Healthy Sleep Habits, Happy Child
196
What to Expect After Sleep Training #1
July 1, 2024

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Healthy Sleep Habits, Happy Child

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A Step-by-Step Program for a Good Night's Sleep

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Healthy Sleep Habits, Happy Child

5th Edition: 
Chapter 1 (only 16 pages!) outlines everything you need to know about your child's sleep.

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Introduction

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

Blog Posts 15, 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!

Blog 196What to Expect After Sleep Training #1

(See Blog Post 62)

I learned to stay on the schedule in order to avoid fighting with circadian rhythms.

I concluded that I won’t win that fight, but my baby would lose!

Our son was born perfectly on time. My approach for the first year of being a mother was to follow my baby. So, whatever he needs I will give it to him. I thought if he cries it is my task to find out what he needs and give it to him. Co-sleeping was a given to me as part of my attachment-oriented approach. Unfortunately, I haven’t had any clue about how to establish good sleeping habits. I thought good sleep will come by itself as part of the development and I just need to make him fall asleep until he can do it by himself. I suspected that we may have a sleeping problem when he started to cry intensively for 2 hours or longer when he was two months old. A friend (psychologist) suggested to put him to bed early, i.e.  between 6 and 8 pm. I did this and since then he never cried so intensively again. However, we still had a sleeping problem. It was very difficult to make him fall asleep, he had problems to stay asleep and he woke up very early (3 am, 4 am, at lucky days 5 am). My partner slept in another room, because the slightest movement made our son waking up. When he was 4 months old, I asked my friend again for advice. She said that our son needs to learn to self-sooth and suggested extinction according to Dr. Weissbluth’s book. I read the chapter but couldn’t accept the idea of letting my baby cry. I felt that this is against my maternal instinct. So, we tried a lot of other methods without any success. The situation got worse and worse until our son was 6 months old. After three nights in a row with almost no sleep, I decided that it is enough. Our son was very much overtired as we were. We decided to do extinction and to let him sleep in his crib in his own room. Since the very first night, he sleeps with usually none or one interruption when he is hungry and cries very rarely. At the beginning, I was so surprised that I couldn’t sleep, because I worried that something is wrong. But after some nights I learned that everything is fine, and I could enjoy sleeping again. It took some days until the exhaustion of the last 6 months disappeared. That changed the life of our whole family! 

However, during the day, we needed to fix other sleep-related problems. Our son still cried almost each time when we put him to bed. The duration varied between 10-90 mins. Sometimes, he really cried intensely.  After one more month, I was quite desperate because there was no progress. I wrote Dr. Weissbluth an email and asked him for advice. He explained that we need to schedule the naps in line with the biological rhythm, that is, the midmorning nap starts between 9-10 am and mid-day nap between 12 and 2 pm. Additionally, he suggested the following: “TEMPORARILY move the bedtime earlier, if needed, based on drowsy signs in the late afternoon and early evening.  For example, lights off at 5 or 5:30pm might be needed for only a few nights so he gets more sleep in the front end, awakes better rested in the morning, and is more able to get to a 9am and 12-2pm nap.  Once both naps have improved, the bedtime might be shifted to a later time, for example 5:30-6:00pm.”. Our problem here was that we couldn’t stay on the schedule because sometimes, our son slept very long during a nap and was not tired at the suggested time frame of the next sleeping. Thus, based on analyzing our sleeping diary, Dr. Weissbluth suggested to limit the nap duration to 90 mins at midmorning to help our son to fall asleep at mid-day. Although Dr. Weissbluth warned us not to be too fast in moving the bedtime at night to a later time, we started it too early when our son learned to sleep longer in the morning. That led to more crying. I learned to stay on the schedule in order to avoid fighting with circadian rhythms. I concluded that I won’t win that fight, but my baby would lose! Moreover, Dr. Weissbluth helped us to optimize the soothing procedure by having his father do the soothing. We realized that soothing of his father resulted in less crying than soothing of me, his mother. He explained that our son might respond differentially to our routines because he knows that his mum is able to breastfeed him. 

