Tuesday, August 01, 2006

Calculated Risk

Little Timmy, you remember him? He's been coming to my place for two mornings a week for the last couple of months. The idea is to get him used to me and this place before he starts full-time in the fall. Is it working? Mom would give answer that with an unqualified "Yes!" He wriggles with enthusiasm when he sees me, he smiles at the other children, he rarely fusses when she leaves. "He's settling in so well," she says. "He just loves being here, I can tell." I think he does, too, as much as he loves anything. However, I would answer with a qualified yes. Timmy does have the sweetest smile. He can take pleasure in his little accomplishments - finally touching the cat (!!!), pulling himself to stand on the furniture. He can interact nicely with the other children, to the limits of his age. He can play on his own, or alongside the others. He can do all these things, but the truth is, he doesn't often. His problem? Here are the symptoms: He's fretful and clingy. He needs a lot of attention. He wants to be carried most of the time. He demands to be in the same room as me at all times. If I get more than three feet from him, he crawls after me, wailing. When he is held, he's twitchy, pinching at my arms with his fingernails and clutching my hair and clothing. If another child gets too close, he cries. He doesn't eat much, he drinks only when being held. He plays when I'm sitting beside him, or when he's in physical contact with me (his back leaning against my shin, say), but even then, rarely for more than five minutes. When we read, he sits in my lap, but again, is twitchy, tossing his head side to side, flailing at the pages. So what's the problem here? It's not that he's not settled in. As his mother notes, he greets me with a smile, and he includes the other children in his greeting. He's not teething, and he's been perfectly healthy since he started. Not even a sniffle. The problem is that this boy is chronically and severely sleep-deprived. His mother believes that he "doesn't need much sleep". She knows this because "he never sleeps more than 20 minutes at a stretch, except at night". At night, he sleeps eight hours. A ten-and-a-half-month-old who gets eight hours at night and another hour during the day is not getting enough sleep. Not nearly enough. By my calculations, he's about three hours short per night, and another hour or two short per day. This kid is getting a good four to five hours less - per day! - than he needs. And it shows. His mother is delightful, quite sensible in all other child-rearing practices, but this is her blind spot. And, as he's her first child, she sees his behaviour as normal - that's just what babies are like! So I'm taking this child on the assumption that with a little sleep training under his belt, he will turn into a different child. A calm, relaxed, non-twitchy child, able to play independently for more than a few seconds. I sure hope I'm right!

~~~~~~~~~~~~ © 2006, Mary P

16 Comments:

Blogger Amy said...

I have read this refrain from you before, and I would like to hear what one should DO when their child doesn't seem to need much sleep.

My daughter is going to be one in 10 days. She will often stay up until 10 pm (we start the bedtime process at 9 pm, usually), and will wake up a few times in the night, and then wake up around 8 am. Lately she has been resisting nap until after lunch, so she'll take a two hour nap from, maybe, 2 - 4 or 1 - 3 (it's kind of screwed up right now, because she's in the process of dropping a nap, much to my dismay). Occasionally if we're out (driving) she will fall asleep in her carseat around 5 or 6, but if I try to sneak her in and up to bed, she wakes up.

I am nursing her. I almost always nurse her to sleep. Her dad is able to hold her and sing to her and get her to go to sleep, but if I try it, she screams and tries to nurse. Eventually I give in, because I don't want to fight her when she's already tired and sleepless.

Otherwise, she is a very good baby. She is not clingy as you describe Timmy. She plays independently for a good, long time (30 minutes or more, alone) while I get other things done around the house on a regular basis. She is smart and verbal and mobile and funny. She laughs a lot, is a terrific eater, and is a joy in all ways - except at nap time and bed time.

So, what do you suggest I do? I am absolutely unwilling to let her "cry it out" - we have tried, and she gets more and more hysterical - there is no "crying down" with her.

