Sleep Solutions for Your Baby, Toddler, and Preschooler :: the blog

Sleep Book Review: Healthy Sleep Habits, Happy Child

This is the first is a series of sleep book mini-reviews that will be posted to this blog. These sleep book mini-reviews are mentioned in Appendix C of my brand new book Sleep Solutions for Your Baby, Toddler, and Preschooler: The Ultimate No-Worry Approach for Each Age and Stage. The purpose of these reviews is to help parents to zero in on additional sleep books that may be compatible with their child's temperament, their parenting style, their family's unique needs and circumstances, given what they have learned from reading my book.

Healthy Sleep Habits, Happy Child: A Step-by-Step Program for a Good Night’s Sleep
By Marc Weissbluth, MD
3rd Edition
Ballantine Books, 503 pages, $14.95 US/$22.95 Cdn

About the book:
Weissbluth explains the key role that sleep plays in allowing children to be at their best during the day—to achieve Weissbluth calls optimal wakefulness. He points out the link between sleep problems at night and a child's behavior during the day: "Sleep problems not only disrupt a child's nights, they disrupt his days, too, by making him less mentally alert, more inattentive, unable to concentrate, and easily distracted. They also make him more physically impulsive, hyperactive, or lazy. But when children sleep well, they are optimally awake and alert, able to learn and grow up with charm and humor."

Weissbluth argues that, at around three to four months of age, all children are ready to begin the process of beginning to learn to sleep well. Parents sometimes get in the way of this natural process of sleep learning, however: "When parents are too irregular, inconsistent, or oversolicitous, or when there are unresolved problems between the parents, the resulting sleep problems converge, producing excessive nighttime wakefulness and crying."

Weissbluth recommends the cry-it-out sleep training method (See Sleep Tool 2 in Sleep Solutions for Your Baby, Toddler, and Preschooler for a detailed analysis of this sleep training method and a comparison to other sleep training methods), in which the child's cries are ignored in an effort to "extinguish" night-time crying. He argues that this method is the most effective. "The general reason why a gradual approach tends to be less successful in the long run is that it takes longer and there are always natural disruptions of sleep, such as illnesses or vacations. The subsequent reestablishment of healthy sleep routines using a gradual approach becomes very stressful to the parents. Several days or weeks of a gradual approach often wear down parents, so they give up and revert to their old inconsistencies. Parents who have successfully used extinction know that they might have one, and only one, night of crying after they return home from several days on vacation or from a visit to a relative's house."

Weissbluth does an excellent job of spelling out the physiological processes that govern sleep in young children -- specifically how becoming overtired can set off a series of biochemical processes that can make it even more difficult for your child to get to sleep the next time naptime or bedtime rolls around. The underlying theme of this book is "sleep begets sleep," which is why Weissbluth is so insistent that you have to make ensuring that your child gets adequate daytime and night-time sleep a priority for your family.

Comments from members of the Sleep Solutions for Your Baby, Toddler, and Preschooler book panel about Weissbluth’s book or cry-it-out methods in general:

"I know several moms who have had great success by sticking with routines, and that’s great. They seem limited, however, as to when they can do things during the day because they have to be home at certain times for naps." - Jennifer, 25, mother of two

"I don’t think the cry-it-out method is bad for [babies]: it's just very hard to do as a parent. It almost killed me the first few times she cried for more than ten minutes. I didn't go by the book enough to know if I gave it an honest chance for Edie. 'No cry' doesn’t work entirely for us either. Sometimes she cries no matter what if she’s tired. Sometimes she’ll cry in my arms on her way to her crib for a nap. Sometimes she'll cry harder if she's being soothed when she'd rather be sleeping. Sometimes I swear she is hollering 'Leave me alone. I’m trying to fall asleep.' I think we’re going to come to some agreement that is partway between cry and no cry. We’re not there yet." - Laurie, 38, mother of one

