1. real estate

the
Sleep Handout
( for Ages 6 Months to 2+ years )
Dr. Todd Wolynn
Copyright © 2011 Kids Plus Pediatrics
2
INTRODUCTION
June 10, 2010
Just as children learn how to walk, they also learn how to fall asleep.
Mr. Smith
FewDear
moments
are as precious as rocking a baby to sleep. But equally precious is the ability of a baby,
without
difficulty,
to settle itself to sleep.
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Understanding
the
concept
and
learning
how
you
can
teach
your
child
to
“self-soothe”
is
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more about the child, the family, and their sleep history.
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cultural beliefs? Does the family want a change in the child’s
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sleep? If so, why? Does the sleep history reveal a potential sleep
issue
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toddler
period.
I have
opinion
on these
subjects,
I’ll do my
best
explainconsequat,
my thoughts
on the
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subject throughout this handout.
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understand
it’s just
an opinion.
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It’s
not
The
Answer,
The
Right
Way,
or
The
Only
Way.
It’s
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An Opinion.
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TheLorem
sleepipsum
approach
describe
in this handout
works
allow children
6 months
to 2utyears
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establish
self-settling-to-sleep
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This
clearly
structured
technique
allows
your
child
to
learn
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When we say No to children at this age, when we don’t let them do whatever they want to do, we’re not
Sincerely,
surprised
if they cry. Self-settling to sleep is no different. In fact, it may be the first big No they
experience, so it’s completely reasonable for them to cry. On average, crying associated with this
technique is much less then you might imagine. The vast majority of kids “get it” within 2-5 days, and a
Chad
Hermann of our Kids Plus patients complete the process within 1-2 days.
good
percentage
Communications Director
The majority of the world’s children co-sleep in a family bed. I respect a parent’s decision on the
approach they wish to take regarding their children’s sleep habits when based on cultural/social beliefs.
There are risks and benefits to this practice, and I refer parents to the AAP guidelines on co-sleeping.
Pleasant Hills 850 Clairton Blvd., Suite 1200
■
Squirrel Hill/Greenfield 4070 Beechwood Blvd.
Pittsburgh, PA 15236
■
■
Pittsburgh, PA 15217
412 466-5004
412 521-6511
■
www.kidspluspgh.com
3
June 10, 2010
If you, as a parent, have a separate room and crib/bed for your child, then you probably want your child
to feel comfortable and sleep soundly in that place. This handout is intended to have your infant-toddler
gain
Dearconfidence,
Mr. Smith security, and success in the “going-to-sleep” and “staying asleep” phases.
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Human
beings
learn
through
daily
experiences
through
repetition.
This conditioning
process
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LEARNING & CONDITIONING
By 6 months, the vast majority of infants no longer require feedings throughout the night. They’ve
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to be greatly improved, in both overnight sleep and napping. Medical disorders such as neurologic or
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gastroenterologic
conditions can impact sleep, but they’re not typically the cause of early childhood
sleep
problems.
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So
what
about
infants
(upattovero
4 months)?
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I nihil
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feeding,
and/or
using
assist
your child
to go
to sleep
aren’t
“wrong”
or erat
“bad.”
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spoiling your young infant by picking her up; you’re providing the care and love that your child needs.
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Some
infants
require
assistance,
while
others in
require
extensive
parental
fall asleep.
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So
when is sadipscing
it appropriate
pattern?
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That
depends.
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Infants
rapidly develop
physically
and
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amet. their ability to learn increases. A 1month-old infant crying in the crib is not going to “learn a lesson” by “crying it out.” A 6-month-old
infant crying because you’ve just placed him in the crib to go sleep is a different situation. So is the 7Sincerely, who’s placed in the crib asleep but awakens in the middle of the night crying.
month-old
Infants 6 months and older frequently are conditioned to wake and alert us that they want a parent
Chad Hermann
present
to go back to sleep. (They don’t need a parent; they want a parent. That’s an important difference
Director
toCommunications
remember.) This
pattern can be easily modified, or reconditioned, to allow the baby to gain the skill
set necessary to fall back to sleep without assistance.
A 6-month-old infant understands much more than a 1 or 2 month old. After 6 months of age, infants
Pleasant Hills 850 Clairton Blvd., Suite 1200
■
Squirrel Hill/Greenfield 4070 Beechwood Blvd.
Pittsburgh, PA 15236
■
■
Pittsburgh, PA 15217
412 466-5004
412 521-6511
■
www.kidspluspgh.com
4
June 10, 2010
crying in their crib are often stopped merely by the sight or sound of you approaching their crib. This is
because they’re anticipating that your next action is something they want: to be picked up, held, or fed.
They
in short, been conditioned.
Dear have,
Mr. Smith
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Specifically, they’ve learned: CRY, and someone will immediately come to the crib, pick me up, and
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hold/rock/feed/give me what I want.
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With sleep problems, think of crying as the child’s attempt to call for Room Service. It’s appropriate for
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your
child
expect
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answer our call. But…
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…after
months ut
of laoreet
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pattern
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awakenings to persist and even to worsen. And those
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endless room service calls are ones no parent wants to
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keep
answering.
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By
approximately
6 months
age, placerat
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intervention. In other words: she may call for room service, but she really doesn’t need it.
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learn
to walk
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through
independent
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and children
learn toaliquyam
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et dolore magna
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If
parents
caught
their
children
every
time
they
fell
while
learning
to
walk,
their
children
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Parents
who
regularly
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much
difficulty
falling
asleep
on
their
own
or
staying
asleep
through
the
night.
But
if
your
child
is
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dependent
on aliquyam
you (or aerat,
caretaker)
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then
expect
your
child
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in
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Each
time
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five-months) child cries (during typical sleep hours) in the crib, he’s pushing the Room Service button.
And as long as he keeps getting room service delivered, he’s going to keep pushing the button.
Sincerely,
Infants come to expect the rocking, holding, feeding when they cry to help them get back to sleep. This
is usually a result of the child being conditioned to fall asleep outside of their crib (in the arms of their
Chad Hermann
parents,
or in their parent’s beds or TV rooms with the TV on, or while being fed, rocked, etc).
Communications
Therefore, whenDirector
they awaken, they expect and desire the same conditions to go back to sleep. Children
who require parental assistance almost every time they go to sleep are dependent on someone other than
themselves to get them to go to sleep.
The primary problem, then, is simple:
Pleasant Hills 850 Clairton Blvd., Suite 1200
■
Squirrel Hill/Greenfield 4070 Beechwood Blvd.
412 466-5004
Pittsburgh, PA 15217 ■ 412 521-6511
Pittsburgh, PA 15236
■
■
www.kidspluspgh.com
5
June 10, 2010
The child is dependent on his parents to help them to sleep. And so the child is unwilling to self-settle.
As adults,
should be independent of this process of going to sleep.
Dear Mr.you
Smith
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dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita
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voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata
We all have our own sleep-onset associations. What are they? Whatever it is that makes you feel
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comfortable
so you can fall asleep. Since you’re independent, you can recreate these associations every
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timejusto
youduo
go dolores
to sleep:
flipping your pillow over, turning on music, pulling your covers up or down, and
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LOCATION / SLEEP-ONSET ASSOCIATIONS
getting your body into a comfortable position. Imagine if you were DEPENDENT on someone else to
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Imagine in
ringing
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out until
someone
into your
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room
to flip
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up your
covers,
positionqui
your
body.
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magna
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To fall
asleep
independently,
a child
has to
learnerat
how
to recreate their OWN sleep-onset associations.
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Rocking,
holding
and feeding
interventions
candolor
become
problematic.
Other
possible
interventions
commodo
consequat.
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vel eum iriure
in hendrerit
in vulputate
velit
esse molestie
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which
can
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problematic
include
singing,
stroking
putting
pacifier
in theluptatum
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odiobaby,
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baby’s
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enim line:
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tation ullamcorper suscipit lobortis nisl ut aliquip ex ea commodo
consequat. Duis autem vel eum iriure dolor in hendrerit in vulputate velit esse molestie consequat, vel illum dolore
Often
SLEEP-ONSET
ASSOCIATIONS problems involve where (location) the child falls asleep. If a
eu feugiat
nulla facilisis.
child almost always falls asleep on a parent’s shoulder, or in the TV room on the couch with the TV on,
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or while
being driven around in a car, then the child comes to expect and “require” this setting to fall
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asleep
regularly. It is unreasonable, in one night, to place your child awake in her crib and expect her to
sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy
happily
fall asleep.
eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et
justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet.
