Chapter 1
My Child Doesn't Sleep Well
WORDS OF ADVICE
Before you start, please read the following recommendations carefully.
• First of all, you need to be convinced that this method will work for you. In order to teach a child healthy sleep habits, you, the parent, grandparent, babysitter, or caretaker, are the key player in the process. And your confidence in this method is essential to your success! If you trust the method completely, you will project your confidence to your child and will see quick and tangible results. You will be faced with new situations, and-trust me-many of them will be extremely trying, especially at 4 am. This is why all the caretakers must work together, drawing from the same set of standards and following the same rules.
• Make sure that your child doesn't have medical ailments when you begin treatment. Methodically rule out any type of illness that may be causing your child to sleep poorly, the most common of which are ear infections, lactose intolerance, gastric reflux, and, occasionally, psychological or psychiatric problems. Con-sult your pediatrician to help you with this.
• Recognize that all kids can learn to sleep well even though each child is different and has a unique personality. Some kids catch on quicker than others. Some do as they're told. Others are more stubborn. Some children are calm and some, more active. From the minute your child is born, you, as a parent, start to see these different personality traits. And of course they're important, but they should never be used as an excuse to justify insomnia. Teaching your baby to sleep simply means teaching her correct sleep behavior! We learn to sleep, just as we learn to eat, read, and go to the bathroom. Sure, there are active kids who can barely sit still, so it's tough imagining them reading a story quietly to themselves. But they will figure it out, sooner or later.
• Remember that your child needs you. You, the parents and caretakers, are the ones who will teach her how to sleep on her own; she can't learn this alone. My method offers you all the tools you need. First I'll explain what good sleep behavior involves; then I'll help you teach this to your child. So stop feeling powerless! There's no reason to feel guilty: No one has ever explained to you how a child learns to sleep. All you need is someone to help guide you!
• After so many nights of collective insomnia, you are probably feeling exhausted, irritable, and nervous, but remember that your child is suffering, too. Sleep is an important part of everyone's life, and children who sleep poorly are usually crankier and more dependent on their caregivers than kids who sleep well. Once they've completed my method, many parents feel that they are looking at a whole different child. They say things like, "She's calmer, she's in a good mood, she plays by herself more often, and she's even nicer." But this isn't true. Your baby was born nice and was simply suffering from sleep deprivation.
WHY IS IT IMPORTANT FOR MY CHILD TO SLEEP WELL?
One simple reason: Nobody can live without sleep, not even animals. During sleep, a child's brain grows and matures more rapidly than it does during daylight hours. Additionally, the body creates everything it will use throughout the next day, which is why a child who doesn't sleep well at night is cranky, nervous, tired, and drowsy in the morning.
WHY DOESN'T MY KID SLEEP WELL?
Before jumping into the method, let's take an inside look at the physiological aspects of sleep. To begin, let's define what a biological rhythm is and how long it lasts.
Biological Rhythms
A biological rhythm is the systematic repetition of a pattern that takes place in the body, such as the pattern of sleep and wakefulness. Infants repeat a specific biological cycle every three to four hours, which includes such activities as waking up, eating, being bathed, and sleeping. This kind of cycle is called an ultradian rhythm.
Adults follow a circadian rhythm. The word circadian comes from the Latin circa, meaning "about" or "approximately," and diem meaning "day." The adult pattern of sleep and wakefulness is repeated (approximately) every twenty-four hours.
When Does This Biological Rhythm Change?
Once babies are three or four months old, they begin to progressively lengthen their biological rhythm as they adapt from the three- to four-hour ultradian rhythm to the adult twenty-four-hour cycle. At this age, babies start to sleep six hours in a row-a huge gift to parents!
Once a baby is six months old, she should sleep for twelve hours straight with two or three short (one-hour) naps during the day-one after breakfast, another after lunch, and the last one, which is optional and shorter, after a snack.
How Does This Change Happen?
