broken sleep
Sleeping

No more broken sleep

Paediatric sleep consultant Lucy Wolfe tells us how to banish sleep woes to ensure better shut eye at night for your entire family.

Children’s sleep problems are all too frequent and come in a variety of guises. Studies suggest that 30%- 69% of children experience a sleep disorder at some point. This can include trouble going to sleep and most commonly difficulty staying asleep.

What constitutes a sleep problem?

This may vary from household to household. Our task as parents is to ensure that our children are getting enough uninterrupted and good quality sleep for their bodies. Broken and inadequate amounts of sleep can have implications for a child’s mood, behaviour and cognitive development. It is a vicious cycle; children who get less sleep one night, will potentially have trouble sleeping well the next. What do you do when your child insists on visiting you overnight?

Where does your child sleep?

To begin, it is necessary for parents to decide on where they want their child to sleep. Some family units want their children to sleep in their own space and to maintain this overnight. Others practise a ‘family bed’ scenario where co-sleeping is normal, either from the start of the night or at some point overnight. Co-sleeping is quite common, 35%-55% of pre-schoolers sleep with their parents and once that suits everyone, then there are no sleep issues.

When co-sleeping helps your child to doze off

However, if you are a ‘reactive’ cosleeper are and only operating a family bed sleep approach in an effort to get sleep, you may need to help define what the sleeping arrangements should be for your child and family unit. You may need to help your child to understand what is expected of them and where everyone should be, both at bedtime and in the overnight period. Lots of bed hopping can mean broken sleep for everyone, often resulting in one parent leaving the bed to sleep in the spare room to make space for the visitor.

Define your child’s sleep space

Lots of parents report nocturnal visits from their children. Often this can be due to the way the child is going to sleep at bedtime. If the parent puts the child to sleep in the family bed, only to transfer them to their own bed once asleep, you can potentially expect a night caller, wanting to simulate what happened to him/her at bedtime.

Also, if you lie down in your child’s bed or use drinks or other sleep aids in order for them to go to sleep at bedtime – reasonably, she may request a replay of events from last night’s bedtime.

Sleeping is a skill

Young children typically require skills to self-regulate, self-quiet and go to sleep without a parent present in order to become efficient at sleeping soundly overnight.

Some children can be independent at bedtime and still visit the parent’s room overnight – they may not have learned to ‘stitch’ their sleep together without parental presence; this is a learned behaviour and may also need to be addressed in isolation. If you want your child to sleep in their own bed, in their own room, then this is where your child’s sleep should begin at bedtime and end in the morning time.

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Make sure bedtime is appropriately timed

Ensure that the time that your child goes to bed is appropriate for them. Watch out for overtired signs such as intense eye rubbing, hyperactivity, impatience, crankiness; all of these factors can make the body find it more challenging to actually stay asleep overnight. A reasonable bedtime for most children is between 6pm – 8pm.

When dealing with your child overnight, it is a good idea to meet them in the hallway if you can, so that they never make it to the parents’ room. Definitely don’t let it get to the stage that they are climbing into bed with you. Try to be as responsive as possible, but also be firm and clear in your expectations. Return them to bed and stay with them, if necessary, until they go back to sleep.

It takes practice

You may need to repeat this exercise a number of times and gradually reduce parental attention and presence. This will take time and patience with many parents experiencing long wakeful periods overnight. This is short-lived and the long periods will shrink with your child ultimately learning excellent sleep skills for life. Be prepared for protestations from your child, help him/her process the changes and always maintain a high level of consistency in your approach.

Help them to understand sleep

It may help to make a booklet with your child to help them understand that you want them to sleep in their own bed all night long. Illustrating this in words and pictures can help with understanding, but will not eliminate protest.

Any changes that you make with sleep can potentially be met with resistance.

Make a decision, formulate a plan of action and understand that it can take upwards of four weeks and sometimes longer with older children to change the pattern of behaviour. Ensure that your child has a calm bedtime routine that happens before you want them to go to sleep. I recommend that this happen in their bedroom, outside of the bed. Allocate at least 20 minutes to get ready for sleep, getting changed, doing songs and stories and generally helping their little body to relax in advance of sleep.

Good luck and sweet dreams!