What
about
the child
that
fallsconsetetur
asleep outside
the elitr,
crib and
is then
put ineirmod
his crib
already
asleep?
If this
Lorem
ipsum
dolor sit
amet,
sadipscing
sed diam
nonumy
tempor
invidunt
ut labore
et
child
awakens
(not
sick,
and
not
requiring
food)
is
it
really
a
surprise
that
he
won’t
fall
back
to
sleep
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clita
his kasd
own?gubergren,
Of course
It is, after
all, more
than ipsum
a bit unsettling
to go to sleep in one place and wake up
nonot.
sea takimata
sanctus
est Lorem
dolor sit amet.
in another.
Imagine
if you went to sleep in your bed every night, then woke up every morning on your kitchen floor.
Sincerely,
You’d be freaking out! You’d be calling your friends and saying, “I’m telling you, it’s the same thing,
every night! I go to sleep there, but I wake up here! What’s going on here??!!”
Chad Hermann
Director
ThisCommunications
comparison really
isn’t far off from the experience of an infant who falls asleep while rocked on a
caretaker’s shoulder and then wakes in her crib. Unless a child is conditioned to learn to fall asleep
independently in her own crib, it’s unreasonable for parents to expect that she will easily fall back to
sleep if she awakens in the middle of the night.
Pleasant Hills 850 Clairton Blvd., Suite 1200
■
Squirrel Hill/Greenfield 4070 Beechwood Blvd.
Pittsburgh, PA 15236
■
■
Pittsburgh, PA 15217
412 466-5004
412 521-6511
■
www.kidspluspgh.com
6
June 10, 2010
Infants are completely dependent on someone, other than themselves, to recreate a SLEEP-ONSET
ASSOCIATION that is impossible for them to do for themselves. So it makes sense that they cry until
someone
Dear Mr. helps
Smith to recreate the going-to-sleep process for them.
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dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita
kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur
sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam
voluptua.
At vero eos
accusam
et justoasleep
duo dolores
ea rebum.
clita
kasd this
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no sea natural
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Infants
frequently
getetused
to falling
whileetbeing
fed. Stet
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sit amet.with
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amet,
consetetur
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elitr, sed
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nursing
infant
andipsum
will also
bottle-feeding.
some
infants,
this becomes
an diam
embedded
eirmod
tempor
invidunt
ut
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et
dolore
magna
aliquyam
erat,
sed
diam
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At
vero
eos
et
accusam
et
part of the going to sleep.
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FEEDING / SLEEP-ONSET ASSOCIATIONS
At
what
agevel
is eum
this pattern
considered
as in
anvulputate
unnecessary
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autem
iriure dolor
in hendrerit
velit esse molestie consequat, vel illum dolore eu feugiat
barrier
to
self
settling?
6
months,
9
months,
12
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months,
2 years?
dolore teor
feugait
nulla facilisi. Lorem ipsum dolor sit amet, consectetuer adipiscing elit, sed diam nonummy nibh
euismod tincidunt ut laoreet dolore magna aliquam erat volutpat.
It really depends on your philosophy and parenting style.
Ut wisi enim ad minim veniam, quis nostrud exerci tation ullamcorper suscipit lobortis nisl ut aliquip ex ea
There
is no right answer here. But if you want your
commodo consequat. Duis autem vel eum iriure dolor in hendrerit in vulputate velit esse molestie consequat, vel
infant/child to self-settle, it’s not likely to happen if the
illum dolore eu feugiat nulla facilisis at vero eros et accumsan et iusto odio dignissim qui blandit praesent luptatum
baby requires a feeding to fall asleep. For the reasons I
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listed above, I believe 6 months is a reasonable time to
nihil imperdiet doming id quod mazim placerat facer possim assum. Lorem ipsum dolor sit amet, consectetuer
let the child learn self-soothing techniques.
adipiscing elit, sed diam nonummy nibh euismod tincidunt ut laoreet dolore magna aliquam erat volutpat. Ut wisi
enim ad minim veniam, quis nostrud exerci tation ullamcorper suscipit lobortis nisl ut aliquip ex ea commodo
Here, I want to address a BIG NO-NO regarding
consequat. Duis autem vel eum iriure dolor in hendrerit in vulputate velit esse molestie consequat, vel illum dolore
Feeding and Sleep. Some parents take huge risks by giving an infant a bottleful of milk to drink in his
eu feugiat nulla facilisis.
crib while falling asleep. This can lead to severe dental disease requiring extensive oral surgery. “Bottle
Consetetur
sadipscing
elitr,result
sed diam
nonumy
tempor
invidunt
ut labore
et dolore
aliquyam
Tooth”
Caries
(cavities)
when
infantseirmod
typically
drink
formula
or juice
frommagna
a bottle
as theyerat,
fallsed
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asleep. These liquids have sugars in them, and since the infant/child is groggy and headed into sleep
sanctus
est drinking,
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as he would
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(thanks to decreased swallowing and mouth cleansing). Thus, the liquids coat the teeth, allowing et
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and can
to
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sed
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tempor
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et
significant infections.
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kasdfinal
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sanctus
Lorem
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amet.
One
note: anobelly
full of food
or est
drink
at night
child’s stomach is actively digesting
when it should be resting. This leads to increased pooping and peeing, which causes your child to wake.
Sincerely,
So, bottom line: No bottles in bed.
Chad Hermann
Communications Director
Feeding Your Child to Get Her to Go Back to Sleep in the Middle of the Night
Feeding your infant when she awakens in the late evening and early morning (usually between 10pm &
5am) is a problem typically related to making Feeding-to-Sleep a part of the bedtime routine. When
parents discuss this concern, they tell me, My child is HUNGRY, and that’s why she’s awake and eating.
Pleasant Hills 850 Clairton Blvd., Suite 1200
■
Squirrel Hill/Greenfield 4070 Beechwood Blvd.
Pittsburgh, PA 15236
■
■
Pittsburgh, PA 15217
412 466-5004
412 521-6511
■
www.kidspluspgh.com
7
June 10,
2010 tell me, Look, he eats two 8 ounce bottles through the night; he MUST be hungry.
Some
parents
But if I wake up in the middle of the night and someone gives me two cuts of Mineo’s Pizza, with the
Dear Mr. Smith
cheese bubbling and slightly browned and the crust toasty warm and crisp, a cold cup of Pepsi sitting
Lorem
ipsum
dolor
sit amet,
elitr, to
sedwant
diam to
nonumy
invidunt
ut labore
et
right
there,
I’m
eating
it! I consetetur
don’t havesadipscing
to be hungry
devoureirmod
that. tempor
(Talk about
Room
Service!)
dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita
kasd
no sea is
takimata
est or
Lorem
ipsum
amet.itLorem
ipsum
sit amet,
consetetur
So
if agubergren,
15-month-old
offeredsanctus
a bottle
breast,
anddolor
she sit
drinks
up when
shedolor
awakens
at 3AM,
was
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elitr,
nonumy
eirmod
tempor
invidunt
ut laborealways,
et dolore
magna
erat, to
sedeat.
diam
she
hungry?
Didsed
thediam
child
need to
eat? The
answer
is almost
NO.
Shealiquyam
didn’t need
She
voluptua.
At eating
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ea rebum.
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ate
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because
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est Lorem
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consetetur
sadipscing elitr, sed diam nonumy
chance
that feeding
are associated
withipsum
holding,
cuddling.
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justo
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et eaall
rebum.
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gubergren,
no sea takimata
sanctus est
Lorem
ipsum
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By
6 months
almost
infants
night without
REQUIRING
food
intake.
Their
can
store
andvel
useeum
theiriure
energy
they
need until
morningvelit
when
themolestie
next feeding
is toveloccur.
Duis up
autem
dolor
in hendrerit
in vulputate
esse
consequat,
illum Almost
dolore euall
feugiat
children
older
than
6
months
who
“have
to
feed”
to
fall
back
to
sleep
at
night
are
trained
or
nulla facilisis at vero eros et accumsan et iusto odio dignissim qui blandit praesent luptatum zzril delenit augue duis
conditioned
to be
nightfeeders.
