Guest Post: Pam Edwards – How the Wonder Weeks Affect Sleep

Today we feature a guest post from sleep consultant Pam Edwards. Pam is a Certified Infant & Child Sleep Consultant and founder of Wee Bee Dreaming Pediatric Sleep Consulting in Grande Prairie, Alberta. Healthy sleep is addicting and she has made it her life mission to help families all across the world get the sleep they deserve – a good night’s sleep doesn’t have to be a dream!

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Have you guys heard of the ‘Wonder Weeks’? The Wonder Weeks is a book that was written by two doctors and describes ten developmental growth spurts that baby goes through in her first 82 weeks of life. These developmental growth spurts aren’t the same as the physical growth spurts, although they do occasionally overlap. During these developmental growth spurts, or ‘Wonder Weeks’, baby is putting so much effort into learning new skills that she begins to act out of sorts (what they describe as the 3 C’s – clingy, crying, and cranky). Not surprisingly, and what I want to talk to you about, is that these Wonder Weeks can affect baby’s sleep. Read on for a description of the different Wonder Weeks and how they can throw a wrench in your baby’s sleep schedule.

 

Wonder Week 5 – The World of Changing Sensations

Previous to this leap, your baby’s perspective of the outside world is soft and undefined – in other words, it hasn’t changed much in his mind from life in the womb. Suddenly, he is able to make more sense of this new world, and this is very overwhelming to him.
How does this affect sleep? This is the age where the evening fussy period begins to develop. A big cause of this evening fussy time is overstimulation from the day, and over-tiredness. The evening is often the busiest time of the day in a family’s household – dinner is being prepared, older kids have activities and need to do their homework, mom or dad is just coming home from work. That means that sometimes baby can be kept up awake much longer than he should be (remember, at this age it shouldn’t be any more than 1 hour max). To help combat this fussy time, make sure baby is still soothed to sleep every hour, even during this busy time. Try to keep the house as calm and relaxed as possible, to make the transition from day to night easier on baby.

Wonder Week 8 – The World of Patterns

Babies at this age are now experiencing the world in a whole new way. They start to recognize simple patterns (not just visually, but things like ‘I have 2 hands!’ or ‘I can move my leg like this!’) Baby starts to be able to focus on things for longer periods of time, and becomes more curious about the world around her.
How does this affect sleep? This increasing alertness makes it all the more important that baby’s environment is conducive to sleep. If her sleeping area is too bright, she may have trouble shutting off her brain. If it’s too loud and chaotic, she may have a hard time powering down for sleep. Ideally, baby’s bedroom should be pitch black, and playing white noise can help reduce stress and help baby sleep better.

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Wonder Week 12 – The World of Smooth Transitions

One of the big physical milestones that baby will have hit around the 8 week mark is the ability to bat at and kick objects with her arms and legs. These movements were often very jerky and clumsy – which is normal for a baby who is just learning how these limbs work! But approaching Wonder Week 12, baby’s movements become smoother, more precise. As well, baby is also starting to perceive more changes in the world around him – how moms voice goes higher when she’s singing a song, how the room becomes dim when the sun goes behind the clouds, how the dog always barks when the doorbell rings. The world is becoming a more organized place to baby!
How does this affect sleep? Around this age, as baby becomes stronger, he may start to break out of his swaddle. Many parents take this as a sign that baby no longer wants to be swaddled, but at this age most babies still do have at least a touch of the startle reflex and thus swaddling is still necessary. Oftentimes, we need to switch up our swaddling technique so that baby isn’t able to break-free. Check out this video below for the most amazing swaddling technique out there (and trust me, my baby was a Houdini and I tried everything!)

Wonder Week 19 – The World of Events

As adults, there are a lot of things that our brain does that we just don’t think about, such as our ability to predict the outcomes of certain events. For example, we know that when someone jumps in the air, they will come down. This is what baby’s brain is working on during this Wonder Week – learning very simple sequences of events (I drop my toy, mom picks it up, I drop it again, mom picks it up again – fun!)
How does this affect sleep? Now that baby is able to (somewhat) predict what will happen next in certain circumstances, having consistent routines becomes even more important. Babies do not like surprises, they thrive on routine and predictability. Your baby is now able to understand that a warm bath means it’s bedtime soon, or that when mom sings ‘Twinkle Twinkle’ it means it’s nap time. Click here for ideas on how to begin a flexible routine with baby. Wonder Week 19 also coincides with the ‘4 month sleep regression‘. Read up here to prepare yourself for this change in your baby’s life.