This change comes about thanks to a group of cells in the human brain* that work like a clock. The goal of this "clock" is to adjust a person's needs to the twenty-four-hour biological rhythm.
Think of this as an old kind of clock that needs to be wound. Seventy percent of newborns manage to "set" their clocks with a few routines or some simple encouragement from their parents, such as being picked up, put in a crib, told good night, rocked a bit, or sung a lullaby.
Not all children set their own clocks, however. The other 30 percent of babies can sleep just as well as those in the first group-they simply need a bit more "winding." It is very easy to readjust a sleep cycle, but it has to be done as soon as possible. My experience shows that the earlier you start to correct bad sleep habits, the easier they are to solve. So let's get started!
How Can You Wind the Sleep Clock?
You can set your baby's clock by exposing her to certain external stimuli.
• Reinforce the contrast between light (day) and dark (night); and the contrast between noise (day) and silence (night). In this way, you promote the idea that light and noise are part of daytime wakefulness, while darkness and silence are associated with nighttime and sleeping. During the day, never create an artificial environment. Don't lower the shades or tiptoe around while your baby is napping. Just act normally!
• Use meals as a cue to announce your child's next nap or nighttime sleep.
• Teach sleep habits. Show your baby how to fall asleep on her own, without anyone's help. Don't worry: I'll explain this more in the next section!
CLINICAL CHARACTERISTICS OF INFANT INSOMNIA (CAUSED BY INCORRECT SLEEP HABITS)
If your child doesn't manage to change her biological rhythm and doesn't learn to sleep correctly, she'll suffer what is clinically called infant insomnia. The characteristics of this disorder are:
• Difficulty falling asleep alone.
• Waking up often at night.
• Sleeping lightly (waking up at the slightest noise).
• Sleeping fewer hours than normal for children of the same age.
If your child exhibits the above behavior, don't be alarmed! She is perfectly normal both physically and psychologically. She just hasn't learned how to sleep properly-a problem you are about to solve.
SUMMARY
My Child Doesn't Sleep Well: Sleep Physiology and the Biological Clock
• Newborns have an ultradian biological rhythm that lasts between three and four hours. During this period, they wake up, are bathed, eat, sleep, and repeat the process.
• At about six months of age, babies adapt to a circadian rhythm, which means that the systematic sequence of activities repeats itself every twenty-four hours. At night, they should sleep between eleven and twelve hours straight (in addition to their daytime naps).
Seventy percent of children adjust to this cycle without any problems thanks to a group of cells in the human brain that work like a clock.
The other 30 percent need external stimuli to help them "wind" their clock:
• Reinforce the contrast between light (day) and darkness (night); between noise (day) and silence (night).
• Use meals to cue bedtime.
• Understand that they can and will fall asleep on their own.
Chapter 2
What Are Good Sleep Habits?
All of us, at some point, have dreamed of returning to childhood: that glorious stage of life when we didn't have to punch in at eight o'clock in the morning or worry about leaky faucets. During the early years of life, our only obligations are eating and sleeping. Sounds pretty good!
Still, you can be sure that even these were not such simple tasks, at least not at first. We all had to learn to do them correctly; if nobody had ever taught us to use a fork and spoon, we might still be mopping up our spaghetti sauce with our fingers. And it might never have occurred to us that a balanced diet can involve more than chocolate!
From this, we can reach two crucial conclusions. First, eating is not the same as eating well, and-in much the same way-sleeping is not the same as sleeping well. Clearly, your baby sleeps at some point during the day-he couldn't live if he didn't. However, it's another thing altogether to sleep correctly. So how can you know if your child is sleeping well? Very simply. If you can answer yes to the following questions, then there is no problem:
• Does he go to sleep happily and without crying?
• Does he fall asleep on his own?
• Does he sleep in his crib with the lights turned off?
• Does he sleep for eleven or twelve hours straight? (Although some children need a bit less, this is the average.)
Second, sleeping, just like eating, is learned. Sleep is a habit and, as such, must be taught.
