Nurturing Sleep

2 year with disturbing night wakes...

My partner and I decided to try Nurturing sleep after a recommendation from a friend. We had reached a point where the lack of sustained sleep was causing problems not only for our little girl but was also taking its toll on us as parents. We hadn't slept more than a few hours for over 6 months. We found Ann to be very approachable and professional but also caring and sympathetic to our situation. We all worked closely together and it was through communication and guidance from Ann that we were able to identify things which we could change and steps which we could take to try and improve our lives.

Our daughter responded very well to small changes and we saw a marked difference in the first few days. The work on emotional aspects really seemed to work for her and actually brought us closer together as a family unit. A few weeks on and we have had a few nights of complete sleep with no interruptions. Everyone is happier and life is somehow just that bit easier. Everything is not perfect, this is not some magical fix, but through continued work and support from us as parents and from Ann as our sleep consultant we know that things will just keep on getting better.

Parent feedback from evaluations:

On a scale of 0 - 10, how would you rate the overall quality and relevance of the information, support and guidance provided?

10. I love how personalised the guidance was and your gentle approach was totally in tune with how to wanted to approach any type of sleep ‘training’. Almost everything you suggested worked and if it didn’t any further suggestions seemed to work – just like magic!

we would both say a 10

11!

How did you feel about the level of support provided via email/phone/skype? Was it adequate, too much, not enough?

Absolutely perfect. We felt completely supported throughout the whole process without ever feeling like we needed more or that any chat was a waste. And when things got a bit rocky you were more than willing to slot in additional chats at very short notice!

Just about right. Skype chats were useful and discussions were very helpful. Email was very good as well. Replies were very quick and advice was clear.

Perfect amount.  

Did you find the written sleep plan and notes helpful? - was there anything that was particularly helpful or useful to you?

Very helpful! We went back to them on a number of occasions and really felt like they were completely customised to our situation and child. Also, the additional websites provided were incredibly useful and fully supported the notes provided.

Written notes were really useful. This was especially the case as we sometimes did not get to speak to you together but also it was written very clearly so we always had a base to return to.

Yes – the written plan and notes were extremely helpful – they were a great summary of the conversations had, avoided having to clarify small (often forgotten!) tips and were a useful point of reference. The introductory notes at the beginning of sleep work and the overview of the intended approach summarising the weeks ahead were so useful to help to understand what was to happen in the subsequent weeks. It made me feel less anxious about all of the changes given it was in a step-by-step approach and prepared me for the next step. 

Was there any specific element of your sleep work that you felt helped more than others? 

Understanding crying and play elements. I had to deal with my own hurts and fears  first which then made me a lot more comfortable when dealing with my child. With play elements also brought the whole family together creating a stronger, cohesive unit!

The introduction of the notion of play  was good and helped a lot. Also trying to understand why she was waking as opposed to just accepting that this was the norm was interesting. It was quite surprising just how quickly she changed.

Most notably, there were two aspects that stuck out for me which were changes I had no idea about, yet made a huge difference to sleep. The first was the play aspect  & Secondly, understanding crying.

At the end of the month, Sunday March 26th the clocks ‘spring forward’ an hour in keeping with British Summer Time. Adjusting to new times and losing an hour’s sleep can be disruptive for babies and young children’s sleep and may threaten your well planned daily and routines. With a little forward planning though, the adjustment to BST can be made easier for all!

Sleep experts suggest making changes to children’s waking/sleep times gradually in small steps, so start making changes 5-6 days before the clocks ‘spring forward’. The aim is to move your child’s day 15 minutes earlier every second day. To start then, if bedtime is normally 7.30pm and your child wakes at 7am, wake your child at 6.45am, so bedtime becomes 7.15pm. Do this for 2 days and move the day’s routines 15 minutes earlier as well. Then move the day forward another 15 minutes for 2 days, and repeat until you are putting your child to bed an hour earlier, to coincide with the clocks ‘springing forward’ an hour on Sunday morning.

Practical Tips for Success.

Although there maybe some timings you can’t adjust, like baby groups, nursery or playgroup times, try to keep your daily routine as consistent as possible during your ‘adjustment week’. The timing of mealtimes for example helps set children’s internal biological clock and sleep/wake cycles, so move your child’s mealtimes 15 minutes earlier too in relation to waking time and planned bedtime.

