Monday, 1 February 2016
Night waking
Initially babies require one or two feeds during the night. Most will barely wake to feed, do so efficiently and swiftly return to sleep. This physical reuirement gradually reduces to one night feed and then to sleeping through. Formula fed babies should be able to sleep through by about six to nine months. Breast fed babies often seek a night feed for longer. As long as night feeds can be completed without prolonged waking most mums will cope well.
Some mothers try to eliminate a feed by replacing it with water. While this may work in a few cases, replacing one "reward" with another does no eliminate the waking. Whether water, formula or breast feeds are given the infant is picked up, cuddled into mum and has a period of intense closeness which some come to rely on.
When you wish to eliminate a night feed it is more often successfull when done by a gradual reduction in either the volume of formula, or duration of breast feed. This way the child learns that there is less reason to wake. Consequently they start to sleep longer.
Not all night waking is about feeding. Some children seek the reassurance of a parent when they have had a bad dream. Night terrors affect children who have not had sufficent sleep in 24 hours or have had experiences which they found traumatic. Some are simply poor sleepers who tend to use night sleep as a period of "naps" and as a result they wake regularly throughout the night and the parent has to intervene to get the little one back to sleep. Some have developed the belief that they cannot return to sleep without parental intervention.
How parents should deal with night waking depends on the sleep history and the possible causes of the waking. This, along with looking at the parental response helps in the development of a plan to eliminate these regular night wakings. As with many sleep difficulties it is not true that one remedy will work for every child.
If you would like help to resolve your child's sleep difficulties contact us ;- Info@dream-angus.com
Friday, 29 January 2016
Ellie
A Case study
Ellie was 2 years 6months
old. She was the older of two children. She had always slept without waking her
parents, until the arrival of her baby brother. Although her parents had done
some work to prepare her for the new arrival she was suddenly not at all keen
to accept bed time. She had a good pre bed routine but now dad had to settle
her if mum was feeding or caring for her baby brother. She did not like this at
all, and the protests she set up were proving challenging. First she would try
to delay bed time by wanting to wait until mum could take her to bed. Then, if
mum was able to do this, she would expect mum to remain with her until she was
asleep. She was not afraid of her room before, and had never had any difficulty
in completing her pre bed routine and settling to sleep within a few minutes.
Her brother was about 4 months old when I was asked if I could help mum improve
this situation.
Although to begin with Ellie
was doing her best to delay bed time, she was sleeping through the night, and
initially her parents had thought this was her way of protesting at less time
one to one with mum. They had gone along with things until the bed time delay
had gone from half an hour to two to three hour,s before she would finally give
in to sleep. At about this stage she was also waking through the night and
demanding mum resettle her. Ellie could determinedly remain awake and chatty
for two to three hours before she would allow her exhausted mum to return to
her own room.
We talked about the
changes Ellie was dealing with and how she had coped with each part of these
changes. Previously dad had often been late home and had not had much to do
with a pre bed routine. Dad was keen that she accept that he settle her and was
a little concerned that she would not co-operate with him. We discussed his
ideas of how to settle her and how much time this should take. We talked about
the games she liked to play with dad and the differences between mum and dad's
views of a good pre bed routine. We looked at practical aspects of Ellie's
becoming more independent and how best to support that alongside her sleep
patterns.
From sleep diaries it
became clear that she was waking when her brother was being settled for the
night, when he was fed through the night, and occasionally when Ellie needed to
go to the toilet. We then had a long discussion about what we thought Ellie was
feeling and thinking and how best to help her to accept her role as big sister.
Mum and dad were given
strategies to use to help Ellie make appropriate decisions and feel involved in
the process. It took a few weeks before Ellie started to protest less about bed
time and to allow the settling process to be shortened.
As children grow and
develop their own independence they become aware that they have few to no
choices in life. The only control they have is over what they put in their
mouths. This can result in picky eating for some. Giving a child some control
of their day to day life can reap big rewards for parents as it also improves
the child's view of fairness. Children can be given choices, usually between no
more than two things.
The choices offered should both be acceptable to the
parents.
"Do you want to put
on your socks or your pants first? " for example. If the child is allowed to make choices
through the day and the time comes when there is no choice, X has to be done,
the parents can say "OK, you made a lot of choices today, now it's my
turn. You have to ....." The child may protest but will see this as a fair
action and usually will accept it. A
choice between more than two possibilities can be confusing at this age but
having made a choice and having to live with the consequences of that decision
is part and parcel of becoming an independent person.
Within a few weeks Ellie
was much more settled and slept through the night without disturbing her
parents. She accepted her pre bed routine with mum or dad and the household was
happier and better rested.
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