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What does a sleep trainer usually hear when a new client gets in touch?
It is not uncommon for me to find an email written between 2-6am from a sleep starved parent asking for help. They know the problem but can’t see a way to solving it. Often they report that their child slept well until their 4 months sleep regression. Since then, illness and holidays have worsened an already poor sleep pattern in their child. Sometimes the child will sleep through the night, but just as the parents think they see progress, it all falls apart again. Their happy little child is tearful and exhausted and so are the parents…
Does this feel familiar?
There is never just one answer to this problem but a few questions and a look at the little one's routine can usually help to find the way. Before I speak to my parents on a consultation, I like to have an informal chat to understand what is causing the problem and what are the barriers these parents are finding. This could be that they are unsure what approach to take, are too exhausted to sit up all night, feel concerned when they hear crying or or simply don’t believe their child can ever sleep through the night like others do.
That means during the consultation we can really look closely at each individual child and find a routine and approach that suits each family personally. I always warn parents that the first night might be tough, but virtually every time they report back after the first night, that it wasn’t nearly as hard as they had thought. In fact many feel relaxed, enjoying the simplicity of having a plan during the night, confident that they are doing the right thing and not causing unnecessary stress on their child. It is also reassuring to know that their child will never be asked to do something they are not developmentally capable to doing, often far exceeding parents expectations.
I’ve had 40 years of experience with the under fives. Yes, I can’t believe it’s that long either, but our Norland reunion celebrating 40 years since we all started our training this January confirmed this. I have been sleep training since 2006, and wish I had kept tally of the hundreds of wonderful families I have worked with and literally thousands of times a child has fallen asleep bedside me. It is wonderful to watch and being with your child as they wake until they fall asleep in the night is incredibly bonding. The main feed back I hear is that family life is much happier and that the child is eating, sleeping and playing better than was ever expected.
How does sleep deprivation affect my child?
After 3 months of age a baby will begin to lose the reflex to automatically fall asleep and start to develop a circadian rhythm. This circadian rhythm, the internal body clock, begins to develop over the next few months and by 6 months most babies are able to sleep through the night for 12 hours. Not every baby can do his for a number of reasons, but after 6 months of age babies and young children can generally be coaxed into a good rhythm which will aid their sleep.
When I take a family through sleep training, I go through some of the reasons they are doing this for their child. There are in fact four developmental areas that are notably affected by a lack of sleep.
Physical development
Deep sleep in the earlier part of the night is important as it restores the body, rests and mends muscles and repairs and develops cells which aid growth. Sleep deprivation can cause the body to crave high energy foods which can lead to childhood obesity in the long term.
Curiosity and learning through play
If a child feels mentally alert they are keen to explore the world, to try new things and explore how they work. In the lighter sleep waves in the early hours of the morning, the brain processes the days experiences and plants them in the long term memory. This is an important part of the learning process.
Social skills
The lighter sleep, REM (rapid eye movement) or dream sleep in the early hours, aids emotional regulation. This helps the brain to explore and reassure emotions felt during the day and improve emotional resilience. Experiences often feel better after a good nights sleep. Over tired children can react in impulsive behaviours which can cause friction with friends and families. This is the age where the skill of making bonds are practiced and friendships shared.
Health and wellbeing
The hormone Cortisol is released in response to stress, and exhaustion is certainly stressful. Cortisol also raises the blood sugar levels and increases obesity. It can suppress the immune system at the time children are trying to build up their resistance to disease and decreases bone formation. In addition, a tired child is living off Adrenaline to them keep going. This fight of flight hormone makes resting very difficult and perpetuates the problem.
Although most children will find their own way to get enough sleep, some will certainly benefit from a helping hand from sleep training. Most parents report that their happy, lively child is even happier and calmer whilst focussing and enjoying games after a few nights of quality sleep. They are eating better and loving their cot and bedtime.
Sleep helps beat germs.
In the grips of winter we all see our families fighting off one infection after another.
