The Ultimate Guide to Night-time Parenting

24 Nov

The Ultimate Guide to Night-time Parenting

How to get a good night’s sleep

 

How can I get my child to sleep through the night? A frequently asked question and source of much stress to many parents. Night-time parenting is a hugely controversial and divisive subject. There is an immense amount of conflicting advice that exhausted parents are burdened to sift through and hope for the best. With this Ultimate Guide to Night-time Parenting, I hope to summarise the leading research into an easily digested form so that we can all get a good night’s sleep.

 

Who are the experts?

Professor James J. Mckenna, the world’s leading expert on mother-infant co-sleeping, Dr. William Sears, renowned expert on attachment parenting and author of Nighttime Parenting, Elizabeth Pantley, author of the famous No-Cry Sleep Solution and Dr. Mayim Bialik, advocate of co-sleeping and attachment parenting. All of these experts have performed extensive research on the subject of night-time parenting.

For starters, let’s make it clear that night-time parenting is not something that must be borne entirely by the mother, even if she is exclusively breastfeeding. Dr. William Sears explains how partners can get involved in night-time parenting too:

 

 

Dr. Sears makes an important point that surprisingly, both attachment parenting advocates and those in favour of other methods, can agree on: a child benefits greatly from a consistent bedtime routine. What exactly this routine should be differs greatly with the methodology in question, but from an attachment parenting point of view, a bedtime routine for an infant may be as simple as breastfeeding them to sleep. For an older child, a familiar routine may be putting on pajamas, brushing teeth, getting into bed and having a bedtime story.

 

What is normal sleep for a baby?

Our Western culture places great emphasis on the need for a child to sleep independently and uninterrupted. Particularly first-time parents may receive information that causes unnecessary stress from unrealistic expectations. While it is true that some babies do sleep for eight-hour stretches at a time, it is not abnormal if your child does not. For infants it is not in their best interests to sleep for such long periods of time.

Dr William Sears reminds us that by medical standards, sleeping through the night is not an eight-hour stretch. It is considered from midnight to five am. This part is often left out when those in the medical community are informing parents. By the age of three months approximately 70% of babies will sleep for this five-hour stretch. Another 13% of children will achieve this by six months of age. A rather large ten per cent of children will not sleep uninterrupted during their first year of life. Which category your child falls into is not a measure of your parenting skills. If your child has difficulties with sleeping and you feel that something is not right, it is always a good idea to rule out any medical conditions that may be causing your child’s sleeping difficulties. Commonly, allergies and various digestive problems can cause trouble with sleeping.

The sleeping patterns of babies are of course transient and as many parents know, just because your child sleeps for eight-hour stretches for a few weeks is no guarantee he will continue to do so, and he may not again for several months. Things like teething, colds, ear infections or even learning a significant new skill such as crawling or walking, can all contribute to restless nights.

 

Where is the best place for my child to sleep?

There really is no ‘best place’ for a child to sleep, at least not as a general rule; rather it is something different for each family. For an infant, the safest place to sleep is in close proximity to his or her mother or main caregiver. The mother is a newborn’s main environment and the benefits of sleeping close to the mother at night are much the same as the benefits of babywearing during the day. A mother’s closeness boosts her baby’s immune system and is the best tool for regulating her baby’s breathing, body temperature and heartbeat as well as providing emotional nourishment.

Before further discussing different sleeping options, I will first provide a set of definitions as used by Dr. James Mckenna and Thomas Mcdade in Why babies should never sleep alone: A review of the co-sleeping controversy in relation to SIDS, bedsharing and breast feeding:

  •  solitary sleeping – a child sleeping in a separate room outside the supervision of a committed adult.
  • co-sleeping – sleeping in close proximity to your child, whether that is:
    1. roomsharing – sleeping in the same room on different sleeping surfaces, for example a crib next to the parents bed.
    2. bedsharing – sharing the same sleeping surface with your child.