Adjust naps according to wake-up time during the adjustment week. Try to avoid longer than usual naps - unless your child is unwell or there is another reason for an increased sleep requirement.

Start the bedtime routine 15 minutes earlier too and keep it consistent and predictable. The rituals you include within your routine help create feelings of security and emotional wellbeing for children by providing a predictable, loving wind-down to sleep.

Keep the bedroom dimly lit during the bedtime routine and throughout the night, work with light and dark to support your goals.

Outdoor play will promote sleep and reduce sleep latency, that is, help your child to get to sleep quicker – remember, using light and dark cues will support you big time!

If a slow, gradual approach doesn’t work for your family due to activity commitments, try working with 1 big jump to the new time for older babies, toddlers and young children. Wake your child at the usual adjusted time, and start working with the new timings Sunday.

Remember, it may take your child a few days to adjust, especially if you take the 1 big jump approach. Think of the adjustment as similar to jetlag, which is temporary, but actually does settle over a few days.

What is implicit memory?

Well, iimplicit memory is a subconscious memory related to previous experiences that are imprinted into your brain. If you tune into yourself deeply, and you become deeply aware of sensations, you can become aware that certain environments, sensations, smells, touches, tastes, sounds or situations will trigger a feeling and emotion related to a previous experience and time. Its different to our explicit or recall memory of daily events, like remembering last years holiday on a bleak January day!

We all have implicit memory;

Babies brains develop capacity for implicit memory as early as 3-4 months in utero, so from that time they absorb all the sensations we experience. So some experiences become imprinted in our memories, good and not so good. Birth experiences for example can become imprinted into our memory, and we know that birth can influence and affect us in many ways, including health, behaviours and sleep. Imprinting can go very deep, its linked to our implicit memory, but its the feelings and deep emotional memories that we hold.

When working with young children's sleep and behaviours then, Its important to look beyond the observable behaviours, the surface stuff as I call it, and dig deeper, teasing out what may be influencing them on the deeper, biological, social/emotional levels. Its only then that we can find appropriate and holistic answers to seemingly difficult sleep and behavioural issues.

Have a look at these videos about Implicit memory, Imprinting and how birth influences our lives - Enjoy!!

The imprint: What it is and how it is impacting on your life:

Ray Castellino and Infant Sentience: https://www.youtube.com/watch?v=Owc5xxVAASU ;

Microbirth: https://www.youtube.com/watch?v=6CTmwUU2iHU ;

Related article: Making Assumptions about children's sleep: http://maternityinstitute.com/making-assumptions-about-childrens-sleep/

The festive season is approaching and preparations are underway in many households! Excitement mounts as anticipation of the big day snowballs…

Nativity plays, parties, Christmas shopping, gifts to wrap, decorations and baking! With all the extra excitement toddlers and young children can easily become over tired, over stimulated and find falling asleep difficult. So here are some practical tips to help maintain balance and good sleep for young children during this busy time, and that will also help keep parents feel calmer over the holidays!

Tip 1: Protect and maintain your bedtime routine; this can be tough! When there’s so much to do and with Christmas visitors and parties routines can go out the window!, However, do your best to preserve the bedtime routine because it’s your child’s familiar wind down of predictable steps to sleep time which will help them prepare their minds and bodies for sleep. From the emotional wellbeing point of view, providing that quiet, calm closeness provides vital connection time that will support your child’s feeling of safety, reassurance and calmness that supports restful sleep.

Tip 2: Remember to use the nap time routine; if our child still naps, do your best to preserve the nap wind down routine too. It often helps to extend the nap routine by 5-10 minutes if here’s been alot of change or excitement, just to give just a little more time to calm the system and prepare for letting go into sleep. If you haven’t used a nap routine until now, its worth considering one; generally I suggest using the same set of cues as bedtime – a darkened room, comfy sleep clothes, a story, lullaby, kisses.... and sleep wells... before finally settling into bed or cot.

