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Nevena Lovrinčević

TEACH YOUR CHILD TO SLEEP From infants to preschoolers: How to prevent and cure sleeping problems


Edicija Dobar roditelj

TEACH YOUR CHILD TO SLEEP Author Nevena Lovrinčević Illustrations Neda Dokić Editor Natalija Panić Lector Nevena Čović Prepress Ljiljana Pavkov Publisher Kreativni centar Gradištanska 8, Beograd tel.: 011/3820 464, 3820 483, 2440 659 e-mail: info@kreativnicentar.rs


This book is dedicated to my husband Stanislav and our inexhaustible spring of joy, care, pride and love: Dimitrije, Natalija and Mihailo


Contents INSTEAD OF A PREFACE - MY EXPERIENCES

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1 WHY IT’S IMPORTANT FOR PARENTS THAT THEIR BABIES SLLEP WELL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 WHY SLEEPING PROPERLY IS IMPORTANT FOR A CHILD 10 WHAT DOES ‘SLEEPING PROPERLY’ MEAN? . . . . . . . . . . . . . . 12 DIFFERENT SLEEPING HABITS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 ‘Good sleepers’ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 ‘Bad sleepers’ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 THE MOST FREQUENT PROBLEMS WITH SLEEP . . . . . . . . . 14

2 SOME FACTS ABOUT SLEEP . . . . . . . . . . . . . . . . . . . . . . .18 CHILDREN’S SLEEP PHASES . . . . . . . . . . . . . . . . . . . . . . .19 How does your child sleep at night when he reaches the age of six months? . . . . . . . . . . . . . . . . . . . . . . . . . . . .20 ASSOCIATIONS CONNECTED WITH SLEEP . . . . . . . . . . .22 Why do some kids wake up crying at night and others do not? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23 CRYING . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .26 FREQUENT ADVICE ABOUT CRYING . . . . . . . . . . . . . . . . .27 “Don’t carry him around!!” . . . . . . . . . . . . . . . . . . . . . . . . .28 Just let him cry! . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .28

3 PREPARING FOR SLEEP – EVENING RITUALS . . . . . . . .31 Why are bedtime rituals necessary? . . . . . . . . . . . . . . . .31 Which activities are desirable? . . . . . . . . . . . . . . . . . . . . .32 The duration of rituals . . . . . . . . . . . . . . . . . . . . . . . . . . . .33 Suggested evening rituals . . . . . . . . . . . . . . . . . . . . . . . . .34 Babies aged up to six months . . . . . . . . . . . . . . . . . . . . . .34 Toddlers aged six to 18 months . . . . . . . . . . . . . . . . . . . .35 Children aged 18 months to three years . . . . . . . . . . . . . .35


Children aged three to six, or older . . . . . . . . . . . . . . . . . .35 Pre-puberty kids and adolescents . . . . . . . . . . . . . . . . . . .35 What makes a good ritual? . . . . . . . . . . . . . . . . . . . . . . . .36 BEDTIME IRRITABILITY . . . . . . . . . . . . . . . . . . . . . . . . . . . .36 BEDTIME FEARS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .38 How to help children overcome fears . . . . . . . . . . . . . . . .38 PUTTING TO BED . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .40 PUTTING TO SLEEP: UNDESIRABLE HABITS . . . . . . . . . .42 Pacifiers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .42 Feeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .43 Holding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .43 Sleeping with parents . . . . . . . . . . . . . . . . . . . . . . . . . . . .44 More complex bedtime habits . . . . . . . . . . . . . . . . . . . . . .44 The difference between evening rituals and putting to sleep . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .45

4 RECTIFYING UNDESIRABLE SLEEP HABITS . . . . . . . . . .46 PLAN OF ACTION: HOW TO TEACH CHILDREN TO FALL ASLEEP AND SPEND THE NIGHT ON THEIR OWN . . .47 The plan is as follows: . . . . . . . . . . . . . . . . . . . . . . . . . . . .47 Why is this method efficient? . . . . . . . . . . . . . . . . . . . . . .49 Does this method cause emotional damage to the child? 50 Deviating from the plan . . . . . . . . . . . . . . . . . . . . . . . . . . .51 How to make implementation of the plan easier . . . . . . . .51 TIME-OUT: SETTING LIMITS . . . . . . . . . . . . . . . . . . . . . . . .53 OPEN DOOR, CLOSED DOOR . . . . . . . . . . . . . . . . . . . . . . .56 LOOKING FOR YOUR OWN SOLUTIONS . . . . . . . . . . . . . .58 DILEMMAS AND CONSIDERATIONS . . . . . . . . . . . . . . . . . .59 A SPECIAL TOY OR BLANKET . . . . . . . . . . . . . . . . . . . . . .61 How to introduce the special toy . . . . . . . . . . . . . . . . . . . .62 SLEEPING IN THE PARENTS’ BED . . . . . . . . . . . . . . . . . . .62 Sleeping in the parents’ bed: yes or no? . . . . . . . . . . . . . .63 The child refuses to stay in its bed . . . . . . . . . . . . . . . . . .66