 

The subject of co-sleeping is one that many parents have little information on, despite it being something that the vast majority of parents do at some point in their babies lives, sometimes even by accident. Dr. James Mckenna gives an excellent summary on the issues of co-sleeping in the following video:

 

 

As breastfeeding is once again becoming more popular in Western culture, it is certainly having an effect on the sleeping arrangements of families. Breastfeeding releases certain hormones that are designed to help the mother relax and pause to feed her child. These hormones coupled with sleep deprivation can make you very, very tired and many mothers have difficulty staying awake when they breastfeed their child, especially at night. Due to this, many mothers will end up sleeping next to their child, even if they have every intention not to. What is important is to make sure the sleeping environment is safe. For example, the sofa is not a good place to breastfeed at night, because co-sleeping on a sofa or couch is very unsafe and can be potentially fatal for the child. For this reason it is best to breastfeed on a safe and appropriate sleeping surface when you are feeling very tired, even if you do not wish to bedshare with your child. Sometimes sleep just happens.

 

What is a safe sleep environment?

Most people that have grown up in Western culture are left with the impression that all bedsharing with an infant or child is dangerous and perhaps even inappropriate and not something that should be done. Dr. James Mckenna has made the observation that:

Most babies die in cribs, so do you conclude that cribs are dangerous and babies should sleep with parents? No, you concentrate on solving the problem, but with co-sleeping you attempt to eliminate the practice. That is not science, that is a cultural choice.”

Here is a comprehensive list of rules that I have adapted from Dr. James Mckenna’s Guidelines to sleeping safe with infants and Elizabeth Pantley’s Family Bed Safety Checklist:

 

Guidelines for Safe Sleep

 

  • Safe sleep begins with the presence of an informed and committed parent.
  • Always place a baby on their back, wherever they are sleeping.
  • If you smoke, drink, use any kind of drugs that inhibit arousal from sleep or are overly exhausted from sleep deprivation, you should not bedshare with your child. In these situations it is better to co-sleep by roomsharing, where baby and parent sleep on separate surfaces.
  • Make sure there is no part of the bed or crib that a baby can become wedged in, such as headboards, footboards or side rails or even a gap between the mattress and the wall. Make sure a crib has a well-fitting mattress with no gaps. When using a crib as a sidecar, make sure the mattresses are level and without gaps.
  • For obese parents it is safer to have your infant co-sleep on a separate surface.
  • Bottle-feeding babies should sleep on a separate surface next their mother, rather than share the same surface.
  • Babies should not bedshare with older siblings as they do not understand the risks their bodies pose. Have an older sibling sleep on a separate surface if you wish to co-sleep with all your children.
  • Babies should sleep on a firm surface. Avoid waterbeds, sofas, couches, lambskins, beanbags and any other soft and yielding bedding or surface. There should be no stuffed toys or pillows in a baby’s or young toddler’s sleeping environment. Make sure you keep your own pillow and blanket away from your baby’s head and face.
  • Bedsharing babies need lighter clothing and blankets than solitary sleeping babies. Overheating is dangerous for babies and may be a factor in SIDS.
  • Very long hair should be tied up to prevent entanglement around the infant’s neck. Do not wear anything with strings, ribbons or anything else with the potential for entanglement.
  • Do not wear perfumes or strong-smelling lotions as they may affect your baby’s delicate senses.
  • Never let any pets sleep in the same bed with your baby.
  • The benefits of bedsharing only occur when the bed is actually shared, therefore do not leave you baby alone in an adult bed. The child should sleep somewhere else, such as in a crib, until the parents are ready for bed.

 

When the guidelines are adhered to, co-sleeping is a perfectly safe practice that has shown to be protective for infants and lower their risk of SIDS. In Hong Kong co-sleeping is the normal thing to do, and they enjoy one of the lowest rates of SIDS in the world. Studies have also shown that in South Africa bedsharing babies have a higher rate of survival than solitary sleeping babies.

 

How should I respond to my child at night?

When you wake up in the middle of the night for the umpteenth time, your rational thinking mind is not at its best. Many parents struggle with how to respond to their waking child, do I go? Do I stay? What is the best way to react for us to all get some sleep? This is especially confusing as mothers are encouraged to breastfeed and parents are culturally encouraged to have a separate bedroom for their baby, a combination that is certainly a recipe for a sleepless night! Dr. James Mckenna points out that:

The mismatch between infant biological needs for nighttime contact and feeding and societal goals to keep parents from their infants and children  during the night probably explains why in non-industrialised societies Western parents struggle and complain the most about how their infants and children fail to sleep.”

