April Moments

Maybe, just maybe, telling the story is just as important as the story itself

Biological, not logical

Sleep is one of the most discussed topics among parents. It also can be a subject that causes disagreements. Actually, I believe what causes the arguments is the method parents use to accomplish sleep in their children.

There are many reasons why sleep is important to the human body. Pediatrician Marc Weissbluth, M.D., author of one of the most helpful parenting books I’ve ever read “Healthy Sleep Habits, Happy Child,” explains sleep is restorative and necessary for high quality, long-term brain function.

“Sleep is the power source that keeps your mind alert and calm,” he writes in his book. “Every night and at every nap, sleep recharges the brain’s battery. Sleeping well increases brainpower just as lifting weights builds stronger muscles, because sleeping well increases your attention span and allows you to be physically relaxed and mentally alert at the same time.”

Given the importance of healthy sleep habits, it makes sense that Weissbluth argues that sleep deficiency in childhood could harm neurological development. “Chronic fatigue can reduce your child’s ability to succeed in school,” he offers. “If your child does not learn to sleep well, he may become an incurable adult insomniac, chronically disabled from sleepiness and dependent on sleeping pills.”

Over the past few months, I have found myself wishing that every parent and anyone who spends time caring for babies and young children would read this book. One of the basic tenets of Weissbluth’s teaching is that children must learn how to fall asleep on their own; it is not an innate ability with which they are born. He teaches parents – and caregivers, for that matter – to respect the need for sleep, even if the baby is ready for a nap only one hour after waking in the morning and even if the baby is ready for bed at 6 p.m. Yes, I know that’s early, but it is typical of babies’ circadian rhythms to be drowsy and ready for nighttime sleep between 6 and 8 p.m. Purposely keeping a baby awake past her natural drowsy time, which I am often tempted to do as a working mom, is not respecting the need for sleep.

Speaking of being a work-outside-the-home mom, sometimes I feel as though Cecilia is at a particular disadvantage. Spending several waking hours at day care certainly has had an effect on her sleep habits.

In addition to being able to fall asleep on their own, children must learn how to transition between sleep cycles and put themselves back to sleep after a night waking. Based on my amateur observations and conversations with other parents, this is often more of a struggle than the initial falling asleep time. I know it is in our house.

There are many illogical truths about sleep, especially in babies and children. According to Weissbluth, these truths are “biological, not logical.”

  • Truth No. 1: Sleep begets sleep. If a baby gets quality, restorative sleep during naps, she will sleep better at night. One day last week, almost-10-month-old Cecilia refused both naps while at day care. I felt like crying when the ladies in the baby room told me she didn’t sleep. I knew I was in for a long night of fussing and waking. When I shared my concern that she would wake up several times that night, they were surprised and confused. One even offered, “Really? I’d think she would sleep really well at night if she didn’t nap because she would be so tired.” I responded, “I know you would think that, but it’s not true. Sleep leads to more sleep.” Honestly, I didn’t want to be right. I wish Cecilia would sleep perfectly all night when she doesn’t nap, but that’s not what happened. She did indeed wake up several times that night.
  • Truth No. 2: Early to bed equals late to rise. Again, you would think the opposite is true. However, putting a child to bed early, during his drowsy state, usually means he will sleep later. Once a child becomes overtired (classic signs are eye rubbing and hyperactivity), it is much more difficult for him to fall asleep and stay asleep. This is because, in the overtired state, the body secretes stress hormones that are meant to fight sleep. A vicious cycle ensues. Baby is tired, but the drowsy window of opportunity passes. Baby becomes overtired and seems hyper. Parents think Baby is not sleepy, so they allow him to stay awake. Baby eventually enters into the hysterical zone and has even more trouble falling asleep and staying asleep.
  • Truth No. 3: All sleep is not created equal. Have you ever taken a nap in the car? Did you feel refreshed when you awoke? Probably not. For babies over the age of about 4 months, sleep while in motion is not considered restorative. Given that restoration is believed to be the primary reason the human body needs sleep, Weissbluth advises against allowing naps in car seats, strollers and swings if at all possible, recognizing that it will inevitably happen occasionally.
  • Truth No. 4: All crying is not created equal either. One of babies’ forms of communication is crying. They may cry when they are tired, hungry, cold, hot, scared, soiled or in pain. We parents must use our best detective skills to determine the reason for crying. Of course we want to meet their needs. We feed them when they are hungry and cuddle them when they are afraid. These are natural, appropriate responses. Often the crying stops when we meet the baby’s needs. But what about when it doesn’t? What about when we’ve tried everything and the baby still cries?

