Hawksflight & Associates

Dr. Richard Ferber supports sleep routine in addressing sleep problems of infants.

"How well your child sleeps from the early months affects not only his behavior during the day but also your feelings about him...

Parents often believe that if their child is a restless sleeper or can't seem to settle down at night, it's because he is by nature a poor sleeper or doesn't need as much sleep as other children of the same age. 

These beliefs are almost never true.

Virtually all children without major medical or neurological disorders have the ability to sleep well.  They can go to bed at an appropriate time, fall asleep within minutes, and stay asleep until a reasonable hour in the morning.  And while it is normal for a child (or an adult) to wake briefly a few times during the night, these arousals should last only a few seconds or minutes and the child should go back to sleep easily on his own.

Nor, (with a few exceptions) are they part of a "normal phase" that must be waited (and waited, and waited) out.  Finally, there is usually nothing physically or mentally wrong with the child himself.  Most parents are immensely reassured to know that sleep problems are common in all types of families and social environments, and that most children with such problems respond well to treatment.

...if you are in the habit of rocking your child to sleep (or rubbing his back, or any similar custom) for twenty to thirty minutes each night, and you need to repeat the ritual once or twice in the middle of the night to get him back to sleep, you may actually be interfering with his sleep and delaying his ability to sleep through the night.

It is very important for some children to be put down awake so that they can learn to settle themselves and fall asleep alone both at bedtime and after nighttime wakings.

If bedtime is pleasant, your child will look forward to it instead of becoming fussy when the time approaches.  Bedtime rituals differ, of course, and you should choose a routine that suits your family, but make sure you always allow enough time to spend with your child each night.  Follow the routine as consistently as you can.

Your baby's sleep patterns during the first few days after birth are not an indication of things to come... Although most infants will develop a regular twenty-four hour sleep schedule regardless of anything we do or don't do, parents can assist the process considerably.

Feeding patterns are an important part of an infant's daily schedule... consistent schedules are especially important in treating sleep disorders.

So if you are beginning to address a sleep problem in your child, be sure to set up a firm schedule and stick to it rigorously for several weeks after your child has begun sleeping well again.  At that point you will be able to relax the schedule somewhat without the problem recurring."

Richard Ferber, M.D.  Director, Center for Pediatric Sleep Disorders, Children's Hospital- Boston AND Associate Professor of Neurology at the Harvard Medical School

"I don't want my child to hate me!" is a cry Dr. Sugar Kansagra hears often, but she comforts parents with a common Babywise principal: Consistency is critical to success.

"There are a variety of ways to approach sleep training, and it really depends on what you as the caregiver are comfortable doing.  No matter what anyone tells you, there is no 'right' way to sleep train your child.  Since every parenting style and every child is different, the key is picking the solution that you can stick to.  The two most important aspects to picking a solution are:  determining how comfortable you are with crying and how quickly you want the problem solved.

Caregiver guilt is a common reason why sleep training fails.  If a child is crying, the natural response would be to console him or her.  But remember, sleep training is not for you.  Although you will benefit as well, the main reason to sleep train is for the health and well-being of your child.  Not being able to self-soothe and go to sleep independently can be a burden for the child.

"I DON'T WANT MY CHILD TO HATE ME"-- This is a fear for many parents. We worry that our child will feel abandoned and therefore become distant from us.  You can rest assured that studies show this is not true.  In fact, the exact opposite may be true:  an infant's level of security can actually be better after going through sleep training, not worse.  And remember, children don't start forming long-term memories until around the age of three, so they will not remember anything from this process.

Sleep training calls for a level of authority and rigidity that may feel uncomfortable.  However, you care capable of making it through this process.  Persistence is the key.  If your persistence can outlast that of your child, you will successfully sleep train your child.

Consistency is critical to success.

Once you start sleep training, don't turn back.  The process can take several days to weeks.  Don't give up on sleep training after just a few nights.  The most effective and proven sleep training solutions do involve some crying.  But remember that it is for the health and well-being of your child."

