Parenting Expert

Sleep & Nap Issues: How To Cope While Sleep Training Your Baby

We're doing our own version of Sleep Training around here, since baby #4 has proven to be immensely resistant -- and LOUD -- in our efforts to help her sleep through even a decent portion of the night. Adorable as she is, she's the most rotten sleeper I've yet produced. Tough Love is in order. Sure, she sleeps OK in the stroller.

But Tough Love is rough on me -- and on the family. A fussing (or screaming) baby feels like a constant reminder of some kind of parental inadequacy, and is really grating on the nerves. Not to mention the fact that it often happens at ridiculous hours of the night when most other babies are surely sleeping soundly. And forget sleep for poor mom. I'm a zombie.

But persist I must. I won't give in to an 18-pound 8-month old, no matter how cute she is (in the daytime, at least). It will be worth it in the end.

Here are my tips for getting through this rough time, if you're going through Sleep Training:

Make sure you and your partner are on the same page. There's nothing worse than arguing about sleep training techniques at 2 am, standing outside the door of a screaming baby. Agree ahead of time -- or don't attempt it.

Prepare the older kids for nighttime noise. I tell my lightest sleeper that he may hear the baby fussing at night. "But you're a big boy and can roll over and go to sleep. Soon we'll all get better sleep."

Use a little reverse psychology on yourself. (You're so sleep deprived it just might work!) Instead of preparing for a night of sleep, prepare for a night of watching "guilty pleasure" TV, listening to great music from your (childless) past, or even folding laundry. Fooling yourself into thinking you don't really need to sleep somehow makes it less painful to be up at weird hours.

Take a deep breath, have a zen moment, do some mindfulness meditation, yoga, or pray -- pick your version of expressing gratitude and relaxation. Having a non-sleeping, screaming baby at 2 am is really hard. But in the scope of things, not really that big of a deal. A few moments recalling the years when we feared we couldn't get pregnant, or thinking of friends who have a baby who's quite ill, and others who have God forbid lost a child, and I'm ready to get through another tough night of sleep training. Having a healthy, happy, non-sleeping baby is a high-class problem we're blessed to have, quite honestly.

I've written other posts about getting through the sleep deprivation aspect of this, but let me also mention our friend caffeine here. Don't overdo it. At my peak, I have a mug of java in the morning, some iced tea at lunch, and another cup of coffee around 2. That's 3 servings a day. Any more and I get frazzled and nutty -- and no more awake than if I had stayed with the 3 servings. Studies say that some coffee is fine for most of us, but too much will definitely make you feel worse.

Sleep Training eventually works -- I'm writing this now as the baby sleeps nicely in her crib. Get through the rough nights and I promise things will improve!

Aloha,

Dr. Heather The BabyShrink Mom of Four, Parenting Expert

Sleep & Nap Issues: Got a New Baby? How to Manage The Sleep Deprivation

Boy, am I tired. You'd think I'd get used to the lack of sleep by now -- this is our fourth child, after all. But the crushing effects of sleep deprivation continue to be the hardest part of parenting, for me. I could change diapers and nurse and even chase toddlers all day long, if I could just GET SOME SLEEP. But this baby is just like her siblings, and she sleeps sporadically at best. At 4 months of age, she sometimes awakens once or twice at night -- but more often three or four times -- to nurse and be comforted. I've got 3 other kids, a day job, and you, dear reader, to keep me more than busy. I'm tired. IMG00341

When I had our first child, I had secret visions of the wonderful sleep-inducer that I'd be. "Babies need sleep, and so do parents. I'll get the baby to sleep." Somehow, I thought I could use my super-shrink powers to calm, soothe, or hypnotize her to sleep.

I was wrong. Our first didn't sleep reliably through the night until she was four. FOUR!

Since psych grad school, oddly, is completely unhelpful in the preparation for parenthood, I sought out and read every single "Baby Sleep" book out there. All the major titles. I tried everything, religiously. Didn't work.

And in the process, I got more and more sleep deprived myself.

There's not much recognition out there that parents' sleep deprivation often goes on for a really long time, and despite how difficult that is, it's actually quite normal and typical for a baby to be up a lot at night for several months, and even beyond. I was doing some research for this post and I found something really annoying -- most articles only address the FIRST MONTH of how to survive with a newborn. The implication is that things really improve in the sleep department after that first month of your baby's life. AS IF! In the first month, you're getting by on adrenaline, grandma's help, and that extra sympathy and interest everyone still has in the new baby. It actually gets WORSE after that first month; you lose most of those extra perks, the baby STILL doesn't sleep very well, and you're slowly but surely losing your mind from the accumulated lack of sleep.

