Lucy Wolfe
I am a sleep consultant and mum of four children. I work with families and children from birth to six years of age to establish positive sleep associations in the early days and to address frustrating sleep problems from six months onwards – without leaving a child alone to cry.
First of all, it’s important to emphasise that not all sleep challenges require intervention or ‘fixing’. Infant sleep is highly complex and not at all organised and so what feels like a problem may well be just what your child’s sleep looks like at this early stage. However, as time evolves and your child gets older and more robust, most sleep challenges will benefit from adjustments and intervention.
From around six months of age, the character of your child’s sleep has locked into place neurologically and the originally disorganised nature of infant sleep starts to become more organised.
At this stage it more or less looks like adult sleep, except the young child needs more sleep than an adult and they dream more, too. Essentially, your child will start to have to cycle through their natural sleep phases and this is where issues can start to arise.
Factors
There are two major contributory factors to most sleep issues in babies aged six months and over. The first might be described as a parental dependency in the context of your child’s sleep. This means that if you are involved in getting your child asleep or partially asleep, your child is not yet independently able to go to sleep themselves.
When a child of six months and older who has been helped to sleep starts to cycle through sleep, the brain will periodically have a ‘partial arousal’. This is a bit like a ‘check-in’ system, where the brain checks to see if everything’s okay – ‘is everything the same as it was when I first went to sleep?’ If it is, your child will more than likely roll over into their next phase of sleep, unless they are hungry and require a feed.
Unfortunately, if there is a level of dependency at this age and stage, when the brain checks in and things are not the same – the bottle/dummy/breast/parent is no longer present – or the child has been transferred to the cot or bed already asleep or very sleepy, this partial arousal becomes a complete arousal and your child will call, cry and look for you to help them into their next phase of sleep.
The second part of many sleep struggles, and one that is more significant for some families, is all about the internal body clock – your child’s circadian rhythm. This rhythm will not be completely set until after the age of around four years, but it is of enormous significance from birth.
Your child needs lots of sleep, including daytime sleep, and they also have what I would describe as an ideal time or optimum time to be awake and an optimum time to be asleep. Young children who are not in sync with these times may find it more difficult to either go to sleep or stay asleep or, for some, a bit of both.
Timing for sleep is everything and although in the early days I endorse flexibility, at this age I would perhaps become more prescriptive. Often families that I work with have timing issues and nothing else. This makes the sleep issues no less challenging, but they can often be the reason why parents feel they have ‘tried everything’ and nothing has worked.
What does your child do when they start to get tired? Perhaps they get cranky, whiney, fussy, moany? These obvious signals usually indicate an overtired child: intense eye rubbing; wide yawns; stretching limbs; clenching fists; arching the back; becoming agitated, a little bit impatient, unreasonable and non-compliant; wanting to get up with you, then wanting to get down again; not really knowing what they want.
Going to sleep when you are overtired often means that the brain is in a heightened state of neurological arousal. This means that your child sleeps lightly and everything wakes them – a flush of the toilet, creaking stairs, for example. You may be experiencing frequent nighttime arousals directly after bedtime, or maybe long wakeful periods overnight, perhaps some early rising and/or short and varied nap durations. All of this can be a sign that your child’s naps or bedtime, or both, are happening when they are already overtired. Sometimes it can be as little as 10 minutes too late!
The premise of the bedtime routine is to bridge the gap between wakefulness and time for sleep and I suggest that you not only do this at bedtime, but for nap time as well. When you have an order of events at bedtime and follow the same procedure every night, it is a great sleep cue for your child – ‘this is what happens to me when it is time for sleep’.
The perfect bedtime routine
1. Quiet the house an hour before bedtime. Turn off the television/computer. Spend one-to-one time with your child.
2. Finish any feeds in the living room or kitchen, so that you work towards weakening a potential feeding–sleeping association.
3. Consider a soothing bath to round off the day if you have the time. Alternatively, do a quick face wash and teeth brush and then go to your child’s bedroom for the rest of the bedtime sequence.
4. In the bedroom, dim the lights, pull the curtains and consider using white noise in the background, at the volume of a shower, to help regulate your child’s heartbeat and relax them. Turn this off before they are asleep.
5. Get your child ready for bed: change the nappy, put on the pyjamas and get them into their sleeping bag if you use one.
6. While getting your baby ready for bed, sing a particular song and say the same words over, so that they can learn the words that you say before lights out – ‘sleep time now, Harry, it’s night night… ’
7. Do some quiet reading or story-time with your child.
8. Provide a 20–30-minute wind-down. Build a process that you can add to as your child grows up.
9. Have an end to your routine; a certain phrase, turning off the lights or an ‘I love you’ ritual that signals the end of the routine and the start of your child needing to go off to sleep.
10. Then place your child in their cot – relaxed but awake – and use the stay-and-support approach if required.
Lucy Wolfe is the author of The Baby Sleep Solution published by Gill Books.