Incidentally, I did not require much sleep as a baby. My mom says that she's just like me. Her paternal grandfather is also a notorious night owl - requiring only 4 or 5 hours a night, and her maternal grandmother (my mom) is a born night owl - she stays up until 12 or 1 and then sleeps late (which is also my preference). I truly believe that, genetically, she just doesn't need to sleep, but assuming that your suggestions are gentle and in line with my own parenting philosophy, I'm willing to try what you might suggest.

Thanks!

8/01/2006 02:59:00 PM  
Anonymous MIM said...

Oh, yeah. That child id DEFINITELY not getting enough sleep. But he will once he starts with you full-time in the fall . . . of course, you'll have to convince mom that contrary to her intuition, she'll have to put him down EARLIER in the evening, not later.

8/01/2006 03:16:00 PM  
Blogger Mamacita Tina said...

I whole-heartedly agree with you. We went through a period with Laurel where she cat napped during the daytime and only got 8 hours of sleep at night. She was clingy, squirmy and unhappy(a.k.a. cranky). I'm not exactly sure how we did it, but we've finally got her sleeping 11-12 hours at night and taking 2 one to two hour naps during the day. What a change in her behavior. She smiles, she plays independently, she interacts better with everyone, including family members and friends she doesn't see much. I'm a firm believer in children getting enough sleep.

8/01/2006 04:54:00 PM  
Blogger Jenorama said...

Holy moly, Batman!

Jen is also not getting enough sleep.

Seriously, I hope that you can turn this around!

Any chance the kid is also reacting to a corn syrup or red dye allergy? I know other kids who have had similar problems even if these two foods were remotely in their diets.

8/01/2006 05:25:00 PM  
Blogger Kristen said...

This is one thing, as you've confirmed for me, that we actually did "right" from the beginning (thank goodness!). I canNOT imagine trying to train a one-year-old to sleep more - a newborn was hard enough, but at least with them, you KNOW they need it, you know they'll go to sleep... a one-year-old has so much more spunk and willingness to torture his/her parents (haha)! I agreee that's exactly what needs to happen in these cases, though. As hard as it may be....

8/01/2006 05:44:00 PM  
Blogger Eden said...

I agree w/ your assessment. My son behaved much the same way and I recognized that he wasn't getting what I considered to be enough sleep. We were using a cosleeper beside our bed. I guessed that he woke overnight b/c he was uncomfortable.

We moved and we assmbled his crib in our bedroom instead of in his nursery. This way he can still be nearby while getting used to his crib. He not only sleeps overnight but his nap length has increased from an average of half an hour to two hours!

In turn, the behaviors you mentioned (crying if I went out of sight, clinginess beyond the natural desire to be held and cuddled) have evened out. He can still get upset if I walk away but not as quickly or as intensely and I chalk it up to natural separation anxiety.

Maybe a way to bring it up might be to mention if he sleeps in a crib, co-sleeper or co-sleeps w/ Mom & Dad. She might not even realize. I mentioned it to our pediatrician and he chalked it up to me spoiling him by cuddling him at night. I cuddled him to get him back to sleep!

Anyway, problem solved and you've really hit the nail on the head w/ your assessment ;)

8/01/2006 06:02:00 PM  
Blogger Jerri Ann said...

I am a sleeper and people make fun of me because my children go to bed at 7 and 7:30 (1 and 3 respectively) and get up at 7:30 or 8. They take good 2 1/2 to 3 hour naps.....the very ones making the most fun...the ones whosse children have never slept more than 8 hours at night or 2 hours for a nap and are chronically irritated and anxious....hummmmm I thank you for the confirmation that I am not the one who is lulu!

8/01/2006 06:53:00 PM  
Anonymous Chelsea said...

Oh I feel for the Mom! My son is 9.5 months and he was VERY similar. Fortunately I was given "Healthy Sleep Habits..."
I couldn't stand the doctor BUT he was still right (much to my chagrin!) So at least I had an idea of what I should be aiming for.