And of course there ARE some babies who sleep beautifully from very early on. (But parents of THOSE babies aren't reading this post, are they?) It makes those of us with crummy sleepers feel there must be something wrong with my baby; or, there must be something wrong with my parenting. The urge to compare our babies to other babies is just too tempting. Not recommended, but hard to avoid.

When Your Baby Starts to Sleep Better...and then Regresses It's also easy to worry that "something is wrong" when your baby seems to be sleeping better....then all of a sudden is back to waking several times a night. Please know that regression is normal in many developmental areas, especially in early childhood. Sleep is no exception. My second-born slept a good NINE hour stretch from the age of 9 weeks until the age of five months. Then he started trying to roll over, and he roused himself several times a night with his new-found pursuit. After prematurely congratulating myself that we finally had a decent little sleeper, I just about lost it when he regressed back to waking several times each night again. Just as you get used to being up all night with a newborn, you also quickly get used to regular sleep again. And when your baby regresses and you have to go BACK AGAIN to being up and down all night, it somehow feels WORSE than when you were used to it before. "Of Course, MY Baby Sleeps Through the Night!" Another thing that happens is that we compare our experiences to other parents'. That's a mistake, because PARENTS LIE. Not all parents, but enough of them DO get caught up in the game of comparing kids that you end up getting some pretty skewed information. And for some reason, the misinformation also comes from other parenting "resources", which are often misleading. Even most pediatricians have little sympathy for our sleep deprivation. After all, most of these doctors take overnight call and had to be awake for their residency training for a couple of days at a time for years, so sleep deprivation is a relative term for them. And when your pediatrician says you can expect your baby to "sleep through the night" at 12 weeks of age, guess what she means? Sleeping a 6-hour stretch (sometimes, at least), is considered "normal". But in my book, that's not sleeping through the night, especially when most babies that age want to go down for the night at around 7 or 8 pm. By the time YOU get to bed, the nighttime rounds are just beginning.

The WORST advice you get is to "sleep when the baby sleeps". Well, DUH. But it's not that easy, is it? Babies' sleep cycles can sometimes be so unpredictable that they have their best stretch of sleep smack in the middle of the day, when you need to shop, cook, do stuff with your other kids, and otherwise live your life. Waking up every hour or two in the middle of the night is often more the reality for many young babies.

And I don't know about you, but it's impossible for me to sleep "on command". OK, baby's asleep now, ready, get set...SLEEP! It doesn't happen that way, does it? There are biochemical reasons for that. Once we're awake for far too long, or we're awakened one too many times at night, our bodies start to produce hormones to keep us awake. That's when you get that hyper, wired, "I-know-I-should-be-sleepy-but-I'm-wide-awake!" feeling at 3 am.

You might think that I'm going to give you some fabulous secrets for getting your baby to sleep. Sorry, folks -- sleep is one of the things you can't "make" your child do -- along with other bodily functions like eating and pooping. And if I had found the holy grail of making a baby sleep through the night, I would be a very rich Baby Shrink indeed. The truth is, nobody's done that. But I have come up with some tips, over the years, from both my experience as a shrink and as a mom, for how to SURVIVE the sleep deprivation that most of us experience with babies:

How to Survive Baby-Induced Sleep-Deprivation In order to be safe behind the wheel of a car and to keep your body (and mind) relatively healthy, you MUST get at least adequate sleep a couple of times a week. Consider this a Doctor's Order: GET HELP so that you can at least 1) sleep in at least 2 mornings a week, complete with eye shade and ear plugs so that you don't feel like you're "listening" for the baby, and 2) get at least a 90 minute break most afternoons when you can lie down and rest (and hopefully sleep). If you're a first-timer, it might not be easy to trust anybody to care for your Babe, even if you're eyes are crossing from lack of sleep. But you MUST force yourself allow a trusted person to help you. Not easy to arrange? I know. Essential for your health and well-being? YES.

Get some exercise -- preferably outside -- for at least a few minutes each day. I know it feels impossible when you're wiped out, but there really is a magical effect in taking even a few minutes' brisk walk. Getting outside in the sun will also help to re-set your circadian rhythms, which are being hammered by your 24/7 schedule. I promise, you'll feel better. You might also be able to sleep better when you get an opportunity later on.