Sugar Kansagra, M.D.  Director, Duke Pediatric Neurology Sleep Medicine Program

As a maternity nurse and child care expert, Gina Ford understands the overall goal of routine and has hundreds of thousands of parents' experiences to back her up.

"I personally believe that the majority of babies thrive and are happier in a routine.

During the years that I worked as a maternity nurse, I read hundreds of books on child care.  I have also had the unique privilege of working personally with more than 300 families around the world."

I would typically arrive at a home a few days after the birth and live with the family 24/7 for periods of 3-5 days, or sometimes several weeks to six months.

While establishing a routine is often very hard work and requires sacrifices on the part of the parents, hundreds of thousands of parents around the world will testify that it is worth it because they quickly learn how to meet the needs of their babies so that any distress is kept to a minimum.

The aim of the routine is not to push your baby through the night without a feeding but to ensure that structuring his eating and sleeping during the day will keep his nighttime waking at a minimum.

If the baby is fed every time he cries, mothers tend not to look for other reasons as to why the baby may be crying-- overstimulation or over tiredness, for example.

Of course, all babies must be fed if they are genuinely hungry; no baby should have to cry to be fed or should be kept on a strict timetable if he is genuinely hungry.  But in my experience, and if research on sleeping problems is anything to go by, a huge number of demand-fed babies do not automatically fall into a healthy sleeping pattern months down the line."

Gina Ford, Child Care Expert in Great Britain after years as Maternity Nurse

Dr. Weissbluth breaks the bad news that some parents actually create the sleep problems their children have, but the good news is, any parent can correct and prevent sleep problems following Babywise principles. Read more:

"The Five Elements of Healthy Sleep:  

1. Sleep duration: night and day sleep  
2. Naps  
3. Sleep consolidation  
4. Sleep schedule  
5. Sleep regularity.

For all babies:  It will become more and more difficult to soothe and sleep the baby in the evening hours at six weeks of age, counting from the due date.

All babies have spells of fussing and crying.  These spells distress all parents.  All parents want to soothe their baby.  The more the baby fusses or cries, the less she sleeps. The less the baby sleeps, the less the parents sleep.  The less the parents sleep, the harder it is for them to soothe their baby.

Sleep is the power source that keeps your mind alert and calm.  Every night and at every nap, sleep recharges the brain's battery... when children learn to sleep well, they also learn to maintain optimal wakefulness.

Sleep problems not only disrupt a child's nights, they disrupt his days, too, by making him less mentally alert, more inattentive, unable to concentrate, and easily distracted.

The bad news is that some parents create sleep problems.  The good news is that parents can prevent sleep problems as well as correct any that develop... The truth is that some parents swing back and forth between firmness and permissiveness so often, they cannot make any cure stick.

As your baby's brain matures, the patterns and rhythm of sleep change.  If you always adapt your parenting practices to these changes, your child will sleep well.

In 1925, the father of the Stanford-Binet Intelligence Test, Dr. Lewis M. Terman, published his landmark book, Genetic Studies of Genius.  He compared approximately 600 children with IQ scores over 140 to a group of almost 2,700 children with IQ scores lower than 140.  For every age examined, the gifted children slept longer.  Two years later, about 5,500 Japanese schoolchildren were studied, and those with better grades slept longer.  Even seventy-nine years later, Dr. Terman's study stands apart in design, execution, and thoroughness.  A 1983 scientific sleep laboratory study from Canada has provided objective evidence confirming Terman's result, that children with superior IQ had greater total sleep time.  Both studies agreed that brighter children slept about thirty to forty minutes longer each night than average children of similar ages."

I believe that in infants and young children, a cause-and-effect relationship exists between disturbed sleep and fitful, fussy behaviors.

This means that there is a progressive worsening in a child's mood and performance even when the amount of lost sleep each day or night is constant.  So a baby becomes increasingly crabby even if her nightly sleep is constantly just a little too brief."

Marc Weissbluth, M.D. -  43 year Pediatrician; Founded Sleep Disorders Center at Childrens' Memorial Hospital in Chicago and is Professor of Clinical Pediatrics at the Northwestern University School of Medicine.