5 SLEEP RHYTHMS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .70 Forming a good sleep rhythm and its importance . . . . . .70 An infant’s rhythm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .70 Feeding cycles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .71 Separating night from day . . . . . . . . . . . . . . . . . . . . . . . . .71 Monitoring needs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .72 Frequent rhythm disturbances . . . . . . . . . . . . . . . . . . . . . .74 EATING DURING THE NIGHT – A FREQUENT CAUSE OF POOR SLEEPING . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .79 Eliminating nighttime meals . . . . . . . . . . . . . . . . . . . . . . . .81

6 OTHER SLEEP PROBLEMS . . . . . . . . . . . . . . . . . . . . . . . . .83 Nightmares . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .83 Frequent causes of nightmares, and how to deal with them . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .84 How to help a child who is suffering nightmares? . . . . . . .86 BRIEF AND INCOMPLETE AWAKENINGS . . . . . . . . . . . . .88 NIGHT TERRORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .89 How to help children who have night terrors? . . . . . . . . . .91 SLEEPWALKING . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .93 How to help children who sleepwalk? . . . . . . . . . . . . . . . .94 BEDWETTING . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .94 Approaches to the treatment of bedwetting . . . . . . . . . . .98 SOME MEDICAL REASONS FOR POOR SLEEP . . . . . . .103 COLIC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .103 OTITIS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .105 A FEW WORDS AT THE END . . . . . . . . . . . . . . . . . . . . . .107


INSTEAD OF A PREFACE - MY EXPERIENCES Dimitrije, my first son, was a wonderful, happy and fast-growing baby … but a terrible sleeper! It took a whole lot of rocking to get him to fall asleep, and he would wake several times every night. In the daytime he would only nap, and always at unpredictable hours. To get him to sleep his father or I would have to cuddle him while he touched our eyes with his fingertips. This went on for months, even years. He was three-and-a-half when he first began sleeping all night on his own – until then his father and I were constantly exhausted. We looked for solutions in numerous books about childcare, but they all turned out to be pretty useless. I was advised to either sleep when the baby was sleeping, or just to endure until the phase was over. I was never able to sleep when Dimitrije was asleep, simply because I am not a baby and cannot sleep in two- or three-hour instalments. Quite the contrary – I was so tired and tense that even when he did fall asleep I stayed awake and waited for him to wake up so that I would begin the cycle anew. Of course, I knew full well that the ‘phase’ would pass some day - I don’t know of any teenagers who wake up their parents at night because they can’t sleep. But what I didn’t know was how to survive it all? And what sort of ‘phase’ it was that could last more than three years?

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Just as Dimitrije began sleeping properly, our daughter Natalija was born. I thought it would be different this time – after all, I am now experienced, and I am a professional psychologist, and will know how to cope. BIG mistake! After a relatively stable and peaceful month of two began the same story: she woke up often and the same old rituals had to be repeated, only instead of our eyes, she preferred touching our earlobes. I though a bottle of fruit juice might help (“Maybe she’s thirsty…”), but the only result were several nappy-changes every night and cavities in her teeth, after we had very quickly progressed from one bottle to five or six a night… Of course, Natalija slept no better than her brother had done – quite the contrary: she only began sleeping properly after her fourth birthday. I though I would never again have a proper night’s sleep! I went to work every day and took care of the family, and I really needed a few good hours of sleep every night. But so far the was no success. When I got pregnant with Dimitrije’s little brother Mihailo, I decided to investigate the sleep question thoroughly. I obtained foreign literature and brought in my own clinical psychology experience, relying mainly on an excellent book by Dr Richard Ferber, and developed a ‘plan of action,’ which I began putting into practice the day Mihailo was born. Success at last! Mihailo acquired a good sleep rhythm very quickly and slept peacefully through the night. He is now five, and has never had any problems with his sleeping habits. And I am happy, fit and rested, which is quite rare for a woman raising three children. I have conveyed my experiences to many other parents who have also achieved much success, so that I am happy to share them with you here!

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1 WHY IT’S IMPORTANT FOR PARENTS THAT THEIR BABIES SLEEP WELL All novice parents (and many of the more experienced ones) know that one of the first questions they will be asked by friends and relatives is: “Have you managed a full night’s sleep?” This no accident, of course. Your kid’s sleeping habits will affect all other aspects of your own life. If your baby’s broken sleep makes you sleep badly for days or weeks, that is not a disaster, but if it turns into months or years, then things begin to get critical. Lack of sleep will make you tired, irritable, tense, prone to snapping at the slightest provocation - simply put, you’re at the end of your tether. You feel ineffective as a parent, out your depth. You begin asking yourself if there’s something the matter with your child. Or perhaps with yourself? Are you a bad parent? And what about the advice you’re getting? “He’s just spoiled – just let him cry!” … “Avoid taking him into your arms or he’ll get used to it!” … “It’s all just a phase!”