When you hear your child crying, it is the most natural thing in the world to go to them and attend to their needs. Should the current alignment of celestial bodies be a factor in your reaction to your child? Does it not seem strange that in our mostly science-minded Western society, we often look to the position of the sun and the moon to decide when it is appropriate to respond to our children? It is strange, because it is not scientific, it is cultural.

So how does all this attending to children throughout the night get the parents a better night’s sleep? The Attachment Parenting International Research Group has found that co-sleeping can reduce parental fatigue. The parent that doesn’t have to get out of bed to attend to their child will gain significantly more rest than the parent that has to keep getting up and going to another room. Co-sleeping is also a great aid in breastfeeding, as close proximity to your child encourages both milk production and more frequent feeding. As an added bonus, co-sleeping can also help to build a secure attachment relationship between you and your child through night-time bonding.

A very important finding is that mothers who co-sleep with their babies report feeling more rested and receiving more sleep than those who don’t. Research has also shown that women who breastfeed their children while lying down report feeling better rested than those that breastfeed while sitting up. These seemingly small things can make a difference. It also makes a difference for other family members in the house. When a child sleeps in close proximity to his mother, she is able to pick up on his subtle signals and attend to him before there is any need for crying.

 

What if I don’t want to co-sleep?

Some families dislike the idea of co-sleeping and others have found salvation in various forms of sleep-training or The Ferber Method. There is nothing inherently wrong with this and there is no reason you can’t achieve a secure attachment relationship with your child (or a good night’s sleep) even if you don’t co-sleep. Night-time is not the only time available to bond with your children. Some bedsharers do indeed enjoy this particular aspect, the opportunity for night-time bonding. For example, a parent that has to work long hours may feel they can contribute more to their parent-child relationship by sharing sleep.

 

What about the parents?

Dr. Mayim Bialik  is a vocal supporter of attachment parenting and dedicates a chapter in her book, Beyond the Sling, to her experiences with co-sleeping. In the following video she gives a quick rundown on some of the myths and truths concerning co-sleeping:

 

 

One of the more cultural concerns with co-sleeping is the effect it has on the relationship of the parents. Western culture certainly places an inordinate amount of importance on a simple piece of furniture. Most families live in homes that have more than one room and in many instances have several pieces of furniture. Often a little creativity contributes positively to a relationship. There is no reason a mattress and/or frame needs to dictate the state of your personal relationship.

 

What long-term effects does co-sleeping have for the child?

So parents are generally able to attain more sleep with their children close to them, how does this arrangement affect the child? The Attachment Parenting International Research Group has found the effects to be quite positive. Parents that attend to their child’s needs throughout the night do not have children that awaken more often, nor do their children develop inferior sleep habits later on. Co-sleeping has a positive effect on the parent-child relationship and is a great tool for building a secure attachment with the parent. Securely attached children have been shown to be more social, more ready to engage in new activities and more likely to form healthier relationships in adulthood.

 

What about night-time fears?

In the Western world various night-time fears are common, such as being scared of the dark or of monsters under the bed. Small children lack the capacity to handle these fears on their own and will need the help of a responsive and compassionate parent. At around five or six years of age, the frontal lobes of the brain begin to mature. This is the part of the brain that allows us to reason, problem-solve and determine how we react to emotions. Before this maturation, children do not have all the tools they need to deal with their fears on their own.

From an evolutionary perspective it makes sense that children find nocturnal separation to be distressing. It is biologically sensible for a child to sleep close to his or her parent, as they have done for the majority of human history. It is of course not only solitary sleepers that suffer from nightmares and other night-time anxieties, bedsharers encounter these problems too.

Something to consider is the amount of stress your child may be under during the day. Things like recent changes to the daily routine or difficulties at daycare or school can cause elevated levels of stress. Another thing to consider is your child’s sleep requirements. If your child is going to bed long before they are tired they have more time to dwell on things in the dark and create fears.