 Tip 3: Keep consistent wake-ups and bedtimes – weekends and holidays too! As difficult as this may sound – it can really help to keep sleep consistently good! Children’s sleep is regulated y 2 main sleep processes, the biological clock and homeostatic sleep pressure. The biological clock is set to expect sleep at certain times during the 24 hour day, and sleep pressure builds to support the biological sleep times. However, if wake ups are too late, sleep pressure will be out of sync with the biological clock and falling into sleep may become problematic. A good example is jetlag, if we allow children to sleep in an extra hour (assuming they are well and healthy of course) their biological clock will be an hour out of sync. Sticking to a consistent daily sleep routine is good for adults too!

Tip 4: Maximise the impact of light and dark; when you and your children wake in the morning, make sure the lights go on too. Our biological clocks respond to light and dark cues; light switches off the melatonin (sleepy hormone) flow and turns on the cortisol – prompting our bodies to wake and be active. Sleep pressure then begins to build towards our next sleep time, and reducing lighting for the bedtime routine triggers the sleep hormone melatonin that supports relaxation and sleep. Outdoor activity and playtime in the fresh air every day not only supports the biological clock and daily rhythms, but also helps young children release tension and prepares growing bodies for sleep!

Tip 5: Avoid screens before bedtime!! Televisions, computers, ipads.... great ways to calm a child down, or maybe not! Many devices use LED lights which can hinder sleep.LED lights emit blue light which prevents melatonin – the sleep hormone secreting. The blue light ‘tricks’ the brain into thinking its still daytime, even when its past bedtime! So, after tea I suggest turning off the TV, avoiding screens – and engaging in some connection playtime, before moving into the bedtime routine. See my article about Calm bedtimes for more about the value of play before bedtime.

Tip 6: Be aware of how food may influence sleep; Christmas = rich food and indulgence! Its important to keep in mind though that some foods will hinder children’s sleep; processed and sweet food can stimulate young children and rich, fatty foods may cause digestive difficulties and disturbances. So with that in mind, do your best to ration processed, sweet and rich foods as much as you can. Also keep in mind that there are some foods that support sleep. Sleep inducing foods include healthy carbohydrates and foods containing calcium and tryptophan - so good sleepy food options include eggs, wholemeal toast, whole grain cereal, milk, bananas, pitta breads… and.. TURKEY!!!

Tip 7: on a practical level - Think about using white noise: This is just brilliant for masking all those unusual festive noises… whether they are parties next door, friends in for drinks, reindeers on the roof, sleigh bells and Santa coming down the chimney! It’s easy to phase in – and easy to phase out. I suggest using a natural sound, like rain or running water. Phase it in over a few days, playing it at low volume in the background during your bedtime routine and during the night and naps, then gradually increase the volume to about as loud as a human voice or soft shower so it masks and softens external sounds. Phase it out in the same way – reduce the volume night by night over a fews or week.

Tip 8: keep the bedroom peaceful; avoid putting exciting new toys in the bedroom… keep it calm, balanced without added stimulation. Bedroom play is great, I often suggest this for young children because it can support sleep, but keep the Christmas excitement away from the bedroom.

And what about parents? Well, my final tip is that parents, aunts, uncles, grandparents... follow the same festive sleep tips as those for the children!

In a nutshell:

• Consistent sleep and wake times and get some outdoor activity every day.

• Turn off TVs and screens a couple of hours before your bedtime – read a book or potter or write a list instead:

• If you have a lot on your mind – write it down before bedtime! Make a list of all the little things you may forget so you don’t lay wake thinking about them – then keep the list by the bed so that if you do wake up thinking about Auntie Sally’s present – you can write it down and stop dwelling on it!

• Allow your body to wind down for sleep – a relaxing bath or shower, book to read... a healthy bedtime snack;

• When you finally get into bed – relax!! Let your mind and body relax; See these 3 mindfulness meditations to support sleep from the Chopra centre, and focus in on each muscle group ad consciously relax your muscles... feeling the release and calmness in your body as you Let-go...

Three meditations to help you calm your mind and help you fall asleep. The Chopra Centre.

