Thursday, July 11, 2013

Book Review: Healthy Sleep Habits, Happy Child

Sleep is going pretty well over here, except when it's not.  So I'm continuing to read the sleep books I borrowed from a friend.  Healthy Sleep Habits, Happy Child, by Marc Weissbluth, M.D. took me about 4 hours to read (during two days of naps) with some skimming and skipping all sections past Dylan's current age-range.

Summary:
Based on research, children who sleep better are happier, less hyper-active, and perform better in school.  The average child needs about 14 hours of sleep.  In the newborn stage, this sleep will occur in short bursts throughout a 24 hour period.  By around 6 weeks, babies start to organize their night-time sleep and sleep longer periods.  By about 4 months, naps start becoming more organized with most babies taking 3 naps.  Between 5 and 8 months, most babies take 2 naps. The last nap falls off sometime after a year.

Total sleep need does not change significantly during the span of the first few years, so when a child drops a nap, bedtime often must be moved earlier.  Dr. Weissbluth says that most babies should be going to bed between 6 and 8 pm and waking around 7 am (with 1-2 night wakings for feeding up to 9 months).  The first nap should occur sometime between 9 and 10, the second between 1 and 3, and the third between 3 and 5. (Starting during that range, not sleeping through the entire range.)

His major focus is advocating the merits of "cry it out." He prefers the extinction method where you do not go back in the room.  You let your child cry for up to 1 hour at nap-time and as long as necessary at night.  He argues that if you do not do this, you will be teaching the baby to cry for the period of time it takes you to come in and give comfort.

He advocates putting the child down when tired, but before yawning and eye-rubbing.  He says to use whatever soothing routine you like including nursing to sleep and does not see the need to wake the baby as you put them down (as Dr. Karp recommends in Happiest Baby on the Block).  But he does not agree with any type of motion during sleep and is at best ambivalent about white noise.  He says to put them down when you finish the soothing routine whether they are awake or asleep.

My Opinion:
Dr. Weissbluth is very blunt and he might make some people angry.  He, like the authors of Babywise, also spends a good deal of time explaining that research does not support attachment parenting (in that the child will not feel abandoned and it can often disrupt good sleep).  But overall I liked his heavily research-based information and he did acknowledge common practices like the "family bed."

Although he believes in CIO, he also explains "Graduated Extinction" and other methods of reacting to a baby's cries.

He often talks about two working parents keeping their baby up too late so that they can play with him after work.  That got a little old and annoying.  I agree that the sleep times that he advocates are most common, but if a family has to shift the schedule a bit on both ends to have time together, I think that can work too...as long as you're not actively playing at 8:00.

My Take Aways:
Dylan has been sleeping until about 6 am, but mostly that is because I needed to feed him them when I went back to work. (He is currently 6 1/2 months adjusted, 9 months actual.)  So I'm going to leave him a little longer and try to get to 7 or 7:30 (he's usually just happily babbling at this time). I'm currently at home for summer break and will have a nanny in the home in the Fall.

I've been trying to find a pattern in Dylan's naps for ever now, but I like the times that Dr. Weissbluth recommends so I am going to try to stick to them.  He's been pretty consistent in frequency and duration of naps, they just always occur at different times.  I think it will be pretty easy to get closer to standard times.  It's not really different from what I'm already doing...it's just that I think by working on the wake-up time, the nap times will be a little bit more consistent.  And Dylan is definitely a 3 time napper (sometimes more).  He still also wakes up at 35 minutes or so, but doesn't get really upset and has been able to put himself back to sleep within 10 minutes (usually just 2-5).

Lastly, I'm going to try to keep pushing bedtime earlier.  Overall bedtime has ranged from 6:30 to after 8:30 with a mean of right around 8:00.  I'm not sure if it's the light or what, but it seems that however tired he is, he won't sleep until 8.  (I could buy black out shades, but I'm not sure if it's necessary right now.)  I have a nice little routine of bath, lotion, pjs, bottle, walk (and sometimes a book if he's less tired) that seems to be working well.  Then I turn on his white noise and his mobile with the light, but no sound and if I put him down just right after the walk...

We are so close to having everything be good.  Bedtime is difficult every other day or a little less than that and very seldom does he get into a full-blow freak out cry, so I'm still not willing to CIO.  My peanut needs his precious calories.  And I kind of did it the other day when he was a bit congested and I couldn't stand to hear his labored breathing. : (

So hopefully if I stay really consistent during the day - not in time, but in making sure he gets enough nap-time - and I keep a good soothing routine, we'll be okay without more formal sleep training.