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What can parents do? The stress that you are under has probably caused a crisis in your own relationship with your mate, and on top of it both of you are constantly thinking about what would be best. Let the little one cry – but for how long: all night!? Maybe she’s hungry … or thirsty … or had too much to eat … or feels lonely … or had a bad dream … or has a pain of some sort … or should not have had eggs for supper … or should not have watched a cartoon before going to bed?! And so you enter anew into the vicious circle of lack of sleep and unsuccessful attempts to change something. Except for the first few weeks in a baby’s life, the problem of sleep is not just a ‘phase’ that you simply need to survive. Your problem affects millions of parents. That does not mean that you are all bad parents, and your child’s problem with sleeping is not something for which you should feel some sort of guilt – your child has simply adopted incorrect sleep patterns. The fact that you become a parent does not mean that forfeit your own right to sleep!

WHY SLEEPING PROPERLY IS IMPORTANT FOR A CHILD When we meet a child that its parents describe as a poor sleeper, most of the time we see a happy and bouncy baby. But the parents do not look well at all: exhausted, tense, with sunken cheeks… Who is the one that has a problem?

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There is nothing at all the matter with little children who have difficulty falling asleep and awaken several times a night – most of the time they get all the sleep they need, but the parents are the ones who are denied sleep. But if kids who sleep poorly do not have any direct problem, they do have indirect ones. Why? Well, it’s easy to understand: if parents, especially mothers, are exhausted, deprived of sleep and irritable, and feel they are making mistakes but do not know how to rectify them (all of which are problems which appear in parents whose kids do not sleep properly), these are certain to affect their relationship with their children adversely. Sometimes already on leaving the maternity ward mothers are told by a nurse that “…the baby slept little, and will be a problem…” From that moment on we expect our child to be a ‘bad sleeper,’ accept it as a necessary evil and allow bad sleeping customs to be formed. Even when we qualify our child as a ‘good’ or ‘bad’ sleeper, there then appears a dimension even more important than sleep: the child becomes generally good or bad. How many times have we all heard the following: “He’s such a good baby … we don’t hear a sound from him all night!” In this way when a child is described as a ‘bad sleeper’ there is a hidden implication – that he is not good, because he causes problems for his parents. Such a message, that we convey to children seldom realising that we are doing so, is definitely not good for the development of a child’s personality. Let alone the fact that it is completely wrong! It’s simple: if a child sleeps well, that means that the mother and father are rested and satisfied and feel that they are adequate and effective parents, which makes their relationship with the child better, from which the child can only benefit! When children sleep well, adults feel more adequate and secure, which means that the kids have better parents.

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WHAT DOES ‘SLEEPING PROPERLY’ MEAN? Simply put, all children (if aged over six months and in good health) can be said to be sleeping properly if they: • regularly fall asleep at the same hour; • fall asleep in about 15 minutes, without having to be lulled to sleep; • sleep for about as long as all children in their age group (see the table in the next chapter); • have a regular daytime and nightly sleep rhythm in accordance with their age; • generally do not wake up at night, and if they do - to go to the toilet or have a drink of water - subsequently easily fall asleep on their own; • get up at a reasonable hour in the morning. The following may sound improbable, but all children aged more than three or four months (in any case no more than six), who do not have a major medical problem, can sleep this way – sleep soundly. But when that is not the case, most of the time bad sleeping habits adopted by the child are the cause. Fortunately, children have a huge capacity to learn and with the correct approach will have little problem adopting positive habits and learning to sleep well. All children aged over six months are able to get a full night’s sleep without waking up.

DIFFERENT SLEEPING HABITS ‘Good sleepers’ Some children establish a good rhythm from day one: sleeping, eating… without any intervention by the parent. As they grow up they sleep very well, and sometimes you will even find it hard to wake them up if you have to get up early to travel somewhere. There is little that can disrupt their sleep: light and noise and

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changes of environment do not bother them at all. If they are for some reason forced to alter their sleep schedule, they adapt easily. At a dinner organised by his parents for a dozen guests, Marko, who is three, happily fell asleep under the dinner table at his bedtime even though his parents had forgotten about him… We usually call such children ‘good sleepers’.

‘Bad sleepers’ Other children are very sensitive to changes in their schedules, and fall asleep with difficulty and only with their parents’ help. It’s as if they are constantly in fear of missing something. Usually they are lively and restless kids who even when they finally get tired fight against sleep and struggle to stay awake. They react to every sound, every change of their sleep schedule or an exciting visit as if they’re thinking: “I’ll get out of sleeping!” As you try to lull such kids to sleep (and I myself had two, and experienced it many times), as they fall asleep they twitch several times and look at you as if to say: “Ah, you’re still here – I don’t want to sleep!” Such kids are usually (unfairly) described as ‘bad sleepers’.

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