My daughter, Sally, has never been a good sleeper. There were 2 main issues: 1) she always woke in the night and ended up in our bed with us and 2) there were many nights when she’d stay awake in the night for up to 3 hours. Sally was a few months off full time days in school and many well-meaning family members and friends would tell me that when she did start nursery, she’d soon get exhausted and sleep through the night. However, I know my daughter. Instinctively, I knew school would not tire her out. In fact, it would probably make her mind more active, and therefore, more opportunities to lie awake at night. (And, I have been proved right!). So, I knew if I didn’t try and tackle her sleep, she’d get more and more exhausted. And, of course, an exhausted child is usually a poorly behaved one, who just can’t cope with changes to routine or new experiences.

Sally was that baby who would only fall asleep in your arms being rocked or in the vibrating chair. She was that baby who would literally scream the place down if you left to fall asleep on her own. This was right from the moment she was born, and she was now fast approaching her 4th birthday. Consequently, her father and I were exhausted. Nearly four years of disrupted sleep, night after night, was taking its toll on us.

During her 4 short years, we’d tried everything to try and get her to sleep in her own bed through the night. The “controlled crying” or “cry-it-out” method was the worse one we tried. She cried so much that after 5 minutes, she’d be close to throwing up. It just didn’t feel right to let a small person cry so much, unsupported and alone. It just felt wrong. And, it felt also like it would never work anyway. We tried it twice – when she was around 18 months and 2 ½ and both times, we gave up very quickly.

We tried the “sleepy cushion” which we sat on whilst she fell asleep, and every third night it would move further and further out of her bedroom. And, it worked! We could sit outside her room and she’d eventually fall asleep. But, that was it. It didn’t make any difference to the night time wakes, and after a bout of chicken pox, we were back to where we started – the sleepy cushion firmly back in her room!

We’ve had a mattress on her floor in her room – night after night after night… that lasted about 3 months. We’ve had her bed in our room – again for about 3 months. But, all we got in the night was “I want to be in the BIG bed” – didn’t matter she was right next to us.

So, in the end, we bought a king sized bed and just resigned ourselves to the fact Sally would sleep in our bed forever (or so it seemed!). But I knew this couldn’t go on forever, and with her fourth birthday approaching, I knew it was time to try and tackle it, hopefully, once and for all.

I was mooching around Mumsnet, and one thread was asking for any recommendations for a sleep consultant – with a gentle approach. One name kept coming up – Ann Caird. So, I looked on her website and was struck by how her approach was just what we were looking for. She didn’t look to train the baby/pre-schooler to sleep – instead, she tried to find out what possibly was causing the little one to stay awake, and try to address the underlying fears or concerns. As she said, sleep training was just like putting a plaster on a wound without trying to treat the underlying causes. This was music to my ears, as I’d always felt Sally “feared” sleeping on her own – and sadly, there’s no reasoning with a 3 year old, there’s no magic wand to take away their deep rooted fears, as they really can’t communicate appropriately how they are feeling or what they really fear.

I contacted Ann, and after an initial telephone conversation with her, giving a little bit of history, we both felt that she could help us. She was able to work with us during August/early September, so this would give us an opportunity to start the work during the summer holiday and into the start of Sally’s school.

The process includes completing an in-depth questionnaire, going right back to how the pregnancy and birth process was. I must admit, just completing the questionnaire felt cathartic – a chance to relive things, and maybe start to look at the situation with fresh eyes and a fresh perspective.

Ann’s method is to try and get to the underlying causes of the sleep issues. To try and understand what the child might be feeling. She doesn’t claim to have all the answers, as, let’s face it, the child will rarely turn round and tell us what they’re really feeling or why. Then, she aims to builds confidence, to give the child a feeling of control, to gently address any fears, but all the time allowing the parent to support, to be there and help the child through the process.

And, interestingly, the sleep programme didn’t start with the evenings or the nights. It started with play!

Another important part of the programme was Ann’s approach to tantrums. Before we started, Sally could have some humdingers – screaming her head off over the smallest of reasons – usually because we’d stopped her doing something life threatening or because she’d had the green spoon when she always has the purple spoon to eat her yoghurt! But, my approach was always to try and control the tantrum; to try and lower the volume, to try and stop it. Inevitably, this led to the tantrum escalating, and me getting more and more angry.

