Healthy Sleep Habits, Happy Child
155
Why Sleep Training or a Sleep Solution Fails
October 30, 2023

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Healthy Sleep Habits, Happy Child

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Healthy Sleep Habits, Happy Child

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Introduction

A Healthy Child Needs a Healthy Brain, A Healthy Brain Needs Healthy Sleep

If you have not already done so, please read Blog Posts 1 through 5 that describe how sleep is important and beneficial. I will post specific information for parents and children based on my book, “Healthy Sleep Habits, Happy Child.” Please do not be put off by my book’s length. This is a reference book. Read only the topic of interest to you.

Blog 155Why Sleep Training or a Sleep Solution Fails

Sleep training or a sleep solution (Blog Posts 19, 25, and 138) fails for two main reasons:

  1. The usual bedtime is too late (Blog Post 130):

This causes the child to usually be at a higher state of neurological arousal making it difficult to easily fall asleep and/or stay asleep.  Sometimes, the actual clock hour of the bedtime does not appear to be too late from the parents’ point of view, but because of unhealthy naps, for the child’s brain, it is indeed too late.  Here a super early bedtime might be temporarily necessary so that the child awakens in the morning better rested which then permits healthier naps.  Once better rested during the day from better naps, then the bedtime might be moved a little later but not as late as the original too late bedtime.

  1. Parental inconsistency.
  1. Parents have ‘special events’ (late night family activities, play dates, sports events, etc.) too frequently with late bedtimes so the child is too often, but not usually, overtired.  There are not enough nights of early bedtimes to fully recover (Blog Posts 79 and 80).
  2. Parents vary too much in their bedtime routines in terms of its duration, the sequence of soothing efforts, or how often they actually have a bedtime routine (Blog Posts 10, 87, 89, and 90).
  3. Parents provide intermittent reinforcement by sometimes giving unnecessary attention at sleep onset (causing bedtime battles) or in the middle of the night (causing a night waking habit).
  4. A temporary super early bedtime is sometimes unacceptable because a parent fears that the child will get up too early or a parent won’t see the child when returning from work.Or a temporary super early bedtime is sometimes impossible because of family circumstances. In either case, moving the bedtime a little earlier might still help a lot (Blog Post 137).

There may be unappreciated or unresolved issues that cause or contribute to the two main reasons above.

  1. Parental subjective blindness to their own sleepiness (Blog Posts 13 and 8486) causes parents to not appreciate how uncomfortable their child feels.
  2. Mothers are not emotionally available or sensitive (Blog Posts 14, 17, 57 and 88).
  3. There is impaired teamwork between the parents (Blog Posts 17 and 18).
  4. Maternal anxiety, depression, or dysfunctional cognitions (Blog Posts 3942, 88, and 120) with or without:
    A. TV or screens around bedtime (Blog Posts 21 and 22).
    B. Bed sharing (Blog Posts 82 and 96 ).
  5. Cultural issues (Blog Posts 6062, 77, 78, 101, 111 and 134).

Comments

  1. Hi Dr Weissbluth – if a child is put to bed at a super early wake time (say 5pm) to correct for a poor nap day, and is already trained to sleep through the night (12 hours straight) and ends up waking up at 5am for a feed, would it end up throwing off the entire nap schedule (wake up at 7am for nap #1 at 9am) and how should this be approached? My baby is 6.5 months old.

  2. Dr Weissbluth,

    I have 4 month old (week 14 corrected) twin boys, save I’ve read your book on twins probably 3 or 4 times now.

    The boys are sleeping very short naps during the day and only eating about 2oz instead of their normal 4oz, and then waking up angry and hungry, but again only eating a little and then sleeping short spurts.

    At night, if we’re lucky, they eat 3 or 4oz, go down around 630pm and wale up angry at 1130. We feed them, then they wake up between 330 and 500am every morning, then again around 730am.

    This week we have tried doing full extinction, and the one cried for over 2 hours on Tuesday, was quiet the next 2 days, then cried over 2 hours again tonight. Now it’s almost 1130, they’re screaming again, and I’m basically holding my wife back because she’s worried they’re starving, I think they’re just awake and trying to get us to come in.

    I’ve read the blog about “Sleeping through the night” but you don’t mention feedings very much in many of your blogs.

    Should we force our twins to not eat through a night to increase their appetite in the morning, should we continue to let them cry during the middle of the night to learn to self soothe?