Wonder Week 26 – The World of Relationships

Babies at this age start to be able to perceive distance between objects (or between people). To baby, the world is now a very big place and he is so very tiny. Things he wants are out of reach, and when mom leaves the room, there is no way to get her back! Therefore, babies at this age begin practicing ways of getting to these things that they want – by crawling, scooting, or rolling!
How does this affect sleep? As you can imagine, this new-found realization of how big the world is can bring with it some anxiety. Unless you are co-sleeping with baby, sleep times are a time of separation, and baby may begin to fight them! Help baby to realize that just because you’re not right there beside her, doesn’t mean you are gone forever. Play peekaboo, or practice leaving the room for short periods of time and then returning with a big smile on your face. Soon she will realize that you are still there for her even if you’re not next to her 24/7.wonder weeks 2

Wonder Week 37 – The World of Categories

Babies at this age love to start experimenting. They like to see the way food feels when you squish it, but that’s it’s different from the way yogurt feels. He is now able to group people, objects, animals, sensations into categories.
How does this affect sleep? Baby may start to experiment in other ways, perhaps in how acting a certain way affects the way his parents react. When I wake up throughout the night, how do my parents react? Does my mom rush in with a bottle or a boob and help me back to sleep? Or does my crying at night not serve much purpose, perhaps mom pops her head in to say ‘it’s okay, go back to sleep’. Baby may start to test these limits to see what will happen, and if baby gets what he wants, then these tests not become new habits (or if baby has always awoken many times at night, these habits continue or become worse). Obviously there are times when baby’s cries can signal a need vs. a want, but if these cries are occurring 8 times a night every single night, then it is no longer something a baby at this age needs.

Wonder Week 46 – The World of Sequences

During this Wonder Week, baby is now learning that there is an order to things in life. There is a certain pattern of events that needs to occur before he is successful at something (big block goes on the bottom, then the smaller one goes next, then the smaller one goes after).
How does this affect sleep? While some parents may have become more relaxed with baby’s routine, it is still so important at this age. If nothing else, make sure you continue a consistent bedtime routine with your child. Repetition and structure help children feel safe. Bedtime declares that the day is over. When you are loving and firm about when it is time for bed, you are building your children’s confidence in their world. Repetition for young children is comforting — ever wonder why they want the same story over and over? The repetition of the getting ready for bed routine (getting into pajamas, brushing teeth, a drink of water, a story, a hug, goodnight) lets your child know what to expect and helps him or her feel secure.

Wonder Week 55 – The World of Programswonder weeks 3

This Wonder Week begins your baby’s journey into toddlerhood. He has made so many big discoveries in the past year but he still has so much to learn about the world around him. This Wonder Week brings with it the understanding that there are multiple means to an end (in other words, different sequences can accomplish the same thing).
How does this affect sleep? Lots going on around this time! Many babies may just be learning to walk, weaning from breastfeeding may occur around this time and a lot of moms (or dads!) may be returning to work. Not coincidentally, this is also the age where separation anxiety is at its peak, and it can most certainly affect sleep. So what can we do to ease the anxiety that your toddler may be feeling during this time (keep in mind too that separation anxiety can hit at any time throughout baby’s life and often seemingly comes out of nowhere):

I know you’re tired of me saying it but…consistent and soothing nap and bedtime routines are increasingly important during the throws of separation anxiety.
Check yourself. Your baby can feed off of your emotions and if you’re anxious, tense, upset, or worried, then chances are your child will feel those emotions right along with you. When you’re putting baby down for sleep, be relaxed and confident, and it will help your toddler feel that way as well.
Help him feel better about good-bye. Sneaking away is one of the worst things you can do and will only compound your child’s feelings of anxiety. The last thing you want an anxious child to think is that by letting you out of their sight, you’re gone forever (well, it feels like forever to them!) Say a loving, confident, firm good-bye and let your child see you leave. He will learn that when you say good-bye, it still means you’ll come back.
Comfort your child but don’t create new (and bad!) habits. If your child is fitfully protesting at naptime, or waking throughout the night in tears, then you should absolutely comfort them. Your child’s psychological needs must be met as well! But keep these interactions short and sweet – this is not the time to sing songs, read books, turn on a TV show, bring baby into bed with you, or lay on the floor in baby’s room (guilty of this one!) New habits are created at lightning speed, so even after the separation anxiety is gone, the new habit is here to stay.

