elevating child care

Baby Sleep Struggles (Guest Post By Eileen Henry)

A bonus of getting older (there aren’t many) is a more acute awareness of where our talents lie, and also our limitations. For instance, there are many parenting issues about which I feel confident  and capable of offering advice – however, sleep isn’t one of them. Although I can certainly help with the basics, I find sleep problems a bit too thorny and complicated.  (Granted, I knew far more before my third baby arrived, a high energy boy who fought sleep with a vengeance.) So, when Anna e-mailed me about the difficulties she’s having with her infant son, I decided to place her in the best hands possible and turned to RIE-trained sleep specialist Eileen Henry.

Dear Janet,

I was wondering if you could give me some advice on one thing.

We have a wonderful six-month old boy, who we are trying to raise according to Emmi Pikler and Magda Gerber’s thoughts. Ever since he was really small he would lie happily on the floor while we were nearby if he needed us. He is really relaxed and can engage in various activities on the floor for a really long time. But the nights are what trouble us. He used to be a great sleeper, probably not really our doing, but he would fall asleep all alone, and only woke up for quick feeds, then went straight back to dreamland. About two months ago something changed (and honestly we could not think of a reason), and he has had troublesome nights ever since. He is hard to wind down, but now it is more than that. He is *very* upset if we leave him in his bed in the evening and will not fall asleep unless we are talking to him, sitting right next to his cot. We have tried to decrease our presence gradually, but it does not work – he starts screaming. And, when he awakens in the middle of the night, he needs us to go sit there and talk to him. Sometimes he does it over and over for a very long time. I am really worried, because after a night like this he is obviously very tired. And then there are nights when he sleeps right through without a stir.

I would be grateful for any advice,
Anna

Dear Anna,

Congratulations, it looks like your child has successfully mastered one of the important developmental skills of becoming a successful, autonomous sleeper — he is capable of falling asleep on his own. Now that you have observed this and experienced this, how do you hold on to it during all of the changes that will come along and challenge this innate ability?

At six months of age your child is now in the second stage of infancy. And at this stage it is quite common to see a disruption in sleep patterns. The first thing you will want to address is the “when” of sleep by making sure bed time is adjusted to fit the needs of a six-month-old. Whereas the newborn generally goes to sleep between 7:00 p.m. and 8:00 p.m. by six months that time becomes closer to 6:00 p.m. and possibly as early as 5:30. The window of sleep for the 6-10 month old child is 6:00-6:30 p.m. to 6:30-7:00 a.m.

The biggest issue in the discipline of sleep is “how” sleep is done in your home. Since I consider sleep to be a health and safety issue, it is best that the parents are in charge of this realm. Now that your child is more aware of your role in his life and has a complete understanding of who handles all of the complaints in his world, he may start to develop his own opinion as to how HE wants sleep to be done.  His current opinion is that he wants you to stay in the room, talk to him, and watch him fall asleep. He wants what all of our children want at one time or another, and over and over again. He wants you to fix it for him. And since you are well versed in the RIE philosophy, you already know that the more we do for them, the less they are able to do for themselves. Sleep is no different.

I can see that you have tried to ease yourself out of this picture, and when you do so he cries. The cry is what I help parents with the most when it comes to sleep. Struggle (crying) is inherent in ALL development. Our children will cry in their struggles with gross motor development and fine motor development. In learning to walk they will fall down and cry. They might even throw stacking cups across the room in frustration and cry. They will try to communicate with us verbally and throw a fit when we don’t understand them. The young child’s brain is miraculously designed to not only handle these disturbances but actually expand due to these disturbances. 

It is okay to let your child struggle in his efforts to fall asleep and return to sleep. He is already doing it in all areas of development, and he can handle it around sleep as well. And to do this the parent must distinguish between struggling and suffering. Struggling we let happen. When our child is suffering, we show up with love, compassion, empathy and reassurance. Whether our child is 4 months, 4 years or 40 years old…we will always attend to suffering. We attend to it… we don’t fix it for them.

Talk to your son. Tell him how sleep will be. Tell him that you will sit with him and then you will leave the room for him to fall asleep.