They
candolor
learn
reconditioned)
to fall
to sleep
without
dolore te feugait
nulla
facilisi. Lorem
ipsum
sit(and
amet,be
consectetuer
adipiscing
elit,back
sed diam
nonummy
nibh
eating.
This
also
includes
breastfeeding
babies
(yes,
including
the
ad
lib/feed-on-demand
babies).
euismod tincidunt ut laoreet dolore magna aliquam erat volutpat.
Ut wisi enim ad minim veniam, quis nostrud exerci tation ullamcorper suscipit lobortis nisl ut aliquip ex ea
I’m a Lactation Consultant and a huge breastfeeding advocate. I’m passionate about promoting and
commodo consequat. Duis autem vel eum iriure dolor in hendrerit in vulputate velit esse molestie consequat, vel
supporting breastfeeding. But in spite of this, I have sometimes found myself at odds with other
illum dolore eu feugiat nulla facilisis at vero eros et accumsan et iusto odio dignissim qui blandit praesent luptatum
breastfeeding advocates who clearly support breastfeeding on demand. The mantra is that babies don’t
zzril delenit augue duis dolore te feugait nulla facilisi. Nam liber tempor cum soluta nobis eleifend option congue
know from a schedule, so you should breastfeed them on demand. And I agree.
nihil imperdiet doming id quod mazim placerat facer possim assum. Lorem ipsum dolor sit amet, consectetuer
adipiscing elit, sed diam nonummy nibh euismod tincidunt ut laoreet dolore magna aliquam erat volutpat. Ut wisi
That
said, depending on your parenting style and sleep philosophy, I don’t feel that “on demand”
enim ad minim veniam, quis nostrud exerci tation ullamcorper suscipit lobortis nisl ut aliquip ex ea commodo
breastfeeding
has to continue through the night for a child past 6 months of age when a family wants the
consequat. Duis autem vel eum iriure dolor in hendrerit in vulputate velit esse molestie consequat, vel illum dolore
child
to learn self-settling. If you plan to practice an Attachment Parenting style, then you most surely
eu feugiat nulla facilisis.
will be breastfeeding and co-sleeping. If your culture or belief is sleeping in a “Family Bed,” I don’t try
sadipscing
elitr, sed diam
nonumy
inviduntrisks
ut labore
et dolore and
magna
aliquyam
toConsetetur
impose this
sleep approach
(though
I doeirmod
reviewtempor
co-sleeping
and benefits
discuss
howerat,
to sed
diam
voluptua.
At
vero
eos
et
accusam
et
justo
duo
dolores
et
ea
rebum.
Stet
clita
kasd
gubergren,
no
sea
takimata
avoid co-sleeping risks related to adult bedding and adult characteristics during an office visit).
sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy
eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et
justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet.
Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et
dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita
kasd gubergren,
sea takimata
est Lorem
ipsum
amet. another way, and that’s fine. But the
There
are manyno
different
wayssanctus
to approach
this.
Youdolor
may sit
choose
SELF- SETTLING
way I’m describing here works almost 100% of the time – IF you carry it out as instructed.
Sincerely,
This approach is all about helping your child develop SELF-SETTLING sleep skills.
Some
people describe this parenting sleep approach as the cry it out method. The intent is certainly not
Chad Hermann
toCommunications
make your baby
cry, of course, but most 6-+-month-old infants will cry when not given what they
Director
want. This is normal and should absolutely be expected. It’s the exception, not the rule, for the 6+monthold who is not given what he is demanding to sit quietly rather than protest.
Sometimes, this crying makes parents feel guilty. But should it? If a child wants to play with a sharp toy,
or run into the street, or stick a finger in an electrical outlet, his parents stop them from doing these
Pleasant Hills 850 Clairton Blvd., Suite 1200
■
Squirrel Hill/Greenfield 4070 Beechwood Blvd.
Pittsburgh, PA 15236
■
■
Pittsburgh, PA 15217
412 466-5004
412 521-6511
■
www.kidspluspgh.com
8
June 10, 2010
things. When the child cries because he didn’t get his way, do the parents feel guilty? Of course not. And
they shouldn’t – because they’re doing what’s best for the child at the time, and they’re also teaching the
child
Dear important
Mr. Smith lessons in safety that will condition him for later in life.
sit amet, consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et
ALorem
child ipsum
who isdolor
completely
dependent on his parents to fall asleep will cry if placed in the crib awake and
dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita
left
alone. We don’t like to hear crying, of course, but we need to remember that all crying does not
kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur
mean children are in pain, in fear, or suffering an illness. Taking a toy from a 6-month-old infant may
sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam
result in crying, but that’s fairly easy to figure out. If a 6-24 month-old child who expects you to rock/
voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata
hold/cuddled her to sleep is placed into crib wide awake without these desired behaviors, she will cry.
sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy
eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et
Many parents feel uncomfortable withdrawing this
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assistance that the child “needs” get to sleep. The crying is
Duis autem
vel eum
iriurepain,
doloror
in some
hendrerit
in vulputate
often
perceived
as fear,
other
negativevelit esse molestie consequat, vel illum dolore eu feugiat
nulla facilisis
at verofeel
erosguilty
et accumsan
et iusto
odiocaused
dignissim
condition.
Parents
because
they’ve
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te
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crying, and because they’ve abruptly removed something
euismod
ut laoreet
magna aliquam
erat volutpat.
their
childtincidunt
has both
growndolore
accustomed
to and incorporated
into
a sleep
consider
is the
abrupt
of
Ut wisi
enimroutine.
ad minimBut
veniam,
quis this:
nostrud
exerci
tationonset
ullamcorper
suscipit lobortis nisl ut aliquip ex ea
crying
from
the
healthy,
well-fed
8-month-old
with
a
clean
commodo consequat. Duis autem vel eum iriure dolor in hendrerit in vulputate velit esse molestie consequat, vel
diaper
reallyeu
any
different
theatabrupt
onset
of cryinget iusto odio dignissim qui blandit praesent luptatum
illum dolore
feugiat
nulla from
facilisis
vero eros
et accumsan
from
an
8-month-old
from
whom
you’ve
just
taken
away
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liberatempor cum soluta nobis eleifend option congue
sharp
or dangerous
object?
nihil imperdiet
doming
id quod mazim placerat facer possim assum. Lorem ipsum dolor sit amet, consectetuer
adipiscing elit, sed diam nonummy nibh euismod tincidunt ut laoreet dolore magna aliquam erat volutpat. Ut wisi
Not
enimreally.
ad minim veniam, quis nostrud exerci tation ullamcorper suscipit lobortis nisl ut aliquip ex ea commodo
consequat. Duis autem vel eum iriure dolor in hendrerit in vulputate velit esse molestie consequat, vel illum dolore
The
child cries
and protests, because he wants what you’ve taken away. Whether you’re withholding the
eu feugiat
nulla facilisis.
sharp object or the rocking-to-sleep, you’re child is upset and therefore cries. But either way, you’re
Consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed
doing the right thing.
diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata
sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy
Despite this reasoning, many parents feel so uncomfortable or guilty about not meeting their child’s
eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et
going-to-sleep demands that they continue to do so even though it repeats the cycle, and even though it
justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet.
continues
to make the child dependent on them to fall asleep.
Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et
dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita
You
don’t want to hear your child cry, just as you don’t want to see your child fall. But when your child
kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet.
is learning to walk, he will fall. And fall again. We don’t like it, but we accept it as an unavoidable part
of the learning process. The child gets up, on his own, over and over again until he masters the skill and
learns
to walk independently.
Sincerely,
Crying while learning to self-settle is the same thing.
Chad Hermann
When
children learn
how to sooth themselves to sleep, it’s often the first time they learn about
Communications
Director
boundaries. In fact, it’s often the first No they really learn from: NO, I am not going to take you out of
the crib. You have to go back to sleep on your own.
Consider this analogy: Do you give your child candy or cookies every time they ask? No. What if they
Pleasant Hills 850 Clairton Blvd., Suite 1200
■
Squirrel Hill/Greenfield 4070 Beechwood Blvd.
