Consistency key to getting baby to sleep

Consistency key to getting baby to sleep

“For Getting Baby to Sleep, Sticking to a Plan Is What Counts”

After years of colicky debate over which method is best for getting babies to fall asleep by themselves, experts have a soothing new message: just about all the techniques work, so pick one you are comfortable with and stick with it.

Despite their apparent differences, most of the behavioral approaches reviewed in the October issue of the journal SLEEP were supported by evidence that they resulted in infants and toddlers learning to fall asleep independently at bedtime and when they woke during the night. Of the 52 studies examined in the review, 49 showed positive results, with 82 percent of the infants and young children in the studies benefiting significantly.

In other words, it doesn’t matter what method you choose, including the old “let them cry themselves to sleep” method, as long as you’re consistent the child will learn to fall asleep on her own. But some methods were still slightly better than others.

The strongest evidence was found for the toughest and the easiest approaches.

Perhaps not surprisingly, the easiest option is preventing sleep problems in the first place, through simple parent education, whether one-on-one training, group classes or booklets. Such programs typically encourage parents to have a peaceful, consistent evening routine in which children are placed in bed “drowsy but awake” to help them develop independent sleep skills. Three well-designed randomized trials have found that the babies of parents who had such training slept significantly better than those whose parents did not.

At the tough extreme is the cry-it-out method, formally known as “unmodified extinction,” in which parents are taught to put a child down for bed, close the door and ignore all crying unless the baby is in physical distress. Despite 23 studies showing its remarkable effectiveness, most parents find the technique too emotionally grueling, the task force found.

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  • When my now 28-year-old daughter was a few weeks old, I was having the proverbial problem and asked the doctor what to do.  “Just let her cry till she falls asleep” was his answer.  I came home determined to try it and enlisted my husband’s cooperation. 

    Put the baby down at the usual time and waited.  Crying began almost immediately.  I sat down and steeled myself for the duration.  Three hours later I was near insanity and she was still crying.  It was the last time I tried that method.  It was also my first signal that this was a strong-willed kid!

  • What we’ve generally done is to put Isabella down after she’s done breastfeeding. If she’s awake we let her cry. If it doesn’t stop after 20 minutes, we go in again, comfort her, rock her, and then put her down again. However at this point, she usually goes right to sleep and if she doesn’t we don’t have to wait the 20 minutes.

    What helps, I think, is a consistent evening routine. At about 4:30 or 5, she gets dinner, then a bath, then Melanie feeds Bella in her darkened room and puts her to bed.

    We didn’t start this, however, until about a month or so ago. Before that it was much more difficult. In the early weeks, I just stayed up with her and rocked her to sleep in the recliner chair, going to bed finally about 3 am when I handed her off to Melanie.

    I think next time we’ll try some of this sooner.

  • A baby that has not napped well during the day will not go to bed easily at night.  Granted, I have been termed the “sleep Nazi” in my household, but I do insist on the children (eversince they were a couple months old) sleeping more than sufficient amounts.  All 3 of them, by the age of 6 months, never have had trouble going to sleep again.  They nap until they are 4 or 5 years old (yes…3 hour naps), and it only takes minutes (depending on how long the book is!) to settle them down.  And they are trained to sleep ANYWHERE (as long as there is a crib or a bed).  So if you want me to visit you in the afternoon, I need to be there for 3 hours so whomever it is can nap!

  • I think some of that is dependent on the personality of the baby. Isabella has never been a good napper. Even when we can get her to go down for a nap during the day, she never stays down more than 45 minutes. Often it’s 20 minutes.

    That’s not for lack of trying. Isabella has always been very alert and awake since the day she was born and one consequence has a lack of desire for sleep during the day.

    As for sleeping anywhere, Melanie says when she was a baby she would only sleep in her own bed which put a crimp into her parents’ social life. No matter where they were, at 8 pm they had to go home and put Melanie to bed.