During sleep, children and adults produce proteins known as cytokines, which the body relies on to fight infection, illness, and stress. Besides battling illness, they also make us sleepy, which explains why having the flu or a cold feels so exhausting. It forces us to rest, which further aids the body's ability to heal. Too little sleep appears to impact the number of cytokines on hand. Research found that adults who sleep fewer than seven hours per night are almost three times more likely to develop a cold when exposed to that virus than those who sleep eight or more hours. Our youngsters are all growing their immune systems, and lack of sleep makes this a harder task for their bodies defenses. It is important to give our children under five years 10-12 hours sleep a night.
Screen time
How much screen time is too much for our children?
Recent research has studied past papers and concluded that whilst looking at a screen does no harm to our children we do need to think about when the screens are used. For many it is used as a means of encouraging an interest in computers, which are part of our lives and especially those of our children. Tablets have been shown to improve hand eye co-ordination and problem solving. It seems reasonable to use it as a quick treat when children are asked to participate in something that would be hard to keep a sustained interest such as during a family wedding reception. So, screens shouldn’t be given an unfair hearing. The advice from this latest research is simply to think about when it is used. Too near to bedtime can stimulate the young brain at a time when a child needs to be winding down. This effect occurs even when the screen is on night-time setting with warmer back lighting. It is generally considered best to stop all screen time 1-2 hours before bedtime for a successful nights sleep. The sleep will be further improved if your child gets plenty of physical exercise during the day, and a balance of skills and activity will further improve learning. So my conclusion? Computers can be fun and educational, they are also an important part of our lives. But let’s remember to use them as part of the whole day, sparingly and before the pre bedtime wind down.
How Does Physical Activity Help You Sleep Better? Based from The Sleep Foundation
Sleep plays a vital role in your mental and physical wellbeing. Different processes that occur during sleep help to promote healthy brain activity and maintain good overall health. For children and teenagers, sleep is also key for proper growth and development.
Sleep deficiency can interfere with these bodily processes. The term “sleep deficiency” refers to the inability to get enough high-quality sleep. This may occur due to sleep deprivation, or simply not getting enough sleep, or there may be other underlying reasons, such as a sleep disorder or circadian rhythm misalignment. A lack of high-quality sleep means your body has less time to recover during the night. This can also lower your body’s defence against diseases and medical conditions.
The effects of sleep deprivation on physical health include:
Obesity: Studies have found sleep loss can increase your risk of becoming obese. Your body produces and regulates various hormones during sleep. These include ghrelin, which makes you feel hungry, and leptin, which makes you feel full. Lack of sleep can cause your ghrelin levels to increase and leptin levels to decrease, meaning you are more likely to feel excessively hungry and overeat.
Heart Problems: Blood pressure is generally reduced during sleep. Thus, decreased sleep can lead to a higher daily average blood pressure, which in turn may increase your risk of heart disease and stroke. Inadequate sleep has also been linked to coronary artery calcification3, a major predictor for coronary heart disease.
Insulin management: Insulin is a natural bodily hormone that regulates your glucose (or blood sugar) level. Sleep deprivation can affect how your body reacts to insulin and cause your glucose level to rise, which in turn puts you at higher risk for developing Type 2 diabetes4. Similarly, reduced sleep or poor sleep quality may adversely affect glucose control in known diabetics.
Immunohealth: During sleep, there is a peak in the number of certain T-cells, various cytokines, and other important components of your immune system5. Not getting enough sleep can affect >how the immune system responds to viruses and other infections. Long-term reduction in sleep can also lead to persistent low-level inflammation throughout the body, which underlies many chronic medical conditions.
Cognitive Performance: A good night’s sleep can improve your ability to concentrate, be creative, and learn new skills. People who don’t get enough rest often have a hard time paying attention and are more likely to make errors at work or in school.