Pittsburgh, PA 15236
■
■
Pittsburgh, PA 15217
412 466-5004
412 521-6511
■
www.kidspluspgh.com
9
June 10, 2010
cry? No again. (I hope.) Say your child loves Elmo, and she already has several Elmo dolls in her room
at home. While walking through a store, your child sees Elmo on the display shelf and cries because she
wants
THAT
Elmo. Do you buy another Elmo just to calm her down and get her to stop crying? If you
Dear Mr.
Smith
do, we have a lot more to talk about than just sleep.
Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et
dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita
Many parents tell me about the difficulties they have getting their child to sleep while admitting that
kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur
other caretakers or daycare centers seem to have no trouble getting the child to sleep independently.
sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam
This example demonstrates how a child can be conditioned to respond to different people differently.
voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata
sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy
I eirmod
once worked
with the parent of a 22-month-old who “required” a two-hour bedtime routine involving
tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et
reading
books, soft music, massage, cuddling, and being rocked to sleep before being able to be placed
justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet.
in a crib for bedtime. I asked how the child napped. The parent told me that naps were equally tough and
Duison
autem
eum iriure
hendrerit
in vulputate
esse molestie
consequat,
vel illum
feugiat
long
the vel
weekends
at dolor
home.inWhen
I asked
about velit
weekdays,
the parent
admitted
that dolore
those eu
naps
were
nulla facilisis
at child’s
vero eros
et accumsan
et iusto
dignissim
qui blanditatpraesent
luptatum
duis
handled
by the
day
care, where
napsodio
came
like clockwork
12:30PM
everyzzril
day,delenit
with augue
no book,
dolore
te
feugait
nulla
facilisi.
Lorem
ipsum
dolor
sit
amet,
consectetuer
adipiscing
elit,
sed
diam
nonummy
nibh
no rocking, no massage, music or cuddling. The parent was at a loss to explain why this occurred.
euismod tincidunt ut laoreet dolore magna aliquam erat volutpat.
I Ut
couldn’t
help
wisi enim
ad myself.
minim veniam, quis nostrud exerci tation ullamcorper suscipit lobortis nisl ut aliquip ex ea
commodo consequat. Duis autem vel eum iriure dolor in hendrerit in vulputate velit esse molestie consequat, vel
“Well,
clearly,”
I said,nulla
“thefacilisis
daycareat has
Cot.” et iusto odio dignissim qui blandit praesent luptatum
illum dolore
eu feugiat
verothe
erosMagic
et accumsan
zzril delenit augue duis dolore te feugait nulla facilisi. Nam liber tempor cum soluta nobis eleifend option congue
The
widened
with
excitement.
nihilparent’s
imperdieteyes
doming
id quod
mazim
placerat facer possim assum. Lorem ipsum dolor sit amet, consectetuer
adipiscing elit, sed diam nonummy nibh euismod tincidunt ut laoreet dolore magna aliquam erat volutpat. Ut wisi
“What’s
a Magic
Cot?!”
enim ad minim
veniam,
quis nostrud exerci tation ullamcorper suscipit lobortis nisl ut aliquip ex ea commodo
consequat. Duis autem vel eum iriure dolor in hendrerit in vulputate velit esse molestie consequat, vel illum dolore
I eu
laughed,
and then
explained the joke.
feugiat nulla
facilisis.
Consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed
There
are, of course, no Magic Cots. But there are regular, predictable, consistent routines. The kinds of
diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata
routines,
and prevailing nap rules, that kids are more than willing to comply with when they learn that
sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy
they
have no other choice. Without those routines, and without the enforcement of those rules, kids
eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et
know
thatdolores
they’reetthe
ones calling
thekasd
shots.
justo duo
ea rebum.
Stet clita
gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet.
Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et
Day
cares
understand
anddiam
theyvoluptua.
create anAtatmosphere
that allows
– and
– ea
a child
toStet
self-clita
dolore
magna
aliquyam this,
erat, sed
vero eos et accusam
et justo
duoexpects
dolores et
rebum.
settle
for naps. What
do at day
care, ipsum
you can
do sit
at amet.
home.
kasd gubergren,
no seaproviders
takimata sanctus
est Lorem
dolor
Sincerely,
TRAINING & RE-CONDITIONING
We
allHermann
condition our children. Sometimes, we have to recondition them.
Chad
Communications Director
When your 9-month-old crawls toward the electrical outlet, you move her away and say, No. When she
immediately starts to crawl back toward the outlet, you pick her up, move her, and say No even louder.
The baby looks at you, the boo-boo lip comes out, and she begins to wail – as she heads back toward the
outlet. At no point, no matter how often or loudly she cries, do you consider letting her make it to the
Pleasant Hills 850 Clairton Blvd., Suite 1200
■
Squirrel Hill/Greenfield 4070 Beechwood Blvd.
412 466-5004
Pittsburgh, PA 15217 ■ 412 521-6511
Pittsburgh, PA 15236
■
■
www.kidspluspgh.com
10
June 10, 2010
outlet. And you never, not even for a moment, no matter how often or loudly she cries, consider letting
her stick her finger in that outlet. To you, it’s clear: Outlet=Electricity, Electricity=Danger, and
Danger=No.
Even if she cries more, you resist. Your stance is as firm and unyielding as a brick wall. She
Dear Mr. Smith
learns that no matter what she does, no matter how often or loudly she cries, she will not be allowed to
Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et
touch
the outlet. Eventually she learns that if she tries again, she will fail. Eventually she just stops
dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita
trying.
kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur
sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam
Conditioning works best when the process is clear and consistent. You know that, and you provide that
voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata
clarity and consistency, when your child is crawling toward an electrical outlet. You need to know it, and
sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy
you need to do the same thing, when she’s not self-settling in bed.
eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et
justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet.
Going
to Sleep
is Tough.
And
Duis autem
vel eum
iriure dolor
in Learned.
hendrerit in vulputate velit esse molestie consequat, vel illum dolore eu feugiat
nulla facilisis at vero eros et accumsan et iusto odio dignissim qui blandit praesent luptatum zzril delenit augue duis
Think
it. Going
to sleep
is tough!
doloreabout
te feugait
nulla facilisi.
Lorem
ipsum dolor sit amet, consectetuer adipiscing elit, sed diam nonummy nibh
euismod tincidunt ut laoreet dolore magna aliquam erat volutpat.
Sure, a nice cozy bed or crib seems like a fine place to relax and drift off. But don’t forget that the
Ut wisi enim
ad minim veniam,
quis nostrud
tation
ullamcorper
lobortis
nisl ut aliquip
ex eato sleep
primitive
predecessors
from which
we’veexerci
evolved
lived
in muchsuscipit
less safe
surroundings.
Going
commodo
consequat.
Duis
autem
vel
eum
iriure
dolor
in
hendrerit
in
vulputate
velit
esse
molestie
consequat,
meant – and still, in some ways, means – putting down ALL your defenses. If an invading tribe or vel
illum dolore
feugiat
nullayour
facilisis
at verobehind,
eros et accumsan
et iusto
odiotodignissim
blandit
luptatum
hungry
bear eu
came
across
sleeping
you weren’t
likely
fare veryqui
well.
Wepraesent
mammals
are
zzril delenit augue duis dolore te feugait nulla facilisi. Nam liber tempor cum soluta nobis eleifend option congue
hard-wired
this way.
nihil imperdiet doming id quod mazim placerat facer possim assum. Lorem ipsum dolor sit amet, consectetuer
adipiscing elit, sed diam nonummy nibh euismod tincidunt ut laoreet dolore magna aliquam erat volutpat. Ut wisi
Ever
see a dog prepare to go to sleep? Watch the
enim ad minim veniam, quis nostrud exerci tation ullamcorper suscipit lobortis nisl ut aliquip ex ea commodo
genetically programmed instinct. The dog chooses a
consequat. Duis autem vel eum iriure dolor in hendrerit in vulputate velit esse molestie consequat, vel illum dolore
strategic spot, typically with a good view of the area,
eu feugiat nulla facilisis.
then circles round and round and plops down, curled
elitr, ased
diam
eirmodOnly
tempor invidunt ut labore et dolore magna aliquyam erat, sed
inConsetetur
a ball, itssadipscing
back against
wall
or nonumy
other barrier.
diam
voluptua.
