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"Sleep, per chance to dream!" Shakespeare knew what he was talking about when he stated that sleep was the brain's time to rest and to dream. Although this appears to be all good and fine, most parents at one time or another find their rest and their dreaming disturbed by their child. Sometimes that disturbance is expected, when a child is ill or hungry. However, some nighttime waking appears to be less warranted and without obvious reason. What is the secret to a night of peace and tranquility? You need only to search the Internet for information to find a variety of facts and opinions on how to get your child to sleep, some as drastic as locking them in their room. What you quickly will find is that everyone has an opinion, based upon expert evaluation of the prevailing literature and scientific evidence. Science aside, what really is important to a parent is getting the proper rest, because you can handle the day much better if you have a good night's sleep. Therefore, I will take a broader and more practical approach. As I look at life in Southern California, so I look at sleep - developmentally and culturally. The developmental model will always pose the question, "What can I expect? Am I asking for something that my child is not ready to give or do?" For example, if you expect your child to walk at 6 months, you surely will be disappointed since he will not do it until he is nearly a year. You may even feel you have failed as a parent and produce unnecessary self-torture. This is where science and current literature can help. Knowing that a child of less than 3 months old is not neurologically able to sleep through the night will change what you expect, how you manage the situation and ultimately how successful you are as a parent. The cultural model asks whether the management is universal or variable, depending upon where you live or grew up. Many cultures have children sleep with parents until late childhood and separate them at early adolescence. This may not be what you want, but any judgment you may have about absolute right and wrong practices may need to be put aside. A few examples: • A 4-year-old who is in a fantasy stage may see monsters on the wall and become frightened when she is partially awake. Telling her that they are not there may not be enough and she may cry and need further reassurance. Try offering her a pillow and a blanket on the floor in your room. Most children will readily accept this and everyone in the house will be sleeping again. She will eventually return to her room as she matures and feels reassured. • Your 6-month-old wakes up and wants to be fed every three hours. Children at 6 months have the ability to sleep through the night and can put themselves to sleep independently. Although crying himself to sleep at this age does not seem to have any harmful effects, you may not want to allow your child to cry for an hour, which may be necessary if you use this method. Understanding that you really need to wean yourself from him rather than him from you may get the desired result. Putting him in the crib nearly asleep with a special stuffed animal may eventually become reassuring during partial waking. Remember how good your own bed feels even after a wonderful vacation? Try to make the crib one of the most desirable places possible for your infant. He will eventually want to be there because it will be one of the most comfortable places for him. • Don't be afraid to have your child sleep with you. As long as your child is not disturbing your sleep, there is no good evidence that co-sleeping has any detrimental effects. One note of caution: If you decide to change this behavior at any point, for whatever reason, it may take some time for your child to readjust and learn new sleep behaviors. Don't expect results in a day or two. So read all that you can, keeping in mind your child's developmental stage and any cultural bias you or an author may have. Look for practical solutions to get sleep and don't expect change in a day. I suggest you make gradual adjustments in the sleeping arrangements. In this way, the change for the child will not be drastic while the results will be better and more long-lasting. The majority of children will respond to simple measures. However, if these simple measures did not bring success, talk to your doctor or health professional for further help. Dr. Clyde Wesp is a pediatrician with Southern Orange County Pediatric Associates, with offices in Lake Forest, Laguna Hills and Rancho Santa Margarita, and is affiliated with Saddleback Memorial Medical Center, Mission Hospital and Children's Hospital of Orange County. He is a member of the American Academy of Pediatrics and the Memorial Care Physician Society. |
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