I finally had my son cry it out one night. It was a last resort- definitely not my first choice, but he was so miserable and cranky all the time and nothing I did seemed to alliviate the problem. I had followed all the other advice: Put down awake but calm, don't feed to sleep, a regular routine etc.

It worked so well that in a few days he went from 10.5 hours of sleep to 15.5 hours (12 at night!)

I'd bet you have a wonderful approach to sleep training that wouldn't be so traumatic- Please share so my next child doesn't have to go trough all that! :^)

8/01/2006 08:15:00 PM  
Anonymous Jennifer said...

Geez! THANK YOU for that! I've been shouting it out to so many of my friends just how important sleep is in the grand scheme of life and still some of Jordan's playmates don't hit the sack until well past ten o'clock! I'm going to send these mommies over to your site to catch up on some well-worth it reading for their wee ones' sake!!!

8/02/2006 02:23:00 AM  
Blogger L. said...

Just catching up after 3 weeks away, and --- wow. My oldest son got only eight hours of sleep a day (an average of five at night, and then the rest in 20 minute catnaps after each feeding) and my pediatrican told me this was "normal for some babies," and I believed her! (Ironically, she is in a practice with Harvey Karp, but this was long before he wrote his sleep book).
Then when he was 10 and a half months old, and started walking, he suddenly tired himself out so much that he started napping properly and sleeping through the night. Thank god he wasn`t a late walker -- I would have had a total breakdown.

8/02/2006 03:38:00 AM  
Blogger Michelle said...

I agree - my son is 8 months old and generally sleeps 10-11 hours at night but was getting no where near the right amount of sleep during the day and once we've started purposefully putting him down for naps, his whole demeanour and moods changed!

8/02/2006 07:08:00 AM  
Blogger Mary P. said...

Welcome to Amy, Eden, Jeri Ann, Chelsea, and Michelle! Such a host of new faces!

Amy: I looked for an email for you, because your comment deserves/requires a lengthier response than can be accommodated by a comment box. This will be a long comment, and it still won't say all that I'd like to say.

It is possible that your daughter's sleep patterns are simply normal for her. By your accounting, she's getting 12 hours, which is within the normal range, though at the low end. Her behaviour certainly indicates a sufficiently-rested child. She's moving to one nap a day, which at 12 months puts her at the early end of single-nappers, but again, it's within the normal range. So far, so good!

The problems I see as you describe your daughter's patterns are the late start to her night's sleep and the frequent wakings during the night. Her resistance to afternoon naps is becoming a problem, now, too.

The idea that it could be genetic? Well, it could, of course. With behaviour like this, though, it's hard to tease apart what is truly genetic, and what occurs consistently within a family because it's inadvertently fostered. (Another variation of the nature-nurture conundrum.)

Unfortunately for people who have poor sleepers (though I'm not entirely sure your daughter truly falls in this camp) and who also want to use only gentle methods, the method that experts consistently find is most effective in achieving a child who routinely sleeps soundly and long without a fuss is cry-it-out.

('Experts' as in scientists with sleep labs, not 'experts' as in people who are interviewed for the popular media and mainstream parenting magazines.)

Well, nuts, I hear you say. What do you do if CIO is anathema to you? Well, there are methods that seek to eliminate crying entirely. In my experience, they are simply not as effective. There are also methods that, while they don't try to eliminate tears, to try to minimize crying, and they do work. Would those be more acceptable?

Where to start? We'll start with the most basic, most important thing to do, based on the well-proven truism that "sleep begets sleep". An under-rested child fights sleep, and sleeps less soundly when they do succumb.

You say you're starting her night routines at 9. My suggestion: start much earlier, aiming for her to be asleep between 7 and 8. Try pushing it back by 20 minutes, every 2 or 3 days. In three to five weeks, you will have pulled her beginning-bed routines to 7.

This single step may result in a child who stops fighting the afternoon nap. It's a good starting place.