  • Well, kids are all different, and so are household routines.  One friend has kids who are not fun to be around when they are sleep deprived.  She’s a bedtime Nazi perforce.  I get to be a snack Nazi, because mine are no fun when they are hungry.  They tend to be light sleepers—up early and up late!  And this was true right from the start.

    With the oldest, we did the “cry to sleep” thing.  It lasted 45 min the first night (I would have given up after 3 hours, or even sooner!), 20 min the second night, and then she went to sleep when put to bed.  The second was an early riser—5:30 AM every morning until he was 2 or so.  The third was (and is) my angel, just an easy kid.  The fourth had a medical condition which required waking him for an 8 hour med cycle.  I’m ashamed to say the fifth was a blur!  Other than establishing bedtime with the first kid, we did very little in the way of forcing the issue.  I guess we took it for granted that there would be a bedtime.  We fought a bit about WHEN bedtime should be—7:30 (my husband) or more flexible 8-8:30 (me).  But after a while it’s a moot issue if the older kids are involved in activities such as (say) baseball.  And if you have little ones with high school students, they learn to be pretty adaptable for the most part.  I would try to avoid an overly elaborate bedtime routine, because it can be pretty hard to maintain through additional kids…

    But I still remember those sleep-deprived years, which are JUST BARELY in the past…  Good luck!

  • So far, it seems the bedtime routine is fairly adaptable. When we were in Houston for a long weekend I skipped the bath, just fed her and changed her clothes and put her to bed. She cried for about five minutes and then slept just fine. We’ll see how things go when we visit my parents for the holidays.

  • Crying to sleep doesn’t work for some kids.  Another factor is “nature versus nurture.”  I have always had problems sleeping.  When I was little, I never took naps, and it took me forever to go to sleep.  When I was really little, my parents would joke about it.  As I got older, they tried to say it was some kind of behavioral thing I should be able to change.  Now, they still act like it’s something I can change.
    My mother also has sleep problems, but doesn’t see the connection between mine and hers.
    My children have a hard time falling to sleep at night.
    We’ve tried letting them cry it out, and they just cry all night. 

    The problem with all these kinds of “studies” is they still have the old Pavlov, Skinner behaviorist idea that people are computers that can be programmed to some standard model.  We are all unique individuals created by God with different temperaments, physical conditions, sleep habits, etc., and the trick is just to learn how to work with them.

  • “The problem with all these kinds of “studies” is they still have the old Pavlov, Skinner behaviorist idea that people are computers that can be programmed to some standard model.  We are all unique individuals created by God with different temperaments, physical conditions, sleep habits, etc., and the trick is just to learn how to work with them.”

    JC,

    That’s rather my reaction as well. And you know I’m much happier as a mother realizing that Bella just isn’t a big napper than I would be if I were trying to solve the problem of why she doesn’t sleep as much as the books (and other parents) say she should.

    When I gave in and realized that it’s just the way she is, I stopped wondering what I was doing wrong, worrying about why my kid doesn’t sleep as much as other people’s kids, and started simply enjoying her for who she is. I’ve found that I’m much more effective if I watch her and follow her cues than if I try to force her into some mold that just doesn’t fit her.

  • Sleep patterns change quickly when kids are young.  The 3-hour crying jag when my kid was weeks old turned into a sound sleep a couple of months later.

    I can sympathize with Melanie’s parents.  For a year or more my kid would sleep in two places—her own bed and the carseat.  Forget nights at Grandma’s.  Forget just letting the baby fall asleep on your shoulder.  She was a napper, which meant that I learned how to stay home a lot when she was small.

    On the positive side, those naps provided time to get things done.  When she was awake, she was in motion, usually somewhere I didn’t want her to be doing something she should not be doing.  She could mess up a room faster than I could clean it up.

    When she was old enough to understand them, bedtime stories were a must do.  I was never sure whether she or I enjoyed them the most.

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