Marc Weissbluth's Blog, page 14

Weekend Treat

A funny discussion on parenting and happiness by some economists:

Freakonomics » The Economist's Guide to Parenting: Full Transcript

For the record, I believe Profesor Caplan is incorrect on his opinions on television-there is a lot of potential harm in using an "electronic babysitter."

-Daniel Weissbluth

Filed under: Announcement

The Basics of Infant Sleep for Parents of Twins

I will be presenting "The Basics of Infant Sleep for Parents of Twins" at Prentice Women's Hospital in Chicago on July 19th, 6-7:30PM. Call (312) 926-8400 to register.

Marc

Filed under: Uncategorized

Talk next week…

I will be giving a talk next week to expectant mothers in the Chicagoland area:

Wednesday, June 15 at 6PM at Bubbles Academy . Click the link to register.

Have a nice day!

-Daniel Weissbluth

Filed under: Announcement

Refund for Android App…

I am refunding all orders of the Android platform version of the Weissbluth Method Infant Nap App.

Although the Apple App has gotten some bad reviews, I feel that it has, on some basic level, accomplished what we had set out to do- which was give some very good age-specific sleep advice and reminders of when to look for signs of drowsiness: effectively sleep training your child. Unfortunately, I cannot say the same for the Android App, therefore I am removing the App from the marketplace and removing the link to the App from our blog. This Android App was not a proper representation of my father's ideas and he should not be associated with its failure.

If any of the people that bought the App email me their name and mailing address, I will cross check it with the list of people that got the app and will send them a full refund in the mail. –Daniel Weissbluth

Filed under: Announcement

Behavioral Book Review 7

At a recent dinner, I was discussing with a child psychiatrist the increased prevalence of autism. We agreed that part of the reason was an increased awareness (and consequently detection) among the many people that are in contact with a developing child: i.e teachers, parents, pediatricians etc… Is this increased awareness of how children relate to others due to a shift in societal values? To what extent does social media/technology contribute to this new emphasis on social interaction? We do know that digital technology has dramatically increased the speed, and breadth of social interactions and, in the case of social media, fundamentally changed the dynamics in which people are communicating. Thankfully, despite the newest iteration in technology, the same rules for social interaction in the classroom, playground, and kitchen still apply. For this reason, I found "Teaching Your Child the Language of Social Success" (Duke, Nowicki, Martin) very useful and a great read for parents.

This book came out in 1996-the internet was just starting to enter our lives with early versions of web browsers and sites like Ebay. Unconcerned with this burgeoning digital media, these authors were examining the social qualities in children that causes them not to "fit in" in daily activities and how to remediate those deficiencies. This child may be described as tactless, insensitive, dumb (although they are usually average or above average intelligence), lacking in social maturity, difficulty perceiving danger, rules. The feelings of sadness, bewilderment, and anxiety often accompany this social-perceptual disability. The authors wrote the book for parents and for teachers and they start by explaining the difference between verbal and non-verbal communication. One interesting point the authors make is that "body language" is only one component of non-verbal communication and that paralanguage, rhythm, gestures, tone are all important too. Another interesting point they make is that much effort by parents and educators is spent on the formal training of verbal communication whereas all of our non-verbal communication is learned through non-formalized teaching/experience.

This book, which is very easy to read, is an attempt to formalize the education of non-verbal skills in children and it was fantastic. The authors parse out how space, touch, facial expression, gestures, "objectics" can all color our verbal communication. The easy format of the book will help any parent or teacher employ exercises to teach children these qualities and help them pick up on social cues in many environments. I would recommend "Teaching Your Child the Language of Social Success" (Duke, Nowicki, Martin) to any parent who wonders why their (very bright) child is struggling in social situations either at home or at school. –Daniel Weissbluth

Filed under: Behavior

A Good Night's Sleep Isn't a Luxury: It's a Necessity

This is the title of Jane Brody's piece in The New York Times on Tuesday, May 31 on page D7. It is informative and well written. Unfortunately, there is nothing in the article about infants, toddlers, children, or teens. Additionally, there is no suggestion that adult sleep problems may have their roots in not learning to sleep well when much younger. The general adult population does not appreciate sleeping well as a health habit like exercise and seat belts. Therefore, many adults have a blind eye to their children not sleeping well. But for those of you who are reading this blog, even when there are struggles over sleep issues, know that you are giving your children a gift of healthy sleep that will last their lifetime. Read the article to imagine how better your children will be for your efforts now. This is no small thing. Coincidently, the title of her article has appeared in my handout, Sleep Smarts written years ago and has appeared in this blog on more than one occasion.

