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Children’s Sleep

Posted on 30 January 2015

Here Mandy Gurney, founder of Millpond Children’s Sleep Clinic and co-author of the sleep book "Teach Your Child to Sleep" lays out some strategies to help with children’s sleep problems.

It is very rare for a child never to suffer any sleep problems at all.  You are a lucky parent if this is irrelevant to you!

One of the most common sleep problems is inappropriate sleep associations.  This is simply that a child learns to fall asleep with certain conditions present at bedtime.  That may be a dummy, a bottle or a breast for example.  When the child wakes up in the middle of the night, if the association is not present, they will find it very difficult to go back to sleep on their own.  Therefore children need to learn to fall asleep independently.

Difficulties settling at bedtime is also another common sleep problem.  This can often be caused when there is little or no bedtime routine.  Many people will agree that a good bedtime routine is the anchor of pre sleep techniques and introduces cues for sleep and induces sleepiness.  A good routine also regulates the body clock and this can be introduced as early as possible but at least by the time the child is 3 months old.  The whole routine should not last more than 30 minutes with a bath only lasting about 5 minutes.  It can be tempting to use the bath as a play time but actually it is preferable to use this as a sleep cue and a calming down trigger.  Establishing a regular bedtime and wake up time and sticking to it – even at week-ends is the key.  Computers and televisions should be avoided one hour before sleep as this can bring on wakeful feelings. Lights should be turned down and clear boundaries enforced.    The child should be placed in their cot or bed feeling drowsy and without any props.  You should then leave the room while your child is awake so they learn to fall asleep independently.  Your child should be asleep within 15/20 minutes.  This will only happen if the day time nap routines are regular and consistent and as the child gets older, these are reduced.  The room should be at a regular temperature of 18 degrees.

Night feeding is a common sleep problem too. It is recommended that from 3 months you give a child a pre-bed feed BEFORE the bath so that feeding does not become an inappropriate sleep association.  From the moment you start this technique you teach independent sleeping.To turn now to some strategies to help change behaviour, controlled crying is one that a lot of people talk about albeit probably the most controversial.  If you don’t like hearing your child cry or if they are under 6 months old, then this one is not for you.   The idea is that parents return at regular intervals to briefly check on their child when they are crying. However the key to success is not to touch them.

Your child is placed in their cot awake and you leave the room.  They will start crying.  You return after a minute to briefly check and reassure them that you are there. Do not cuddle, pat or pick them up.  Check at regular intervals until the child starts to quieten. Wait to see if he is settling to sleep.  If they cry again, start checking again and you repeat this until the child is asleep.   You need to repeat the process every time he wakes.

Another very popular strategy is called Gradual Retreat.  Parents often adopt degrees of physical closeness in order to help their child get to sleep e.g. rocking to sleep or getting into their bed to sleep.  When you decide that this is not an option for you anymore the child will need some kind of training to enable you to leave the room. This is a gradual method based on the idea of parents distancing themselves from their child little by little until they no longer require their parent’s presence to fall asleep.  It can be used for any age.

First of all you must decide on the first degree of separation. So for example you may decide to rock your baby to sleep instead of feeding him or sit on a chair next to the bed rather than in the bed. Every 4th night you move onto the next degree of separation. You have to resist the pressure to return to the previous position. Your child must be fully asleep before leaving the room and you continue to move away until outside your child’s bedroom.  This is a very successful method although takes time and input from you.

 Recommended books:

  • “Healthy Sleep Habits, Happy Children”; Dr Marc Weissbluth
  • “Teach Your Child to Sleep”; Millpond Sleep Clinic
  • “Sleepfaring”; Jim Horne

Recommended products:

  • Sleepytot; baby comforters that hold dummies and teethers to help babies sleep soundly through the night
  • Snuggle sacs; an alternative bedding solution to keep children warm

Mandy has had over 30 years’ experience as a registered general nurse, midwife and health visitor. She has been running sleep practitioner workshops for health professionals in the NHS across the UK for a decade.

 Article by Mandy Gurney from Millpond Sleep Clinic.  The views are the author’s own and are not meant to replace medical advice.  If you have concerns please contact your health visitor, infant feeding specialist or GP.