Wonder Week 64 – The World of Principles

Your toddler is now starting to think about different ways to accomplish his goals, and what the consequences of his decisions are. He may start to imitate others or role play his daily life. He may begin nagging/whining to get his way, or showing signs of aggressive behavior, and he is starting to figure out how to get someone to do something for him.
How does this affect sleep? When it comes to sleep at this age, you need to start thinking of your ‘baby’ as a toddler. Sleep issues at this age are not usually sleep-related, and are now discipline-related. A child this age is learning how to get his way, and what actions get him those things (crying at bedtime means I get to stay up later, crying throughout the night means I get mom’s attention, crying during nap time means I don’t have to nap!) Breaking the cycle of positively reinforcing negative behavior is key. Children learn from repetition, therefore just as soon as he can figure out that his negative behavior elicits a positive reinforcement, he can learn that his negative behavior does not elicit a positive reinforcement.

Wonder Weeks 75 – The World of Systems

During this final mental leap (which occurs around 17 months), your child is now able to perceive ‘systems’ (meaning your family is different from a friend’s family, etc.) He is also now understanding that he can choose how he wants to act; helpful, patient, careful, etc. His little conscience has begun to develop!
How does this affect sleep? We discussed limit testing during Wonder Week 37 but this Wonder Week is where it really comes into play. As written in the Wonder Weeks book, “You can’t spoil babies, but you can toddlers! By understanding what is happening inside that little head of your newly formed toddler – and remember, they are pretty savvy – you can shape the future behavior of your toddler and set values and norms that will carry him through life.” This can be applied to our child’s sleep as well – whatever he has come to expect with sleep times at this age will shape how he feels about sleep for the rest of his life. While setting limits is hard (nobody likes to see their child upset!) it is an absolutely essential part of parenting. The first limits that a child can test are those that come to sleep (and unfortunately, these are the limits that parents are often the most lax with!)

Death: When Separation Anxiety Becomes Reality

The funeral of EJ’s grandfather was to be the 5-year old’s first confrontation with death. EJ’s parents felt he was ready to handle a highly emotionally charged event like a funeral. He was a highly-intelligent child, articulate, and able to understand the finality of death. EJ had witnessed his mother starting to grieve as her father lay dying, and he seemed to handle it appropriately.

But the morning of the funeral, as his mother dressed him in uncomfortable black suit with a scratchy collar, EJ began to get nervous about what he was going to see. While his mother struggled to clip on his tie, EJ asked her a question:

“Mumma, what will Pop-Pop look like in the thing?” EJ did not yet know the word “coffin.”

“He’ll look normal, Sweetie. He’ll look just like he’s sleeping.”

How Not to Explain Death to a Child

That night, EJ could not fall asleep. He knocked on his parents bedroom door several times, telling them he couldn’t sleep.  Finally, his mother let him in the parent’s bed, but EJ did not sleep until almost midnight.

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The next night was the same. EJ asked his mother to lay with him in his bed, something he never did. When she tried to leave, EJ would become upset and beg her to stay. The bed was no where near large enough for an adult and a child, and EJ tossed fitfully for an hour before finally drifting off.

After a week of this, the mother called me for a consult.

EJ’s mom, also a highly-intelligent person, knew that her father’s death was the trigger for EJ’s sleep difficulties, but she didn’t know how to fix it. It was EJ, however, who revealed the connection his mother had made between death and sleep.

“He looked like he was sleeping,” EJ told me.

“He did?” I replied, feigning surprise.

His mother took a deep breath.death

“I told him that,” she admitted. We did the rest of the counseling session without EJ in the room.

I took my own deep breath.  EJ’s mom knew she had goofed. But in her grief and confusion she made an honest mistake. I told her that many parents explain death to their children this way, and she shouldn’t feel too bad. I told her that the difficulty EJ was going through now was more psychologically complicated than she might realize.

Creative Stretching of the Truth

I told her that EJ’s sleep disruption now was not entirely due to the fact that he was afraid to die if he fell asleep. EJ was now afraid of losing his mother.

His grandfather’s funeral was a real, concrete example of a person losing a parent.  If his mother could lose her father, that meant that EJ’s parents would die some day too!  As insightful and articulate as EJ was, his anxiety over losing his mother was so great that he couldn’t come to terms with this scary thought.

I counseled EJ’s mom to spend more time than usual reassuring EJ that she would be there for him, and that she’d never leave him.  EJ was smart enough to know that this was not strictly speaking true, but the reassurance would be essential for him to be able to sleep. I call this type of reassurance “Creative Stretching of the Truth.” Of course we all will die. But you don’t have to remind your kids of this. At some level, they already know this.  To help them resolve the conflicts that lead to their separation anxiety, it’s best to lie, just a little: you’ll never leave them. You’ll always be there for them.

deathNow, About This Death/Sleep Thing

 

With EJ, the cat, so to speak, was out of the bag. It wouldn’t do much good to explain to him that death is not like sleep. He already knows this, rationally. But emotionally it will be hard for him to unhook the connection. I recommended to EJ’s mom that she not mention it again. Instead, I suggested that she focus on keeping the evening routine as regular and predictable as possible. This suggestion was part of a list of recommendations when there is a death in the family.