At
vero
eos
et
accusam
et
justo
duo
dolores
et ea rebum. Stet clita kasd gubergren, no sea takimata
then does it slowly drift off to sleep, with one eye
sanctus
est Lorem
ipsum
dolor sit
Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy
never
quite
seeming
to close
allamet.
the way.
eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et
justo
duo dolores
ea rebum.
kasdofgubergren,
no sea takimata sanctus est Lorem ipsum dolor sit amet.
We
humans
don’tethave
quiteStet
thatclita
much
an on-guard
Lorem
ipsum
dolor
sit
amet,
consetetur
sadipscing
elitr,
sed diam nonumy eirmod tempor invidunt ut labore et
mode when we go to sleep – though some maladapted
doloreroutines
magna aliquyam
erat,
sedon-guard
diam voluptua.
At vero eos et accusam et justo duo dolores et ea rebum. Stet clita
sleep
can retain
this
characteristic.
kasd
gubergren,
no
sea
takimata
sanctus
est
Lorem
ipsum dolor sit amet.
Modern humans in safe settings have
learned to suppress this vigilance. But this ability to
loosen up and let it all hang is not necessarily the Default mode in our Genetic Factory Setting.
Sincerely,
Some infants while appropriately nursed, rocked, held, kissed and cuddled to sleep don’t spontaneously
transition to self-sufficient sleep automatically. Sometimes as a parent, you have to move your cursor to
Chad Hermann
the lower left corner of the screen, click on the Start button, open the Control Panel, and manually click
Communications Director
off the “On Guard” mode and click on the “Self-Settle” mode.
Of course, it isn’t that easy. But would you be surprised if I told you it’s almost that easy? And that it’s
almost always much easier than parents thought it would be?
Pleasant Hills 850 Clairton Blvd., Suite 1200
■
Squirrel Hill/Greenfield 4070 Beechwood Blvd.
Pittsburgh, PA 15236
■
■
Pittsburgh, PA 15217
412 466-5004
412 521-6511
■
www.kidspluspgh.com
11
June 10, 2010
My thought is that sleep has a genetic/nature piece and learned/nurture piece. You may be naturally
hard-wired to be a Night Owl (like me) – able to watch Letterman, read a couple of chapters of a book,
and
Dearcomplete
Mr. Smithall sorts of paperwork ‘til 3AM without any problems. Or you might be one of those 6am
Bright Eyes (like my wife) who’s up and excited and ready to shine before the sun is.
Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et
dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita
Some of our genetic programming is more easily modified than others. Ten years of parenting has
kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur
reluctantly shifted my sorry Night Owl butt out of bed before 7AM pretty regularly. I don’t even grunt or
sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam
growl first thing in the morning any more. But don’t get the idea it’s my first choice. Messing with those
voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata
Night Owl-Bright Eyes settings is a lot tougher than altering the “Go To Sleep” settings.
sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy
eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et
Going
to sleep is much more easily conditioned or taught.
justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet.
Duis autem
vel eum
iriureisdolor
in hendrerit
in vulputate
velit esse
vel illum
eu full
feugiat
Because
going
to sleep
a vulnerable
time,
and because
we molestie
may notconsequat,
innately chose
to dolore
go from
nulla facilisis to
at sleep
vero eros
et accumsan
et iusto
odio dignissim
qui blandit
praesent luptatum
duis
wakefulness
without
help and
reassurance,
children
in a tumultuous
settingzzril
maydelenit
have augue
a difficult
dolore
te
feugait
nulla
facilisi.
Lorem
ipsum
dolor
sit
amet,
consectetuer
adipiscing
elit,
sed
diam
nonummy
nibh
time switching out of vigilance mode at bedtime. Most infants and children, however, are not typically
tincidunt
ut laoreet dolore
aliquam
erat volutpat.
ineuismod
a stressful
environment.
After magna
6 or more
months
of being assisted to sleep, many children readily
make
theenim
switch
to self-settle
mode
with only
gentle
nudge. suscipit lobortis nisl ut aliquip ex ea
Ut wisi
ad minim
veniam, quis
nostrud
exerciatation
ullamcorper
commodo consequat. Duis autem vel eum iriure dolor in hendrerit in vulputate velit esse molestie consequat, vel
(By
thedolore
way:euiffeugiat
you’renulla
the parent
those
babies who
from
the
first night
birth
couldluptatum
selfillum
facilisisof
at one
veroof
eros
et accumsan
et iusto
odio
dignissim
qui after
blandit
praesent
settle
and
sleep
through
the
night,
I
have
a
question
and
a
recommendation.
First:
why
the
heck
are
you
zzril delenit augue duis dolore te feugait nulla facilisi. Nam liber tempor cum soluta nobis eleifend option congue
reading
this? Second:
don’t
anyone
elsefacer
howpossim
well your
child
sleeps,
because
with kids
nihil imperdiet
doming id
quodtell
mazim
placerat
assum.
Lorem
ipsum
dolor sitother
amet,people
consectetuer
ofadipiscing
similar ages
will
probably
hate
you!)
elit, sed diam nonummy nibh euismod tincidunt ut laoreet dolore magna aliquam erat volutpat. Ut wisi
enim ad minim veniam, quis nostrud exerci tation ullamcorper suscipit lobortis nisl ut aliquip ex ea commodo
consequat. Duis autem vel eum iriure dolor in hendrerit in vulputate velit esse molestie consequat, vel illum dolore
Why They Failed: Just Do It (Correctly)
eu feugiat nulla facilisis.
Parents
often
tell me elitr,
they sed
havediam
“tried”
to let
theirtempor
child fall
asleep
their
own prior
to aliquyam
seeing me,
Consetetur
sadipscing
nonumy
eirmod
invidunt
ut on
labore
et dolore
magna
erat,but
sed
that
just didn’t
diamit voluptua.
At work.
vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata
sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy
Many
that do ut
fail,
fail et
fordolore
one of
two aliquyam
reasons: erat, sed diam voluptua. At vero eos et accusam et
eirmodfamilies
tempor invidunt
labore
magna
justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet.
1)Lorem
Theiripsum
approach
but they sadipscing
don’t stickelitr,
withsed
it diam
long nonumy
enough eirmod
for thetempor
conditioning
dolor is
sit sound,
amet, consetetur
inviduntto
ut take
laboreeffect.
et
dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita
2)kasd
They
don’t recognize
a critical
flawestinLorem
their ipsum
approach.
gubergren,
no sea takimata
sanctus
dolor sit amet.
In the first example, the infants have not been given ample opportunity to learn that there are new rules
inSincerely,
place to support self-settling. In the immortal words of Yoda, the grandest of all Jedi Masters: Do or
do not; there is no “try.”
Chad
Hermann
So
Jimmy
is 6 months old, and his parents agree tonight Friday night is the night. They feed, clean, and
Communications
Director
cuddle
Jimmy prior
to bedtime, and place him in his crib wide awake. They follow a reasonable
approach, but at some point, Jimmy’s crying reaches his parents’ threshold, they say enough is enough,
and they go in to hold and rock him to sleep.
If Sleep Self-Settling is followed as outlined later in this handout, it’s extremely rare for a child to fail if
conditioning is followed and appropriately completed.
Pleasant Hills 850 Clairton Blvd., Suite 1200
■
Squirrel Hill/Greenfield 4070 Beechwood Blvd.
412 466-5004
Pittsburgh, PA 15217 ■ 412 521-6511
Pittsburgh, PA 15236
■
■
www.kidspluspgh.com
12
The Flaw in the System: Groggy, But Awake?!
June 10, 2010
Remember that time when you were sitting in the back of class, or in a meeting, with your eyes closing
and opening, your head bobbing, obviously falling asleep yet still able to hear the teacher or speaker? To
Dear Mr. Smith
your amazement, you were even able recall some of the words the speaker said while you were drifting
ipsum
dolor
sit amet, consetetur
sadipscing
elitr,sitting
sed diam
nonumy
eirmodkind
tempor
invidunt utyou
labore
inLorem
and out.
This
is because
even though
you were
in class
looking
of ‘awake,’
hadet
dolore magna
diam 1
voluptua.
