 A Nurture group’s aim is to start where each child is and through unconditional positive regard form strong bonds and attachments to support the social, emotional and behavioural needs of children – I could see how these core qualities relate to the role of a sleep coach and was intrigued about how these can be used as a basis for sensitive and responsive sleep practices. There are 6 principles of nurture that I want to explore in relation to children’s sleep and share how you can incorporate them to support sleep in your family. Six principles of nurture:
#1: Children’s sleep is understood developmentally There is a lot of change that occurs in the sleep cycle in the early months of a child’s life. Not only is their circadian rhythm aligning with night and day, and their ability to make melatonin maturing, but their sleep cycle will evolve from a very simple one to a highly complex multi-stage mature sleep cycle. The infant sleep cycle matures from this: REM – NREM3/4 – REM – NREM3/4 (Newborn sleep cycle) To this: NREM1 – NREM2 – NREM3/4 – NREM2 – NREM1 – REM – NREM1 and so on… This shows you the sleep development that happens in the first 6 months of a baby’s life but there are other physical and cognitive leaps that may impact sleep - for example, rolling, crawling, object permanence, walking, talking and separation anxiety to name a few! Sleep Development The main sleep development that parents will hear about is the one that occurs at around 4 months aka the ‘4-month sleep regression’, when actually this is not a regression at all, but sleep developing, it does seem to occur most commonly around the 4th month of life – but there is variation just like with all development. Some babies will undergo a maturation of their sleep cycle earlier or later than 4 months, so it’s wise to avoid rigid thinking about this. Between 2-6 months (commonly at 4 months) the sleep cycle matures – it can feel unsettling for babies. Look again at how different the sleep cycle is, and you’ll easily see why this can cause some sleep disturbance this is why the sleep space needs to be a safe base. #2: The sleep space offers a safe base The organisation of the environment, decisions about where baby might sleep, sleep routines and parents being responsive and consistent in their approach all play a part in the sleep space being a safe base. Environment This is the first thing most parents think about, designing the nursery - but the sleep environment is more than aesthetics, it’s about the environment being calm, loving, welcoming, not too hot or cold and a place to be able to take a break from the important busyness and stimulation going on in waking hours. Where baby might sleep It is important to make sure that where baby sleeps is safe and that if anyone is caring for babies that they are aware of the safe sleep guidelines, the guidelines might have changed and it’s especially import to share these with grandparents or babysitters. The key message is that baby should be placed on their back to sleep, with a clear cot - no bumpers or pillows or toys, a firm mattress, and not too hot. Babies should be kept in the same room as parents for sleep until at least 6 months and that goes for naps too. Many families will decide to bedshare with their baby and may be told that this is not a safe practice, there is a persistence of fear-based messages about bed-sharing, despite the worldwide data on its normalcy but it must be done safely and there are situations when it should be avoided. La Leche League explains the safe sleep seven:
I would also add...
In addition, it is not safe to fall asleep with baby on a sofa or armchair. Babies who are swaddled but are beginning to show signs of rolling or have reached 8-12 weeks should be transitioned out of using this for safety, and in many cases need a bigger sleep space than the next to me crib, so they can roll and get comfortable, what was once supporting baby to sleep might actually be hindering them now. A baby who can flip over onto his tummy while sleeping worries parents, but it is a natural development, Fern Hauck SIDS expert says "Once your baby is strong enough to roll onto his stomach by himself, you don't need to worry about him staying on his back all night. This is especially true if he's been enjoying playtime on his tummy during the day, can hold his head up well, and can roll from his tummy onto his back again by himself" Sleep routines Routine’s get a bad name in the baby world, largely to do with popular parenting books that promote above all else very strict routines such as set times for naps, or how long to feed on each breast or the 3- or 4-hour feeding cycles. These are not the routines I am talking about. I’m talking about rituals and routines that allow baby to feel safe and secure knowing what is coming next, such as a bedtime routine. The research is clear that the more nights per week the same predictable steps are in place in a bedtime routine the better the sleep outcomes (aka