A Healthy Child Needs a Healthy Brain,
A Healthy Brain Needs Healthy Sleep.
If you have not already done so, please read Blog Posts 1 through 5 that describe how sleep is important and beneficial. 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. This is a reference book. Read only the topic of interest to you
COMMUNITY SLEEP CONSULTANTS
Sleep consultants, located online, are available in most cities and give personalized face-to-face advice to help children sleep better. Often, consultants also perform services online. Their website will give information regarding fees, services, professional training, and educational background. Request a free initial encounter to see if there appears to be a good fit between you and the consultant’s personality. Anyone can promote themself as a sleep consultant because there are no state or national professional standards. However, some sleep consultants have received certification from online training programs. Anyone can create a training program because here, too, there are no state or national professional standards. Investigating the training program founder’s background, along with the training program’s course content, assessment methods, and recertification requirements might help in choosing a “certified” sleep consultant. A training program will help you find a consultant in your area. Training programs are available in many countries.
When contacting a training program, ask if they have any actual data on the success rates of their graduates. Naturally, every community sleep consultant will publish parent testimonials but objective data collected by the training program might give you confidence that their graduates are effective. Perhaps, ask the community sleep consultant where she received her training and whether such data is available. Beware of claims not supported by any data. Here is a program that I am familiar with:
• Family Sleep Institute: familysleepinstitute.com (Full disclosure: I am an unpaid adviser to FSI with no financial interests or potential conflicts of interest)
Family Sleep Institute Survey
In 2020, the Family Sleep Institute conducted a survey of 94 consecutive sleep consultations performed by 37 different consultants in 15 countries (46 percent were in the US). The most common age of the child at the onset of the consultation was 5 months. Recommendations included safe sleep to prevent SIDS, putting the child to sleep independently, drowsy but awake, regular bedtimes, and age-appropriate sleep and night feeding schedules.
At twelve months of age or younger, parent’s concerns were night wakings (98 percent), napping (84 percent), nighttime eating at undesirable times (84 percent), and bedtime issues (71 percent). The success rate in resolving these concerns was 93, 82, 86, and 95 percent respectively. Similar concerns and success rate percents were observed among children thirteen months of age or older. Overall satisfaction rates with the consultation were high: Complete satisfaction, 89 percent; somewhat satisfied, 7 percent; neutral, 2 percent; and completely dissatisfied, 1 percent. Families that had a bedtime routine at initial contact were more likely to be satisfied. Increased parent satisfaction was associated with using extinction or graduated extinction at the end of the consultation.
Most families maintained their initial choice for a sleep solution throughout the consultation (13 for extinction, 45 for graduated extinction, and 23 for fading or a version of check and console). For these families, “completely satisfied with the sleep training consultation” percentages were 100, 91, and 86 respectively. Other families changed from their initial choice for a sleep solution to a subsequent choice that involved attending to their child less at night.
Using extinction as an initial sleep solution was associated with increased likelihood that the child would be sleeping independently through the night, eating during the night at desirable times, and going to bed without bedtime issues at the end of the consultation. Again, using extinction, compared to other choices, at the end of the consultation was associated with increased satisfaction with the sleep training consultation. The more experienced consultants were more likely to recommend extinction as an initial or subsequent sleep solution. Recommending extinction as an initial or subsequent sleep solution occurred almost exclusively in the US and Canada.
DO I HARM MY CHILD IF I LET HIM CRY AT NIGHT TO LEARN SELF-SOOTHING?
IT IS NOT NECESSARY TO MAKE YOUR CHILD CRY TO HAVE A GOOD NIGHT’S SLEEP
WHAT A PARENT CAN DO
• Some babies sleep better than other babies. Develop coping strategies to reduce stress if your baby has extreme fussiness or crying. Plan to encourage self-soothing skills at 2 to 4 months of age. Blog Post 20.
• ‘No Cry’ sleep solutions (‘Fading’ and ‘Check and Console’) may solve sleep problems. Blog Post 19
• Communicate with each other and coordinate nighttime parenting practices. Consider delaying your response to nondistress sounds your baby makes at night by 5-10 seconds, especially after 3 months of age. Blog Post 18.
• 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.