Learn meditation and breathing techniques to calm the stress hormones that keep you awake when you should be sleeping. Any "mindfulness", prayer, yoga, or other meditative technique that focuses on breathing will work. If you feel hyper and over-tired, even TEN SECONDS of mindful breathing will help you slow down and feel better. But do strive for 15 minutes a day in order to get your stress hormones under control. This will help you to sleep better when you DO have a chance.

Don't obsess over how little sleep you're getting. Believe me, I've been there -- staring at the digital numbers on my bedside clock, getting madder by the minute about yet another night of lousy sleep, up and down with the baby. The less sleep you get, the more upset you become, and a vicious cycle begins. Don't obsess about it. Let it go. Tell yourself: Oh well, another late night. This is something I can look back on later in life and laugh about. I know I feel beyond exhausted right now, but this too will pass. And if you can't sleep, then read or watch TV. Just give yourself a break about it.

Don't compare the amount of sleep you're getting now to how much sleep you USED to get or need. I know you used to sleep in until noon, and you couldn't function with less than 8 hours before this, yadda yadda. But your body has changed -- you're a parent now, and things ARE different. Yes, your body needs sleep, but you're also pretty good at adapting to less sleep -- at least for the short term. It feels impossible to "roll with it", but that's what you've got to do.

Don't be afraid of the "Cry It Out" method for your baby -- once she's old enough. I think you can safely start that at about 9 months of age for most babies -- after they have sufficiently developed the memory skills to remember that you'll be coming back eventually, despite being left to cry (and sleep). Before then, you can (of course, with your pediatrician's blessing), allow baby to fuss, grunt and make noise before rushing to get her; many babies are NOISY sleepers (another reason for them to sleep in their own rooms), and don't actually need to be picked up. Try to learn the difference between "grunty-noisy-baby-sleep" noises and actual "come feed or comfort me" noises.

And finally, try to adopt a bit of a Zen attitude about all of this. Because your crushing sense of exhaustion will quickly dissipate one day, sooner or later, as your baby naturally develops a better capacity to sleep at night. Then you'll be on to the next parenting challenge. So pace yourself. Our oldest is almost 9 and I still almost cry in relief as I check in on her, in a deep sleep, late at night. How can they grow this fast? (Cue the music to "Sunrise, Sunset".) Is this the baby that so challenged my sense of order in the world, simply because she wasn't a great sleeper for the first few years of her life? And here she is, a beautiful, intelligent, happy third grader, reliably sleeping from 8 pm to 7 am every day. Development is a magical thing, people. We parents can only provide love, structure, safety, support and guidance to shape these fabulous creatures that are our children, while the amazing processes of "growing up" happen before our (sleep deprived) eyes. We can't "make" them sleep, but we can't "make" them roll over, sit, stand, speak, and run, either. So step back for a minute to bask in the miraculous glow of your child's growth and development. It's a beautiful thing! I hope this helped. And now, please excuse me while I try to get some sleep!

Aloha,

Dr. Heather The BabyShrink Mom of Four, Parenting Expert

Here's another post on babies and the normal range of their sleep patterns.

Toddler Behavior: What to do When Your Toddler Won't Nap Anymore

It happens to the best of us. We work so hard to establish nice, regular nap schedules for our babies. Finally, we've gotten used to a more predictable nap schedule for our toddler. And boy, do we need it: Running around after a toddler all day is HARD WORK. We need that couple of hours to clean up, get stuff done, pay attention to a neglected sibling, and sometimes -- gasp! JUST RELAX! Then, it happens. One day, your toddler decides that, hey, why not just STAY AWAKE, instead of go to sleep? There's so much to do, let's just keep the party going ALL DAY LONG! And the frustrating thing is that, usually, she'll nap perfectly well at daycare. This makes us feel like WE'RE doing something wrong.

UGH. A non-napping toddler triggers desperate measures. We lie down with the offending 2 (or 3)-year old, we pretend WE are sleeping (and sometimes, we don't have to pretend!). We bribe. We cajole. We threaten. Sometimes it works -- and sometimes it doesn't. And on the days it doesn't work, our toddler is a fussy, tantrumming mess by dinner time. Or worse: she falls asleep in the car at 4pm, meaning she'll then stay up till 10 or 11 pm! Yikes!