less unnecessary nightwakings), and it’s something you can establish as early as you like. Responsive and consistent approach Supportive and responsive parenting in the early years of a child’s life is important for healthy social, emotional and cognitive development. Responsive parenting with baby results in a secure independent child later – wow – that really goes against the notion of making a rod for your back, doesn’t it. What else is important is a consistent approach to bedtime and sleep, it is ok to help babies fall asleep and for as long as everyone wants, it is ok to cuddle, hold or rock and feed babies to sleep, it is also ok to put babies down awake and allow them to drift off after a loving bedtime routine, the key is to be responsive to his need for his age and stage and have a consistent approach, what I mean by consistent is not yo-yoing from one parenting style or method to another every few nights. #3: Nurture is important for the development of optimal sleep The key themes in nurture are listening, responding, engaging, being valued and noticing and praising small achievements. Listening Listing to babies and children is a key tool used by Hand in Hand Parenting and one which I advocate greatly, it can be difficult to fully listen to our babies, toddlers and children if they are upset and are having big emotions, often the best way to respond is to listen, be physically connected or close with touch or eye contact but allow our children’s emotions to come out by listening to them, rather than distracting or trying to stop the feelings (aka not really listening but changing the subject). This viral Facebook video highlights exactly what I mean You might listen by paraphrasing what they are telling you, “oh you don’t want to go to sleep……”you are sad that it’s time to go home” or by saying just a few words “ you’re sad”, “I hear you”, “ you didn’t like that” and then allowing them to have their emotions while you are physically with them. I am not saying that we never distract our babies or quickly fix things that might cause them upset, but that we tune into what they need and often a listening ear is the answer especially around bedtime. Responding We spoke about responding earlier, but an important note to add is that listening to our babies, toddlers and children cry is nothing like and nor should it be thought of or used as a disguise for cry-it-out sleep training methods. Engaging We can engage with children about sleep and what is expected around sleep from even a very young age, the bedtime routine is a perfect example of setting expectations, we can also communicate expectations by talking to our little ones about sleep, why we sleep, what the benefits are, what we need them to do at bedtime with visual aids such as a social story or picture books. It is also important for us to be realistic with our expectations, newborn babies will and need to wake frequently for feeds and older toddlers will need to be tired enough at bedtime to be able to fall asleep easily. Valued Being valued means so much to people right! It’s a sure fire way to get cooperation, especially around sleep with our children. Always look for an opportunity to give choice, “the blue PJ’s or the green ones?” “crackers and cheese or weetabix for supper?” And for older children having a say in what time bedtime is and designing their own bedtime routine are all beneficial. I love the tips for family meetings in the book How to Talk so Little Kids will Listen by Joanna Faber and Julie King. Noticing and praising small achievements Often when sleep has gone out the window it is easy to focus on what’s not working well, noticing and praising small achievements is a top tip, “Reuben I noticed you followed all the steps in your bedtime routine we agreed on” or “Reuben I seen you were in bed at 9pm last night” Now he might not have drifted off to sleep peacefully but he still achieved something that needed to be noticed. Likewise, it’s easy to forget to talk to ourselves in that way, be kind to yourself and praise yourself for the small achievements too. #4: Language is understood as a vital means of communication I love love love the book How to Talk so Little Kids will Listen, it gives such easy to understand and implement tools around language with our children. Here are some of my favourite tools: Language to support behavior and emotions Many parents have found that when we limit commands and simply name the feelings or describe the situation that it prevents children from acting out…..
Communicate with I not YOU: When you are expressing frustration or are angry, use I, avoid the word you….. The you is accusatory, as soon a child hears you, she feels defensive, she may respond by arguing, laughing inappropriately, running away or getting angry. There is a world of different from “you are out of bed again!” and “I get frustrated when everyone is still awake at 11pm!” It is more effective to describe your feelings WITHOUT the word YOU.