Filed under: Hot Topics in the News

SLEEP CONSULT: CHILD #1

4/20: DAY#1: Naps begin and persist.

4/23: Father: I am worried about jinxing the progress thus far but it has been unbelievable positive he is sleeping through the night consistently from about 6PM-6:30AM with one dream feed at 10PM. We have been putting him down a little sooner than the one hour in the morning because he looks exhausted. Naps have been good and overall he is more awake and happy with very little if any fussiness. He is so smiley and talkative in the mornings now and very engaging throughout the day. Last night he went right to sleep at 5:30PM but for the previous nights he would cry for the 5 minutes and then 10 minutes with a soothing period in between. This morning he was crying for the second half of his morning forced nap time and had to be soothed via pacifier and hand on belly several times. We can't believe how well he is doing and are so looking forward to the weekend with him so that we can spend time with him during the day. The best way to sum up how I am feeling is relieved. Everyday the anxiety that I used to have regarding coming home to him dissipates. While I love him so much and always miss him, up until recently, I have run home from work to "relieve" the nanny so that I could deal with his fussiness, crying, acid reflux, colic, crying, discomfort, etc. However, I currently feel happy for him and excited to see him. He is so much happier but also easy to be around. My wife and I cooked tonight while he slept and we only looked at the monitor so that we could look at him because we love him and missed him tonight. In the past, we obsessively looked at him on the monitor in order to make sure he was asleep and to calm our nerves that he would wake at any moment and be unable to be soothed. We are able to hang out tonight and to enjoy each other's company. We were a couple first and parents second for the first time in a while (not to take anything away from our love for him or for the responsibility we gladly accept)."

Mother: The sleep training process has helped him so much in that he is more alert, smiling more, able to "maximize" his growing potential when he is awake because he is not "fussy" or crying. The hours he is up are more enjoyable for him and for US! What a difference, I am such a believer! My husband and I have been much happier, we feel hopeful and the 5:30 bed time gives us time together at the end of the night when we get home from work where we are able to talk, catch up on our days without him screaming and having to soothe him for hours. Thus far there are no areas of disagreement regarding the path you are prescribing. On the contrary, we are better rested emotionally and physically and feel so much happier!

4/27: Mother: It is upsetting to think of having to keep him home to nap in the crib all day and it actually leaves me feeling stuck and helpless b/c I am the type of person who is active and likes to take him out at least during the day for walks, etc. I am wondering if we can shoot for one long nap in the crib i.e.: 1-3 which seems to work for him? There is no question that he is getting better and better every day.

MW: Yes, I know that helping him sleep better is now limiting and makes you feel trapped. But it will be liberating in the sense that you will never have a fussy baby when you are outside having fun with your son and your friends. You will never have bedtime battles or night waking problems. If you stick to my plan on weekends and make sure that the nanny enforces the plan during the week, then you will be rewarded soon with a dramatically better rested family. You cannot make his sleep schedule conform to your social wishes and expect him to be well rested. If you try, the results are junk sleep and you know what damage will follow.

5/13: Mother: "He is SO much happier and more settled in his disposition. He is less "fussy" and more comfortable. I feel he is responding positively to the routine and structure being implemented. As an individual I feel much less tense and anxious about coming home and less worried about night time. I don't fear the evenings. As a parent I feel I am doing "right" by our son and taking really good care to meet his needs over my own. Our marriage is less strained and we are both more relaxed about his overall disposition.