    1. Perhaps the feeding questions could be best answered by your pediatrician who has the growth curve data: are they following their curve or increasing or decreasing their trajectory? Then you might be able to more clearly know how many ounces/24 hours they need for nutrition and can have a better guide regarding daytime and nighttime feeding. At this point, you will have more confidence in whether the crying at night is from hunger and needs to be attended to or whether it can be ignored. A general statement is that most children at this age need to be fed twice at night but I think specific information for your twins regarding the number of ounces they need will provide more clarity regarding how often they need to be fed at night and how many ounces they need to take in at night.
      “I’ve read the blog about “Sleeping through the night” but you don’t mention feedings very much in many of your blogs.” Sleep cycles come from the brain, not the stomach. So if a child is growing well and fed only when hungry, ‘feedings’ are not usually an issue regarding sleeping. But with twins or premature babies, it’s good to check-in with your pediatrician. Does this make sense to you?

  3. Thanks for the reply Dr!

    Your answer does make sense. I just see testimonials on your site and in the book where babies seem to sleep 12 hours without a feeding every night, and I want my boys to get to that point.

    At our 4 month checkup the twins did increase on the growth chart, the pediatrician said they were doing well. They’re still very low on the percentile curve, but she wasn’t worried about how much they were eating.

    It’s just been a pattern we’ve noticed that over the last couple months they started eating and sleeping in smaller increments throughout the day, much like they did when they were newborns. Obviously that’s frustrating and gets to be a real grind.

    Last night after we let them cry it out, they woke up around 1130. We let them cry until midnight, but wanted to get some sleep so decided to feed them. They both ate way more than usual, and then slept until 530am.

    It’s a small sample size, but that already feels like improvement.

    We are going to move bedtime to 5:30 today and try starting a routine where we can read them a book for 15min and then put them down.

    That you again for your reply and your time Doctor!

  4. Hello again Doctor,

    We’ve had some improvement at night. Both twins went down calmly yesterday, but one twin still wakes up about an hour and then screams for at least an hour (down from 2 hours, so I guess that’s progress). They woke up 1230am, we fed them, then wake at 430 am, fed, then again at 730. They’ve been in better moods, they go down easier.

    But I have one more question about sleep during the day.

    The boys have been going down easier now, but after about 30-45min our troublesome sleeper twin will wake up and scream. We’ve tried to see if we can wait him out, but he will scream nonstop until the other twin is ready to wake up.

    Do we let the twin cry it out? Do we sooth him? I’m worried soothing will teach him to keep screaming. Do we let him wake up again and also wake the other twin so they’re in sync?

    Yesterday he basically screamed through every nap until about 3pm when we feed them, have them a bath and put them down. I don’t think he slept at all during the day.

    Again, I want to thank you for your time and advice.

  5. They’re fraternal.

    Sorry if you’re getting repeated responses from me. For some reason the site won’t accept my reply.

    1. Because fraternal twins may have different sleep needs and sleep schedules, try put the twin with sleep issues to bed at time 10-15 minutes earlier and if doable, also start the naps 10-15 minutes earlier for 4-5 days and nights. Keep a sleep log and let me know what happens.

  6. Dr. Weissbluth–

    Your book and advice has really been invaluable to us. Our baby is now 6.5 months old and is generally a great sleeper. He takes his mid morning and afternoon nap (and sometimes a third depending on the quality of the first two) without fuss, he WANTS to go to bed at an early time (5:30-6), and he goes to sleep without complaint.

    However, we’re having an issue in that he continues to wake up at night to eat. I had been breastfeeding him exclusively up until about 3 weeks ago, he finally started taking formula and eating some purees during the day. He seems to be eating a lot during the day–at least 18 oz or more of formula/breastmilk and a few tablespoons of puree. He’s growing and seems very happy, not fussy during the day. I was hoping with this transition, that he would start sleeping through the night more regularly. But he still gets up twice–once around 1/2 a.m., where he genuinely seems hungry and I feed/change him. The second is around 5 a.m., and he doesn’t seem that hungry at that point. If I nurse him these times, it’s usually 15 minutes or so and he goes right back to sleep (we follow your advice and don’t play with him, strictly diaper change and feeding). But it is getting hard to keep having my sleep so disrupted, and I’m genuinely not sure he needs two feedings at night anymore given what he eats during the day.

    I know your book said that breastfed babies might need to eat at night up until 9 months, and might even continue waking up 2 times a night. Is this kind of pattern normal or should we try to sleep train him out of at least the second feeding, which seems more like a comfort feeding?

    1. “But he still gets up twice–once around 1/2 a.m., where he genuinely seems hungry and I feed/change him.” How many ounces does he take and how quickly?

        1. It’s not always easy to determine whether or not this feeding is really needed or whether it should be ignored to avoid habit feeding or habit night-waking. Perhaps this question might clarify: First, he sucks eagerly (suck-swallow, suck-swallow, etc.) than later he slows down (suck-suck-suc-swallow, suck-suck-suck-swallow). Ususally (most of the time), during the first phase of eager eating, how long does it last and how much does he take?

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