Re-framing language It is very common for us to describe a situation as above and then follow it up a BUT….a much more effective language tool is… 1: The Problem With That…..(replace a ‘but’ with this) “I can see that you don’t want to go to bed….the problem with that is that it is 10:15pm” “I can see that you are sad about not being able to keep playing your games……the problem with that is it’s bed time” 2: Even though you know….(replace a ‘but’ with this) “Even though you know that we can’t stay out longer on our bikes, you are sad about that” “Even though you know it is bedtime and we need to start our bedtime routine you are sad you can’t stay up and watch movies……” Other opportunities for expressing feelings
#5: All Behaviour is communication It is well understood that all behaviour is communication, so when our babies, toddlers and children find it difficult to settle at bedtime, I suggest parents take a moment to observe what is going on, keep a diary to see if they can figure out the root cause of fussiness, resistance or off track behaviour. Once the root cause(s) are identified you might want to make a change to the routine, timings, how you respond or set limits and really try to understand the feelings - circling back to the principles in #3 and #4 above. #6: Sleep transitions are significant in the lives of children Sleep transitions are signification in babies and children’s lives, while some will manoeuvre them with easy most will need support and understanding when we make changes. It is wise to make small changes and shifts and take things at your child’s pace. Examples of key sleep transitions are:
Many parents worry about how they can get their older baby or toddler into their own cot if they have been bedsharing or roomsharing, they might have tried the conventional way in the past and it has simply been too difficult. However, there is a sensitive way to make this transition – the floor bed! Often the difficulty comes when parents try to transfer after their little one has fallen asleep, they fall asleep fine in arms or feeding but as soon as there is even the thought of a transfer into the cot – ping! And the whole process starts again… Here is an example of how to use the floor bed to sensitively support your toddler transition from bedsharing and/or feeding to sleep to falling asleep in his cot and more independently. First - preparation The first thing is to prepare, set up the new sleep environment, get the cot ready. I like to take the front off the cot so that there are three sides, top, bottom and back and drop the mattress to the floor.
It is important that the mattress is dropped to the floor for safety, and the room is toddler proofed, for example nothing is left that your toddler could get a hold off and it hurts them, all drawers are attached to the walls, all clothes are away and there is a stair gate on the door. Some families have even made a floor bed with a giant pen around it for safety.
Next - coaching strategy Then using a camping mattress make a co-sleeping bed next to the mattress for a parent to sleep in, the idea is that you can still have physical contact or feeding to sleep lying down but baby falls asleep in their own room in their own sleep space, so no more dreaded transfer! Parents can then gradually over several days and weeks, make small shifts towards no longer feeding to sleep/co-sleeping or whatever it is they want to change, parents would still offer shushing, patting, humming as part of the transition then when ready make the shift to less and less physical contact by rolling away slightly or having some space between parent and child. Parents would making small shifts, until at the child's pace, they are able to fall asleep with little assistance from their parent, and the parent can then make the move to building up the cot, if needed - and getting out the room after stories, kisses and cuddles. Other Idea’s to help with sleep transitions Another idea which most parents think sounds a little crazy is to post a life size photo (head shot) of one or both parents in the room. Younger children can relate better if the size is more realistic so an 8x10 headshot usually works well. Research shows that this is helpful for children in dealing with separation, including specific research with children in day-care settings who are given a picture of Mum to keep in their pocket. The children will take it out and look at it from time to time and be comforted The introduction of a transitional object can also help, involve this teddy/bunny as part of the family, breakfast, lunch, dinner, give it a name, invite it to be part of stories and play and bath time and so on, then move to keep it for sleep time as a comforter. As always keep safe sleep in mind, it’s not recommended that a comforter is in the cot with unsupervised babies under 12 months of age. SummaryWe have explored a rather big topic today in a rather long blog, if you are still reading - thanks and wow, but I felt I couldn't give it justice any other way, we have explore the 6 principles of nurture in depth as related to sleep...
And given examples of how you can use these principles in a practical way in your family. If you have any questions please reach out. Nadia x https://www.nurtureuk.org/nurture/six-principles-nurture
https://www.basisonline.org.uk/ https://www.lullabytrust.org.uk/ https://www.unicef.org.uk/babyfriendly/wp-content/uploads/sites/2/2018/08/Caring-for-your-baby-at-night-web.pdf https://www.basisonline.org.uk/wp-content/uploads/sites/6/2018/11/Infant-Sleep-A5-8pp-Final-Booklet.pdf https://www.elephantjournal.com/2020/03/this-viral-video-of-a-dad-holding-space-for-his-toddlers-meltdown-is-everything-kelsey-michal/ https://www.handinhandparenting.org/who-we-are/mission-vision-core-beliefs/
Archit Mehta
9/12/2023 10:33:53
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