Nap schedule? What schedule?

Reader Ilima worries that her 2-year-old still needs a nap, but has starting refusing to sleep. What to do, she asks?

Dear Dr. Heather,

I have a napping question. My daughter still takes naps at day care, but we can't get her to nap at home. At home she gets out of her bed and won't stay in. If I leave her alone she just gets out and plays in her room. If I stay and supervise, she does whatever she can think of to provoke me and get a reaction, and it becomes a game that gets her stirred up. If I lie down with her, she just wants to talk and play with me. She's 2 and a half now. She still seems tired, and I know naps are important for her brain development. Any thoughts?

Ilima

Dear Ilima,

I've been there. All morning long, you're talking yourself through the frustrations of dealing with a toddler by planning what you'll finally be able to do, once she goes down for her nap. If I can just make it until 12:30, I can eat a nice, peaceful lunch, straighten up this mess, and catch up with a friend on the phone. But your toddler's got other plans.

What Not To Do You can't force anyone to sleep, especially a toddler. It's similar to feeding and potty-training issues. Trying to force a toddler to eat, poop, or sleep is a setup for disaster. You don't want to trigger a power struggle -- one that you'll lose -- by trying to MAKE her follow her nap routine.

You also can't allow yourself to get desperate and miserable about this new turn of events. I know it's really easy to get comfortable with a nap routine, and it feels impossible to get through the day without it. But don't panic. Here's why: Your Baby is Growing Up! Babies NEED to sleep during the day. Their brains can't handle all that stimulation without shutting down after a few hours. But your toddler's brain is growing past that stage -- and isn't that an amazing thing? She can handle more now. And despite what other "experts" may say, most children automatically get the amount of sleep they need, more or less. They require your direction and support, but they don't need you to closely control their need for sleep. As my mentor (an infant development expert) said, while scolding me for putting too much emphasis on my own toddler's nap schedule, "If she's tired, eventually, she'll sleep! You don't need to make a federal case out of it!"

But She Still Seems Tired! I know. this development thing isn't perfect. She'll still have crabby, tired days as she transitions from daily napping to no naps. Some days, she'll absolutely NEED to nap. And on those days, feel free to insist that she does. But on days that she resists -- let her stay up. If she falls asleep on the couch or in the car later, wake her so that she doesn't stay up to an ungodly hour. Eventually, her boody will adjust, and she'll sleep in later in the mornings, or allow you to put her down at night a bit earlier, or nap once in awhile.

Then Why Does She Nap at Daycare? Take it as a compliment -- daycare isn't as fun as home. Your toddler would MUCH rather be up and having fun with her family. Unfortunately, she also saves her worst toddler moments for you as well. That's why this "Dr. Jeckyll/Mr. Hyde" sort of dual-personality thing is so common at this age. All her very best -- and very worst -- moments are reserved for you!

Tricks for the Toddler in the Napping Gray Zone If you know she needs a nap but she's been resistant, use these tips that I learned from our kids' expert babysitter. Say, "Today, you don't nap. But you need to lie down in your bed with your book for 30 minutes. But whatever you do, DON'T GO TO SLEEP!" Often, your oppositional toddler will resist your suggestion to NOT SLEEP -- by sleeping. (Hey, I never said they were RATIONAL as toddlers, just OPPOSITIONAL!)

Decide in advance that she won't nap on a certain day, and make a big deal out of it. Say, "Hey! Today is a NON-NAP DAY! You get to be a big kid and NOT NAP! And on non-nap days, bedtime later is at 6:30, because you're SUCH A BIG GIRL!"

Plan your life differently. From now on, you won't be able to count on mid-day time for yourself. But you CAN plan for more evening time. You can also plan your toddler's day accordingly. Set aside "quiet time", "free play time", and other set blocks of time when you encourage her to entertain herself. Reward her with praise or little rewards for playing nicely and quietly for increasingly longer blocks of time. As she gets older, you'll be able to count on her more and more, so that you get little "mini-breaks" throughout the day, instead of one long nap period.

Remember, your toddler is becoming a KID, and kids don't need daily naps. Kids go to school, go to sleepovers with their friends, and in general gain more independence every day. (Sigh! I know it's a cliche, but now that our oldest is 8, I see how truly fast they do grow up!) This is just another phase in the amazing process that guides the development of your child. Hang in there!

Aloha,

Dr. Heather The BabyShrink Mom of Four, Parenting Expert