Acknowledge: I hear you crying.                                                         

Empathize: This is hard. I know you want me to stay.

Reassure: I am near. You can do it. I will come if you need me.

The separation anxiety your child may be feeling around sleep can be the same that the infant feels in the waking hours. And in RIE we are honest, “I am going into the other room now. I’ll be back.” And we leave with confidence, knowing that we can all have the necessary feelings associated with separation. And it is followed by the satisfying feelings of a warm reunion. We come to them…we are present…and then we go. Over and over again, this is the pattern. And when we can bookend the separation with what Magda Gerber called “100% Wants Nothing Quality Time”, this creates the best possible preparation for separation and a reunion worth waiting for.

With warm regards,                                                                       

Eileen Henry, RIE Associate
Compassionate Sleep Solutions                                                                                       http://www.eileensclasses.com                                                                                                                                      303.953.0203                                                                                      

Good news… Eileen has offered to advise others with sleep issues here, too. Eileen, thanks!

Anna is sharing her RIE parenting journey here: Every Moment Is Right

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21 Responses to “Baby Sleep Struggles (Guest Post By Eileen Henry)”

  1. avatar MLR says:

    This was great. Thank you for adding Eileen’s perspective, and I look forward to more posts from you. I love your emphasis on distinguishing suffering and struggling – wow! I have personally found sleep (or lack thereof) to be one of my biggest struggles as a parent, both on the sake of my daughter (who barely slept the first 6 months of her life, and at 23 months still has a tough time settling down for naps) and for my *own* sake. Reading this very thoughtful, empathetic way to deal with the struggles just feels RIGHT. Thank you again.

  2. avatar Marcela says:

    I just wrote a post desperately asking for help and voila, I see this post today. Serendipity!

    Here is the issue we are having with my daughter (very similar to Anna’s child).

    As a baby she slept very well, could go to sleep on her own, and would sleep about 6 hours straight, nurse, and go back to sleep. When she turned 4 months all this changed, she stopped being able to sleep on her own, and started waking up every 2 hours.

    Part of the problem is we were travelling for a few weeks and we changed all of her routines and since we were staying with other people I couldn’t let her cry so I helped her fall asleep and then nursed her several times a night.

    Now that we are home she refuses to fall asleep on her own, wakes up every 2 hours and wants to nurse as long as she possibly can. The problem is she doesn’t nurse much during the day because she is too distractable. I don’t want to lose my milk supply so I let her nurse often during the night so she can maintain adequate nutrition levels and so I can keep up my supply. Otherwise I’d be more disposed to letting her “cry it out”.

    We’ve used a RIE approach and she is very independent and plays by herself with us observing for a long time, but then she finds it hard to wind down and nap.

    DUring the day when we put her down for naps she will usually only sleep 20 minutes and that’s it. If someone holds her she can sleep longer.

    I am really worried as she is getting such little sleep. Right now she goes to bed around 9pm (we try and try to get her down earlier but she refuses!), and wakes up at 7 am. And during the day she will take 2-3 20 min naps. I know this is not enough and she needs more sleep for proper brain development but I don’t know what else to do.

    HELP!

    • avatar Eileen Henry says:

      Dear Moms in Search of Sleep,

      I know this all sounds so simple. And yet the truth is that it is far from easy.

      Traveling can really wreck our sleep. And if we have an audience we are less able to stick to a plan that involves even the slightest struggle. My recommendation for travel is to do the best you can in sticking to routine. Create sameness in the environment and in the predictable routine of the day, when and where you can. But don’t let it ruin the vacation feel of a vacation. If your child naps in the car seat or in the stroller, be grateful that it happened and then move on.

      Just the thought of getting on a plane with an infant triggers an anxiety in me. “What if we get stuck on the tar mack for an hour?”–happened when my son was 4-months-old. “What if her ears hurt and she decides to arch her back and scream for two hours.” — happened to my daughter when she was 6-months-old. During this episode I turned to see my toddler being fed M&M’s like they were doggie treats by a well intentioned passenger. “What if the passengers look on with disgust and panic and I can’t find an empathetic gaze in the crowd?”— is happening, somewhere in the air, over this earth, as I write.