Memory Consolidation: Sleep is essential for processing memories6. During the third non-rapid eye movement stage of your sleep cycle – also known as slow-wave sleep – your brain begins organising and consolidating memories. The rapid eye movement stage that follows may help to cement these memories. As a result, not getting enough sleep can affect your ability to remember important details.
Mood: People who don’t get enough sleep may have a harder time controlling their emotions, making good decisions, and coping with different aspects of daily life. Sleep deficiency can also lead to mental health issues, such as depression and increase one’s risk of suicide.
Growth and Development: For children and adolescents, deep sleep triggers the release of hormones that promote healthy growth, increase muscle mass, regulate puberty and fertility, and repair cells and tissues. Children who don’t receive enough sleep may feel angry or sad, struggle with school work, and have a hard time engaging with their peers in positive ways.
The amount of sleep you need changes with age. Newborns and infants require as much as 15 to 17 hours of sleep per night, whereas teenagers can usually get by with eight to ten hours. Adults between the ages of 18 and 64 generally need seven to nine hours. After reaching 65, this amount drops slightly to seven or eight hours.
The Importance of Sleep Hygiene
Sleep hygiene is a catchall term for practices and behaviours that influence sleep quality and duration. It can include bedtime and wake-up routines, as well as your diet, physical activity, and other aspects of daily life.
Key components of good sleep hygiene include:
Consistent Sleep Schedule: You should strive to go to bed and get up at the same times each day, including on the weekends and when you’re traveling. Many people find a consistent bedtime routine can help them get to bed on time.
Prioritising Sleep: Adequate sleep can be tough to juggle along with family life and socialising. However, you may need to occasionally forgo these activities in order to get enough rest.
Responsible Napping: After 6 months old a baby or child should wake at 3pm for a 7pm bedtime.
Relaxing Bedroom Environment: Think of the bedroom as a sleep sanctuary. Maintain a sleep-friendly bedroom, such as blocking light with thick curtains, and setting your bedroom thermostat to 17-20 degrees Celsius, which many experts agree is the ideal temperature for sleep.
Healthy Habits: Exercise, good food, relaxation and low stimulation before bedtime. No screen time within 2 hours of sleep, it is too stimulating for a child.
Sleep training
Does children’s sleep training really deserve the criticism it receives of a stressful unloving method of control over children? Well, as a sleep coach myself, let’s look at he process together. I recently heard a lactation counsellor describing her view of how the child was put under huge stress and felt abandoned throughout sleep training.
I was relieved to be able to assure her that no credible sleep coach would ever do this or would sleep train a baby under 6 months and maybe older depending on the health and circumstances of the child. I was also able to explain how for some families they do not mind disrupted nights, but for others it affects their relationships, health, family harmony and enjoyment of family life leading to a poorer childhood for their child. The children themselves are often susceptible to low immunity, poor concentration, violent outbursts and an isolated sense of misery as they honestly don’t know what to do with themselves.
We teach our children to eat, walk, potty train, why wouldn’t we teach them to feel confident about sleeping without assistance. And that is quite simply what sleep coaching is about. Gently giving children new sleep cues, strengthening their circadian cycle and developing positive routines that give your child a positive sleep experience. Parents can help their child develop sleep confidence. Later they can find the right moment to let their child learn to settle themselves, without disturbing the process.
This gives the child skills to sleep comfortably throughout life, stay fit and well in health and well-being and be ready to learn. I truly believe the benefits to a family struggling with a lack of sleep are life changing and totally positive.
My testimonials from families will reassure you. Please feel free to contact me if you would like help with your child’s sleep.
https://www.xanthelukes.co.uk/home Photo by Annie Spratt
Going back to work feeling exhausted….?
I have had a few calls lately with the same problem.
How to you return back to work from maternity leave when you get so little sleep? I have been helping families get their children to sleep through the night for 8 years now, and one thing I know for sure, the sooner sleep issues are resolved the sooner a family can get back to enjoying life and most importantly, each other. Being tired puts a huge strain on relationships, growth and development, concentration and physical and mental health. It affects both child and parents. The comment I most often hear is “Why didn’t I ask for help sooner?” If you feel you would benefit from support to teach your child to sleep through the night please contact me. I look forward to meeting you.
