Blog Post 18-Teamwork

Healthy Sleep Habits, Happy Child
by Marc Weissbluth, M.D.

A Healthy Child Needs a Healthy Brain,
A Healthy Brain Needs Healthy Sleep.

“Sleep Readiness” is the title of Chapter 11 of the United States of America Department of the Army field manual (FM 7-22) that prepares young men and women to become soldiers.  It is the official document that describes how all young recruits will acquire necessary skills during the process that is sometimes referred to as basic training or “boot camp.”  Updated in 2020, it is based on empirical data using traditional scientific methods.  Sleep is serious business. 

If you have not already done so, please read Blog Posts 1 through 5 that describe how sleep is important and beneficial, from the point of view of the United States of America Department of the Army.  I have lightly edited, added emphasis, and condensed Chapter 11 in order to show you how “Sleep Readiness” can also help parents help their child sleep better.

Initially, I posted Chapter 11 (Blog Posts 1 through 5) to emphasize the value of healthy sleep.  Based on the material presented in Chapter 11 of the Army field manual, Blog Posts 6 through 15 show how basic principles of sleep apply, not only to military basic training, but also to parenting.

Going forward, I will post specific information for parents and children based on my book, “Healthy Sleep Habits, Happy Child.” Please do not be put off by my book’s length. For now, only read the single, age-appropriate Chapter for your child.  Later, if you wish, read Chapters on What is Healthy Sleep, Why Healthy Sleep is Important, and Preventing Sleep problems.  Finally, if needed, read the Chapter on Sleep Solutions.

            Let’s go!

TEAMWORK and NIGHTTIME AWAKENINGS

COPARENTING

            Coparenting is the manner in which parents work together to raise their children. Within the context of specific family differences (Blog Posts 14 and 17), to achieve healthy sleep for your child, focus on teamwork.  Coparenting quality may be evaluated by asking parents to report on how they see their partner as a coparent regarding positive features such as:

                        · Agreement: “My partner and I have the same goals for our child.”

                        · Closeness: “My relationship with my partner is stronger now than before we had a child.”

                        · Support: “My partner asks my opinion on issues related to parenting.”

                        · Endorsement: “I believe my partner is a good parent.”

                        · Division of labor: “My partner does carry his or her fair share of the parenting work.”

Also, coparenting quality may be evaluated by asking parents how they see their partner as a coparent regarding negative features such as:

                        · Exposure to conflict: “How often in a typical week, when all 3 of you are together, do you yell at each other within earshot of the child?”

                        · Undermining: “My partner does not trust my abilities as a parent.”

            In a study of infants during the first year, parents were asked these questions and questions about parents’ beliefs about responding to night wakings (“My child will feel abandoned if I don’t respond immediately.”). When the mother strongly endorsed beliefs about immediately responding to night waking and the father did not, the positive coparent quality features were lower.  The more strongly parents endorsed immediate responses to the infant night wakings, the higher the negative features of coparent quality were rated.  “Results emphasize the importance of communication and concordance in nighttime parenting practices for aspects of parents coparenting relationship.”

PARENTAL TOLERANCE FOR INFANT CRYING

            Professor Sadeh used “a two minute video clip of a 6-month-old baby playing on a carpet who then starts crying (after 10 seconds), with a gradual increase in crying intensity and visual distress signs.  Prior to watching the video, a written cover story was presented to the participants: ‘The following video is of a very demanding baby.  His parents are trying to ignore some of his crying to allow him to calm down by himself.  Please look at the video and decide when you feel it is absolutely necessary to intervene.’  The purpose of the cover story was to create a standardized description of the situation and to increase motivation to tolerate the crying and delay the response.” Here are some of his results:

                        · Childless couple:  Intervention delay for husband, 60 seconds, and wife, 50 seconds.

                        · Parents with child with no sleep problems:  Intervention delay for father, 50 seconds, and mother 45 seconds.

                        · Parents with child with sleep problems: Intervention delay for father, 45 seconds, and mother 35 seconds.

            Parents with a child, about one-year-old, who has sleep problems “demonstrated shorter intervention delays in the crying clip and tended to attribute more distress to the crying infants compared to parents in both control groups.  Our results suggest that parents of sleep-disturbed infants appear to have a lower tolerance for infant crying, which may be a predisposition underlying their excessive involvement in soothing their infants to sleep which may lead to the development of sleep problems.”

            The reason that I show the actual number of seconds of delay before the intervention is because there is such a small difference between the two parent groups (only 5-10 seconds).  Maybe if parents could delay their responses to night awakenings, after 3 months of age, just 5-10 seconds, their child would have more opportunity to develop self-soothing skills.  Why 3 months?

            In a separate study, Professor Sadeh, using the same video clip, again measured the number of seconds delay before intervention in couples during pregnancy and at 6 months postpartum. He also recorded objective sleep measures on the child at 3 and 6 months of age. He found:

                        · Prompter responses during pregnancy was associated with prompter parental responsiveness in the early months and predicted better infant sleep at 3 months of age.  

                        · Prompter responses at 6 months are associated with poor quality sleep (more night wakings and more wakefulness after sleep onset) at 6 months.

            The results suggest that prompter responses after 3 months (but not before 3 months) interfere with the development of self-soothing ability in the baby. Also, as in the previous study, husbands showed more delayed responses than mothers. 

Summary

Nondistress sounds (Blog Post 11): Try to not respond to nondistress sounds, especially after 3 months of age.

Low or feeble sounds that sound like a whimper or a quiet moan or groan may or may not indicate distress (Blog Post 11): Try to respond after a brief delay, especially after 3 months of age.

Distress sounds (loud or intense sounds): Always respond immediately.

IT IS NOT NECESSARY TO MAKE YOUR CHILD CRY TO HAVE A GOOD NIGHT’S SLEEP

WHAT A PARENT CAN DO

•  Communicate with each other and coordinate nighttime parenting practices.  Consider delaying your response to mild, suspected distress sounds (Blog Post 11) your baby makes at night by 5-10 seconds, especially after 3 months of age.

•  Encourage partner to help care for baby daytime and nighttime.  Be emotionally available at bedtime.  Seek help if your child is not sleeping well and there are symptoms of anxiety or depression for yourself or partner.  Blog Post 17.

•  Encourage self-soothing; the earlier the better.  Consider leaving the room after putting your child down to sleep. Provide opportunity for naps based on drowsy signs.  Encourage partner to help care for the baby daytime and nighttime. Blog Post 16,

•  Plan for healthy sleep by focusing on sleep quality, not just sleep quantity. Provide opportunities for naps. Blog Post 15

•  Make a sleep plan that you are comfortable with; be flexible and tolerant.  Blog Post 14.

•  Become more aware of the difference between how you feel when well-rested versus mildly sleepy. Blog Post 13.

•  Try to maintain a regular sleep schedule.  Blog Post 12.

•  Try to not respond immediately to every quiet sound your baby makes at night.  Blog Post 11.  

 Practice soothing to sleep and bedtime routines, every night, if possible. Blog Post 10.

  Watch for drowsy signs. Blog Post 9.

  Respect your child’s natural sleep rhythms.  Blog Post 8.

  Encourage an early or earlier bedtime (even a slightly earlier bedtime may produce better sleep.  Blog Post 6) especially at 6 weeks.  Blog Post 7.

• Recognize that a healthy brain requires healthy sleep. Blog Posts 1, 2, 3, 4, and 5.

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