      Here is what helps. Accept that every time we leave the comfort and routine of the home we enter into a mystery. (Thanks you Hari Grebler for introducing the concept of relaxing into mystery to me.) Talk to your child about what is different while away from home. And try to adopt the spirit of…Here we go. We will all do the best we can. We don’t know what will happen. And if it gets ugly…this too shall pass. The day before you return talk to your child about returning home and how things will go back to the way they were.

      As I said in my last post, this is the age of the second stage of infancy. And because you have been such an excellent mommy your child is ready, able and willing to be in relationship. And you are the primary one in her life. Her little, healthy, brain is quite literally “jacked up” on life and love. WELL done! Here is a way to help her wind down and settle.
      • Now is a good time to do day time nursing in a separate room, away from any stimulation and in 100% relationship. I call it the nursing meditation. We are ONLY nursing. As our mind wanders away and into the story of…laundry, what to do for dinner, will she ever sleep again…we gently label it “thinking mind” and return to the nursing moment. My wandering mind has an attention span with less focus than my dog. I used a mantra, “Nursing. Just nursing.”
      • Establish what sleep experts call a “focal feed”. This can happen anytime between 10:00 p.m. and midnight. And the typical infant is capable of a six hour stretch after this feed. If and when she wakes up (anytime after 10:00 p.m) she gets to nurse once for (almost) as long as she wants. She will want to nurse back to sleep. When her eyes get heavy tell her, “Your eyes are sleepy. I will put you back in bed to sleep.” Tell her when you put her to sleep for the night, “I will feed you once after 10:00 p.m.” When she wakes, feed her, put her back to bed and softly tell her, “I will feed you again at breakfast.” For all other wake ups use what I call “alternate forms of soothing.” Meaning you come to her, comfort her, and not fix it for her. When we truly respond to the authentic needs, the infant tends to drop the feedings on their own as they don’t need them any more. See how smart and capable they are.
      • Good work. You know that bedtime has to become earlier. Adjust it by 10-15 minutes every other night. Get it up to 8:00 over the span of a week or so. Be there for a while and then shoot for 7:30.
      • Naps. Work on naps over the next two months. As the night stabilizes and she goes back to bridging the light sleep cycles on her own it will translate to day. She is waking at 20 minutes because she is coming to light sleep and wanting you to put her to sleep again. Start working on the “when” of the discipline of sleep and for naps start with 45 minutes. When she wakes at 20, give her 25 more minutes to return to sleep. You can go in and comfort her and reassure her. But she doesn’t come out until the 45 minutes is past…whether she slept or not.

      Warmly,
      Eileen

  3. avatar Fernanda says:

    Wow! That´s great and challenging at the same time. I can imagine is much easier to leave my playing in the next room and come back to him for the warm reunion than to leave my baby crying and being able to identify if his crying means struggling or suffering. Are there hints we can use to note the difference?
    I couldn´t understand what you mean by “100% Wants Nothing Quality Time”, maybe that was a hint already.
    Thanks!

    • avatar janet says:

      Fernanda, you read my mind — I wanted to ask Eileen the same question (and hopefully she’ll have the chance to come back here and answer). How do we disinguish a struggling cry from a suffering one?

      I can explain Magda Gerber’s “Wants Nothing Quality Time”. It means being 100 % attentive and open, without an agenda, the way Magda recommends observing an infant playing. It’s being totally responsive, but not directive. (“Wants Something Quality Time” is also giving full attention, but while doing an adult-led task together like feeding, diapering, bathing.) I wrote more about this in Magda Gerber’s Gift To Grown-ups – Parenting That Engages The Mind: http://www.janetlansbury.com/2010/05/magda-gerbers-gift-to-grown-ups-parenting-that-engages-the-mind/

    • avatar Eileen Henry says:

      Dear Fernanda,

      “Wow! That´s great (simplicity is great) and challenging (somewhere close to “far from easy) at the same time.”