Ann explained tantrums from Sally’s point of view. The reason for the tantrum didn’t matter – they weren’t about getting at me, or because of the colour of the spoon – Sally just used this as an excuse to “let off steam”. She explained that as a little one without the ability to fully explain feelings and emotions, these feelings and emotions can, and do, build up and a tantrum is just her way of “letting it go” – channelling release in the loudest possible way!! So, Ann’s approach was to let them happen, but to support her as she went through the “tantrum” until finally, she collapsed in a flood of tears and would want hugs and cuddles with Mum in such a special and connective way.

So, second day into the programme, Sally had a tantrum – and this time, I got on my knees, and just waited. And, instead of everything escalating, after Sally had a good scream, out came the tears – big tears – but also cuddles. We’d cuddle and cuddle, and then she’d just jump off me and run off as if nothing happened. Job done!!

Well, a few tantrums in, I felt totally different to how I had at the start. I no longer feared them, I no longer felt the world’s worst Mum who couldn’t control her 3 year old… instead my attitude to tantrums now are “bring them on”… as I view them as Sally’s need to let off steam. She only really has them every now and then – and usually when things have been brewing up for a few days. In fact, they’re not really tantrums now, as Sally usually just goes straight to the crying part.

For example, at her fourth birthday party recently, things were becoming a bit overwhelming. She was becoming clingy to me and I could see a lot of tension building up. Let’s face it, she was looking forward to this party for ages – and being the eldest in her year, was the first one to have a party and so all the focus was on HER. Well, thank goodness a balloon popped, as Sally used it as an excuse to have a damn good cry – with lots of cuddles from me whilst I waited for the tears to abate. The tears were way out of proportion with the balloon pop, but I just knew Sally needed that cry to let off steam. And, she had a really good sleep that night!

So, that leads me back to the sleep. After the 2 weeks play, we started on the long road to sleeping in her own bed all night, without the need for Mum or Dad to be “there”. Ann’s approach is to involve Sally as much as possible – give her as much control over the situation as possible.

Ann told us at the start that there might be tears, but in no way, was this controlled crying. And, she was right. Putting Sally to bed, or during the night, when she was challenged to break the imaginary cord between us, there were lots of tears, but instead of leaving to cry on her own, we’d be there to support, to let her cry as a way of letting go of the fears.

Ann’s explanation about crying makes sense. When our child cries, our first instinct is soothe them and stop the tears. To say “sushhhh, there’s no need for tears” and to try and make things better. But, when they are crying because they have so many emotions inside they need to get out, when they need to cry to demonstrate just how deep their fear is, by stopping the crying, we’re saying their feelings and emotions are not valid. By letting them cry, but being there for them, we’re validating their feelings. And, let’s face it, when we feel emotional, a damn good cry does us the world of good.

So, where are we now? We’ve finished the six week programme. Sally is in her bed all night, but she does still wake up a few times, and calls out to make sure we’re still there. We’re not quite there yet – but we’re on the path, and I think, given time we’ll get there. We’ve got the tools. We know when to push Sally a little further along, to challenge her, to bring out the tears, but equally, we know that we can’t do that continually – we’d be too exhausted and I think Sally’s fears are so deep rooted we’re better off treading lightly and gently, and allowing her to settle after each “challenge”.

We also know when Sally needs to let off steam – when a tantrum won’t be far off, when she needs to have a good cry and usually, after a good cry, we know we’ll have a far more settled night too.

Ann’s approach has been enlightening. It’s opened my eyes to see things from Sally’s point of view. Why she has this fear of being on her own, I don’t know. It might be something from the traumatic birth experience, it might be something completely different. All I know, it’s been pretty much all her life, but, hopefully, given time and a few more challenges from us, we’ll get there.

What you get from Ann is understanding, explanation, support and encouragement. You get to go at your pace. It’s not easy at times. During the most challenging times, I found myself at night lying awake on the floor outside her room for hours, waiting for her to drop back off to sleep. But, if you get too tired, or too emotional yourself, Ann will suggest a back off and a gentler approach. You don’t get a quick fix and you don’t train your child to sleep. What you get is an explanation for the possible underlying causes, and then methods to try and overcome these, to enable your child to sleep for themselves.

Overall, I feel I understand Sally better now. And together we’ll get there.