HOW IS A HABIT FORMED?
Let's use the food example to understand how you teach a child a habit:
The Association of External Elements
Whether you realize it or not, we all treat mealtime as a ritual. In a very natural way, you pick up your child, put him in his high chair, put on his bib, and pick up a bowl and spoon. These elements- high chair, bib, bowl and spoon-are constant for the child while he eats and thus enable him to develop the habit. Repeating this association of external elements along with the ritual (in this case, eating) gives the child a feeling of security. After a while, he becomes so familiar with the whole process that as soon as he sees the bowl, he waves his little arms in anticipation of the meal to come.
Exhibition of a Confident Attitude
Keep in mind that kids always pick up adults' moods and emotions. From the very first days of life, a baby understands what you are communicating through your tone; he doesn't have to know the meaning of the words to know if you are angry or happy.
So it doesn't matter if you call him "chubby" or "brat" as long you say it in a sweet voice. On the other hand, a child will surely freak out when he hears "You are so handsome, my darling," if you say it like the child in The Exorcist.
In just the same way, your child can sense your confidence or hesitation as you go through your daily activities. If his caretakers seem unsure of how to feed him, bathe him, dress him, or put him to sleep, then he'll feel insecure at these times, too.
When confident and relaxed parents teach their child to eat, the child notices this and feels confident and relaxed as well.
Parents don't let their kids alter the eating habits they have taught them. If your child sticks his hand into the bowl or sprays orange juice out of his mouth, you will explain to him that he is acting incorrectly. Then you will show him the right way to behave.
Nobody would think that a child would be traumatized by being "forced" to eat yogurt with a spoon, right? After all, when you explain this to your child, you do it in a deliberate and natural way, not as if you are punishing him. Nobody would say, "You've been bad, and now you have to eat your soup with a spoon." If you don't transmit a feeling of punishment, he won't ever feel threatened by the event.
Sleeping is different. Parents frequently punish their children by making them go to bed. And in doing so they make their children associate "bed" with punishment-with something negative and even traumatic.
What Happens if You Express Insecurity While Putting Your Child to Bed?
Let's imagine, for a moment, a situation in which parents abandon accepted mealtime elements such as the high chair, bib, bowl, and spoon. Let's imagine that, instead, they exchange the bib for an embroidered silk shawl and the bowl for a motorcycle helmet, and instead of putting the child in a high chair they decide to set him up in the basketball net in the backyard while they try to score baskets with spoonfuls of baby food from the dining room window.
Absurd, right? Well, now think about what you have been willing to do when your kid starts bawling at midnight. You stand on your head, do the hokey pokey, imitate Barney, or try to hypnotize your child by swaying the hanging lamp in front of his little face. What is the poor kid going to think? He'll probably want to grow up as quickly as possible so that he can sue you.
Seriously, with so much doubt and improvisation, parents are transmitting insecurity. Your child picks up on the fact that you feel overwhelmed, don't know what to do, and are making it up as you go along. He won't learn how to get himself to sleep until you show him how confident you are that he can do it on his own.
HOW DO CHILDREN COMMUNICATE?
Kids are clever little people. From the moment they're born, they observe their parents carefully. They know how to act in order to get you to respond to their desires and demands; which is to say, they know perfectly well that every action on their part provokes a reaction from you. As the baby grows, so does his ability to communicate with adults.
Let's look at a breakdown of your child's communication development.
From Six to Eighteen Months (Pre-Speech Children)
During this stage of development, children communicate with their parents by doing something that causes a reaction. At this stage they can:
• Smile, say "goo goo gaa gaa," clap, and the like. With these cute tricks, they get their parents all excited and puffed up with pride. Still, after the twentieth "goo goo," you've probably stopped listening.
• Cry, scream, vomit, hit themselves, et cetera. With this effective repertoire, kids get your full attention. You come running to their side. There is, of course, nothing really wrong with them; they are just trying to attract attention and have some company.