My children don’t listen to me!
How many times a day do you think you might just be talking to yourself! The children totally ignore you and you end up repeating yourself a few times before shouting to get their attention. Sound familiar?
Well, there could be a few reasons for this. Firstly consider if your child has “glue ear” especially in winter when their eustachian tubes can block up, interrupting their ability to hear.
Provided your child’s hearing is healthy, the reason they cannot hear may be that you child is either too absorbed in their own world to hear or that they are so unable to concentrate they cannot focus on what you are saying. Part of the development we look for in our pre-school aged children, is an ability to concentrate on a task for a period of time, getting absorbed in what they are learning from the game, but also being able to maintain an awareness of what is going on about them. This is known in the EYFS (Early Years Foundation Stage) as Two-channelled attention. A typical nursery situation could be a child who sorts out the decorations he wants to stick onto a page, finding the glue, putting enough on the page and then creatively making a design. This can be very absorbing, however, we also want him to hear when it is time to pack away for lunch time.
Like all learning it takes appropriate development as well as practice for the child to achieve all this. Before they can achieve it, they may be seen as being disobedient, but before 3.5 years old this may not be the case. As with all things children need the time and opportunity to learn this skill at the appropriate stage of development.
Now, imagine this situation to help you put yourself in a child’s situation. It is your daughter's birthday party. You’ve lit the candles on a magnificent cake and are walking to the table waiting for people to stop talking to sing Happy Birthday. There is quite a lot of noise in the room, not everyone notices, your child does though and is watching with delight. That is the moment your partner yells something to you about needing you to take a phone call. You can’t hear who, and don’t really care, you are totally engaged in the moment. You’ve planned it, look forward to it. Didn’t know you had something else you needed to do at the same moment. You continue across the room with the cake only to hear your partner shouting again that you need to take the call. I think most people would either ignore the plea to come to the phone or shout back irritatedly that you’ll ring whoever it was back! I doubt many of you would calmly put the cake down and go to the phone.
So why this story? Well, like a child playing you were totally wrapped up in thoughts in your head. You were focused and looking forward to the event that was about to unfold. You sort of heard the first call, but it was at a totally inconvenient time. You couldn’t deal with it just then, your child can’t either when absorbed in a game. They won’t like interruptions either. You would have ignored the situation just as your children would if interrupted. So how can you help your child here? Well, by simply walking up to them, you shift their attention, then giving 5 minutes notice that they need to pack away gives them time to come out of their world and accept a change is coming. Then following up with clear expectations and limits (e.g. clear up and wash your hands) will become routine for your child that will help the transition to a new activity.
But what if my child isn’t concentrating on anything, I hear you say. In fact he is rampaging through the house. This could be a different reason, problem focusing. In this instance he has so much distraction he can’t differentiate on any task being more important than another. This requires a different approach. In this situation you have to reflect on what has just happened beforehand. Is he over excited, in which case he will need to be calmed down before he is ready to listen. Have you or someone else just been shouting endless instructions at him. None of which he has “heard”. In this case how about leaving him in peace for a few moments, once he has quietened down he will be ready to listen again. If your child is not yet able to focus on an activity for an appropriate period of time, you will need to focus on games and tasks increasing in time where he is encouraged to sit still with you and look at a book, doing a drawing, play with the train set etc. Often when we are busy we can miss the fact that our children have forgotten how to sit still and play. Introducing activities like this throughout the day can help their ability to slow down and listen.
Brina Blum photography
Lights, Camera, Action
It has been huge fun this week doing a video promo with the MAD House toddler group in Taunton. The results will be coming soon. We plan to have an advice hub on specific subjects starting each month from April. More info to come on my face book page. https://www.facebook.com/pg/xanthelukesspecialistnanny/community/?ref=page_internal
Breast or bottle?
