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 Posts 1–5, based on the United States of America Department of the Army Field Manual: Holistic Healing and Fitness, describe what really matters for your child’s sleep. If sleep is an important enough topic for national defense than surely sleep should be considered a serious topic for parenting!
Inexperience, for first-time parents, naturally creates some anxiety about how to best raise your child. Every imaginable opinion is available online to support widely divergent points of view. Many sites create false hopes to get you to buy their product and services. Their marketing preys on your anxiety. Some sleep-deprived parents become desperate. Even though some widely once-popular products and programs have been shown to be useless or dangerous, some of these products and programs are still available!
Caveat emptor (Let the Buyer Beware) is a well-known phrase, but parents also need to beware of false claims regarding rearing children. Myths (Blog Posts 36 and 37), fads (Blog Post 143), and fake news (146 and 147) are a sad part of the history of parenting. Here is a brief cautionary history to give you some perspective on fake promises.
It once was popular to add cereal to a baby bottle or a spoonful of cereal to make the tummy fuller under the misguided belief that their baby will sleep longer through the night.
“We studied whether feeding infants rice cereal before bedtime promotes their sleeping through the night. One hundred six infants were randomly assigned to begin bedtime cereal feeding (1 tablespoon per ounce in a bottle) at 5 weeks or at 4 months of age. Caretakers recorded the infant’s sleep from age 4 to 21 weeks for one 24-hour period per week. Sleeping through the night was defined as sleeping at least 8 consecutive hours, with the majority of time being between the hours of midnight and 6 AM. The results were also reviewed changing the requirement from 8 hours to 6 hours. There was no statistically significant trend or a consistent tendency of one group to have a higher proportion of sleepers than the other. Therefore, feeding infants rice cereal in the bottle before bedtime does not appear to make much difference in their sleeping through the night.” Infant Sleep and Bedtime Cereal. Macknin, M.L., Medendorp, S.V., and Maier, M.C.. Am J Dis Child. 1989;143(9):1066-1068.
From Wikipedia:
The Institutes for The Achievement of Human Potential (IAHP), founded in 1955 by Glenn Doman and Carl Delacato, teaches a controversial patterning therapy (motor learning), which the Institutes promote as improving the “neurologic organization” of “brain injured” and mentally impaired children through a variety of programs. Patterning has been widely criticized and multiple studies have found the therapy ineffective.
American Academy of Pediatrics position statement: According to the American Academy of Pediatrics, patterning treatment is based on an oversimplified theory of brain development and its effectiveness is not supported by evidence-based medicine making its use unwarranted. The American Academy of Pediatrics Committee on Children With Disabilities issued warnings regarding patterning, one of the IAHP’s therapies for brain injured children, as early as 1968 and repeated in 1982. Their latest cautionary policy statement was in 1999, which was reaffirmed in 2010 states: This treatment is based on an outmoded and oversimplified theory of brain development. Current information does not support the claims of proponents that this treatment is efficacious, and its use continues to be unwarranted.
(To be continued)
Hi Dr. Weissbluth. I have a 17 month old child who typically sleeps 11-12 hours at night and used to nap for an hour. A week ago for some odd reason out of no where he started refusing his naps. We kept him up a little bit longer for his nap and then put him to bed a little bit later. We have used the extinction method and for his naps and bedtime. We have him in his room in his crib for an hour and he doesn’t settle. I was able to get him to nap for a couple of days by essentially putting him down asleep and then when he entered the next cycle he would briefly cry and then go back to sleep. We used to be able to give him a bottle and rock him for maybe 10 minutes and he would be put down drowsy but awake. He would reposition and fall asleep. This is not the case anymore. I’m unsure whether it’s time for him to drop his only nap. He will fall asleep in the car if he’s doesn’t nap. Do you have any suggestions! I’m going to look through the book and see if anything helps. He typically wakes up at 7:30. Then he’d go down for a nap at 1:30 asleep around 8:10. He refused his nap today so we will put him to bed earlier.
When do you start the bedtime routine?
Please describe his mood and behavior during the hour before you start the bedtime routine when he is alone (no screens or parental interaction) with his toys.
Our son doesn’t get any screen time. Bedtime (at night) is rarely an issue. He knows after his bath he gets his diaper changed and rocked with a bottle and falls asleep. If he doesn’t fall asleep or wants to play I rock him for 20 minutes total and then leave the room. On nights he fights bedtime, he’s asleep in under 30 minutes, however this is rare (maybe once every 2-3 weeks). His average time in which he’s asleep is 7:30-7:45pm.
Nap time used to be easy. His previous schedule used to be:
7:30am wake-up
12:00pm -snack
12:15pm -upstairs secondary play area to wind down. He’d play and be happy. He doesn’t play by himself more than maybe 15-20 minutes upstairs. If he does, he’ll walk over and check on us then go back to playing. He’d eventually slow down and read a book or if he was ready for his nap he’d start fussing.
12:45-1:00 we would enter the nap room. The time would be based on when he woke up and drowsy signs. In the nap room he would be rocked while fed a bottle. The whole process would take 10 minutes. After he was put down ( eyes closed) he would roll into position and get comfy.
When naps started becoming more difficult we shifted times back roughly 15 minutes. All based on when he initially woke up and drowsy signs.
Please describe his mood and behavior between 4-6pm when he is alone with his toys (no parental interaction).
Between 4-6 he isn’t unduly fussy. He may like a book being read to him or guidance to help him to play with his toys, but he does have adult interaction throughout. If he’s outside he’s completely fine. He gets a little fussy around dinner time (6:00-6:15) but I may contribute that to more of him being hungry. I would like to add that yesterday we put him to bed earlier since he skipped his nap – he was asleep by 7:22pm and he slept until 7:15am this morning. Recently his bedtime has been asleep by 8:15pm due to later naps and waking up later in the morning. Yesterday without a nap he wasn’t extremely fussy, but I should note he did close his eyes for less than 10 minutes in the car at 3pm.
“He gets a little fussy around dinner time (6:00-6:15)” This is presleep arousal, not hunger.
“A week ago for some odd reason out of no where he started refusing his naps.” This is a classic description of cumulative sleepiness.
Presleep sleep arousal and cumulative sleepiness develops from a falling asleep time that is just a little too late.
Your solution is to always have an earlier falling asleep based on how he looks around 4-6pm when he is by himself. The falling asleep will vary based on naps and physical activity.
Does this help?
Hi! So it’s been a couple days. We started the earlier bedtime. The first day we noticed a difference but he still did not nap the first and second day. Today is day 3 of earlier bedtime. He slept 11.5 hours over night. I just put him down for a nap. It took minimal rocking and he rolled into place like before. The only difference now is he woke up after 20 minutes of sleep. We are leaving him in the room for the full hour. The earlier bedtimes don’t seem to make too much of a difference other than him waking up earlier creating a perpetual cycle.
What is the new earlier bedtime?
Please describe his mood and behavior when alone with toys (no screens or parental interaction) during the hour or so before the new bedtime.