Tuesday, September 09, 2008 Sleep and sleep disturbances -- 2
FOUR-Month-Old Babies
* Try to discontinue the 2 a.m. feeding before it becomes a habit. By four months of age, your bottle-fed baby does not need to be fed more than four times per day. Breast-fed babies do not need more than five nursing sessions per day. If you do not eliminate the night feeding at this time, it will become more difficult to stop, as your child gets older. Remember to give the last feeding at 10 or 11 p.m. If your child cries during the night, comfort him with a back rub and some soothing words instead of with a feeding. (Note: Some breast-fed babies will continue to need to be nursed once during the night.)
* Don't allow your baby to hold his bottle or take it to bed with him. Babies should think that the bottle belongs to the parents. A bottle in bed leads to middle-of-the-night crying because your baby will inevitably reach for the bottle and find it empty or on the floor.
* Make any middle-of-the-night contacts brief and boring. All children have four or five partial awakenings each night. They need to learn how to go back to sleep on their own at these times. If your baby cries for more than a few minutes, visit him but don't turn on the light, play with him, or take him out of his crib.
Comfort him with a few soothing words and stay for less than 1 minute. If your child is standing in the crib, don't try to make him lie down. He can do this himself. If the crying continues for more than 10 minutes, calm him and stay in the room until he goes to sleep. (Exceptions: You feel your baby is sick, hungry, or afraid.)
Six-Month-Old Infant
* Provide a friendly soft toy for your child to hold in his crib. At the age of six months, children start to be anxious about separation from their parents. A stuffed animal, blanket can be a security object that will give comfort to your child when he wakes up during the night.
* Leave the door open to your child's room. Children can become frightened when they are a closed space and are not sure that their parents are still nearby.
* During the day, respond to separation fears by holding and reassuring your child. This lessens nighttime fears and is especially important for mother who works outside the home.
* For middle-of-the-night fears, make contacts prompt and reassuring.
For mild nighttime fears, check on your child promptly and be reassuring, but keep the interaction as brief as possible. If your child panics when you leave or vomits with crying, stay in your child's room until he is either calm or goes to sleep. Do not take him out of the crib but provide whatever else she needs for comfort, keeping the light off not talking too much. At most, sit next to the crib with your hand on him.
* These measures will calm even a severely upset infant.
One-Year-Old Children
* Establish a pleasant and predictable bedtime ritual. Bedtime rituals, which can start in the early months, become very important to a child by one year of age. Children need a familiar routine. Both parents can be involved at bedtime, taking turns with reading or making up stories. Both parents should kiss and hug the child "good night." Be sure that your child's security objects are nearby. Finish the bedtime ritual before your child falls asleep.
* Once put to bed, your child should stay there. Some older infants have temper tantrums at bedtime. They may protest about bedtime or even refuse to lie down. You should ignore these protests and leave the room. You can ignore any ongoing questions or demands your child makes and enforce the rule that your child can't leave the bedroom.
If your child comes out, return him quickly to the bedroom and avoid any conversation. If you respond to his protests in this way every time, he will learn not to try to prolong bedtime.
* If your child has nightmares or bedtime fears, reassure him. Never ignore your child's fears or punish him for having fears. Everyone has four or five dreams every night. Some of these are bad dreams. If nightmares become frequent, try to determine what might be causing them, such as something your child might have seen on television.
* Don't worry about the amount sleep your child is getting. Different people need different amounts of sleep at different ages. The best way you can know that your child is getting enough sleep is that he is not tired during the day. Naps are important to young children but keep them less than 2 hours long. Children stop taking morning naps between 18 months and 2 years of age and give up their afternoon naps between 3 and 6 years of age. (MTM)