Atsleep!
vero eos
accusamsensors
et justo duo
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et eamachine
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intosedstages
and 2 of
If et
I slapped
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to your
kasd in
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no seastate,
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dolor
sit in
amet,
consetetur
head
that drowsy
yoursanctus
brain est
would
be ipsum
categorized
“asleep.”
yet,
even
stage
1 and 2
sadipscing
elitr,you
sedcan
diam
nonumy
eirmod
tempor
invidunt (That’s
ut laborepretty
et dolore
magna
aliquyam erat, sed diam
“light”
sleep,
still
commit
things
to memory.
cool,
huh?)
voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata
sanctus
Lorem
ipsum
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ipsum
sit amet, consetetur
sadipscing
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Why
tellestthis
story?
Because
theamet.
mostLorem
critical
partdolor
of conditioning
self-settling
is letting
thediam
babynonumy
truly
eirmodherself.”
tempor invidunt
labore
et dolore
magna aliquyam
erat,(but
sed heavy),
diam voluptua.
At vero (but
eos etslowly),
accusam she
et has
“settle
Even ifutthe
baby
looks awake:
eyes open
head turning
justo duo
dolores“light”
et ea rebum.
kasd gubergren,
no sea takimata
sanctus
est Loremto,ipsum
dolor
sit amet.
already
entered
sleepStet
andclita
therefore
has associated,
and been
conditioned
falling
asleep
where
she
transitioned
from
wide
awake
to grogginess.
Whether
it was
in the
TV room
& eu
Order
Duis
autem vel eum
iriure
dolor
in hendrerit
in vulputate
velit esse
molestie
consequat,
velwith
illumLaw
dolore
feugiat
(dun-dum!)
playing
in
the
background,
or
on
her
parent’s
shoulder
swaying
back
and
forth
–
can
youduis
nulla facilisis at vero eros et accumsan et iusto odio dignissim qui blandit praesent luptatum zzril delenit augue
guess
what
happens
she
wakes
up
not
in
that
same
place?
dolore te feugait nulla facilisi. Lorem ipsum dolor sit amet, consectetuer adipiscing elit, sed diam nonummy nibh
euismod tincidunt ut laoreet dolore magna aliquam erat volutpat.
She cries. (This isn’t rocket science, folks.)
Ut wisi enim ad minim veniam, quis nostrud exerci tation ullamcorper suscipit lobortis nisl ut aliquip ex ea
autem vel eum iriure dolor in hendrerit in vulputate velit esse molestie consequat, vel
Iscommodo
it really consequat.
shocking Duis
that she
should cry? First, she was likely freaked out by the fact that she woke in a
illum dolore eu feugiat nulla facilisis at vero eros et accumsan et iusto odio dignissim qui blandit praesent luptatum
place different from where she went to sleep (the Bedroom-to-Kitchen Phenomenon). Second, she didn’t
zzril delenit augue duis dolore te feugait nulla facilisi. Nam liber tempor cum soluta nobis eleifend option congue
self-settle in the first place! We can’t expect her to awaken in the middle of the night, find herself alone
nihil imperdiet doming id quod mazim placerat facer possim assum. Lorem ipsum dolor sit amet, consectetuer
in a dark and room with out any soothing motion, and just roll over and go back to sleep.
adipiscing elit, sed diam nonummy nibh euismod tincidunt ut laoreet dolore magna aliquam erat volutpat. Ut wisi
enim ad minim veniam, quis nostrud exerci tation ullamcorper suscipit lobortis nisl ut aliquip ex ea commodo
Another parental misconception: when a child is run ragged or skips naps or in some way becomes very
consequat. Duis autem vel eum iriure dolor in hendrerit in vulputate velit esse molestie consequat, vel illum dolore
tired and “worn out” by evening, then they’ll sleep better. This usually is not the case. In general, an
eu feugiat nulla facilisis.
overly-tired child will sleep worse than usual.
Consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed
diam teach
voluptua.
At vero
eos et accusam
dolores
et ea rebum. Stet
clitareasons:
kasd gubergren, no sea takimata
Why
a child
self-settling
skillsettojusto
fallduo
asleep
independently?
Many
sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy
tempor
invidunt
ut labore
dolore magna
aliquyam erat, sed diam voluptua. At vero eos et accusam et
1)eirmod
The child
gains
security
andetconfidence
related
justo
dolores
et ea rebum.
Stet clita
kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet.
to duo
sleep
with each
successful
night.
Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et
2)dolore
The child
greater
quality
sleep. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita
magnaenjoys
aliquyam
erat, sed
diam of
voluptua.
kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet.
3) The child does not develop fears associated with
going to sleep alone.
Sincerely,
4) The family unit does not suffer from the stress
of an unnecessary sleep problem.
Chad Hermann
Director
5)Communications
Most lousy adult
sleepers were lousy sleepers
as kids.
Pleasant Hills 850 Clairton Blvd., Suite 1200
■
Squirrel Hill/Greenfield 4070 Beechwood Blvd.
412 466-5004
Pittsburgh, PA 15217 ■ 412 521-6511
Pittsburgh, PA 15236
■
■
www.kidspluspgh.com
13
June 10, 2010
While certainly not a primary reason for teaching a child self-settling, the chance for parents to regain
normal patterns of sleep and intimacy does provide a significant benefit – both for the parents AND for
the
child.
The parents’ reward is self-evident. The child’s reward comes from having well-rested parents.
Dear
Mr. Smith
Tired parents are bad parents. Well-rested parents have more patience, better senses of humor, and a
Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et
greater
willingness to engage their children in play. Overall, they’re happier people. And better parents.
dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita
kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur
Reconditioning is not difficult. At 6 to 12 months, infants respond to recurring patterns AND learn
sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam
rapidly. If you and ALL caretakers are consistent with your sleep conditioning routine, your child will
voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata
likely learn within a week how to fall asleep on his or her own. Your child will also learn how to put
sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy
him- or herself back to sleep when waking in the night. Most children, in fact, will complete the
eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et
majority of this learning process within 2-3 days!
justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet.
Duis autem
eum the
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dolor in hendrerit
in vulputate
esse molestieplan.
consequat,
vel illum reason
dolore eu
Now.
I mustvel
stress
importance
of a CLEAR
and velit
CONSISTENT
The primary
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at vero
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resolve
a sleep
problem
with conditioning
is dignissim
that the child
is given
mixed
signalszzril
from
one or
more
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caregivers. I’ve had many parents come back to me and state that they carried out the plan I reviewed
euismod
tincidunt
ut laoreet
dolore
magna
aliquam
eratinvolutpat.
with
them,
and that
“it didn’t
work.”
But,
except
the rarest of cases, the failure almost always results
from
a lack
consistency
on the
caretakers
part.
Ut wisi
enimofadclarity
minim or
veniam,
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tation ullamcorper
suscipit lobortis nisl ut aliquip ex ea
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So
how
do you
get that
clarity
andatconsistency?
illum
dolore
eu feugiat
nulla
facilisis
vero eros et accumsan et iusto odio dignissim qui blandit praesent luptatum
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Here
go… doming id quod mazim placerat facer possim assum. Lorem ipsum dolor sit amet, consectetuer
nihil we
imperdiet
adipiscing elit, sed diam nonummy nibh euismod tincidunt ut laoreet dolore magna aliquam erat volutpat. Ut wisi
enim ad minim veniam, quis nostrud exerci tation ullamcorper suscipit lobortis nisl ut aliquip ex ea commodo
Establish a Regular Bedtime Routine.
consequat. Duis autem vel eum iriure dolor in hendrerit in vulputate velit esse molestie consequat, vel illum dolore
eu feugiat
facilisis.
Infants
andnulla
children
learn through repetition. A clear bedtime routine will let them learn to anticipate
that
bedtime
has arrived.
Consetetur
sadipscing
elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed
diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata
So,
parents
often ask,
should
we ipsum
choose?
The
is that
childrenelitr,
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within
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est Lorem
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amet, news
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easily
to invidunt
fall asleep
at different
times.
eirmodlearn
tempor
ut labore
et dolore
magna aliquyam erat, sed diam voluptua. At vero eos et accusam et
justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet.
Choose
a bedtime
works
for yousadipscing
AND your
baby.
thenonumy
time you
choose
is greater
than
one toettwo
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dolor that
sit amet,
consetetur
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sed If
diam
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tempor
invidunt
ut labore
hours
from the
time
currently
asleep,
your
childduo
may
need ettoeahave
the Stet
bedtime
doloredifferent
magna aliquyam
erat,
sedyour
diamchild
voluptua.