"Mikaela's lack of sleep was affecting our family, our marriage, and her emotional, physical, and social health. We knew that as parents we would often make decisions that were in her best interest, whether those decisions made her happy or not. While I am not a huge fan of crying it out, I have to say it produces results better than any other plan we have tried. Every mother hates to hear her child cry: it is heart-wrenching. I try to remind myself that I am not leaving them to cry themselves to cry themselves to sleep. I am leaving them to learn to sleep by themselves. That distinction can be helpful in the middle of the night."  – Michele, 30, mother of two

Technorati tags: baby sleep weissbluth

Family Vacation SOS

"I don't know whether to look forward to our family vacation or to dread it. Our kids are such terrible sleepers."

Here are some parent-proven strategies for helping kids get the sleep they need while you're on vacation.

Pack a piece of home. Your kids will find it easier to settle down for a good night's sleep if you've brought along your two year old's favourite stuffed animal, the storybook you always read to your four year old, or the music CD that the two of them like to listen to after "light’s out."

Stay on schedule. While you might be tempted to scrap everyone's schedules while you're on holiday, being too laissez faire about bedtimes and mealtimes can bring on the biological equivalent of jet lag. So stick to normal wakeup and eating times as much as possible.

Avoid overtiredness. Once kids get overtired, the quality and quantity of their sleep deteriorates because they are so revved up. The result? Grumpy kids and even grumpier parents! So stick to a kid-friendly travel itinerary that allows for daytime naps and reasonable bedtimes and the entire family will have a much more restful (and a much happier) holiday.

Women and Sleep

The cover story in the current issue of Newsweek focuses on women and sleep -- specifically why women aren't getting nearly enough sleep, and why that is depriving us of the quality of life we might otherwise enjoy. (Sleep deprivation not only zaps you of energy, makes you more irritable, and drain you of your enjoyment of life: it ups your odds of developing serious health conditions like heart disease and clinical depression.)

Not surprisingly, the story points out that pregnant women are vulnerable to sleep deprivation, due to hormonal changes, pregnancy discomforts, and sleep-related conditions like restless legs syndrome (RLS) that are more likely to occur during pregnancy. Research has demonstrated a link between restless legs syndrome and iron-deficiency (a common problem during pregnancy) -- something which may explain why some moms-to-be experience the creepy-crawly, spiders crawling up my legs feelings associated with restless legs syndrome (RLS).


The article didn't extend into "sleep deprived parent turf" (a subject I focus on in the parent chapters of Sleep Solutions for Your Baby, Toddler, and Preschooler: The Ultimate No-Worry Approach for Each Age and Stage, but there are lots of great hints on practicing "good sleep hygiene"-- including a reminder not to overdo it with the Starbucks!


You'll also find links to two sleep podcasts to download and listen to at your leisure.

Baby Won't Nap

Cynthia dropped me a line over at my Amazon.com Author Connect blog to tell me about her son's daytime sleep problems. Here are some of the suggestions I offered, based on what she had to tell me about her son's sleep routines.

If a baby isn't getting enough sleep in a 24 hour period, it can be hard for him to settle down for restful naps. Often naptime sleep is the "canary in the mine" -- an early indicator that baby isn't getting enough sleep or sufficiently restful sleep. The National Sleep Foundation recommends that 6-8 month old babies sleep for 14 to 15 hours per day. (The American Academy of Pediatrics recommends the same amount of sleep.) But in its 2004 Sleep in America study, The National Sleep Foundation found that most babies this age were getting a total of 12.8 hours of sleep (9.7 hours at night and 3.1 during the day). Obviously these figures are averages, but you can see that babies your sons age need a lot of sleep in order to function at their best. If your son is sleep deprived, he may be too wired to settle down for truly restful daytime naps. He may only be napping long enough to take the edge of his exhaustion. Is it possible that he needs to sleep in a little longer in the morning or, if he's waking because he's hungry, to go back to bed shortly after his early-morning feeding? Perhaps you could alter his sleeping environment so that morning doesn't arrive quite so early for him (room-darkening shades, creating a "blanket" of sound by using a white noise machine, making sure he's staying dry all night by using sufficiently absorbent diapers, making sure he's not too warm or not too cold at night -- common reasons for a baby waking up too early).