  • Reassure your child, early and often, that you’ll always be there for them, to protect them and keep them safe. Do this even if they don’t bring it up: you should know that this anxiety is somewhere in the back of their minds.
  • Make sure the child eats good food, and gets plenty of exercise.  Every day.
  • Keep the evening routine as regular and as predictable as possible. By evening routine, I mean starting at dinner time.
  • When a death occurs, resist the temptation to associate death and sleep.

 

 

Separation Anxiety Disorder: Define “Excessive”

Separation anxiety plays a role in many infant sleeping problems, as we’ve discussed here. It’s a natural, even healthy sign of normal infant development. But when parents go to the internet to look for information on separation anxiety, they will often find additional discussion of something called “separation anxiety disorder“, and will immediately begin to worry that their baby may have it.

Separation Anxiety Disorder

WebMD, a highly-regarded source of medical information, defines separation anxiety disorder as

… a condition in which a child becomes fearful and nervous when away from home or separated from a loved one — usually a parent or other caregiver — to whom the child is attached.

Sound familiar? It’s the definition of separation anxiety! So what makes it a “disorder”? WebMD does not say.

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The Massachusetts General Hospital site is a little better, in the sense that they try to draw a distinction between separation anxiety and the disorder:

A certain level of separation anxiety is an expected and healthy part of normal development that occurs in all children to varying degrees between infancy and age 6…In contrast, children with separation anxiety disorder have separation worries that are excessive and much greater than their peers [emphasis added].

separation anxiety disorder
Is that excessive?

The problem with this definition is that we are expected to agree on the definition of excessive! When a parent hasn’t slept for 4 days and is going into the little one’s nursery for the 6th time tonight… who’s to tell this parent that this separation anxiety is not excessive? The last thing they need is for the internet to get them worried their baby may have a disorder!

Wait, It Gets Worse

MedicineNet.com confuses the issue even further:

Separation anxiety disorder is a normal stage of development that usually begins in childhood and is characterized by worrying out of proportion to the situation of temporarily leaving home or otherwise separating from loved ones [emphasis added].

separation anxiety disorder
Nothing exceeds like excess

Confused yet? Is it “normal”, or is it a “disorder”? I can understand a parent reading this and deciding both that they have a normal baby and that the baby has a disorder. The difference between “normal” and “disorder” is not clear, and this is a problem with much of the “advice” people will find on the internet. The distinction between normal and abnormal has become blurry. If you cannot tell the difference, join famous company: these days it’s hard to tell.

Help, Please!

ChildMind.org doesn’t help us much deciding what’s normal and what’s not.

Difficulty separating is normal in early childhood development; it becomes a disorder if the fear and anxiety interfere with age-appropriate behavior…

Okay, what’s “age-appropriate behavior”? Isn’t crying when mom leaves the room “age-appropriate” at 9 months? Now I’m pretty sure my 9-month old has a disorder!!!

What Causes Separation Anxiety Disorder?

Whoo boy.  You’re not telling me that something that’s normal (even though it’s a disorder) actually has a cause, are you?

I’m afraid so.  WebMD, again, the trusted source, tells concerned parents what causes their 9-month old’s distress.

Children whose parents are over-protective may be more prone to separation anxiety. In fact, it may not necessarily be a disease of the child but a manifestation of parental separation anxiety as well — parent and child can feed the other’s anxiety.

separation anxiety disorder
Okay, now THIS is excessive!

Oh great! It’s our fault, say the parents, now totally distraught.  Mom and dad fight over which one of them is the “over-protective” one.

The Bottom Line

At the end of the day (see what I did there, tired parents?),  there is no reasonable distinction between normal separation anxiety that your infant or small child may experience, and so-called “separation anxiety disorder”. Is it a matter of degree? Certainly. But where is the line drawn? Reasonable people may disagree.

In a 1964 Supreme Court decision, Justice Potter Stewart, having difficulty defining the meaning of the word “obsenity”, famously quipped “I know it when I see it” and that was that. So it is with separation anxiety disorder (which is unfortunately often abbreviated SAD: sad indeed!) In the absence of a clear dividing line between what your otherwise normal baby is doing and a mental disorder, we are left with “I know it when I see it.”

Allow me to suggest an alternative:

Assume your child is normal. Resist the temptation (from within yourself or suggested to you by others), that your child is anything but normal. If she has a great degree of difficulty separating from you at bed time, let’s manage it. But let us please avoid pathologizing normal infant behavior!

[end rant]