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eos et
accusam
et justo
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rebum.
clita
gradually
adjusted.
(For
this approach,
should
to sit
your
doctor first.)
kasd gubergren,
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The idea behind the routine is to calm, or wind-down, your child. Obviously you want to avoid
Sincerely, your child. This means avoiding loud noise, bright lights, rough play, and drinks with
stimulating
caffeine for at least 30-60 minutes prior to bedtime. The routine doesn’t need to last very long. 5 to 30
minutes is typical. Common bedtime routines can include: snack, bath, bedtime story, cuddling, talking,
Chad Hermann
praying,
and toothbrushing.
Communications Director
The routine is NOT meant to get your child tired or to sleep. Your child must be awake and alert enough
to recognize she is being placed in her crib. If she falls asleep during the routine, then she must be gently
awakened prior to being put in the crib.
Pleasant Hills 850 Clairton Blvd., Suite 1200
■
Squirrel Hill/Greenfield 4070 Beechwood Blvd.
Pittsburgh, PA 15236
■
■
Pittsburgh, PA 15217
412 466-5004
412 521-6511
■
www.kidspluspgh.com
14
June 10, 2010
I recommend the use of a Transitional Object to put in the crib with the baby. The child will typically
bond with this object – a small teddy bear/teething toy, for example. Since this process usually occurs
during
Dearthe
Mr.time
Smitha child goes through teething, it’s helpful if the object can easily be chewed and
withstand teething. Since your child will be presented with a new object for the sleep process, this is also
Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et
an ideal time to eliminate a pacifier or bottle.
dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita
kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur
Once the bedtime routine is complete, your infant should be placed in his crib, with his transitional
sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam
object, awake in the room with a dim nightlight, and the door closed. As I’ve previously discussed, if
voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata
your child has become conditioned to falling asleep
sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy
outside
of the crib or to requiring your presence, then
eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et
youjusto
canduo
expect
your child to become upset and cry. If
dolores et ea rebum. Stet clita kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet.
he could talk, he might say things like, Get me out of
autem
vel want
eum iriure
in hendrerit
vulputate
thisDuis
crib,
I don’t
to godolor
to sleep,
or I’minreally
mad.velit esse molestie consequat, vel illum dolore eu feugiat
nullainterpretations
facilisis at vero are
erosmuch
et accumsan
et iusto odio
dignissim
qui blandit praesent luptatum zzril delenit augue duis
These
more accurate
than
the
dolore
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feugait
nulla
facilisi.
Lorem
ipsum
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sit
amet,
consectetuer
adipiscing elit, sed diam nonummy nibh
ones you’re inclined to make, like You’re abandoning
euismod
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ut
laoreet
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magna
aliquam
erat
volutpat.
me, You’re causing me harm, or You don’t love me.
Ut wisi enim ad minim veniam, quis nostrud exerci tation ullamcorper suscipit lobortis nisl ut aliquip ex ea
Your
first instinctive
to vel
his eum
cry is
to attend
commodo
consequat.response
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iriure
dolor intohendrerit in vulputate velit esse molestie consequat, vel
it and
soothe
crying.nulla
That’s
the conditioned
illum
dolorethe
eu feugiat
facilisis
at vero eros et accumsan et iusto odio dignissim qui blandit praesent luptatum
response
expected
by
the
infant
(and
often
the Nam liber tempor cum soluta nobis eleifend option congue
zzril delenit augue duis dolore te feugait
nullaby
facilisi.
parent).
But remember:
thequod
entire
point
of thisfacer possim assum. Lorem ipsum dolor sit amet, consectetuer
nihil imperdiet
doming id
mazim
placerat
approach
is
to
recondition
the
infant’s
response
to being
in the magna
crib. aliquam erat volutpat. Ut wisi
adipiscing elit, sed diam nonummy nibh euismod tincidunt
ut placed
laoreet dolore
enim ad minim veniam, quis nostrud exerci tation ullamcorper suscipit lobortis nisl ut aliquip ex ea commodo
Theconsequat.
caretakerDuis
should
then
leave
the infant’s
bedroom.
the infant
will bevel
crying
autem
vel immediately
eum iriure dolor
in hendrerit
in vulputate
velitOften
esse molestie
consequat,
illum and
dolore
even
You
should still leave the room. Staying to “calm” the infant or laying her back down is
eu standing.
feugiat nulla
facilisis.
likely to condition her to expect these actions every time you put her in the crib.
Consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed
diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata
This
is also why I don’t recommend the use of a pacifier; if the pacifier falls out of the infant’s mouth,
sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy
she’ll
cry until you come back to put it back in her mouth. Some caretakers try to avert this problem by
eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et
buying
pacifiers
and sprinkling
themgubergren,
inside the
so if one
falls out
the infant
justo several
duo dolores
et ea rebum.
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nocrib,
sea takimata
sanctus
est Lorem
ipsummight
dolor easily
sit amet.
findLorem
another
on dolor
their sit
own.
(It’s
true.) That
approach,
just continues,
and perhaps
worsens,
ipsum
amet,
consetetur
sadipscing
elitr, however,
sed diam nonumy
eirmod tempor
invidunteven
ut labore
et
thedolore
problem.
It’s
much
easier
to
recondition
the
infant
to
self-sooth
without
additional
items.
magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita
kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet.
So you’ve left the infant in the crib awake and alone. If he cries what do you do?
I suggest
waiting 5 minutes, giving him time to possibly soothe himself to sleep. You must time this
Sincerely,
process with a watch or clock, because 30 seconds of crying will seem like an hour.
Chad
Hermannof crying, you can go to the baby’s crib and briefly, verbally reassure him. This does not
After
5 minutes
Communications
Director
involve
picking, lying
down, or even touching the infant. If the baby was happy and pleasant five
minutes ago when you placed him in the crib, and he’s only crying since you left, it doesn’t take a
specialist, or a rocket scientist (I told you!) to figure out what upset him.
He’s angry. He’s almost certainly NOT ill or in pain. (He was just fine five minutes ago; it’s not like he
Pleasant Hills 850 Clairton Blvd., Suite 1200
■
Squirrel Hill/Greenfield 4070 Beechwood Blvd.
412 466-5004
Pittsburgh, PA 15217 ■ 412 521-6511
Pittsburgh, PA 15236
■
■
www.kidspluspgh.com
15
June 10, 2010
suddenly developed tuberculosis after you left him!) So your brief visit at the 5-minute point is to
condition him to expect that his crying will bring you to check on him. If he’s ok except for the
crying,
you
leave the room again.
Dear Mr.
Smith
Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et
dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita
kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur
If I check on you in the crib and everything is ok, but you are upset at being put in the crib, I’m going to
sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam
leave after verbally reassuring you, because I expect you to soothe yourself to sleep.
voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata
sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy
That’s
a long message. But your baby will get it. And understand it.
eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et
justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet.
So, what is the message you’re giving (conditioning) him?
The question I most often get is: How long (after the 5 minute visit) do I let my child cry? The answer I
Duis autem
velis:
eum
hendrerit in vulputate velit esse molestie consequat, vel illum dolore eu feugiat
typically
give
Asiriure
longdolor
as it in
takes.
nulla facilisis at vero eros et accumsan et iusto odio dignissim qui blandit praesent luptatum zzril delenit augue duis
dolorecaretakers
te feugait nulla
facilisi.
sit Once
amet, consectetuer
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Some
tell me
theyLorem
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this isdolor
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again, my method
is elit,
not sed
the diam
only nonummy
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– but
euismod
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aliquam
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volutpat.
whatever you do is going to condition your child to expect the response again. Dr. Richard Ferber,
probably
the ad
most
famous
pediatric
sleepexerci
specialist,
a method
essentially
theutsame
asex
theeaone I’ve
Ut wisi enim
minim
veniam,
quis nostrud
tation offers
ullamcorper
suscipit
lobortis nisl
aliquip
described
so
far,
but
differs
here.
He
suggests
going
back
to
a
crying
infant
(older
than
6
months)
commodo consequat. Duis autem vel eum iriure dolor in hendrerit in vulputate velit esse molestie consequat, after
vel
10
more
minutes,
and nulla
then facilisis
again after
15eros
more
minutes –eteach
reassuring
the
illum
dolore
eu feugiat
at vero
et accumsan
iustotime
odio briefly,
dignissimverbally
qui blandit
praesent luptatum
infant.