Currently, 2.5 months after our start of extinction most of the naps work. However, our son still cries occasionally. During the last 7 days, he cried 5 times more than 15 mins (out of 21 sleeping times). Overall, it was and is a difficult time for all of us. Me and my partner feel very much with our son. At the beginning, I felt very guilty to let him cry. As I am a clinical psychologist, I knew that there is criticism regarding this method, i.e. some researchers say that this method may impair attachment. So, I worried a lot about it. In line with this, some friends and my family also rejected the idea of letting a baby cry. They suggested to be more patient and said that sleeping problems are normal during the first years and we should accept it. Furthermore, family and friends find it strange that we follow a very clear schedule with an early bedtime and that we put our son always in his own bed at home. Actually, this was also difficult to me because that made me quite inflexible regarding my own activities. I learned to compensate this with my new freedom in the evening

  We stayed the course because we realized that we are not better than him in making him fall and stay asleep. It was so apparent that he needs to sleep as much as I need to sleep for being a good mother. Actually, I think that the relationship between me and my son have become better since we started with extinction, because our time together has a better quality. Although he was already a happy baby before, now, his mood is even better, almost all the time very good. Additionally, as a psychotherapist I believe that we are able to change habits and I trust methods that encourage better habits, even if they are distressing in the short run. In the long run, they may reduce stress. 

In summary, we learned the following:

  • Encourage self-soothing as soon as possible. Trust your baby that he/she is able to do it.
  • Schedule bedtime in line with circadian rhythms. Don’t fight with circadian rhythms… you won’t win but your baby would lose!
  • Temporarily, move the bedtime earlier to reduce overtiredness
  • If possible, include the father (or another relative /close person) in soothing routines
  • Meet the needs of YOUR child, that is, watch carefully his/her signs and react to them appropriately

[My advice: 5 months later, at age 13.5 months: His mood got worse, cried again at sleep times, and he woke up too early when he went from 2 naps to 1 nap.  “The plan is to temporarily move the bedtime earlier, even 5:30 pm for 5-10 nights.  He may or may not get up earlier.  Regardless of his wake-up time, during these 5-10 days, gradually try to delay the single nap by extra soothing/playing until about 1 pm.  If he gets more sleep and/or better quality sleep at the front end with an earlier bedtime, then he is more able to begin his single nap a little later which might be more in synch with his biological nap rhythm.  If so, the restorative power of the nap will be greater.  This shift may take several days.  Once he is napping well at the later time, experiment with a slightly later bedtime based on drowsy signs.  This new bedtime might be 6 or 6:15 pm but not much later.  When he was napping twice a day, perhaps the bedtime could have been later.”]

His sleep (and also ours) is good again!  Earlier bedtime was the solution!  I am a little annoyed with ourselves that we fall into that trap again.  I hope we have learned the lesson.

After Sleep Training

My son slept very bad during the first six months. At his first birthday, the doctor diagnosed a slight delay in his development. His sleep became much better after we adjusted the sleeping schedule and did extinction. For almost one year he rarely woke up during the nights.  At the examination at his second birthday, the doctor did not find an overall delay in his development anymore, but he did not pass all tests. At the examination at his 3rd birthday, he passed all tests and the doctor said: “Oh, he did a big leap in his development, right?”.

Although he sleeps much better, he still has problems to fall asleep in the evening. We stay in the room until he is in a deep sleep, otherwise he cries intensely.  Currently, he needs 45-120 minutes of our presence when he takes his midday nap. He naps only at the daycare with the other children.  The “day-mum” puts him down drowsy but awake in his bed and leaves the room. When he skips the nap, he needs only 10-30 minutes, but he is very tired in the afternoon and bad tempered. He resists very strongly to fall asleep without the presence of one parent. Actually, he was able to fall asleep alone, but during a time of illness we fell back into staying in his room and did not find a way out since then. This is a challenge for us as a couple, because we rarely have time in the evening together.

You asked, did helping him., when younger, sleep well have any influence later on, for example, your social life (have you been socially restricted to keep your child well-rested or have you been criticized by friends or family because of your concern for your child’s sleep schedule)?  Oh yes! Frequent criticism was: “You are too rigorous and inflexible regarding the sleep schedule”, “why don’t you skip his nap? We want to do this and that?”, I should use the stroller instead of putting my son into his bed, I should accept that children wake up often during the night (“it‘s normal!”) and my task as a good mother is to accept that I don‘t get much sleep during the night (and during the days as well) as long as the child is so young. We got a lot of harsh criticism because we did extinction. It became our secret.

My advice now that I would give to other parents or expectant parents:  Ask for help and search for a plan that works for your family and you! There is the option to implement good sleeping habits… starting with the birth.

I still feel very bad that I had to do extinction. It was a very, very hard time. I worried very much about our attachment. However, my son has a secure attachment style – we tested it. But if you have a second child, I would implement good habits from the very beginning. Changing habits is possible but might be hard.

We had major setbacks. He still has problems to fall asleep in the evening (see above). Currently, he wakes up one time during the night and cries for his mom. We tried to put him to bed earlier but he does not fall asleep. Overall, it is okay but still challenging for my sleep during the night.

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