What is a 'sleep problem'? (c)
Defining a problem is very difficult. Psychologists report wide variation in how parents perceive what a problem is. Some over-idealistic, inexperienced parents are totally horrified by even half an hour of crying or the very fact of night feeding during the first weeks. Others will put up with almost anything.
A situation is only a problem if you find it problematic, and the aim of this book is not to make you feel guilty about what you are doing if everyone is happy with it. However, it is worth knowing what the long-term consequences of your current routines might be. What does not seem a problem at 7 months (e.g. lying down next to your baby for half an hour while she goes to sleep every evening) may well seem a problem when you have to go on doing it for several years, or if your young child will not let a babysitter replace you!
The founders of 'The Crying Baby Clinic' in the USA, have attempted to create definitions in this elusive area. They define a child with a sleep problem as:
An infant who does not have a regular sleep/wake pattern of 9 hours' consecutive sleep during the night by 6 months of age, and who wakes up more than 3 nights per week for more than one month. They also define a child with a problem as: A tired child who takes over 30 minutes to fall asleep on her own - when this pattern continues for over a month.
Does my baby have a problem? (Babies 6 months or older)
A baby of under 6 months would not normally be classified as a 'problem' (even though the advice in Section 3 will help you with babies of this age who are finding it hard to settle.) Although there are no hard and fast rules, you may find these questions helpful for babies of 6 months or more:
1. Does she sleep significantly less at night than the average for her age?
2. Is she unable to fall asleep without my physical presence (to feed, rock, stroke, etc)
3. Does she wake and cry for me regularly in the night?
4. Is my work/health/relationship/family being negatively affected by sleep deprivation?
If you answer 'yes' to two or more of these, then you can certainly benefit by following the baby sleep programme in Sections 5 & 6 of this guide. Sections 3 contains the keys you need to encourage your younger baby into independent sleeping and will help you avoid the need for a more structured sleep programme later on. (Don't worry if your child is older than 6 months; the programme can be commenced at any point up to 18 months of age, although it may take longer for older babies.)
Results from the ALSPAC study found that
- 33.1% (one third) of 6 month olds were waking up either most nights or every night - and
- 49.5% (nearly half), were waking regularly once or more per night at 18 months of age.
This would seem to indicate that if you wish to avoid a wakeful toddler later it, it is even more important to ensure that your younger baby is encouraged into good sleep habits right from the start.
How do problems start?
'She did sleep well, but now she wakes …..'
Some babies start off sleeping through the night as newborns, but then their sleep patterns deteriorate. This can occur for a variety of reasons, many of them unavoidable:
- an illness, teething or a period of colic
- a major change in routine such as moving house
Other factors listed in the literature as being linked to sleep disruption in young babies include stressful events in pregnancy, particularly difficult births, premature or low birth weight babies and parental stress. However, knowing what caused your problem does not necessarily bring about a cure!
How we parents can make things worse
The factors listed above are largely unavoidable. But there is one important thing that we can change and control and that is the way we as parents behave with our baby. When a baby is newborn, we naturally tend to soothing behaviour such as rocking, making certain sounds, holding her and providing movement which soothes crying. One writer, Dr.Harvey Karp (see further reading section) believes that the reason the newborn babies all seem to respond so well to these things is because certain kinds of noise, touch and motions mimic the womb environment. This provides 'extra womb time' for babies who are necessarily 'evicted' rather too early from the womb so that their big human heads can get through the birth canal.
As these things work so well for a newborn baby, the natural tendency as parents, particularly when we are in a state of sleep deprivation, is to cling desperately to any routines and tactics which have worked in the past. As a result we can find ourselves with a ten month old still needing us to carry out a range of bizarre activities long after they are really appropriate. Worse, by continuing these, after a certain age we are actually training our child to need them! This guide will show you how to wean your child off these things and hence not cry for you.
Katherine Davis, Bath
'On many occasions I ended up driving around with her in the car at 3am and then trying to sleep in the car myself once she was asleep!'
Rhianwen Gilson.
'James at 13 months woke at least twice each night and had to be rocked to sleep in our bed. We felt desperate'.
Mrs. Clarke, Staffs.
'I used to have to lie down on the bed next to Jonathan, sometimes for hours, just to get him to go to sleep'
Sleep deprivation - a health warning
There are two main reasons for avoiding or curing a sleep problem. The first is to protect the physical and emotional well-being of yourself and your family as a whole. If your baby is not sleeping, then either or both parents will be sleep-deprived. Effects of long-term sleep deprivation listed in the literature include: disorientation, weight loss, chronic fatigue, irritability, depression, broken marriages and child abuse. There are cases where individuals already predisposed to illnesses such as ulcers and diabetes have developed these through the long-term stress of living with a night crier. Sleep deprivation is so debilitating that it has been used in prison camps and in cult programming to destroy the ability to think and concentrate.
Angela Brewer, Spokane, USA
We were both a wreck. Our production at work suffered and we even missed days due to no sleep. We were so exhausted that we were irritable and just all around miserable.
Maree White, Bath
'I was finding it increasingly difficult to cope with my other child, 2 year old Melissa. I felt as if my baby was in charge, not me. I had forgotten what it was like to feel rested and refreshed.'.
What is important is to have a period of uninterrupted sleep, not several hours of broken sleep. When parents are at the 'end of their tether' this can lead to a stressful and chaotic environment for the child's early development. And if, as in some extreme cases, the situation contributes to your relationship actually breaking up, this is obviously far from ideal for the child.
The second reason for avoiding sleep deprivation is to further the child's own physical and emotional well-being. Broken nights and the tiredness these produce will interfere with your baby's mood and feeding routines and will ultimately affect a child's physical and psychological development. Babies and children who find it hard to sleep may also end up with sleep problems as adults.
Natasha Radford, Essex
Holly (now 10 months) never slept during the day and averaged 4-5 hours night's broken sleep. I looked and felt exhausted and near to the edge of a nervous breakdown. Both she and her our poor 2 year old had to put up with a grumpy, edgy mummy most of the time.
Take action now!
If, having read this chapter, it has become clear to you that you have a sleep problem, it is important to take action soon, especially if you and your family are all suffering from the side-effects of sleep deprivation. If you postpone taking action because it seems easier in the short term, you will only find it harder to put into effect later on .
If you do nothing, the sleep problems may improve on their own, but it could take many months or even years.
Advice from a reader -
Rhianwen Gilson, Wiltshire
Don't put off trying to tackle the problem (as we did), it just gets more difficult. Remember it is much better for your child as well as for you that they learn how to sleep happily
POINTS TO REMEMBER
- 1/3 of 6 month old babies still always or usually wake at night, but this can often be prevented
- Sleep deprivation can have serious effects on your health, wellbeing and family life
- If you maintain early soothing strategies into older babyhood you may prolong night-waking
- It is always best to take action sooner rather than later - things tend to get worse