So overall, I liked the book.  I ignored his tone a lot of the time (as well as most of the case studies), but paid close attention to the sleep research and his sleep routine suggestions and agree with just about all of it.  But I will definitely keep Dr. Karp's white noise!  Dylan prefers rain.  It definitely helps him sleep through gardeners and garbage trucks and barking dogs.  (I use it for all naps and for his first night-time stretch in his crib.  When I transfer him upstairs to the pack and play, it's off.  So far that hasn't been a problem, but we've had some night-waking the past few nights so I might have to re-evaluate.)

How is sleep going for everyone else?

This is what Dylan's actual sleep looks like for the past couple of weeks.

And here's a picture of him sleeping for good measure.



11 comments:

  1. I loved reading Dr. W's book! I sometimes had to snicker at him when he referred to some kids as "brats". What a strait shooter! I used a lot of his suggested techniques on my 3rd baby and things worked out really well in the sleep department!

    xoxox

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  2. Interesting book review. I haven't read that one. Sleep had been going really well for us, and then he started waking more often to eat. So we started solid food last week, which has helped naps return to his usual length. But then he started teething hardcore, and this past week nights have been TERRIBLE. Everyone says it will get better when the first tooth breaks through. I hope that is soon because this mama needs some sleep! And the CIO is really hard to do. We have used it only when we've exhausted every other option. The longest he has carried on is maybe 30 kin. But we do intervene some. Might not be what others say to do, but it has worked for us. I can't imagine CIO for an hour though. SO hard to listen to it :(

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  3. I read both Weissbluth and Ferber. I got good info from both. Mostly, I liked the research, the focus on wake time (how long an infant at different ages should be awake between naps) and the focus on quality, non-motion sleep. I use all the bells and whistles (white noise, darkened room, low temp, sleep sack, etc.) and my little man is coming along really well with sleep. Usually around 11 hours with 1 or no feedings. We initially did the "graduated extinction" (going in at intervals, a la Ferber) but after a round of sickness and some developmental milestones we had to start over. When we tried intervals again, things got WORSE. So, one night, we bit the bullet and let him CIO. Only 40 mins the first night. The next only about 15. Ever since, he DOES NOT cry unless something is really wrong. He just thrashes around, babbles, and goes to sleep! I am now a believer.

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    1. I'm glad it worked so well for you! We will go there if we need to. We will also see how terribly Hawaii messes things up. I'm very nervous!

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  4. My babe started sleeping for 8 hours through the night at about 10 weeks - just in time for me to go back to work with my sanity. Now he's 7 months and he has started waking at 3 AM to nurse. I'm taking this as a sign that I need to get more calories in him before bedtime. I'm going to add cereal to dinner (so far we've only had fruits and veggies) and if that doesn't do it we might be switching to a formula bottle before bed instead of nursing. That will be a little disappointing but mamma needs sleep too.

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  5. He's adorable, I love that picture! I also read this book (the twins were 3 months at a time). I took to heart certain points, like consistent wake up times--even on days when it looked like the twins would sleep past the 7 AM mark--and that worked wonders. I had to adjust the schedule to fit our needs though. For instance, I'm home alone with them, so I had to make time to do everything twice...bath times, etc. it worked out anyway though, so I think if you tweak things a bit, it won't matter! They are now 14 months, take two 1-1.5 hour and a day, and sleep from 6ish-7.

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  6. I haven't read any sleep books, so I appreciate your reviews!

    Sleep for us is going really well. J goes down for the night between 9 and 10 pm, wakes to feed between 5:30 and 7:30 am, then back down til 9:30 am. She has 3 solid naps during the day.

    The 5:30 pm bedtime seems really early to me, but I would prefer to sleep in until 9 am rather than wake up at 5:30 am. But that's just me. It's summer, we're on summer holidays, visiting family.... Not the most conducive to an early evening bedtime.

    I'm all about lots of sleep! I try to get all of J's bottles in during the day so that she isn't needing calories at night. Also, as soon as she rubs her eyes, it's nap time with her blankie and a soother. She puts herself to sleep within 10 minutes, no crying.

    We haven't had to use a CIO method at all... I understand some families need to and feel very fortunate that our little babe is such a good sleeper at 4.5 months!

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  7. Also - what is that app you use? I'd love to sleep track! And... Dylan is adorable!!!!!!

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