I feel,augue
however,
that each
timenulla
you facilisi.
go backNam
intoliber
the tempor
room, you
or further
selfzzril delenit
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congue
soothing
process.
nihil imperdiet
doming id quod mazim placerat facer possim assum. Lorem ipsum dolor sit amet, consectetuer
adipiscing elit, sed diam nonummy nibh euismod tincidunt ut laoreet dolore magna aliquam erat volutpat. Ut wisi
(There’s
nothing
wrongquis
with
Dr. Ferber’s
approach;
it’s just
different.
you’re
interested
in learning
enim ad minim
veniam,
nostrud
exerci tation
ullamcorper
suscipit
lobortisIfnisl
ut aliquip
ex ea commodo
more,
it’s clearly
explained,
with some
excellent
information
about
pediatric
sleep,vel
in illum
Dr. Ferber’s
consequat.
Duis autem
vel eumalong
iriure dolor
in hendrerit
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velit esse
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dolore
book,
Solving
Child’s Sleep Problems.)
eu feugiat
nullaYour
facilisis.
Consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed
So…
As long as it takes is my professional opinion. But why?
diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata
sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy
Ifeirmod
the child
discovers that you will come back into the room and maybe even pick him up if he cries
tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et
longer
than
20 minutes,
thenStet
youclita
have
justgubergren,
conditioned
him
to a new
process.
To get
youdolor
backsitinto
his
justo duo dolores
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kasd
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est Lorem
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room,
he has
to sit
doamet,
is cryconsetetur
for moresadipscing
than 20 minutes.
he’ll eirmod
do it. Just
as he
will ifutyou
come
Loremall
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dolor
elitr, sed And
diam so
nonumy
tempor
invidunt
labore
et
back
after
30,
40,
or
60
minutes.
Or
longer.
dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita
kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet.
A child will often cry for 30 minutes or longer. But she will almost always self-soothe and go to sleep if
you don’t interfere. (Of course, if there’s a sudden change in the crying, or if something seems out of the
ordinary,
Sincerely,you should immediately go and check on her.) The worst effects of this long crying may be a
hoarse voice, sore throat, or occasionally (if head-banging) a bruised head. None of these are serious.
Chad Hermann
Some
parents have asked me if the crying could cause a hernia, heart attack, or stroke. Unless the child
Communications
Director medical problem, the answer is No. The most troublesome issue for parents is
has
a severe underlying
usually when their babies cry to the point that they gag and vomit. (Vomiting typically doesn’t occur in
this process, with the exception of children with Gastroesophogeal Reflux, but it’s still worth mentioning
here. Also worth mentioning: keep an extra pair of sheets and PJs handy in case they do vomit.)
How you respond to this is very important.
Pleasant Hills 850 Clairton Blvd., Suite 1200
■
Squirrel Hill/Greenfield 4070 Beechwood Blvd.
412 466-5004
Pittsburgh, PA 15217 ■ 412 521-6511
Pittsburgh, PA 15236
■
■
www.kidspluspgh.com
16
June 10, 2010
To the child whose parent picks him up, apologizes, holds, rocks, and/or feeds him, there is likely to be a
new conditioning: that if he’s awake in the crib, he should cry; if he cries and no one comes, he should
cry
harder;
if he cries long and hard enough, to the point of vomiting, then that Room Service response
Dear
Mr. Smith
is finally going to come. (It may be bad room service, and it may be late, but it’s still room service.)
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dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita
On the other hand, if you go to him and calmly, verbally reassure him while you clean him, his clothes,
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and his linens, then immediately put him back into the crib, you’ve given a clear and consistent
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message, conditioning him in a way you want: I will always check on you when something has
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happened, but once I address the problem, I expect you to soothe yourself and go to sleep in your crib.
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eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et
Once
the child has fallen asleep, you do not need to go back in his room.
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autem vel later
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IfDuis
he awakens
in thedolor
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early morning
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odiothe
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typically
before
6ameros
– then
you should
repeat
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you may not have seen the child for hours, and thevolutpat.
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brief physical
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like
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has
fever, you’ll
have
approach
that differently.)
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So,
in essence,
after
5 minutes
crying,
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make a ut laoreet dolore magna aliquam erat volutpat. Ut wisi
adipiscing
elit, sed
diam
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brief
then quis
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and let
themtation
go as
long
enimappearance,
ad minim veniam,
exerci
ullamcorper
suscipit lobortis nisl ut aliquip ex ea commodo
asconsequat.
it takes. Duis autem vel eum iriure dolor in hendrerit in vulputate velit esse molestie consequat, vel illum dolore
eu feugiat nulla facilisis.
Beware of the slippery slope here: 6am can become 5:50, which can become 5:35, which can become
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5:15.
Pick a time. Draw a line. And then stick to it.
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sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy
Naps
should be similar. Infants 6-12 months old typically take about 2 naps per day. From 12 months to
eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et
about
4 years
old,etthey
usually
You should
a pre-nap
routine,
justdolor
as you
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est Lorem
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establish
a pre-bedtime
routine
at night.
You should
putdiam
the child
in eirmod
her cribtempor
– ideally,
withut the
same
Lorem ipsum
dolor sit amet,
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et
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as bedtime
– awake,
then
leave.
(YouAtmight
consider
usingetroom-darkening
shades
for naps.)
If
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crying lasts longer than an hour, then you should abort the nap attempt. (This, however, very rarely
happens).
Sincerely,
I strongly suggest you begin the process with bedtime, not naps.
Chad than
Hermann
More
95% of children will learn to self-soothe within 7 days.
Communications Director
The majority of children will learn to self-soothe within 3-4 days.
The first 1-3 days are the worst.
Pleasant Hills 850 Clairton Blvd., Suite 1200
■
Squirrel Hill/Greenfield 4070 Beechwood Blvd.
412 466-5004
Pittsburgh, PA 15217 ■ 412 521-6511
Pittsburgh, PA 15236
■
■
www.kidspluspgh.com
17
June 10, 2010
Days 1 & 2 can typically have 30-90 minutes of crying and disruptions.
Starting
a weekend or holiday helps.
Dear Mr.on
Smith
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If you have neighbors with a shared, thin wall, you might want to explain what you’re doing in advance
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of starting the sleep training.
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sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam
If someone shares the infant’s room, you should temporarily move her out for a couple days.
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sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy
Ifeirmod
you feel
that this process should take place, but you honestly recognize you’re not able to do it, you
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should
get close friends or family to help and leave for a few hours.
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Duis autem
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Perhaps
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And,
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adipiscing elit, sed diam nonummy nibh euismod tincidunt ut laoreet dolore magna aliquam erat volutpat. Ut wisi
Dr.
Todd
Wolynn,
the President
of exerci
Kids Plus
beenlobortis
a general
pediatrician
enim
ad minim
veniam,
quis nostrud
tationPediatrics,
ullamcorperhas
suscipit
nisl ut
aliquip ex ea(Board
commodo
Certified)
1995.vel
In eum
1997,
he became
interested
pediatric
disorders
and subsequently
consequat.since
Duis autem
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in in
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velitsleep
esse molestie
consequat,
vel illum dolore
completed
two intensive
eu feugiat nulla
facilisis. courses at The School of Sleep Medicine in Palo Alto (which is associated with
Stanford University). After completing the course in 1999, he helped to open the Mercy Hospital
Consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed
Pediatric
Sleep Disorder Program. He was the Medical Director of the program from 1998-2007.
diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata
sanctus est Lorem ipsum dolor sit amet. Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy
eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et
justo duo dolores et ea rebum. Stet clita kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet.
Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et
dolore magna aliquyam erat, sed diam voluptua. At vero eos et accusam et justo duo dolores et ea rebum. Stet clita
kasd gubergren, no sea takimata sanctus est Lorem ipsum dolor sit amet.
Sincerely,
Copyright © 2011
Chad Hermann
Communications Director
Pleasant Hills 850 Clairton Blvd., Suite 1200
■
Squirrel Hill/Greenfield 4070 Beechwood Blvd.
412 466-5004
Pittsburgh, PA 15217 ■ 412 521-6511
Pittsburgh, PA 15236
■
■
www.kidspluspgh.com