How do you feel about Breast feeding? We're hearing a lot in the news and Radio 4's Womans' Hour Survey this week, how pressure is dripped to Mothers-to-be about the health benefits of breastfeeding, causing guilt, shame and even social embarrassment to some of those great Mums who have chosen to bottle feed. These are emotions no Mother should feel, especially as their babies are positively thriving.
So the question I'm pondering is how do we as practitioners strike the right balance on such an emotive subject? As a young student at Norland we spent a month on the post-natal ward helping Mothers among other things to feed their babies. Mothers were shown how to safely make up a formula feed and sterilize their bottles or to get a good latch if breast feeding. I'd been asked to support a 16 year old woman who was trying to breast feed. As her baby latched on, Mum's shoulders reliably rose up to her ears in a mixture of pain and disgust at the process. Dutifully I supported this lady for 2 days before thankfully for her I was given a day off.
When I returned to the ward I found her smiling and singing to her newborn as she calmly fed her contented baby with a bottle. I dreaded breaking into the atmosphere as I realised...I had been the problem. My enthusiasm to "help" her through those early difficulties had made me deaf to what would really help this Mum.
I was grateful for this lesson early in my career and learned that what suits a Mother is very individual. All elements: the desire to breast feed, the desire to get her body back, to share feeding with other family members are as important for the new Mother and important for the practitioner to follow her lead, even if the Mother feels guilt at voicing this. The main challenge for any practitioner is to give the Mother a guilt free voice to decide what will suit her best. To tread the line between cheerleading the breast feeding mother so she doesn't regret giving up early and cheerleading the bottle feeding Mum who is bonding happily with her thriving baby. Something I'm always mindful of.
What is a Maternity nurse?
I have been asked this a few times this week so thought I would explain.
A maternity nurse would live-in with you during the first 6 weeks after birth. Bookings are in 24 hour blocks which you can link up for as much help as you need or want to spend. Typically 3-6 days a week for 2-6 weeks. She can show you how to bath, feed and settle your baby. She will also support breast feeding or bottles and show you how to make up feeds and clean bottles. Good sleep habits can be started during this time, helping to avoid sleep problems later on. Jaundice, colic, thrush and tongue-tie will reveal itself within in these first weeks and a maternity nurse can help you spot and respond to them. She should leave you with a workable routine which will help to organise your day. By helping to organise your daily routine the babies will, in time develop their own, but if breast feeding, I wouldn't suggest forcing a routine or starting bottles to complement the breast feeds for at least 6 weeks.
Most parents report that they feel rested and confident to continue to enjoy the early months alone.
What is a Night Nanny?
Often the biggest help a family can have in the early days of parenthood is a good nights sleep.
This is one of the most common requests I have. Typically a night nanny works from 9pm - 7am feeding, settling and changing your child. If you are breast feeding the nanny can take the child to you or wake you to come and give a feed. All bottle feeds will be done for you and washed up before she leaves. You can book as many or few nights as you wish.
Why won't my child sleep?
This is a common question asked by parents in the small hours of the morning and I notice plenty of traffic on my website from their mobiles at this time.
Very often the reasons are a series of small lessons accidentally developed over time in the rush and muddle of family life. It might be hard to ask for help, but this is a very common problem. With over 30 years of experience I can usually spot the way forward within an hour and guide parents in new ways in which they can unravel the bad habits and bring in new positive sleep associations instead. Often it involves a few tweaks in the child's routine and then careful consistent, persistent management in these new technique to get them back to sleep. These skills will last throughout childhood and be a guide to getting things back on track. You will never regret it!
How to survive the Autumn clock Change
Around the last weekend in October the clocks in UK change. The little saying “In Spring the clocks spring forward, in fall, they fall backwards” indicates that we will gain an extra hour in bed.
”Will we really?” I hear you say!