      Well put! Most of my parents at one point make the same comment.
      “This is by far the hardest thing I’ve ever done.”

      Warmly,
      Eileen

      • avatar Eileen Henry says:

        I have not posted the entire excercise I offer parents in “Listening to the Cry”.
        But it is a mindful practice and any meditation or mindful practice will do. I encourage parents to breathe and get into their bodies and out of their thinking mind before doing the following.

        ~ Rating the level of the cry – You rate your child’s cries on a scale from 1-10. I encourage you to identify the first noises of disturbance as a “one” rather than cooing or babbling. A 10 is crying that is very intense with no breaks. It is typical for Mom to have a different number than Dad on any level of crying. That is fine. But if dad is in charge of the check in at any time, let him go in on the number he chooses to go in on.
        If your child is over 6 months try to give 21 minutes (3 seven minute cycles)before going in. Peak crying can be anything above an 8 on a scale of 1-10. You are the expert on your child. Some mothers know that at a 7 of crying there is no way their child will self soothe. There is no need to let your child go unattended above a 7, yet after 5-6 months of age it is o.k. to let them go for 21-25 minutes at a pretty high number on the scale of 1-10. You decide what number is best for you and your child. Some mothers can only stomach 5 minutes and this still works. It takes longer but it still works if we are consistent, consistent, consistent…did I mention consistent?… in our response.
        It doesn’t matter how many times you go in. It matters what you do when you get there.

        ~ Listen for “cycling” – When the cry starts to cycle (the level goes up and down) this is the sound of the brain soothing itself. What this sounds like is this. The cry may start at a 5, go up to a 7, then down again to a 4, then up again to a 6, then down and up and so on.
        This is an excellent sign and does not need to be attended to. YOU decide if interrupting this will help or hinder your child in their efforts to self soothe. If at some time it appears that your presence is not helping say, “It doesn’t look like I am helping. I’m going to go now and give you a chance to work this out”.

        This is a VERY simplified version of how I work with parents in listening to the cry. The MOST important thing is calming yourself before calming your child. If your anxiety level is high you will want to work hard on reducing that first. Our emotions speak louder than our words do.
        Adopting the attitude of…”This is hard. I know we can do this”…will help your child and you.

        Warmly,
        Eileen

  4. avatar Katie says:

    While baby’s sleep habits are unpredictable, there is a significant stress that is placed on the parent. The importance of baby bonding is crucial to ensure that the baby feels safe and that both fathers and mothers have an attachment to their baby. In these stressful situations, parents who have a deep bond with their baby will feel less stressed by these changes and challenges so early on in parenthood.

    • avatar Eileen Henry says:

      Dear Katie,

      Thank you for mentioning this.

      When I work with parents on sleep we are focusing on three basic needs of the infant.
      The relationship need (bond), food needs and sleep needs. And they are in this order. A loving healthy bond overrides even the food need in young infants.

      When parents come to me for help there is generally an enmeshment of these three basic needs. As the child develops we can untangle these enmeshments. So that in the routine of the day there is ample time for relationship and food. And during the sleep hours – there is only sleep happening. This is the discipline of sleep.

  5. avatar Jeanette says:

    Thanks for your article on sleep. I’m wondering if you could share any research and/or references for:
    – the need for the gastrointestinal system to rest and repair at night
    – the developmental stage at which infants should sleep without parental support

    Many thanks!

  6. avatar Amanda says:

    My baby is 6 weeks old and from about 3 weeks he decided that he will only sleep while being held. If we force the issue he gets overtired and very very upset by the end of the day. We have tried everything from swaddling, chairs white noise etc. We are ok with this for the most part but it is becoming hard on us to live. We co sleep at night and I know he is too young for any sleep training…but is there anything we can do to start a sleep transition?

    • avatar janet says:

      Hi Amanda,

      I’m going to send this to Eileen, and I’m hoping she’ll get back to you shortly.

    • avatar Eileen Henry says:

      Dear Amanda,

      I am a huge fan of co-sleeping with our newborns.