Father: He is able to basically hang out with us, family and other babies while awake without fussiness. He is very trusting of us and the nanny and seems content throughout the day. As an individual, I am much less stressed and am sleeping better. I look forward to coming home versus worrying about what the night will entail. As a parent, I am so fulfilled by this little being and am so focused on caring for him. We are less stressed and are able to cook and hang out at night, talk, leave him sleeping with a baby sitter and go to family events. Truthfully, thus far, nothing has been that difficult with the exception of not seeing him at night during the week. However, I take great joy in hearing about how happy he is during the day and seeing it for myself in the morning. Between 4-5pm, he is happy, easy, loving, engaging and calm. He definitely seems to be ready for sleep after his dinner feeding."

Weissbluth Method Infant Nap App.

Filed under: Sleep Consult

SLEEP CONSULT: CHILD #1

Here is our sleep solution.

1. Temporarily, the nanny and/or parents will wake him if he is asleep at 3pm. No sleep after 3pm. No sleep after 3pm allows him to fall asleep earlier at night.

2. The nanny and/or parents will bathe, feed, and soothe him and put him down, drowsy but awake, at 5:30pm. If he falls asleep during soothing, so be it, put him down anyway. This super early bedtime is essential to repay his sleep debt. It is temporary but we will plan to keep it in place for at least 3-4 weeks. He will get up to start the day between 5:30-6:30am. If he wakes up around 5:30 or later, you can let him be in his crib for as long as he is comfortable or you can attend to him. We don't want to start the day substantially before 5:30am. Also, if he is asleep at 6:30am, do not wake him. Let him sleep as long as he wishes. Mom and Dad will go to sleep earlier at night for 3-4 weeks to repay their accumulated sleep debt and to be calmer in the morning to enjoy his happy company: playing, bathing, dressing, and feeding. Not seeing him when you come home from work is the temporary price you will pay to have a completely new and well rested family! Normally, I would say that if you are 80% consistent, then you are perfect parents because we are not robots. However, for the next 3-4 weeks (including weekends!), be 100% consistent and keep the sleep log going. The sleep log keeps us honest and shows progress which is encouraging even though there will be some crying.

3. Graduated Extinction: Upon being put down at 5:30pm, if he cries then or cries later, ignore him completely for 5 minutes. Then rush to him and pick him up and do what ever you can to calm him down. When calmer, put him down, again, drowsy but awake. At this time or later, if he cries, ignore him completely for 10 minutes. Then rush to him and pick him up and do what ever you can to calm him down. When calmer, put him down, again, drowsy but awake. At this time or later, if he cries, ignore him completely for 15 minutes. Then rush to him and pick him up and do what ever you can to calm him down. When calmer, put him down, again, drowsy but awake. You continue adding 5 minutes more delay time throughout the night. Eventually, he will fall asleep on his own during one of these crying spells. This is called graduated extinction. Because he is last fed shortly before 5:30pm, go to him once in the middle of the night and feed him if you wish and if this occurs before midnight, you might feed him again around 3-5am. Feed him no more than twice at night. Do not embark on this plan if you cannot commit to it or if Dad thinks he might cave in and undercut Mom's resolve. Better night sleep (in synch with his circadian age appropriate biological night sleep rhythm) will have a permissive effect on the development of naps.

4. Focus on the Morning Nap: The reason to focus on the morning nap is because it develops first and you are more likely to be successful since he is most rested from overnight sleep. One hour after he wakes up in the morning, he is put in his crib drowsy but awake for a morning nap after soothing. The room should be pitch black (use black plastic leaf bags and paper tape to temporarily make the room so dark not a scintilla of light gets in) and use a noise machine if street noises are easily heard. He is ignored for one hour…even if he cries hard for one hour. Graduated extinction is used only for night sleep, not naps. If he naps during this attempt but it is less than 30 minutes, try to extend this nap by rushing in for gentle stroking, massage, sush/sushing, or reinsert a pacifier if this helps. To clarify, he might just cry one hour; that ends our attempt to get a nap. He might cry a while, then sleep a brief period (30'); this ends our attempt to get a nap.