Parents often worry about this change in the routine of their under threes, who can struggle to cope with this jump in time. I think the best way to deal with this is making the change over 2 nights. A young child will generally manage a change of 30 minutes each day more easily.
So, I suggest on Friday evening you make bedtime half an hour later than usual. Encourage them to stay in bed quietly for half an hour later on Saturday morning. Follow your usual routine during Saturday but make everything 30 minutes later. On Saturday night repeat and put them to bed and wake them up 30 minutes later. By Sunday morning the clocks will have changed and everyone should be on the same timings.
Ta Da!
photo by Jon Tyson Unsplash
Do different parenting styles matter?
I saw a fascinating documentary some years ago that explored how 4 different families chose 4 very different parenting styles at birth.
They were followed through the first 6 weeks and revisited again on their child's second birthday. One family was following attachment parenting, one family followed Gina Ford and the other families followed more middle of the road ideas. So did the parenting techniques have different outcomes?
After so many years working with hundreds of different families I am very aware of different parenting styles and hugely respect each families’ method. So, I was heartened to see that all families interviewed on the second birthday of this documentary were delighted with their choices, felt well bonded with their children and the children had flourished in a happy home. It proved that so long as the family are happy with their choices, the families thrived.
Personally I don’t mind if families choose to co-sleep, sharing the same bed, so long as it is done safely. However I do feel sympathy for the family who do not choose this method and find their children insist upon it giving them all a bad nights sleep and exhaustion. It is these families that I can most help. By supporting them through and showing them supportive techniques to settle their children, these children can feel confident and safe settling in their own beds. It takes time, it takes determination to learn new habits in a situation that has become intrenched over years but the sooner it is tackled the sooner the benefits show.
How sleep improves social skills
Picture the scene. Children are playing in a small group of friends with the farm set in a family home.
Parents and carers are settled with a drink anticipating a natter. Suddenly a scream of injustice and one child throws himself to the ground because another child moved his toy. The other children look alarmed and move away in a resigned way and the screaming child needs to be calmed down. This is a scene we can all identify with, but what really happened here?
Firstly everyone felt comfortable in a trusting atmosphere and were looking forward to continuing their time together. The child who screamed felt a huge injustice had happened when his toy was touched. He felt a huge swell of emotion as upsetting to himself as those around him. The other children decided to stop playing with him and moved to a friendlier place in the room. The child and carer spent time reassuring the child.
This is a very typical behaviour of a tired child unable to call upon his internal resilience to a set-back. A calmer, less tired child would have been able to ask for the toys return. The game could have then continued in the same happy atmosphere.
Research shows that a toddler who sleeps badly or misses naps is more likely to “show confusion and negative emotion in response to challenging tasks“ (Berger et al 2012). The response of the other children to the tired child, demonstrates a reduced level of social support from those around him. As life goes on for the tired child this behaviour and response becomes a pattern which decreases the child's ability to make social bonds that will support him through life.
In conclusion, by giving the child adequate rest and sleep, the child has more opportunity to develop strong social bonds.
How does sleep affect curiosity and learning?
Children of preschool age need about 12 hours of sleep a night plus any naps for those under two and a half years old.
Put plainly we probably all know the value of giving a toddler a good nights sleep, the effects of poor sleep are at times painfully clear. Sleep improves the mood of our little-ones. By waking rested and refreshed a child is able to benefit in three main areas; curiosity and learning, growth and appetite and social skills. It is wonderful to meet an inquisitive, curious toddler who is thinking throughout the day in a way that brings them the great benefits of new skills. This is the child who wonders how a toy pulls apart, is it possible to rebuild, what does this object feel like when I touch it? The child is finding out and learning about his world. This critical thinking produces the thinkers and designers of tomorrow. The rested brain can concentrate more accurately and retain memory. Reading and learning throughout the day becomes effective. By giving them this night time sleep in one stretch means the brain has time to regenerate and grow cells, process information from the short term memory to the long term memory and the body to recover and prepare for the following day.