I've just finished reading a good book on sleep techniques, an intelligent and compassionate overview of all the variations (with no one method/style favoured), but I can't remember the title, and I can't get to it at the moment. It's an excellent book to help evaluate the pros and cons and what might work best with your philosophy and family.

When I find it, I'll post, or you could email me to talk about this properly.

MiM: I haven't had this discussion with her yet, because until he's with me full-time, there's not enough consistency in his days. But we will! And one of the first principles I'll be teaching her is 'sleep begets sleep'.

Mamacita Tina: Doesn't it make a difference? And isn't the well-rested version SO much easier to get along with??

Jen: The allergy idea is a sound one. I'd look at the more obvious things first - bedtime routines and consistency, etc - but allergies is something to consider later on in the process. In this case, I'd strongly doubt it, since his mother is a vegetarian who eats organic as much as possible. Most of his food is hand-made from entirely wholesome products. I very much doubt he's ingested any food dye in his life! Corn syrup? Possible.

Kristen: In case any of you other people are thinking Kristen let her poor newborn cry it out, let me reassure you that we've spoken. This is NOT what she means!

She's talking about all the pre-training you do to ready a child for sleeping alone, like creating consistent pre-sleep routines, putting the baby down drowsy-but-awake, creating a comfortable sleep environment. Those sorts of things.

If you do this from day 1, the odds that your baby will have sleep issues is greatly reduced.

Eden: Looking at the physical environment of sleep is a basic place to start - one that lots of people overlook! Your baby is sleeping better in a crib in your room, and NAPPING better because his night sleeps are sounder. Sleep begets sleep! Good thinking, mom!

Jeri Ann: Different people can have different parenting approaches, strategies, philosophies, and all be great parents raising healthy, happy kids. But if your child is chronically fretful, distractable, irritable, prone to tantrums, etc... something is amiss and some evaluation is required. If you see a mom whose kids are all calm and cheerful most of the time, you'd think the sensible response would be to ask how she does it, not tease her! *sigh*

Chelsea: Don't you just HATE it when someone you're all prepared to dislike turns out to be RIGHT??? LOL

When you've done everything else - the routines, the drowsy-but-awake, the good associations, the quiet wind-down before bed - when you've done all that and your child STILL isn't settling in peacably, I'm afraid there isn't much you can do to avoid tears. After that, it's down to your child. All you can do is minimize their likelihood, and with lots of kids, this works just fine.

As Kristen (commenter above) experienced, starting early meant that her kids essentially never cried about bedtimes. This is, obviously, the best-case scenario, and it's possible!

It's possible, but doesn't always happen that way. Why? Because some kids are way stubborn!

CIO isn't easy, and cold-turkey CIO isn't the only option available; there are gentler variations. As to any crying at all, though? If you think about it, there are many, many occasions when we tolerate it. Your child cries when you won't let him run out onto the street; cries when you take away a small, choke-friendly toy; cries to be allowed to eat something she's allergic to... There are many times every day when we have no difficulty ignoring the tears and doing what's best for the child. Sleep needn't be any different.

Jennifer: Well past ten? Eek.

So many parents fall into that misconception, though. My child isn't going to bed easily, so I'll keep her up for a while, get her good and tired. THEN she'll sleep. It makes good, intuitive sense - and it's dead wrong!

In fact, if your child fights going to bed at 9, the solution isn't a ten p.m. bedtime, it's a 7:30 bedtime! Weird, but true.

L: Ten and a half months of that, and you didn't have a breakdown? You're a stronger woman than me.

How bizarre that a doctor would say it was normal! I'd have expected her to suspect a sleep disorder sooner than tell you it was normal. Thank goodness he figured it out on his own.