“On the surface, it certainly seems reasonable to say that the cry of your baby communicates messages: feed me, change me, pick me up, hold me, hug me or rock me,” Weissbluth explains. “The question is, why is it that when a parent makes a complete response to these messages, some babies still cry? Alternatively, if crying is a form of necessary communication, why is it that many parents will deliver complete, loving and sensitive care even when their babies do not cry? Perhaps crying as a signal system is not perfect: Some babies cry even when they don’t need to cry because their needs are being cared for, and other babies don’t cry but still receive the care they need. It may be an instinct: Birds fly, babies cry.”

One thing I’ve learned is that I feel helpless when my baby cries and nothing I do helps. When she wakes up in the middle of the night, my first instinct is to nurse her back to sleep. I try that, but sometimes she still cries. I try rocking, bouncing and walking or some combination. I try putting her on her belly – her preferred sleeping position – and rubbing her back. She sucks her thumb for a few seconds, and I think we are golden. I keep rubbing her back, but then she pops that thumb out and cries some more. Sometimes I give her Tylenol if I think teething pain is the culprit. This 2 a.m. circus continues until I am completely irrational, delusional and miserable. I wonder, “Why is she still crying? What am I doing wrong?” Weissbluth writes that if you feed the baby and she does not go back to sleep easily, she was not hungry in the first place. I, along with many other breastfeeding moms, know that nursing is not just about meeting the hunger need. It’s a comfort thing too.

When the aforementioned scenario happens, I know that my sweet Cecilia is simply having trouble falling asleep. I agree with Weissbluth when he writes that it is part of my parenting job to teach my children how to fall asleep on their own. Sometimes all of the nursing, rocking, bouncing, walking and back rubbing contributes to what Weissbluth calls “latency.” Instead of “helping” the baby fall back to sleep, I actually prolong the crying and make her stay awake even longer.

So to answer the burning question that’s been building from all of this sleep talk – yes, sometimes I let my baby cry. Not all the time. Do I believe it will hurt her in the long run? No. Quite the contrary, I believe chronic sleep deprivation is more harmful to brain development than the temporary elevated levels of cortisol secreted when she’s overtired and crying. (For more information about that, read “Why the Middlemiss Infant Sleep Training Study Doesn’t Prove Anything.”) I want to teach her to fall asleep and stay asleep early in life, rather than deal with the problem later during the preschool years or school-age years. When she doesn’t sleep, I don’t sleep. My exhaustion affects my work and my home life. I am an irritable mess who yells at her husband and her 5-year-old when dealing with sleep deprivation.

I would like to clarify that sleep training does not always have to involve excessive crying. I know many parents do not feel comfortable with leaving a baby alone to cry in an effort to teach her how to fall asleep. Weissbluth’s “fading” method, sometimes called the “chair method,” is meant to eliminate night wakings without crying. It is a gradual approach that can take weeks for it to be successful. Also, sleep training is never appropriate for babies younger than 4 months old.

While I truly feel that Weissbluth’s suggestions work for almost all babies and children, the major downside I find with his strategies is that they are generally not conducive to families with two working parents. It is much easier to implement and carry through with consistent nap times when I am in control. Even if I give specific instructions to the daycare workers, I have no control over Cecilia’s daytime sleep habits once I leave there. Aside from photocopying pages from “Healthy Sleep Habits, Happy Child” or buying them copies of the book, I’d love to hear suggestions on how to communicate these “biological, not logical” truths to caregivers. I constantly find myself sounding like a CD stuck on repeat.

Author’s note: This account is based on my personal experience and is not meant to replace medical advice from a licensed caregiver.

Originally published on ovparent.com.


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