5. The rest of the day, nanny and/or parents do whatever they can to maximize sleep and minimize crying: swings, strollers, car rides, co-sleeping, and so forth. You do not put him down and let him cry. Keep the intervals of wakefulness brief so he does not develop fussiness (a "second wind"). The "one hour" in the morning refers to a one hour interval of wakefulness. By keeping this interval brief, we avoid creating a "second wind" and because he is best rested from night sleep, he is more likely to be able to soothe himself to sleep unassisted. Throughout the day, up to 3pm, he is allowed to sleep as much as he wishes and you can sleep him anyway that works including rocking and sleeping in your arms.

6. Eventually, the morning nap will become more regular and longer which will permit a regular and then eventually longer mid-day nap to evolve. He may or may not want a third nap in the mid-afternoon. This process will take a few weeks. Once it is complete, the bedtime may than be moved later.

Weissbluth Method Infant Nap App.

Filed under: Sleep Consult

SLEEP CONSULT: CHILD #1

4/19: MW: Here is a synopsis of his sleep issues. He became sleep deprived because he was allowed to fall asleep too late at night.

The biological rhythm for night sleep develops around 6 weeks after the due date. At this age, the longest single sleep period lengthens to 4-6 hours and predictably occurs in the evening hours. Prior to 6 weeks, the longest single sleeping period is shorter and is randomly distributed around clock time. But most importantly, at 6 weeks, the brain now wants an earlier bedtime. The failure to put him asleep earlier after 6 weeks of age means that he has accumulated a sleep debt that now makes it difficult for him to nap well and easily fall asleep at night at an early biologically appropriate time. Falling asleep too late and not in synch with his night circadian sleep rhythms means that he cannot develop the naps he needs.

Nap rhythms usually begin to emerge about 12-16 weeks after the due date but his high state of neurological arousal makes napping problematical. His sleep tank is starting to go toward empty "between 4-6 PM he looks irritable, prone to fussiness, clingy (always wanting to be held) and requires more attention and has great difficulty going down."

What would you suggest?

Marc

Filed under: Sleep Consult

SLEEP CONSULT: CHILD #1

#1

5 months

Not Napping

Parents Disagree about Crying

Parents Agree about Early Bedtime

Both Parents Work Outside the House Until 7-9:30pm.

Mom Wants to be Outside for Naps

3 1/2 mo).

Mother: Nighttime sleeping from 11PM-7AM. At present, our sleeping issues have to do with his great difficulty napping. For the first two months he would sleep at night and then be awake from 7AM until 11PM when he would fall asleep after having been held and rocked for hours. He screamed in his crib and did not want to nap at all. Our sleep challenges center around naps and not knowing the tools necessary to help him sleep during the day. We are very aware that without his naps he is much more difficult in the evening hours and he is not his smiling happy self that we see and love when he is well rested.

Father: Most days, he does not want to nap and is over tired and fussy. On those evenings, he will cry for long periods of time when we try to put him down for the night. We are both exhausted and it creates anxiety for me every time we put him down; will he fall asleep? Will he stay asleep? Additionally, when I run home from work to relieve the nanny, I have anxiety about how fussy he will be, will he go to bed easily, etc.? We disagree because my wife is more rigid with an exact schedule and willing to let him cry. I also have great difficulty not trying to sooth him when he is hysterically crying in his crib. My wife thinks that I am too soft with handling him and I feel she gets frustrated with him too soon.

Mother: For the first 2.5 months, we did not realize the importance of naps and he rarely slept. There were days when he would be up from 7AM until 11PM (with maybe 1 or 2 short catnaps) with us rocking him and holding him for hours before he would go down. His lack of sleep results in hours of screaming episodes. He is unable to calm himself down and becomes inconsolable. It takes hours to get him calm and just ends up leaving me as his mom feeling hopeless. The screams "go through me" not to mention the pounding headache that accompanies the screaming. During the week my husband and I are tired and I would describe it for myself as anxious, not knowing what to expect when we walk in the door. My husband and I have not gotten on the same page about what routine that should be and for example do we let him cry it out, for how long. Between 4-6PM he looks irritable, prone to fussiness, clingy (always wanting to be held) and requires more attention and has great difficulty going down.

Second "sleep training" app in the whole world!

Weissbluth Method Infant Nap App.

Filed under: Sleep Consult