Make sure you avoid any potentially frightening media before bedtime, which includes adults watching the evening news while the children are present, which has been found to cause sleep disturbances in some children. The best way to respond to your child’s night-time fears is quickly, calmly and confidently. If you are a bedsharer, this can happen quite easily with minimal disturbance to the parents. If your child sleeps separately, this will of course require more from the parents. Indeed in most cases children will begin the night in their own beds and crawl into their parents beds at some point in the night. Despite this being culturally frowned upon, there is nothing wrong with this ‘partial’ bedsharing. It can be both beneficial for the child and the best way for everybody to get the most sleep.

 

What is the gist of it?

The reality is that most small children will wake in the night and require the attention of a parent. Whether this lasts for a few months or a few years, it is not a measure of your parenting skills. The best way to survive this and gain the most rest is to sleep in close proximity to your child and attend to his or her needs through the night. This is especially important if your child is an infant or an unusually anxious child. Whether this is bedsharing or roomsharing depends on what criteria you fulfill and what you feel most comfortable with. Not only will you be achieving more rest, you will be helping to build a secure attachment relationship with your child that will aid them in becoming a healthy, happy and confident adult.

Good Night!

 

LK Hattinen

 

References and Further Reading

 

Books:

Bialik, Mayim. (2012). Beyond the Sling: A real-life guide to raising confident, loving children the attachment parenting way. 1st ed. New York, Touchstone.

Jackson, Deborah. (1999). Three in a Bed : The Benefits of Sharing Your Bed With Your Baby. Bloomsbury.  

Mckenna, James J. (2007). Sleeping with Your Baby: A Parent’s Guide to Cosleeping. Platypus Media.  

Pantley, Elizabeth. (2002). The No-Cry Sleep Solution: Gentle Ways to Help Your Baby Sleep Through the Night: Foreword by William Sears, M.D. (Pantley). McGraw-Hill.

Pantley, Elizabeth. (2005). The No-Cry Sleep Solution for Toddlers and Preschoolers: Gentle Ways to Stop Bedtime Battles and Improve Your Child’s Sleep. McGraw-Hill.

Sears, William. (1999). Nighttime Parenting: How to Get Your Baby and Child to Sleep. Plume.

 

On the Web:

API, Staff. (2002). The Benefits of Co-sleeping. Attachment Parenting International. Retrieved 23 Nov. 2012.

Breazeale, Tami E. (2001). Cosleeping. The Natural Child Project. Retrieved 23 Nov. 2012.

Carrie. (2009). Co-Sleeping and Nighttime Parenting. The Parenting Passageway. WordPress. Retrieved 23 Nov. 2012.

Dewar, Gwen. (2008). Nightmares and night terrors in children. Parenting Science. Retrieved 23 Nov. 2012.

Dewar, Gwen. (2008). Nighttime fears in children: A guide for the science-minded parent. Parenting Science. Retrieved 23 Nov. 2012.

Greene, Alan. (2009). Sleep and the Family Bed. Dr. Greene, putting the care into children’s health. Retrieved 23 Nov. 2012.

Mckenna, James J. (2012) Frequently Asked Questions. Mother-Baby Behavioral Sleep Laboratory. University of Notre Dame. Retrieved 23 Nov. 2012.

Mckenna, James J. (2012) Safe Cosleeping Guidelines, Guidelines to Sleeping Safe with Infants. Mother-Baby Behavioral Sleep Laboratory. University of Notre Dame. Retrieved 23 Nov. 2012.

Mckenna, James J., and Thomas McDade. (2005). Why babies should never sleep alone: A review of the co-sleeping controversy in relation to SIDS, bedsharing and breast feeding. Paediatric Respiratory Reviews. University of Notre Dame. Retrieved 23 Nov 2012.

Middlemiss, Wendy, Katherine Green, et al. (2009). Infant Sleep Safety, What the Research Tells Us. Attachment Parenting International Research Group. Retrieved 23 Nov 2012.

Pantley, Elizabeth. (2002). Checklist for Safe Co-Sleeping. About.com, Toddlers and Twos. Retrieved 23 Nov. 2012.

Sears, William, and Martha Sears. (2012). 8 Infant Sleep Facts Every Parent Should Know. Ask Dr. Sears, A Trusted Resource for Parents. Retrieved 23 Nov. 2012.

Stampler, Laura. (2011). Co-sleeping Bad for Kids? These Parents Kept it Secret. The Huffington Post. Retrieved 24 Nov. 2012.

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