Could something be interfering with your son's naps? Is the daytime environment much busier or noisier? This can make it difficult for a baby to settle down to sleep. (A white noise machine can help a lot. You might also try playing his lullaby CD to provide a soothing blanket of sound.) Something as simple as the timing of naps can cause a problem. Trying to put a baby down for a nap when he is hungry as opposed to when he has just eaten can interfere with naps. (Your baby be naturally tired after he's had his lunch. It only makes sense to work with rather than his natural biorhythms.)

I wonder if your little guy is either making a transition from three naps to two naps (which might explain why his daytime sleep patterns are a bit wacky right now) or if he's having a bit of difficulty adjusting to the fact that there isn't a lot of consistency to his daytime routine. Some babies don't have any trouble "going with the flow"'; others need a lot more consistency. You would be the best one to judge what kind of temperament your little guy has and what works best for him.

The constipation thing could be an important clue. I've heard from some parents who found that sleep problems became a major problem when their child was struggling with some sort of food-related problem. (It's actually amazing how much eating and sleeping link together -- even for us grownups. Have you ever eaten too much food right before bedtime -- maybe at a New Year's Eve party -- and then had a hard time sleeping. Or maybe it wasn't the food....ahem. Okay moving on.)

The lost pacifier issue could be starting to become an issue. I'm sure you've done all kinds of reading about sleep associations and how babies/toddlers naturally want to recreate the environment that was in place when they fell asleep. (That's why you're finding that you're on "pacifier patrol" if the pacifier gets lost while your baby is asleep.) You may want to consider (and I stress CONSIDER) switching your baby over to a different type of "lovey" that isn't as easily lost at naptime. His age is a consideration here because there are sleep safety issues to consider. You can't send him to bed with some of the "loveys" that are safe for older kids because of SIDS safety concerns. But maybe this is something you could work towards in the months ahead -- switching him over to a tiny stuffed animal. Someone recently sent me a sample of a product called Wubba Nub that features a pacifier attached to a tiny stuffed animal. That might be one idea as your baby gets older.

Sleep hygiene (the quality of sleep) is another thought that pops into my head. While sleeping on the run works well in some situations, babies don't get ideal sleep in strollers. In a perfect world, they'd always sleep in their beds. Of course, we aren't raising them in a perfect world, so we have to balance off their needs vs. our needs. But I just thought I'd flag that for you as another possible clue.

Finally, there are all kinds of alternatives to the "sleep training" you're dreading. Read up on the alternatives and go with your gut instinct about what's right for you and your baby.

Snoring: When to Worry

If you're wondering when snoring is and isn't a concern in young children, this tip sheet from Cincinnati Children's Hospital Medical Center does a great job of spelling out when parents should -- and shouldn't -- worry about snoring.

Snoring: It's All in the Family

A brand new study reports that snoring tends to run in the family. Researchers at Cincinnati Children's Hospital Medical Center and the University of Cincinnati evaluated 681 children (median age 12.6 months) and found that infants who snored on a regular basis were three times as likely to have a parent who snored on a regular basis. The results of the study are reported in this month's issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.

To Schedule or Not to Schedule?

To schedule or not to schedule? That is the question. If you're wondering whether putting your demand-fed baby on a schedule would improve her sleep habits, here's what you need to know: Babies fed on demand are no more likely to wake up in the night than babies fed on schedule. But babies who have irregular eating patterns may have irregular sleeping patterns and hence more difficulty sleeping through the night than other babies. In other words, babies whose eating habits are somewhat erratic -- who may have a light breast milk or formula "snack" at one feeding and then the breast milk or formula equivalent of a six-course meal at the next feeding -- are more likely to have totally unpredictable sleeping patterns as well.