Michelle: You're so close to the child, it's sometimes hard to see the big picture. You just know your little guy "doesn't like surprises", or "is particular about the clothes she wears". Then you make this kind of adjustment, and suddenly they're so much more flexible!! How about that? And everyone, child included, breathes a sigh of relief. :-)

8/02/2006 08:36:00 AM  
Blogger kittenpie said...

OUr neighbours child I think suffers the same thing. The mom tells me she won't fall asleep till 10 or 11 and wakes up at 6, and rarely naps. She's nearly four, and is crazed all the time. I'm sure if she slept more, she'd sleep more, if that makes sense. However, I also know it's totally not my place to go telling her how to run her kid, and she didn't ask my opinion, so I'm keeping my yap shut and hoping that they sort it out for all of their sake!

8/02/2006 02:00:00 PM  
Blogger kate said...

Mary, I just wanted to say, "thank you." Thank you for your interesting and well thought out posts here and on PiP. And thanks to MiM too.

Sleep is one of the big issues in my house. I'm a terrible sleeper (since childhood) and my husband stays up until I demand he go to bed. After finally getting my daughter on what I considered a somewhat reasonable schedule (though with more wake-ups and shorter naps than I would have liked), illness and travel have mucked it all up. I'd love the name of that book too when you find it. I was just at the library tonight trying to find something to help and came home empty handed. I'm just not sure how to know what is really "enough". And since my husband gets home pretty late most nights, I'd like him to at least see our daughter and don't necessarily want to get her into bed at 7. I do 99.9% of the work and childrearing in the house as it is.

Would you all consider doing a post at PiP about sleeping and how to encourage sleeping?

8/03/2006 12:35:00 AM  
Blogger Mary P. said...

Kittenpie: It's a tough situation to be in, seeing something and being completely unable to do anything about it! I have a friend whose youngest daughter was much as you describe here. Once a month, our families would each take the other's children for an overnight so the parents could have a night out.

She was just under six when we started these sleepovers. I was told, "She won't go to sleep before ten, and she'll be up at 5." Hmmm... I'M in bed at ten, most nights! I wasn't going to stay up past my bedtime for a five-year-old! So I put her through exactly the same pre-bed routines as my kids, and guess what? She was in bed at 7:45, asleep by 8, and slept till 7 or later. Every time.

She was always a cute kid, just totally hyper. She's a lovely young lady now, but she has all manner of learning disabilities, and I wonder how much of this (or at least their severity) can be attributed to the fact that never once in her life has the poor girl had anything like adequate sleep. I know how fuzzy my thinking and reasoning is after just one or two bad nights.

sigh

Kate: Found it! The book is "Sleep Solutions for you baby, toddler and preschooler" by Ann Douglas. It's a balanced presentation of all the various approaches, and she doesn't have a particular methodoligical axe to grind.

My other favourite, despite its TERRIBLE editing, is the one Chelsea mentions, "Healthy Sleep Habits, Happy Child", by Marc Weissbluth.

Your daughter doesn't have to get to bed at seven if she can sleep later in the morning. While I usually suggest a 7 to 6 kind of night for children under 4, if your family schedule would work better as a 9 to 8, then that's what you do! If, however, she must be up before that, then the earlier bedtime is what's required. You can always make occasional exceptions to the bedtime rule, but not every day.

If you want to continue this discussion, feel free to email me!

8/03/2006 04:38:00 AM  
Anonymous Alison said...

Hi there. I'm a first time mom and I think my daycare provider totally thinks of me the way you mention this mom. My two year old son doesn't nap most days. We had to cut it out because when he did nap, he stayed up until nine or nine-thirty. Problem is that now, it's summer and our schedule is out of wack and he's just started at a new daycare. And so, I've had to say, once they told me how tired he is during the day, that he can nap when he seems to need it. Problem is, we get off schedule one night, he goes to sleep late, then is tired the next day and takes a nap, and then doesn't get to sleep in the night, and so on. It's hard to be on both sides of the care when figuring out this stuff sometimes. Great blog.

8/09/2006 07:34:00 PM  

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