      I think if we let our newborn babies decide how they want to sleep…they might all choose to be held during all of their sleep the first months of life. And it might not be wrong, or bad, or harmful…it just is. But I hear you; it can get exhausting for the parent.

      My recommendation is to start working backwards on the time you are holding him while sleeping and put him down next to you. Work your way back to holding only five minutes. All the while using your wonderful RIE skill of saying what you are doing. You will want to get to the point of saying, “Your eyes are closing, you are sleeping, I will put you down now.” Then…”Your eyes are heavy, you are getting sleepy, I will put you down to fall asleep.”
      If he cries, pick him up, soothe him, and put him back down.
      Keep doing this.

      And be as calm and patient as you can be. Your embodied state of peace and calm could be…well it is in fact…the most important factor of this scenario.
      Approach this with the attitude of…”we have all the time in the world here my love. You have a lifetime of yummy sleep ahead of you. We can take our time. You can do this. I am here.”

      Lastly, for a newborn that bedtime isn’t too, too late. But you will want to move it up in 15-minute increments soon. By 6-months that bed time can be as early as 6:00 p.m.

      Eileen Henry, RIE™ Associate
      Compassionate Sleep Solutions™
      http://www.eileensclasses.com
      303.953.0203

  7. avatar Eileen Henry says:

    I wish I could quote some sources for you on this research I have run across over the last decade of my sleep studies. But it is all in books, inside of boxes, and melded into my sleep program.

    As far as resting the digestive system that information has been gathered over a lifetime of working with naturopaths and health practitioners. My mother owned one of the first heath food stores and restaurants in South Louisiana in the early ‘70’s and I spent a lifetime in the care of nutritionists and not so much in “traditional medicine” Dr’s offices. Although now I would say I am aligned with both western medicine and alternative practices. I try to stay informed on all sides of health issues as not to form a too “hard core” opinion on any one topic.
    I fail at that regularly.

    As far as the… “developmental stage at which infants should sleep without parental support.”
    I have to admit I am not a fan of the “should.” For some families that time is never. Some families value and hold dear the idea of parental support and “parenting to sleep.”

    I am more inclined to when “could” an infant sleep without parental support. And when could the parents of this infant get the sleep they need. And that is different for each child and each family.

    For the typical infant, by around 5-months of age, he can learn the developmental skill of falling asleep and returning to sleep with little to no assistance. However, I am remembering Magda’s quote now, “On their own with our help.” And I firmly believe that around sleep, there will be the nap and the night where…they will need our help. And we will come with our love, warmth and reassurance…and that can be enough.

    Warmly,
    Eileen Henry, RIE™ Associate
    Compassionate Sleep Solutions™
    http://www.eileensclasses.com
    303.953.0203

  8. avatar Vicki says:

    The more I read, the more I connect with the RIE approach.

    My child is 12 weeks old and we are really struggling with sleep. On the days that he naps in the morning and afternoon, he is delightful while awake and falls easily to sleep at bed time. On the days he doesn’t nap well, he cries a lot and struggles against sleep.

    I see this clearly and talk about it to him (I love talking to him), but I can’t help him sleep regularly. I feel like some days I try everything (nursing, rocking, singing, strolling outside, a drive in the car) and nothing works, or it only works for a short time. Some days I’m able to help him back to sleep, some days not.

    I hope as the days go on I am better able to help him sleep and be begins to learn that he feels better when he sleeps (I tell him this too!).

    Thanks for sharing so much wisdom on this blog.

  9. avatar Mama Rose says:

    At 10 months of age, what time should bedtime be and approximately how many times a night should I be breastfeeding? Currently my little guy is going to sleep after 9:30 p.m. and wakes near 8:30 a.m., he’s been real difficult to get to sleep and I can’t seem to get a pattern. I nurse him nearly 3x’s a night still. I’ve been using RIE, but this is the trickiest he’s been. I definitely have anxiety about it, and I know that doesn’t help. Any advice would be fantastic…

    Kudos to you ladies who give wonderful advice. Sometimes as mothers we try too hard; and it’s coming to your site for the simple, sensitive, step-back reasoning we need. Thank you.