Lucy Wolfe, CGSC, MAPSC, is a paediatric sleep consultant and mum of four young children. She runs a private sleep consulting practice where she provides knowledge, expertise and valuable support to families across the country. See www.sleepmatters.ie

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ASK LUCY

Q My son is 18 months old and has just started saying his first words. It is an extremely exciting time in our house and my husband and I are eager to encourage his speaking as much possible. What advice would you give us on how we can foster this without bombarding and confusing him?

AThere is nothing better than hearing your baby begin to talk. All the hard work you have put in over the last two years is coming back tenfold.
Toddlers will vary significantly with ability and speed of which they talk however a guide would be about 50 words by 2 years of age. The most important thing to watch for is that your baby/toddler is cooing and babbling and begins to string sounds together like “Mama/Dada” They should have a wide range of speech sounds and like to imitate you and things they hear.
There are many ways that you can promote Speech and Language development at home:
1. Slowing down your own speech and taking time over conversations with your little one. Every day is a new experience when you are 18 months, nappy changes, bath time, baking a cake brings endless opportunity for you to interact and offer new words for them to hear and repeat. Make eye contact, smile and use exaggerated tones to keep things interesting and fun for your tot.
2. Review the toys that you have on offer to your tot and ensure that they give plenty of open ended play opportunities. Role play is a wonderful way to allow children to take the lead. Kitchens with lots of plates, cups and pots. Fill the pots with dry pasta and allow your child to cook and serve you. Playdoh, painting, gardening and sandpits are also great for allowing your child to take the lead and babble about what they are doing. Read plenty of books together and point and allow them time to answer any questions that you ask.
3. Limit screen time. Overuse of televisions and iPads do not give your child opportunity to interact in a two way manner.
4. Ask your child lots of open ended questions “What’s that?” “Where are we?” Point at things they know the answer to for boosting confidence (Car/ Car, etc.) When they don’t know the answer, explain it to them. Limit baby talk and speak clearly with good pronunciation, remember you are the teacher and they will copy you.
If you are concerned about your child’s speech and language development, be sure to speak with your GP or developmental Health Nurse. They are very skilled at understanding the difference between speech delays and spotting something that may require professional attention.
Enjoy watching their little brains absorb the world around them and listen to what they have to say. It won’t be too long before they won’t stop talking to you, asking “Why Mummy/ Daddy?” every 5 minutes….

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Ask Sarah

Q I’ve heard a lot about the Paleo diet and as I am very interested in reducing the amount of processed foods and grain based meals my family eats, we are considering following this diet. From what I read it seems to be a back-to-basics type of eating. Is a Paleo diet safe for children? My kids are aged seven and nine.

A The Paleo diet is one of the most fashionable diets around at the moment. It is also known as the ‘caveman diet’ and is based on cutting out processed foods, starchy foods like bread and potatoes and eating more meat, vegetables and fruit.
As fad diets go, it is not the worst but there are some good and bad sides to it. Reducing the amount of processed foods we eat is always a good idea and by doing that you will usually reduce the amount of fat, salt and sugar you eat, which is a good thing! The problem with the Paleo diet is that it also cuts out dairy (on the basis that cavemen didn’t drink milk) and this means that the diet is very low in calcium. For this reason it is really not suitable for children who do need a lot of calcium for growing bones. How did cavemen manage without dairy? They ate a lot more food than we do (up to 10,000 calories per day compared to the 2,000 most of us eat). By eating that amount of food they were able to pick up just enough calcium from green vegetables and seeds. To put it in perspective, you would need to eat 16 servings of broccoli a day to get all the calcium you need. This is easier to do if you eat 10,000 calories per day rather than 2,000.
The other problem with the paleo diet is that it is not entirely based in science. Many of the Paleo diets out there say you should not eat wheat, even though we know that cavemen did in fact eat wheat and other grains. These diets also don’t recommend that you eat blubber and the big lumps of fat that were also a large part of the caveman diet!
A final problem is that many Paleo diets encourage people to cut out beans and lentils and to get their protein from meat and fish instead. Many studies over the last few years are clear that eating too much animal protein is linked with more cancer and heart disease. Eating some vegetarian meals based on beans and lentils is a great way to get your protein without always going for meat.
Is this a diet we should follow? I think there is a lot we can learn from the Paleo diets. We could all do with eating less salt, sugar and processed foods and adding in more nuts and seeds as well as more vegetables. However, I think following a strict Paleo diet could lead to low levels of calcium and vitamin D and so it is not suitable for children or teens and adults would need to think about a calcium supplement.