    • avatar janet says:

      Hi Mama Rose! I’m going to contact Eileen so that she can weigh in, but I would advise trying a much earlier bedtime, like 6:30 or 7:00. Often the baby ends up sleeping better and even later when the bedtime is earlier. It might be difficult because you are waiting a little too long and your boy is overtired. The early signs of tiredness can be as subtle as a slightly dazed expression, and this is when it’s easiest for a baby to fall asleep. So, I would try starting his bedtime ritual before you think he’s even tired….and please let me know how this goes… :)

  10. avatar Jana says:

    I know this post is almost three years old, but I had to leave a comment. I have been following the recommendations in this post (and comments) for the past few days, and wow, what a difference I have seen! Everyone said that her 7pm bedtime was so early, but even then I was rushing through our bedtime routine because she was cranky and tired. She is now going down at 6 (faster change than recommended, but I’m just following her lead) and the last two nights she slept for ten hours uninterrupted! And another two after nursing! Naps have been improving too. She has gone from several short sporadic naps a day three a day (today her morning nap was 2.5 hrs, other two were 45 and 30). I’m hoping to converge the later two into one long one, but I know it will take time. I have tried to stick to a very predictable routine which I know is helping a lot. Also, I was confused about watching for the first sign of sleepiness, because she was ALWAYS showing signs of sleepiness. I realize now, I have inadvertently been depriving my daughter of much needed sleep. She WAS always tired. I am so grateful we are getting on the right track now. Thank you Eileen and Janet for the work you are doing. You are making a difference for this little family :)

  11. avatar Jana says:

    *to* three a day…

  12. avatar Dara says:

    I first want to say how much I love Eileen’s warm and supportive tone. Babies need soothing and empathy and so do mamas! There is SO much wisdom to taking care of our own feelings so that any heightened anxiety we feel is not shared with our babies. That being said, I am concerned about babies being left to cry for as long as a half hour. I understand that you are suggesting that they have some ability to self soothe, but I’ve been told that the research does not support that. One book that includes this research is The Science of Parenting; it offers alot about brain development. It cites that the brain is not capable of self soothing before 2.5 to 3 years old. Dr Laura Markham of Peaceful Parent, Happy Kids also cites research demonstrating the need to be comforted by an adult far past 6 months old. It makes perfect sense if you consider that from an evolutionary perspective a baby that is left to cry would not survive to pass on their genes when we lived in the open- which was not that long ago in the scheme of things!! Babies adapted over thousands and thousands of years to be in physical contact with adults and to be responded to when they cried. Or be eaten! A baby left to cry for any length of time is going to experience fight or flight which floods the brain in stress hormones and which also changes the brain permanently over time in unhelpful ways. I’d be happy to share research on this if you would like. I can’t link it from my phone, sorry! I am just concerned that loving parents who take the time to seek out what is absolutely best for their children are being guided to do things that impact the brain in truly negative ways, not to mention the psychological health of the child over a lifetime. I promise I am not wanting to be contrary, I am just hoping to dialogue about this! Thank you for all your support of parents and babies!

  13. avatar Jordan says:

    Thank you Dara — i was going to ask where the science is behind these recommendations… I dont feel that it is ok to let an infant cry alone…Or to ignore a maternal instinct – I simply could not let my child wail and not offer comfort (i always talk soothingly and lovingly tell him what we are doing, etc. But when he is wailing I think he needs to be picked up and held!)… I continue to read recos like Eileens above – gently tell the baby I am not going to nurse him when he wakes up every hour… Okay well when he is screaming hysterically and then so mad that he is up for a whole hour rather than peacefully nursing back to sleep… That is a reco that is useless. I continue to try it but it really is not helping… Ive tried all ways of comforting before offering the breast… By that time he is so riled it is much worse…he is 5 mos and I was just fine w his reg 4-5hr stretch followed by every 2 hrs and then the dreaded 4 mo wakefulness set in and has been plaguing us since… I guess i will continue to be calm and speak to him and hope things improve…

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